CHAPTER X
WELFARE ORGANIZATIONS—THEIR RELATIONSHIP TO RECONSTRUCTION
The activities of the welfare organizations, as a whole, were almost entirely confined to morale work, the supply features of the American Red Cross making it the one outstanding exception. However, for convenience of description, all welfare organizations are included here.a
AMERICAN NATIONAL RED CROSS
The American National Red Cross was the only civilian association authorized by law to supplement the resources and to assist the personnel of the Medical Department in time of war,1 but the services of other civilian organizations could be accepted when such services were supplied through the medium of the American Red Cross.2 The President of the United States formally accepted the offer of cooperation and assistance from the American Red Cross July 5, 1917.3
EARLY PARTICIPATION IN RECONSTRUCTION
The first records of participation of the American Red Cross in the reconstruction work are those of various instances of assistance to the Surgeon General's Office in the selection of personnel for special positions, particularly women. This function became organized when the American Red Cross furnished an employee in January, 1918, as an assistant to the supervisor of medical aides in selecting women to fill the positions offered.4
Preliminary plans for assisting in the reconstruction work were considered in October, 1917, before the plans of the Surgeon General had been submitted to the Secretary of War.5 The home service section of each local American Red Cross chapter was expected to undertake these four main lines of work:5 (a) The coordination and utilization of all vocational training agencies and other institutions and organizations in each community which could be of advantage to the disabled soldier, either in extending or in modifying his preparation for self-support; (b) the establishment of an employment agency and the awakening of a genuine interest on the part of employers, so that these men would have every opportunity for self-support; (c) special personal attention to the men themselves, that they might be encouraged to continue their work until refitted to industry, when they had not by their own efforts succeeded in finding fit opportunities for work that they were able to do; (d) the cultivation of a public opinion which would discourage improvidence and the willingness to be supported at public expense, no matter how distinguished their services or what their disability, if and when they were capable of self-support.
Plans were made for an institute in New York City which would be available for the rehabilitation of crippled soldiers, and it was ready for their recep-
a No records of the war-time activities of the Knights of Columbus and of the Salvation Army are available-Ed.
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tion before there were any war casualties in the Army. 6 The institute was therefore utilized for training cripples from civil life, and the difficulties encountered led to extensive investigations of the entire subject, educational efforts for the benefit of the public, and intensive training of teachers in this type of work.
FORMAL OFFER OF ASSISTANCE IN RECONSTRUCTION OF WOUNDED SOLDIERS
In December, 1918, American Red Cross headquarters offered its service in the reconstruction of disabled soldiers to the Surgeon General as follows:7
It has for several months been our hope and expectation that the Red Cross, with its nation-wide network of well-organized local committees, might be called upon to discharge certain appropriate functions in connection with the aftercare of disabled soldiers and sailors following their physical reconstruction and vocational reeducation in the institutions under your direction. You will of course understand that the Red Cross desires to act in this matter in the fullest cooperation with the official plans of the Government. Inquiries now beginning to come in from our division and chapter offices indicate rapidly growing interest in the subject of the aftercare of disabled men and anxiety as to the duties that Red Cross local chapters will be called upon to perform. If you find it desirable to give us at this time some preliminary indication of the share which the Red Cross will be asked to take in the national program for the reconstruction of wounded soldiers it may be possible with great advantage to make a definite announcement in the Manual of Information above described which we are just now preparing for the press.
In such preliminary consideration as we have given this matter it seems to us that the Red Cross will be in a particularly advantageous position to cooperate in your plans, by reason of the fact that in each of our local chapters there is a home-service section with trained executive workers who will have had the families of many soldiers under their friendly care and assistance during the war. For these reasons, the Red Cross chapters throughout the country will be especially fitted to participate in the work of readjusting to civil and industrial life the discharged soldiers returning to their communities, and to foster public sentiment among employers, among the men themselves, and with the public at large, which will facilitate the most prompt and effective absorption of these men and will offset the danger of their becoming a burden on the community.
We are prepared to print and distribute another special handbook for the instruction four chapters regarding their duties in the program of the aftercare of disabled men as soon as you indicate the part which it is desired that the Red Cross undertake in connection with the Government's program.
In January, 1918, the American Red Cross was represented at the conference of various departments interested in reconstruction which met to coordinate the work. 8
ACTIVITIES AUTHORIZED IN HOSPITALS
Certain activities of the American Red Cross were authorized by the War Department in February, 1918,9 of which the following extracts apply to hospitals:
* * * * * *
2. To render emergency relief of every kind upon the request or suggestion of an officer in charge. All officers are instructed to avail themselves of this assistance whenever, in their opinion, advisable. Officers should be none the less diligent in attempting to foresee the needs of their department in order that they may be supplied through regular Government channels. All such requests must be approved by the commanding officer, who will cause a record to be kept of all such articles.
