Memo concerning the nurse aides assistance in the hospital

1st Page

Elizabeth Vickers, R.N. and Senior Chief Nurse, wrote this letter on August 14, 1943 to Sally Lucas Jean concerning the Nurse Aide Program in the Poston Health Service while stationed at the Poston General Hospital in Poston, Arizona.  In her letter, Vickers updates Jean on the program’s progress with training Japanese American women in the nursing field at the Poston General Hospital and the surrounding areas.  She continues to describe what hospital services the nurse aides had experienced in the training, including the following areas: medical, surgical, obstetrics, pediatrics, tuberculosis, communicable diseases, operating room, diet kitchen, and clinic.  The most salient of all topics mentioned in this letter is the appraisal given by Elizabeth Vickers of the Japanese American nurse aides.

The majority of the letter expands upon the significant presence of the nurse aides and how their presence positively affects the hospital staff, the patients, and Elizabeth Vickers herself.  She gives the nurse aides full credit for most achievements made by the hospital services, such as “the preparation and serving of around one hundred thousand meals” and “the examinations and treatments given in 52,674 patient visits”.  Poston was made for a capacity of ten thousand, but held over thirteen thousand.  At twenty-one meals a week, for about ninety-five patients, one hundred thousand meals would have totalled for one year’s worth — meaning that the nurse aides provided a steady amount of assistance because that is one year that the WRA could not afford to handle without their help.  Following these accomplishments made by the nurse aids, Vickers continuously compliments their character and work ethic she observed in their training and during the tough times they most regularly faced in the hospital – “always with the smile that indicated real interest in the job at hand and the spirit of determination to do”.  At the end of her letter, Vickers explains that she is “not ashamed to say that many of us in the trained personnel group borrowed courage from the excellent spirit shown by the nurse aides and from that, undoubtedly, carried on more efficiently ourselves”.  Her words portray the nurse aides in a good light because she does not refer to them as Japanese Americans, eliminating the bias between Japanese and Caucasian races.  Another way she portrays the nurse aides positively is by complimenting them on their spirit and how that spirit benefitted the other medical workers.  She appreciates their service because without them, many patients would not have been cared for.

Kiyoko Tatsukawa, a Poston nurse aid, smiles while administering medications to patients in her charming nurse uniform. Due to a lack of medical care, nurse aides were needed in the camps to keep the hospitals running.

The presence of the nurse aides was crucial for the survival of many patients in the camps because there was a “lack of medical care contributed to extensive disease and death” (PJD 20).  Administrative motives behind providing Japanese Americans with jobs in the hospital were that help was needed in these institutions and that these jobs would be helpful training for Japanese American men and women.  By giving them opportunities to serve in the hospital and to apply themselves directly to issues that mattered personally to them, the WRA kept the Japanese Americans engaged and ensured that their time spent in the camp was useful.   To allow the Japanese Americans to have jobs while in the camps also served a more public service because it made the Japanese Americans look patriotic and a part of American society.  However, the WRA’s main motivation behind their asking for nurse aide volunteers from inside the internment camps was to supply the camps with medical care without having to ask Caucasian Americans, who were not as willing to do the job.  This was most beneficial to WRA because they knew Japanese Americans were eager for work and the Caucasian Americans wanted no connection to those interned.  This way, the WRA would save money because they knew the Japanese Americans would work for any kind of money.  It was crucial to have the Japanese Americans to work in the hospitals because if they had declined the WRA’s offer, many patients would have died and that would have reflected badly on the government.

In an oral history of Setsu Tsuboi Tanemura, she describes her experience in the Minidoka internment camp where she served as a nurse aide when she was thirteen.  During 1943, teenagers were given the chance to further their education in school or work in the hospital for money.  Few thirteen year olds worked in the hospital, but they were allowed to work because only a small amount of Japanese Americans in every camp had a background in qualified medical training.  Therefore, nurse aides helped with anything in the hospital or nearby clinics to reduce the spread of disease and other sicknesses.  Setsu mostly worked in the obstetrics ward, but occasionally helped in the surgical and tuberculosis ward, even though her father did not approve.  Allowing such young nurse aides to enter highly infected areas of the clinics was dangerous and irresponsible of the WRA; Setsu was infected by TB, though not to the point that she fully had the disease.  However, with the help of Setsu and many other Japanese American nurse aides, many more patients received personal care.

Overall, the WRA appreciated the assistance of the nurse aids; however, they had selfish motives.  The nurse aides did not get paid enough for the work they were doing and their work was more helpful to the appearance of the WRA than the training they were experiencing for the future.

