fore strongly recommended legislation which would make reservation Indians amenable to State laws, and we beg leave to repeat the recommendations with the earnest hope that they will be seriously considered by Congress.

SOCIAL SERVICE ACTIVITIES

A conspicuous feature of the year's developments in the field service was the intensification of activities which have to do more particularly with family and community life. We refer specifically to the following welfare services:

The inauguration of a "Program of health education for Indian schools" including parents and teachers' associations, and a day and boarding school community plan.

The strengthening and extension of the field matron and visiting nurse service.

The authorization of the position of supervisor of native arts. The organization of numerous boys and girls' clubs in cooperation with the agricultural extension work of States and counties.

The forming of women auxiliaries, "Better home clubs" and similar organizations as part of the general "Five-year industrial program.

The significance of the group of humanitarian activities to which we have referred lies in their appeal to the Indian women and, through them, to the improving of social and living conditions in Indian homes and communities. The importance of the "Program of health education in Indian schools," with its correlated reservation social service, is found, in our opinion, in the fact that it presents a practical and comprehensive plan for reaching the women of the tribe whose indifference to efforts to induce them to adopt even the most ordinary of hygienic practices in their homes has long been the subject of pessimistic comment.

It must be admitted that much of the good work done in the Indian schools was not carried forward by boys and girls returning from the schools. They had been trained to keep their bodies clean, their clothing neat, their rooms tidy. They had become accustomed to nutritious food served in a cleanly fashion. Returning to the reservations they found their home conditions did not come anywhere near meeting the standards which their schools had taught them. The result, obviously, was a slump, a setback which wasted much of the education they had received.

Reservation life under such conditions proved to be a wide, unbridged gap in the educational system of the Indian Service. Superintendents and field matrons were supposed to take up the work of the schools and help the returned students through the period of readjustment to reservation life. But on most reservations the superintendents had too much of their time taken up with office work connected with the material affairs of their Indians; they could give but little attention to social service activities. The field matron service was unsatisfactory. There was no well-defined plan to meet the situation presented by the boys and girls just home from the schools. It was small wonder, then, that a goodly part of the energies expended to train Indian pupils in modern methods of hygiene, in home building, and in community welfare was lost.

.

66

It must be understood that very few returned students went back to the blanket." On the contrary every Indian boy and girl who has attended a Government or non-Government school long enough to receive an impress of its training exerts some remedial influence upon home and community conditions. Hundreds of girls have transformed their homes, making them attractive and hygienic. Many boys have become leaders on their reservations and have put into practice what they had been taught. But as a whole Indian home conditions have not been bettered, because the Indian women generally remained indifferent to efforts to persuade them to bring their homes up to the standard set by the schools for their children, and the endeavors of welfare workers to break through the wall of conservatism raised by the tribeswomen against the intrusive ways of white people were generally futile.

The year's accomplishments of the field service, however, hold the promise of a change in the attitude of Indian wives and mothers. Reports from a number of reservations which have been brought to the Indian Office indicate that the practical application of the Indian school health program is changing the indifference of many Indian women to an increasing interest in home improvement. This program has tied up the family with the school and is leading Indian parents to think more of their obligations to their children, particularly along the lines of sanitation and better living conditions.

HEALTH EDUCATION PROGRAM

The "Program of health education for Indian schools" was put into effect last September. It was prepared with the cooperation of the American Child Health Association of New York City and is based upon the report of the Joint Committee on Health Problems and Education of the National Education Association and the American Medical Association in cooperation with the technical committee of 27, which report was prepared under the direction of Dr. Thomas D. Wood, of Columbia University, New York City. The report was modified so that its program would be practicable and suitable for Indian schools and Indian communities.

While most of the program relates exclusively to health education in the schools it provides for day-school and reservation-school community organizations and activities. The program, which most appropriately was printed by Indian students of Haskell Institute, was ordered to be put into effect in all Indian schools and agencies by the Commissioner of Indian Affairs with the approval of the Secretary of the Interior.

In its practical application to reservation life every day school and reservation boarding school is made a community center in a broad sense of that term. The teachers and housekeepers of the day schools are required to visit each home before the opening of the school year with the purpose of interesting the parents in the school. The mothers are invited to meet at the school to organize a parentsteachers' association.

One of the important features of the program is the monthly conference of the farmer, field nurse, matron, doctor, missionary, and day school teachers to discuss problems of community interest and the welfare of individual families and individual students. There

always have been visiting days at reservation boarding schools during which Indian parents visited their children, generally on the grounds, and did little else. Under the new scheme the parents are given full opportunity to acquaint themselves with school methods and school conditions. They are taken into the class rooms, and the mothers are given some instructions in the home economic department.

It has been found that this seemingly simple device to increase the interest of Indian women in their children's welfare and to tie them up with the schools has been surprisingly successful, according to reports, in a number of reservations. When the Indian field service personnel has fully grasped the possibilities of this plan, so that there will be the fullest cooperation between the school and reservation people, we may expect rapid progress along the lines laid down. by this Indian school health program. The commissioner has ordered that all teachers and employees shall take a special course in the health education course of the summer schools they attend.

WOMEN AND CHILDREN

The juvenile agricultural clubs, with an enrollment of over 1,200 boys and girls, which were organized on more than 40 reservations during the fiscal year are extensions of the county clubs for the white population and are under the supervision of superintendents, Indian service farmers, matrons, teachers, and returned students. These clubs are known as sheep, pig, poultry, corn, onion, sewing, canning clubs, etc. The children finance their own projects and are in competition with similar clubs organized among the white children. Indian parents are displaying great interest in these clubs, and it has been found they have exerted a direct influence for the bettering of home and community conditions.