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3. To relieve the anxiety and to sustain the morale of soldiers who are worried about their families at home and to promote the comfort and well-being of these families, authority is given to the American Red Cross to place one or more representatives of the home-service bureau of the department of civilian relief at the service of the men of each division of the Army wherever located. The soldiers should be informed through official orders of the presence of such representative or representatives and that the Red Cross is able and willing to serve both soldiers and their families when in need of any helpful service. This representative and his assistants will be accredited to the division commander and will be subject to his authority and to military laws and regulations. This representative of the Red Cross will have the status of an officer in the Army and will be provided quarters when available. Such assistants and clerks as may be necessary will be provided by the American Red Cross and must be males. These assistants and clerks, if any, will have the status of noncommissioned officers. All reports and correspondence of this office will be subject to censorship of the commanding officer.
* * * * **
5. A representative of the American Red Cross may be attached to each base hospital to furnish emergency supplies when called upon, to communicate with the families of patients, to render home service to patients, and such other assistance as pertains to Red Cross work. The representative of the Red Cross so assigned, together with his assistants, will be accredited to the commanding officer of the base hospital, and will be subject to the same regulations as to status, privileges, assistants, and censorship as provided in preceding paragraph applying to the representative of the Red Cross assigned to division.
* * * * **
8. The commanding generals of all cantonments and National Guard encampments and the commanding officers of all other encampments or organizations with this order are authorized to furnish to the American Red Cross anything that they may request within reason, such as warehouses, offices, light, heat, telephones, etc., in order to enable them to properly carry on the work for which they are assigned.
In the development of a large number of educational centers in base hospitals under conditions of greatest possible haste and urgency it was often difficult to secure personnel, equipment, or supplies rapidly enough through Army channels. Supplies which hospitals could not obtain promptly through military channels were furnished by the American Red Cross under the above authority, and various services rendered in innumerable instances which were so common place at that time that they are not mentioned in reports, but often were of extreme importance. The term "supplies" sometimes included machinery or other articles of considerable value, and it became necessary to regulate such matters to a certain extent. An agreement was published in May, 1918, under which such gifts from the American Red Cross were to be officially accepted by the Surgeon General's Office and thereby became the property of the Government.10
The American Red Cross used its funds generously in procuring workers, supplies, and equipment. It did this in local posts upon the arrangements made with local officers of the American Red Cross, and, also, in a more general way for all posts, through the Surgeon General's Office.11 An illustration is the educational officer's emergency fund of $200 per month. This fund was to be expended by the chief educational officer for items of supplies, equipment, and service needed immediately and not readily procurable from Army supplies or funds. Items procurable in a longer time from Army sources, but whose usefulness would be seriously impaired by the time necessary to secure them from Government sources, were procurable with the funds. The educational officer
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incurred the obligations and they were paid by the American Red Cross officer upon draft made by the educational officer. Accounts were carefully reported and audited both by the Surgeon General's Office and by the American National Red Cross. This fund often procured the lesser items which made immediately available much larger and more extensive equipment from Army sources. It was seized upon eagerly by educational officers as the thing, which made possible more rapid and efficient establishment of the service.11
The question of uniforms for the reconstruction aides who were being sent overseas was raised during the fall of 1918. As these women were not receiving large pay, the American Red Cross undertook to furnish certain articles of uniforms and equipment free and others at cost.12
The Red Cross published the Educational Officers' Handbook, with the approval of the Surgeon General's Office, which was a detailed and methodical description of the duties of educational officers and their relations to the other departments of the hospital, and was of particular value for inexperienced educational officers.11
It outlined the field for educational officers as being the general supervision of all recreational activities, and contained some verv pertinent suggestions which show well the general spirit of the whole movement. It was suggested therein that the chief educational officer call a conference of the representatives of the American Red Cross, Young Men's Christian Association, the Knights of Columbus, the American Library Association, the Jewish Welfare Board, all volunteer agencies and individuals willing to assist in the work at the particular post. At, this conference each agency outlined its own plans and purposes, and a unified cooperating program was the result.
HOSPITAL SERVICE
The field director visited the wards and acquainted himself with any wants either of the institution or the individual patients.13 Many occasions had arisen where the bureau of camp service had been able to supplement the hospital supplies at the camps, to the end that the sick and convalescent might be made more comfortable.13 The fact that the American Red Cross was a volunteer organization made it possible for it to act in such emergency with a speed and freedom impossible to a governmental department.13
The American Red Cross, by request of the War Department, undertook to supplement the regular hospital service by extra attentions to the sick and wounded.13 Daily visits were made to each patient, so far as practicable, and those services rendered which were not possible for the attending doctors or their aides. This visiting was done by the associate field director and his assistants, and often by women from near-by American Red Cross chapters, under the supervision of the associate field director.
With the heavier fighting on the Western Front and the several outbreaks of contagious diseases which occurred in the United States and immediately affected the camps and camp areas, the American Red Cross hospital service materially increased its activities.13 The lines of service which had defined themselves by July 1, 1918, were maintained intact during the whole of the
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year. The regular work for the sick in the wards, for the convalescents, for the personnel of the hospital, and the communication service and emergency service were maintained in increasing measure.
Visiting in the wards was amplified at many of the hospitals by enlisting the service of selected women volunteers from near-by chapters. These volunteer visitors were organized into squads, with the object of having a visit paid to practically every patient every day.
On January 26, 1918, the Secretary of War requested the American Red Cross to extend the communication service which it had in operation abroad to the Army hospitals in this country.13 In several instances commanding officers of hospitals in the United States turned over a large part and in other
FIG. 82.– Interior of an American Red Cross convalescent house
instances all of the hospital communication work to the American Red Cross representatives.13 Other commanding officers followed this lead during the summer and autumn of 1918. The epidemic of influenza which swept the country in September, October, and November, 1918, enormously increased the work of notifying relatives of sick and wounded men concerning their illness and of reporting their progress from day to day.13
CONVALESCENTS' SERVICE
For a time soldiers on the road to recovery had no place in which to spend their idle time, except wards and corridors of the hospitals; so, with the approval of the War Department, the American Red Cross, on, June 30, 1918, had completed or had under construction 52 convalescent houses, in which con-
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valescents might find recreation and amusement to facilitate their recovery.13 These buildings were intended primarily for the use of convalescent patients, but were available for such other services as the officer in command of the hospital may have desired. They provided writing and reading facilities, games, and entertainments. The American Library Association installed collections of books, periodicals, and papers. Each building contained a platform which could be used either as a solarium or as a stage. It also contained a number of bedrooms for the use of relatives of men dangerously ill. A small kitchen was provided for the preparation of food for visitors and American Red Cross personnel.
RECREATION IN HOSPITALS
The division of recreation in hospitals was organized to provide, in cooperation with the educational service of the Surgeon General's Office, supplemental recreation for the sick and wounded in hospitals. 13
It became apparent, after the armistice was signed, that the real load of the reconstruction work in military hospitals in the United States would soon arrive, and it was evidently necessary to divide the field of activity among the welfare organizations in order to avoid confusion and overlapping of efforts.11 When a tentative plan had been drawn up to meet the recreational activities of the Medical Department educational service and the American Red Cross combined, a conference of all welfare organizations was called on November 25, 1918, by the American Red Cross. To this conference were invited representatives of the American Red Cross, the Commission on Training Camp Activities, the United States Naval Commission, the Young Men's Christian Association, the Jewish Welfare Board, and the National Catholic War Council. This conference had for its primary purpose the definite establishment of the status of welfare agencies other than the American Red Cross, with special reference to their cooperation with the American Red Cross in their work in military hospitals. The following program drawn up by representatives of the educational service of the Surgeon General's Office and the American Red Cross was presented and was approved by the conference: 13
1. Entertainment and recreation in convalescent houses:
(a) To maintain, through the American Library Association, a library of technical works, approved fiction, current magazines, periodicals, and newspapers (" home town" papers when practicable), and to make them available to the patients. To make known to the patients the existence of the library and encourage its use by them by use of posters, circulars, etc.
(b) To organize, encourage, and conduct reading circles, debates, story-telling hours, etc.
(c) To provide training in amateur theatricals.
(d) To provide leadership for the development of bands and orchestras, arrange enlistment for training of the men, place and hours of individual and group practice, supply instruments and music, and to cooperate with the hospital authorities in the use of such bands and orchestras as may be organized.
(e) To provide leadership for the development of singing, individually and in groups such as trios, quartettes, etc., and of community singing.
(f) To furnish and maintain a supply of writing materials and tables or desks at which letter writing may be done and to encourage correspondence.
(g) To furnish and maintain an equipment of indoor games, such as cards, checkers, chess, dominoes, crokinole, etc.
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(h) To furnish and maintain musical equipment of player-piano, phonograph, and rolls and records therefor.
(i) To furnish stereoscopes and a supply of photographs chosen with particular referenceto their educational value for use therewith.
(j) To present at regular intervals entertainments of motion pictures, professional talent concerts, musicals, etc.
(k) To organize and supervise social functions such as dances, receptions, etc., for patients.
(l) To supply fruit and flowers, smoking materials and approved refreshments in convalescent houses and to supervise "winter evening" recreations such as popping corn, roasting apples and marshmallows, etc., at fireplaces.
2. Entertainment and recreation in wards:
(a) To furnish "home newspapers" to patients when practicable and, in any event, the best available daily newspapers; to arrange that items of general current interest be read, and to distribute books, magazines, and reading matter.
(b) To regularly distribute a supply of writing materials, post cards, etc., and encourage the writing of letters.
(c) To furnish and maintain such games as may be suitable, such as checkers, cards picture puzzles, etc.
(d) To furnish and maintain an equipment of phonographs and an assortment of, records, the latter to be circulated from ward to ward in such manner as will insure frequent change and variety of selections.
(e) To furnish stereoscopes and an assortment of photographs chosen with particular reference to educational value, the latter to be circulated from ward to ward so as to insure frequent change in assortment available in a particular ward.
(f) To present at regular intervals entertainments of motion pictures, professional talent, musicians, singers, etc.
(g) To supply fruit, flowers, smoking materials, etc.
3. Entertainment and recreation out of doors:
(a) To provide tools, seeds, etc., for the planting of flower gardens, window boxes of plants, vines or trellis, etc., about convalescent houses.
(b) The arrangement and supervision of auto rides, matin6es at theaters, and the transportation involved in such activities.
4. Entertainment and recreation for able-bodied personnel:
(a) To provide ample reading and writing facilities.
(b) To furnish and maintain an equipment of indoor games such as cards, checkers, dominoes, etc.
(c) To provide leadership and instruction in individual, group, and community singing.
(d) To provide instruction in and encourage the development of amateur theatricals, debates, lecturing, etc.
(e) To provide instruction in and encourage the development of musical activities, mandolin and guitar clubs, etc.
(f) To present at regular intervals entertainments of motion pictures, professional talent, lectures, concerts, etc.
(g) To provide for and supervise such social functions as dances, receptions, etc.
(h) To arrange for participation in exercises and games such as tennis, basket ball, handball, croquet, etc
5. Supplemental services:
To arrange for personal religious services and ministrations in wards at the request of individual patients.
Under the above program the American Red Cross devoted its energies more particularly to recreation for patients in convalescent houses and wards, while the services of the allied welfare organizations were to be utilized chiefly in connection with recreation and entertainment furnished for the able-bodied personnel to the extent and at the intervals requested by the American Red
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Cross. The American Red Cross was to be the primarily responsible organization for all volunteer activities in the hospitals.
There were in all about 47 reconstruction hospitals, and at each of these an American Red Cross recreational officer was appointed, with such assistants as he needed, for the purpose of coordinating the recreation work of all the welfare agencies within the hospital and for working out and developing the program of recreation in conjunction with the chief of the educational service at the hospital.13 Even before the program was fully developed in the reconstruction hospitals practically every military hospital desired that the program be extended to them.13 The superintendent of nurses, Surgeon General's Office, also desired that this recreational program be extended to include all nurses in all military hospitals, and the chief of educational service, in turn, requested that this program be likewise extended to all educational and physiotherapy aides in the reconstruction hospitals.13 The program was accordingly extended to all military hospitals and to the nurses and the aides.
In November, 1919, the War Department took over all the work of the allied welfare organizations except that of the American Red Cross.14
In Army hospitals investigations of a medical social nature were undertaken, including those looking toward the provision of proper aftercare of patients at home.13 The entire service had been a heavy obligation and responsibility for the American Red Cross, but results had more than justified every effort.13
An evidence of the increasing opportunity for this class of service was found in the work inaugurated December 10, 1919, in connection with patients suffering from mental disturbances as the result of their war experience.13 The problem of these men had always been a serious one and in many instances even pitiful. It was realized from the beginning that the closest possible system of follow-up would have to be employed to insure that each patient had proper care and personal attention. The department of military relief and the department of civilian relief cooperated to the end that all reports concerning men discharged from hospitals on surgeon's certificates of disability should go forward at once to the home-service section in whose jurisdiction the man resided.
It soon became evident that a special report of transfer of mental patients was highly desirable.13 The department of civilian relief, through arrangements with the Bureau of War Risk Insurance, had been receiving notice of authorization of transfers in order that it might notify the division officers and home-service sections concerned, but it was found that this method was not practicable because many of the transfers authorized were never made and information about those which were made not infrequently failed to reach national headquarters of the American Red Cross until some time after the patient had actually been removed.13 It was realized that the American Red Cross field representatives at the hospitals had excellent opportunities for obtaining this information in advance from the personnel records of the hospital. Accordingly, a form of daily report of mental cases was drawn up and sent out on December 10, 1919, in order that from that date forward there would be no missing link in the chain of service which would tie the man fast to the sources of care and assistance on which he had such an enduring claim.