-Olivia Van Horn

Works Cited

“Memo: Sally Lucas Jean, Concerning: Nurse Aide Program in the Poston Health Service, From: Elizabeth Vickers, R.N., Senior Chief Nurse”, in the Sally Lucas Jean papers #4290, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill. Link: <http://dc.lib.unc.edu/cdm4/item_viewer.php?CISOROOT=/ead&CISOPTR=217411&REC=6&newviewer=yes>

Setsu Tsuboi Tanemura Interview Segment 18.  Interviewed by Tom Ikeda, November 12, 2009, 
Densho Visual History Collection, Densho.

Photograph of Kiyoko Tatsukawa by Stewart,Francis, in the War Relocation Authority Photographs of Japanese-American Evacuation and Resettlement Series 1: Colorado River Relocation Center (Poston, AZ) Volume 3 Section A, WRA no. B-491. Link: <http://content.cdlib.org/ark:/13030/ft3489n7jn/>

Report on immunization in the camps

Vaccination Report summarizing how many inoculations were performed in the camp

This document covers all of the notes that Jean took for inoculation in the camps. It is a report for the Department of Public Health at Poston 1, which was finalized on September 10, 1945. The date on this report indicates that it was written near the disbanding of the Poston camp; therefore, it is a compilation of information on all of the inoculations performed throughout the duration of the camp and the number of camp internees qualified for an immunity certificate. An immunity certificate, or inoculation certificate, is still required to attend multiple public schools across the nation. Every immunization was recorded in a list. Jean also details the number of internees that suffer from physical defects, and lists the number of people from the defects. Jean proceeds to detail the number and the quality of births performed in the camp. She details the vaccinations given to the infants birthed in the camps and lists any peculiar physical conditions. In particular, there were a number of birth defects. Additionally, there is even recommended protocol for caring and delivering infants, as  birth rates in the camp were high She ends with a recommended inoculation protocol for any and all other camps, approved by the Department of Public Health. The importance of this document is that it underlines very clearly what medical and vaccination procedures the camps underwent. By cross-examining these medical records, it is possible to determine the quality of the medical facilities Poston 1 had. She also underlined how many births were in Poston 1, and listed the number of survivors and possible causes of death. Finally, she concludes with a concise report of recommendations for inoculation in all other internment camps.

Vaccination Poster during WWII

Vaccines are a key part of healthy American life. Ever since the invention of the smallpox vaccine in 1796, vaccines have been widely developed. By 1809, the first mandatory vaccination law was enacted in Massachusetts (Salmon). In California, where most of the Japanese Americans resided, vaccination was not yet mandatory. In addition, a large number of Issei, first generation Japanese immigrants, were unfamiliar with California’s inoculation policy, and therefore unable to obtain the vaccination. Vaccination is more effective the younger the child is, but due to high anti-vaccination sentiment in the 20th and 19th century, many parents chose to opt out of vaccinating their children. Smallpox was the most widespread virus, and the virus that had the most vaccines developed for it. Smallpox is a very harmful virus, as it quickly spreads and rapidly consumes a person, causing high fevers that bring upon death. Medical advances from World War I and World War II brought upon highly effective vaccines. Due to the advances of the smallpox vaccine,  “by 1942, less than 1,000 new cases of smallpox emerged in the United States” (Hodge). This is a remarkable trend in the increase of vaccination. However, multiple rural and foreign families did not receive vaccinations since they did not regularly visit hospitals. This in turn led to fewer check-ups and opportunities to become vaccinated. There were exceptions, but the general trend pointed towards a lack of vaccination.

Vaccination upon Entry

 

Vaccination in the Japanese American community rapidly rose by going to theinternment camps. The Japanese American community was the most vaccinated because of the government mandated inoculation policy for entering and residing in the camps. As shown from the Immunization Records document, there were a total of 1090 immunity treatments completed in just camp 1. The majority of those treated were children of high school age, making up almost half of the immunity treatments. A reason for this trend may be that some of the younger children had already received immunizations prior to entering the camp. When children reach high school age, they must undergo “re-immunization”, which is a process of administering booster shots to bolster their immune system. Additionally, it was more important to immunize children as they still went to school in the camps and would attend public schools outside of camp after internment had ended.

In the camps, most of the diseases immunized were the Smallpox virus and the Typhoid Virus. Typhoid Fever is still an ongoing disease, unlike the smallpox virus which has practically made extinct. The Typhoid vaccine, unlike the smallpox vaccine, requires a booster every 2 to 5 years. This is a possible explanation as to why children in the camps received more typhoid vaccines (219) than smallpox vaccines (195). The patients receiving the Typhoid vaccine were primarily children older than two years, which shows that study had already been done on the safety of the Typhoid vaccine. The Typhoid vaccine was a relatively new invention; it was not until the 1950s when the Typhoid vaccine was approved for widespread use. (Bockemühl).

 

Eric Dean

 

Bibliography

Bockemühl, J. “Typhoid vaccination yesterday and today.” Immun Infekt.. 11.1 (1983): 16-22. