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want a stenographer to assist him and with what we have, we could place out children as fast as they came in.

When I left home a couple of days ago they were just putting on a campaign for the sale of Christmas seals for the benefit of the tuberculosis fund. Why could not a skillful manager put on a child welfare week when attention could be called to the great work to be done in finding homes for homeless children. In our county there are several organizations that would be glad to take up the work of finding homes for children. There are several women's clubs, a Red Cross club in almost every town, visiting nurses' associations, associated charities, and many others. All of these organizations would help if asked in the right way but they have not been asked in any way.

The Governor could be asked to set apart a week for child welfare week. By going at this matter in the right way, the way that a successful corporation would go at its business, more applications for children could be developed in a few months than are now developed by our quiet easy unknown process in a few years.

In that way we can take the children out of the institutions and put them into good family homes and in so doing confer a blessing on the children and save the state the expense of building additional homes and large operating ex. penses.

I am not in favor of asking the legislature to pass a law authorizing county boards to hire a welfare worker, or workers. We have all kinds of workers in all counties now who are willing to do anything they may be asked to do and I favor trying that plan first.

Superintendent Treat: I heartily commend Mr. Reed's paper and shall assume that his criticims of placing work on the part of some agencies do not apply to our institution, because , I feel that our placements are carefully made and that the cases are followed up as diligently as our facilities will permit. Quite a large number of applications are declined after investigation for various reasons. Our larger children are all of school age and we do not accept applications unless school privileges are satisfactorily arranged for. “Necessity is the mother of invention” and our agents have for many years had friends scattered throughout their territory-bankers, ministers, business men,

school people, to whom they go in confidence to confer regarding families who are trying to help regain their own children who have been placed with us and also to counsel as to families in the community who have applied to us for children. However we should welcome the trained worker recommended in Mr. Reed's paper. I heartily agree with Mr. Butler that a good home is preferable to any institution for the normal child but am not sure the method he suggests would be practicable.

We have no difficulty in placing the attractive, desirable children and in my mind there is a grave doubt as to the advisability of publicity in the case of the retarded, physically defective or otherwise undesirable boy or girl. It is these problem cases that require the best efforts of our agents because some good man and woman must be found who are willing to make sacrifice in order to give the unfortunate child the opportunity to which it is entitled. Most of our commitments now are by court order and in the larger centers from which our populaion is largely made up the probation officer or social worker has exhausted every possible means of disposing of the case and the children come to us as a last resort.

It sometimes seems that the county authorities take a short cut out of a troublesome situation by sending the unfortunate children to us. I have on my desk now a court order committing a colored boy ten years of age who has never attended school a day in his life. He has been unable to attend school because of the loss of both of his legs. It has become a custom in some counties that the parents shall pay to the county its one half of the total expense of maintaining the child. Then there are the cases where it seems probable that the family will be able in a reasonable time, one or two years perhaps, to properly care for their children. Certainly such children should not be placed with strangers. Statistics show that we place with strangers and return to their homes on an average as many children as we receive so that the Soldiers' Orphans' Home is practically a clearing house and this in my opinion is its proper sphere. The number remaining in the home is made up as I have stated of (1) undesirable children, (2) those who are being held with the prospect of returning to their own relatives, (3) those who have recently been committed and are being classified and put, in condition for placement.

Member McColl: We have at Eldora two very efficient state agents. They have the boys' interests at heart and are very conscientious men, and they are hard-working men. They have placed a great many boys, and reduced the population. But the population has been increasing. Superintendent Von Krog states that the boys who have been placed out were coming back because they were placed before they were ready to go. Children can be placed too rapidly. It is not the number placed but how well we do our work—that is the important thing.

State Agent Charlotta Goff: Mr. Butler's idea of a centralized organization is splendid, and in Minnesota where such a plan is being tried out, we are told that it stimulates cooperation among social workers and that generally it meets with their approval.