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RED CROSS INSTITUTE FOR THE BLIND
As related in Chapter VI, the responsibility for the continued functioning of General Hospital No. 7, after the Medical Department of the Army gave over its control, was assumed by the American Red Cross. 15 Under this arrangement, though the Medical Department held the property on lease, it turned over to the American Red Cross on May 25, 1919, all buildings on a revocable license, so that that organization, in cooperation with the Federal Board for Vocational Training, could carry on the instruction of the blind. The place now became the Red Cross Institute for the Blind. 15
The purpose of the institute was to help the men blinded in the war to become equipped again as quickly as possible to meet their share of the social, civic, and economic requirements of their respective communities. 15
At the beginning four major courses of instruction were offered in the institute, consisting of the supplemental or preparatory course, the vocational course, the avocational course, and the recreational course.15 Among the supplemental courses of instruction were included Braille, English, typewriting and hand training, all essential regardless of what vocation a blinded man might decide to follow. It was the purpose of the institute to train every man so that he might use a typewriter efficiently, write intelligent business letters, and have a sufficient knowledge of Braille to enable him to keep his own notes and to read Braille literature satisfactorily. 15
Through its volunteer workers the institute was able to provide sufficient teachers so that each man might have an individual teacher in such work as Braille; the use of the typewriter; in the training of the hands, as in weaving of nets and baskets, and in simple cabinet making and carpentry; also in training the hearing, as in piano tuning, to furnish an important asset to one who could not see.16
The vocational training aimed to prepare the man for his life work. Courses were given in three general lines-agriculture, commercial, and industrial. Intensive investigations and surveys were made in each of these fields to determine what operations in each of them could successfully be performed by blinded men. Through these studies there was obtained much valuable information and the field ot opportunity for the blinded man actually was widened. The widest possible latitude was given, so that a man might obtain almost any kind of training desired, provided that it appeared to be practicable and advisable for him. Special courses were developed to fit individual needs and desires whenever it was possible to do so; 15 for example, the president of a large insurance company was engaged for several weeks giving intensive instruction in the various forms of insurance.17 After it had been demonstrated that vulcanizing was practicable work for the blind a course in that subject was started. As a result a score of men received this instruction.17
An interesting feature of the work along this line was the establishment of the Evergreen Victory Stores.17 The first was opened at the institute in September, 1919, and a second at Perryville, Md., in November following. Both were under the direct management of the institute and were used as training stations for men taking commercial work. Subsequently a number of stores were established by blinded men who finished the store courses. 17
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The avocational courses were important. The blind man, unable to use his spare time in the same way as the man with sight, is confronted with the problem of what to do on holidays, week ends, and evenings. Idleness is a detriment to the blind man; to be busy is a tonic, and to have diversion is essential; therefore, all men in the institute were urged to take some avocational as well as vocational training. Among the many lines of avocational training that were available and suitable were life insurance, bookbinding, basket making, and music.15
For such times as the blind man did not wish to be occupied at either his vocation or avocation the institute encouraged him to take work along purely recreational lines.15 To a large number music seemed to offer the maximum of relaxation. The men also found much diversion in social gatherings, and the two weekly dances at the institute were very popular with them. Swimming and other athletic diversions, such as bowling, likewise had their followers. For those who enjoyed participation in public affairs and in club or lodge life there were provided student organizations which encouraged practice in public speaking and participation in some parliamentary procedure.15
AMERICAN LIBRARY ASSOCIATION
Welfare organizations other than the American Red Cross were delegated to activities primarily for the benefit of the troops rather than the patients; 18 however, they could participate in hospital activities through the American Red Cross. The American Library Association functioned in this way.
This association, organized in 1876, was designated by the War Department in July, 1917, as the agency to provide a free library service for the Army for the period of the war.19 In developing this service the American Library Association was able to derive a trained personnel from the members of the library profession throughout the country.
One of the important contributions of the American Library Association to the welfare of the Army during the World War was the provision of free library service for the patients, nurses, official staff, and corps men in hospitals. 19
I
In the Army hospitals in the United States this work assumed the proportions of an extensively organized service.19 During the period of the World War books and magazines were supplied to a total of approximately 150 Army hospitals. In each of them provision was made for expert administration or supervision on the part of trained librarians. In 66 hospitals, those containing approximately 500-bed patients or more, the American Library Association maintained its own administrative personnel. A trained librarian, usually a woman, was in charge of the library. To extend the library service throughout the hospital, she had the help of a staff of assistants, sometimes trained librarians supplied by the American Library Association and sometimes members of the enlisted personnel of the hospital detailed by the commanding officer to the library. In hospitals where no personnel was maintained by the American Library Association a trained librarian gave expert supervision, visiting the hospital library at frequent intervals to give advice and assistance to the person in charge of the library, who was usually detailed from the hospital personnel or a member of the personnel of some other welfare organization already
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established in the hospital. In many of the smaller hospitals the American Red Cross gave support to the work of the American Library Association by assuming the actual administration of the service within the hospital.19
HOSPITAL LIBRARY
The aim of the hospital library, while including within its scope service to all branches of the personnel, was to secure for the patients especially the highest degree of service from books, journals, and newspapers.19 The main collection of books usually was located in some central place, sometimes in quarters provided within the Red Cross house or sometimes in a room or building provided especially for the purpose by the military authorities. The supply of books was
FIG. 83.- Hospital library, American Library Association
liberal, amounting to 10,000 volumes or more in some of the largest hospitals, with a range broad enough to supply a real catholicity of taste and a wide diversity of needs. Fiction, which was provided in generous quantities, comprised chiefly the sort which aims wholly to divert. In its selection for this purpose, the American Library Association was guided mainly by the expressed preferences of the patients in so far as their tastes were found to be wholesome.19
SUPPORT OF THE EDUCATIONAL WORK
It was in the support of the educational work in the reconstruction hospitals that the American Library Association endeavored to make its service most vital.19 It was held to be the function of the association to provide for the man injured in war or disabled by its hardships and consequently incapacitated for
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his former civilian pursuits the help which vocational and technical books can render. Every technical book for which a patient demonstrated a real need was supplied for him. The hospital librarian endeavored also to render every assistance to the work of the educational department. Reference books were provided for the instructors of the various classes and the help of near-by public libraries was utilized in research work.
