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10
Generally speaking the conditions under which the negro is housed are
exceptionally bad : in fact nobody seems to bother very much about housing here.
There are, I believe, provisions with regard to nuisances in the health regulations,
but they cannot possibly be enforced. Housing provisions, if there are any—which
I doubt—are not used. In most towns there are numerous houses that should be
under a closing order, and many areas that should be made the subject of a scheme.
Nothing however, is done about them.
The proportion of negroes in various counties and towns varies very much,
being in some places as high as 62 per cent.
As I said at the beginning, the visit to Virginia has been largely in order to
look into the rural hygiene, and though we have stayed in a number of towns,
it has been merely because they have been suitable centres from which the
surrounding country might be inspected. In most we did not visit the health
department, if there was one, though usually we were shown some of the interesting
hygienic or historical features.
Richmond, to which we went first of all, was our headquarters for about
ten days, and we went there in order to have explained to us the organization of
the Central Health Department, i.e., the State Board of Health, and to have
described the methods employed by this body with a view to inducing the county
and town authorities to undertake health work. The chief of the State Board
is the Commissioner, a medical man who is appointed by the Governor. As the
Governor only serves for four years the term of office of the Commissioner may
also be limited to this period. The present Commissioner has, however, held the
post since 1908, and is one of the best loved and most popular men in the State,
in addition to being a quite admirable health officer. It is largely as a result of
his efforts that so much has been done in Virginia to bring it up to its present
position in relation to public health, and that so many as 34 counties have some
sort of health organization, elementary though it may be. In his department
there are a number of sub-departments, e.g., of maternity and child welfare, which
has not done much yet; a venereal disease section, which has done a certain
amount; a tuberculosis section, which is quite active though not tremendously
effective; and a statistical department which is helping the other departments
greatly, though hindered by the absence of laws making births, etc., compulsorily
registrable. In addition, there is a good State laboratory where a great amount
of bacteriology is done.
The inner workings of all these departments were explained to us and
exposed for our inspection. Of the men who are in charge of them I formed the
highest opinion. All of them are enthusiastic and all of them have but one aim—
to see that health conditions are improved.
Though we had not much opportunity, officially, of studying the workings
of the City of Richmond Health Department, I took the liberty of paying several
visits on my own account and noted what was being done. All the work in relation
to infectious disease is done by medical men, two assistants having been appointed
for the purpose. As in most other American towns, there is no fever hospital and
all patients are therefore isolated at home. Each house in which there is a case
is quarantined and placarded wih a ticket naming the disease and warning off
visitors. Another matter I investigated was the milk supply, and without hesitation
may say that so far as regards clean milk production Richmond is years ahead
of any city in Great Britain. Largely this is due to the fact that no one may produce
milk for sale unless he has a permit from the health officer, and is liable to have
his permit withdrawn if conditions at the farm and in connection with production
fail to give satisfaction and to come up to a certain standard. The type of approved
cowshed is admirable. All milk is sold in bottles and is graded. Grade "A" is
milk from tuberculin tested cows and only such milk may be sold raw. All other
milk is Grade "B," and is pasteurized before sale. Anyone who holds a permit