Mr. Slingerland, mentioned by Mr. Butler, was superintendent of the Iowa Children's Home Society, a perfectly splen. did organization which really helped much in organizing and carrying out our state work. We owe a great deal to them, particularly since our first state agent had been with them some fourteen years and was well trained in their school of experience. However their work differs essentially from ours in the matter of selection. When Mr. Slingerland was superintendent he was assisted by several state agents located in different parts of the state. If a family of children became destitute, one of these agents visited the family, had the children examined and such as were normal in every way were admitted to the care of the Society. The children who were handicapped in any way were left to the care of the state, which is just as it should be, but if a large percentage of children received by the state are either crippled, poorly nourished, have bad eyes or are suffering from some other handicap, obviously months, sometimes years of care and treatment will be required to bring them, up to condition fit for placement, consequently the work done by the state moves more slowly that that done by private agencies.

All agencies report that the number of suitable homes open to children is much fewer than a few years ago when economic conditions were so much better than now.

The October (1922) report of the Iowa Children's Home Society shows that six children were placed in family homes and eleven children were admitted to the home. This is probably a fair example of the work being done by placing agencies at this time.

Chairman Strief: Mr. Slingerland is now representing the Russell Sage Foundation. I listened to him recently. Iis contention is that all children should be placed out within a period of ninety days. He does not classify the mentally defective and cripple, but simply says to place them out. This was a broad assertion to make but it was made to a small group of people. He does not demonstrate in any way who is doing that at the present time.

Superintendent Kepford: The policy I assume desired by the board of control to be carried out by the Juvenile Home, is to salvage citizens, to properly care for the neglected, home. less, destitute and delinquent child. On that theory of the law the Toledo institution proceeds. It behooves us as workers in this field to constantly keep in mind the citizens of tomorrow. There is in every normal child admitted to a children's institution a potential citizen. It is not therefore, a question of the movement of populaion, desirable as it may be to place children in good homes, as it is to keep constantly in mind the highest interests of the state.

I probably know as many people in Iowa as any other man. For fourteen years, as is known to most of you, I traveled constantly. I came in contact with the best citizens of the state. After the Juvenile Home had been in operation a while I sent out a letter to county farm agents, Red Cross Nurses and social workers apprising them of the fact that we had some splendid boys and girls who needed good homes. I also addressed 2 letter to the women's clubs directing attention to the desirability of finding good homes for our children. I am sure that the best Toledo and Davenport can do is to approximate a home. But it is difficult to interest a great many childless homes in our proposition. Many people hesitate to undertake the care of a child from our home. I am sure that Mr. Treat and these agents have as much sympathy and tenderness and kindliness for little children as any others. We would all like to have them in good homes. We want them there. They need the homes but you cannot place a child in the wrong kind of a home and save the citizen. Neither can you keep the wrong kind of child

in even a good home. The placing of children is most important. It should be considered from every angle but the citizen of the future should be constantly kept in mind.

The conference reconvened in the afternoon after intermission and proceeded with Member Butler in the chair.

NEW STEPS IN THE PREVENTION OF DIPHTHERIA

IN INSTITUTIONS.

Member Butler: The first paper on the program is “New Steps in the Prevention of Diphtheria in Institutions."' by Don M. Griswold, M. D., of the University of Iowa at Iowa City. Dr. Griswold was unable to be here and I understand that Dr. M. B. French is here and will read the paper.

Doctor French: Yesterday afternoon Dr. Griswold called me to his office and told me that it would be impossible for him to come to Des Moines today and give his paper, and told me I would have to come and so I am here.

This paper will be found on page 69.

Member Butler: Dr. Stewart, you are to open the discussion of this paper.

Superintendent Stewart: I enjoyed Dr. French's presentation of the subject of diphtheria in institutions, fully as much or nearly as much, as I enjoyed his assistance at the institution in January of this year, and his advice last fall a year ago.

To begin with in August 1921, we had develop in the Independence State Hospital, several cases of diphtheria : two cases in July, one case in August, and one case in September; all on the receiving ward on the men's side. By this time we had a great many isolated as being carriers, and finally, we gave everyone one in the infirmary, which is our receiving ward, the antitoxin. In other words we gave about 150 doses of antitoxin. No more cases of diphtheria developed but we were carefully sending in cultures to the bacteriologist at Iowa City and they were coming back positive. A great many of them were in old men, 80 years of age, who had been in the hospital but twenty-four hours. We felt that we were sitting on a volcano. As many of these throats were clear, we could not see where our quarantine would end. We were crowded and we had no room for a quarantine, so we appealed to Dr. Gris

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