SUPPLY OF BOOKS
Subscriptions for general and technical magazines were provided for each hospital, and the supply was largely augmented by gifts of used copies from residents in near-by towns and by the magazines available through the special 1-cent mailing provision of the Post Office Department.19 From time to time the librarians gave publicity to the need for magazines to keep the flow up to the required volume.
HOME NEWSPAPERS
One of the most popular features of the work and one which was not without some therapeutic value was the distribution of home-town papers among the patients. The American Library Association supplied all hospitals with a selected list of newspapers from various localities, and in many cases the librarian was able to extend the list through the cooperation of local agencies, which made home-town papers available in large quantities.
BRANCH LIBRARIES AND WARD SERVICE
In addition to the central library, which provided well-stocked bookshelves, magazine tables, and newspaper racks, with a library assistant always in charge, branch libraries were established in important centers in some hospitals.19 For patients confined to bed and consequently unable to visit either the main library or any of its branches definite provision was made. In several cases their needs were met by installing smaller collections of books and magazines in the various wards and on the ward porches where they would be accessible to the men through ward masters and nurses. In the great majority of hospitals, however, a more satisfactory service was given through the use of a special bedside book truck. With this book truck, well loaded with books, magazines, and newspapers, the librarian or his assistant would go through the wards, making it possible for each man to choose his own reading matter and to secure expert advice or assistance in selection. Figure 84 is a representation of this ward service.
In many cases special collections were installed in the nurses' quarters and in the quarters of the medical staff, and every effort was made to provide for the hospital men a service as satisfactory as that given the patients.
SERVICE TRANSFERRED TO THE WAR DEPARTMENT
This library service to military hospitals in the United States reached its maximum in the spring of 1919, when the number of patients was greatest.19 As the number of men in a hospital was reduced, personnel was sometimes withdrawn, but every hospital received an adequate service as long as it continued in operation. The service continued under the direction of the American
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Library Association until November 1, 1919, when, at the suggestion of the American Library Association, it was transferred to the control of the War Department, together with the library service in camps and posts.19 Included in the transfer were all books and full equipment. The trained library personnel, was also taken over by the Army, under whose direction the service was continued.
YOUNG MEN'S CHRISTIAN ASSOCIATION
The Young Men's Christian Association, which conducted extensive work in all of the Army camps at the beginning of the war, erected huts in the hospital areas.20 The program which was carried on was available not only to the
FIG. 84.-Ward library service, American Library Association
patients but also to the enlisted personnel and employees of hospitals units. While the patients were able to enjoy the entertainments, movies, and religious services, many of them naturally were spectators rather than participants in the athletic activities. During convalescence many of them were able to take part in the educational work.
When the overseas sick and wounded began to return to this country, a reconstruction program was put on at the request of the medical officers through the physical department of the Young Men's Christian Association.20 Corrective exercises were given and such games taught as would be beneficial in bringing back health. Men in the hospitals were reached through a regular hospital
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organization which included bedside visitation, movies, and entertainments in the wards. For those who were able to move about a social and religious program was promoted in the buildings of this association.
The reconstruction work was begun through cooperation with the military hospital authorities and special equipment was made available in certain camps.20 Through trained physical directors and the use of graded exercises, men were helped to overcome the effects of abnormal conditions resulting from injuries. It was found that cheerfulness, energy, and a comradery spirit were valuable adjuncts in the adaptation of games and apparatus exercises to the needs of individual patients. Interesting results were accomplished in the experiment of special exercises used for limbering affected muscles and joints and the prevention of atrophy, the education of muscles of arms and legs to the use of artificial limbs, and in the use of general games of a competitive nature as a mental stimulant in nervous disorders. Effective results were also obtained in the grouping and grading of men for exercises and games during the convalescent period.
In accordance with the general policy of the Young Men's Christian Association, all work of this sort ceased when the volume of need grew to the point where the Government itself was justified in making official provision for it.20
YOUNG WOMEN'S CHRISTIAN ASSOCIATION
The "hostess houses" conducted by the Young Women's Christian Association 21 exercised a direct bearing on the morale of patients, for they provided accommodations over short periods for their female relatives during visits. As all hotels in the neighborhood of large camps and hospitals were continually overcrowded and often were at an inconvenient distance, the hostess house always allowed a greater portion of the visitor's time to be spent with the patient, and in many instances was the deciding factor which allowed the visit to be made. These houses also provided an attractive and homelike center for the men themselves, where they could enjoy various forms of entertainment, meet female friends, and buy a wholesome meal.
JEWISH WELFARE BOARD
The Jewish Welfare Board, after it began functioning as a welfare agency, 21 included in its program extensive hospital activity.22 Daily visits to the wards constituted part of the routine of each field representative of the Jewish Welfare Board.
In this work the volunteer hospital committees of the community branches of the Jewish Welfare Board were of great assistance. Operating without interference with hospital regulations and in complete cooperation with the military authorities, the men and women of the cities and towns neighboring the hospitals brought to the bedside of the sick soldier the comfort of contact with people who reminded him of his own folks back home.