The number of women auxiliaries, where the reservations are organized into district chapters under the "Five-year industrial program" largely increased during the year and on some reservations the women have been organized into "better home clubs."

We have stressed this pronounced intensification of activities dealing with the family and community life of Indians because we regard the Indian home problem as one requiring intelligent study and sympathetic consideration. In previous annual reports we have commented upon the obvious necessity of improving the Indian homes so as to secure for the Indian child the full effect of education.

As we have attempted to show, the Indian woman is a conservative by nature; she is far behind the man in her acceptance of the new ways of living. The essential thing in combating this dislike of innovation is sympathetic help when help is wanted. Here is where the field nurse and field matron service becomes one of the most important units of the Indian Bureau.

During the year the Indian Office made a survey of reservation home conditions with the purpose of reorganizing or rearranging the personnel to strengthen the field nurse and field matron service. For a number of years it has been obvious that this section of the Indian Service has not measured up to its possibilities, and has lagged far behind like activities in centers of white population.

FIELD MATRONS AND FIELD NURSES

The field matron service was first established in 1891 by the Hon. T. J. Morgan, then Commissioner of Indian Affairs. It is interesting to learn from his report what his idea of a field matron was. The following is a quotation from his report: "The duties of the field matron shall be to teach the Indian women everything connected with domestic work, sewing, care of children, nursing the sick, improvement of the house and premises, and organization of societies for the mental, moral, and social advancement of young and old; in, fact, anything which a woman of good judgment, quick sympathies, fertility of resource, large practical experience, abundant energy, and sound health can find to do among an ignorant, superstitious, poor, and confiding people."

This was a large order, altogether too big for the untrained women who were appointed field matrons at the time. Commissioner Morgan apparently left it to the individual field matron to organize her work without direction or supervision, but it must be remembered that at that time what is generally known as "social service" work in this country was just beginning to find itself.

As educational and medical work in the country at large has progressed in the last 30 years, it has become evident that the teaching and training in methods of child care, health and sanitation, and domestic economy must be sound in order to be effective. The instructive visiting nurses of our cities developed from the church deaconesses. From the instructive visiting nurse there has developed the public health nurse, whose duties comprise not only the care of the sick but embrace a much more far-reaching idealthe care of the health of the public. Her field is the whole community; all have a share in her attention, and she seeks to emphasize and teach health. It goes without saying that she does not neglect the sick. Curative care is the vantage ground from which she teaches the practices that will restore and conserve health.

Along with the development of the home and hospital care of the sick has come the increased knowledge and efficiency in dealing with the many problems of home economics. The methods for teaching this knowledge have been revised and broadened. The value of teaching the principles of nutrition to children, as well as to mothers, has become a routine in the schools.

Another development has been along the lines of social welfare— the adjustment of the individual to his environments, both social and economic.

It is in these three professional fields that the field matron is asked to excel, and for this highly important and much-needed work there have heretofore been chosen a personnel from an untrained group of women, many of them more than willing to meet the requirements, sympathetic and enthusiastic, but absolutely without training, and we have been hoping that they would of themselves reach the standards which are demanded of modern, educated, trained social service workers.

It is encouraging to learn that Commissioner Burke not only has the purpose of building up the field matron service to such standards but is planning to give more emphasis to the visiting nurse activities.

There are some reservations where visiting or field nurses, instead of field matrons, are the pressing need. They could carry out a program of school nursing, cooperating with the teachers in the health education program and with the doctors in securing the correction of defects. They could visit the homes and, where possible, organize classes and conferences with the mothers in home care of the sick and the hygiene of infancy and childhood. They would be absolutely necessary in the required follow-up work on trachoma and tuberculosis in the home.

In many western towns and cities Indians are at work. In several places the Indian Service has established field matron stations where the field matron is doing a social service job whose main factors are adjustment of the young Indian women and men to novel economic conditions and a safe outlet for all the social energy, which young people must develop for themselves when they leave reservation life behind them.

The Board of Indian Commissioners for some years has urged the rehabilitation of the field matron service, and it again urges that this most important function of the Indian Service be further strengthened and brought up nearer the standard of the organized and specialized social service of our large cities.

COOPERATION WITH THE INDIAN SERVICE

Another development of the fiscal year covered by this report was the increasing degree of cooperation which organizations outside of the Indian Service are giving to the Government in welfare work among the Indians. The Red Cross, besides retaining a nurse on the Rosebud Reservation, has decided to start two community centers this coming year, one on the Tongue River Reservation, S. Ďak., and the other in the Pueblo of San Domingo, N. Mex. Each center will be in charge of a visiting nurse and also a specialist in home economics. The Eastern Association on Indian Affairs, with headquarters in New York City, which has maintained a trained nurse in the Northern Pueblo Agency, is to place one on the Zuni Reservation as well. The American Medical Association, the National Committee for the Prevention of Blindness, the American Child Health Association, the Junior Red Cross, and an increasing number of local health organizations and agricultural extension societies are working with the Indian Office for the welfare of the Government wards. The United States Public Health Service continues to cooperate effectively, and the medical department of the Santa Fe Railroad is helping the Indian Medical Service to fight trachoma in New Mexica and Arizona. The National League of Women Voters has announced that it has established a fellowship for the year 1925-26, with the Robert Brooking's Graduate School of Economics and Government in Washington for the "study of the American Indian problem, the successive policies of the Government, and the contemporary administration of Indian affairs." The amount of the fellowship is $1,000.