Throughout, it was the aim of the Jewish Welfare Board to serve all the men, irrespective of religious creed or denomination, and in addition to make adequate provision for special needs of the soldiers of Jewish faith.22 The program included every type of service requisite to meeting the physical, spiritual, and mental needs of the sick and wounded men.
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HOSPITAL SERVICE DIVISION
When wounded and convalescent men began returning in large numbers from overseas the special problems relating to their welfare resulted in an elaboration of the Jewish Welfare Board's program. 22 A hospital service division was organized in January, 1919, to promote special activities in conjunction with the efforts of the hospital authorities, educational recreation officers of the hospitals, and the American Red Cross.22
The Jewish Welfare Board, recognizing the importance of physical reconstruction and vocational reeducation in the treatment of overseas patients, assigned representatives of this board to hospital work, men of mature judgment, pleasing personality, tact, sympathy with Jewish ideals and aims, and initiative.22 In addition they possessed special training that fitted them for aiding in the educational and recreational program. Altogether, 54 field representatives were assigned to 40 general hospitals, 17 base hospitals functioning in physical reconstruction, 17 regular base hospitals, 17 debarkation hospitals, and 6 miscellaneous hospitals. In a large number of instances the workers covered two or more hospitals that were in close proximity.
RECREATION CENTERS
While in most instances the representatives utilized existing facilities for the conduct of their activities in the hospitals, the Jewish Welfare Board realized its obligation to contribute its share to the recreational facilities by erecting buildings in hospital grounds and, wherever this was impractical, by establishing recreation centers in the vicinity of the hospital.22 At Fort McHenry, Md., a recreation building was erected; at Walter Reed General Hospital, Washington, and at General Hospital No. 43, Hampton, Va., centers were established just outside the hospital grounds; in all other instances recreational quarters were secured in the towns adjacent to the hospital.22
These centers and buildings became the gathering places for convalescents and corps men in their hours of leisure; here they received articles of comfort, cigarettes, fruit, writing materials, newspapers, magazines, and books. In these quarters they sought and received advice from the field representative on various personal problems and were inspirited to greater contentment and to a more rapid recovery.
WARD SERVICE
The representative of the Jewish Welfare Board made ward visitation one of his chief duties; every reasonable and needful service was extended and every effort was made to induce in the individual a state of mind that would facilitate and hasten his recovery.22
Special ward entertainments were arranged for the men confined to bed Motion pictures, vaudeville shows and concerts, followed by the distribution of refreshments, were part of the ward program. In this work the volunteer hospital committees visited the wards, bringing a message of cheer and service characterized by a matronly solicitude for the welfare of the wounded men. In addition to the usual distribution of articles of comfort they made purchases of things specially requested by the men.
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SERVICE SUPPORTING RECONSTRUCTION
An important task of the field representative was to encourage and induce the patient to avail himself of the opportunities for reeducation and vocational training offered by the hospital authorities.22 The workers of the Jewish Welfare Board in daily contact with the men, with whom they established personal and friendly relations, impressed upon them the importance of reeducation and the necessity of training for readjustment to normal civilian life.
As a further aid in this work the Jewish Welfare Board distributed thousands of copies of My Diary to the patients in the hospitals. 22 This booklet, attractively arranged, contained information regarding war-risk insurance, the Smith-Sears Act, photographs and descriptions of educational activities in which wounded men might participate, blank pages for diary purposes, and other material, the purpose of all of which was to stimulate interest on the part of the patient in his own speedy recovery and to assist the hospital authorities in their efforts at rehabilitation and reeducation.
The Jewish Welfare Board assisted the education department In numerous other ways, the chief of which was supplying needed equipment. 22 Typewriting machines, bicycles, roller skates, tools of various kinds, farm machinery, reed, desks, printing outfits, and special educational materials were furnished.
ENTERTAINMENT FOR HOSPITAL PERSONNEL AND PATIENTS
From the viewpoint of the special problems relating to the care of wounded and sick soldiers an adequate and varied entertainment program in the hospital was of importance.22 Vaudeville and motion-picture shows, amateur nights, concerts, musicales, socials, picnics, minstrel shows, banquets, dramatics, and dances were arranged regularly for both convalescents and corps men. In addition, wounded men were given automobile and bus rides, taken on sightseeing tours, sleigh rides, launch parties, and boat rides. Theater parties frequently were arranged in the neighboring towns. Baseball, bowling, basketball and football teams composed of wounded and slightly disabled men were formed and games arranged. The Jewish Welfare Board likewise was succesfull in promoting athletic competition among disabled men. In addition, checker and chess tournaments were arranged in the hospitals. A checker and chess expert was engaged to tour some of the hospitals and give instruction in these games.
Every secular and Jewish holiday was fittingly celebrated, generally including some form of special entertainment.22 One of the features of the entertainment program was the distribution of refreshments and cigarettes among the soldiers present.
It was the effort of this board to provide diversion and recreation for every man, and every resource was utilized in this regard in order that the Jewish Welfare Board might in some degree help in maintaining the morale of the men and in keeping them mentally absorbed in such activities as would distract them from all thought of their ailments.22
In response to a special need and in accordance with the wishes of the War Department, the Jewish Welfare Board undertook welfare work at the hospitals and camps in behalf of non-Jewish Russians and men of other Slavic
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races.22 A large number of these men did not understand the English language and had but little conception of American institutions and Government and the principles for which this country was engaged in the war. The fact that these men, confined to the hospitals, were, in addition, lonely, dejected, and ill at ease in their unaccustomed surroundings made more important the necessity for a generous program of welfare work.
Men specially qualified by reason of their understanding of the psychology and language of the Russians were assigned to this work.22 Lectures in their native tongue were delivered to gatherings of these men, special pamphlet material supplied, foreign newspapers, magazines, and books furnished, and entertainments provided. Cigarettes, fruit, and other much desired comforts were distributed among them, and every need met by the field worker. Personal welfare work, involving many special problems relating to these men of Slavic extraction, constituted an important element of the program.
IN CONVALESCENT CENTERS
In response to a request from the War Department Commission on Training Camp Activities, the Jewish Welfare Board inaugurated a welfare program in the convalescent centers established in some of the large Army camps.22 In addition to the usual program described herein the field representatives actively participated in the Government organization and direction of activities. In some instances workers were placed in charge of educational and recreational activities. Special entertainments, home hospitality, and classes were arranged for the men in these centers. Refreshments, cigarettes, and souvenirs were liberally distributed among the convalescent men.
REFERENCES
(1) Act of April 24, 1912, 37 Statutes, 90.
(2) Special Regulations, No. 61, War Department, October 8, 1917; General Orders, No. 17, War Department, February 13, 1918.
(3) General Orders, No. 82, War Department, July 5, 1917.
(4) Memorandum from Maj. Henry R. Hayes, S. C., N. A., for Major Brackett, January 2, 1918. Subject: Medical Aides. On file, Historical Division, S. G. O.
(5) Letter from W. Frank Persons, director general civilian relief, American Red Cross, Washington, to Mr. Otis H. Cutler, manager insular and foreign division, Red Cross Building, Washington, D. C., October 30, 1917. On file, Record Room, S. G. O., 080-1 (American Red Cross), T.
(6) Annual report of the American National Red Cross for the year ended June 30, 1918. On file, Historical Division, S. G. O.
(7) Letter from W. Frank Persons, director general of civilian relief, the American Red Cross National Headquarters, Washington, D. C., to Maj. Gen. William C. Gorgas, Surgeon General United States Army, Washington, D. C., December 27, 1917. On file, Record Room, S. G. O., 353.91-1 (General).
(8) Memorandum from the Surgeon General to the Secretary of War, November 7, 1917, and attached papers. On file, Record Room, S. G. O., 356 (Reconstruction).
(9) General Orders, No. 17, War Department, February 13, 1918, par. V.
(10) Office memorandum, the Surgeon General's Office, May 4, 1918. On file, Record Room, S. G. O., Miscellaneous Letters, A-577.
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(11) Final report of physical reconstruction as conducted by the Surgeon General, United States Army, 1917 to 1919, by Maj. A. G. Crane, S. C., U. S. Army, director of the educational service, division of physical reconstruction, Surgeon General's Office, undated, 316. On file, Historical Division, S. G. 0.
(12) Instructions for reconstruction aides, Overseas Service, Office of the Surgeon General, undated. On file, Record Room, S. G. O., Miscellaneous Letters, C-428.
(13) Annual reports of the American National Red Cross, 1917 to 1920, inclusive. On file, Historical Division, S. G. O.
(14) Circular No. 483, War Department, series 1919.
(15) Annual report, the American National Red Cross, for the year ending June 30, 1919.
(16) The American Red Cross Assistance to the United States Medical Department in the United States, by Lieut. Col. C. H. Connor, M. C. On file, Historical Division, S. G. O.
(17) Annual report, the American National Red Cross, for the year ending June 30, 1920.
(18) General Orders, No. 57, War Department, May 9, 1917; Bulletin No. 50, War Department, September 5, 1917; General Orders No. 46, War Department, May 9, 1918.
(19) Letter from M. W. Meyer, in charge of publicity, American Library Association, Washington, D. C., to Col. Casey A. Wood, M. R. C., U. S. A., Office of the Surgeon General, Washington, D. C., November 18, 1919 (and attached papers). On file, Historical Division, S. G. O.
(20) Letter from J. S. Tichnor, associate general secretary, the national council of the Young Men's Christian Association of the United States of America, to Lieut. Col. F. W. Weed, Washington, D. C., May 2, 1925 (and attached paper). On file, Historical Division, S. G. O.
(21) History of the Commission on Training Camp Activities, April, 1917, to September, 1919, prepared by the war plans division, General Staff. Copy on file, Historical Division, S. G. O.
(22) Letter from Louis Kraft, supervisor home service department, Jewish Welfare Board, New York City, to Col. Casey A. Wood, M. R. C., C. S., secretary board of publications, Office of the Surgeon General, War Department, Washington, D. C., January 23, 1920 (and attached papers). On file, Historical Division, S. G. O.
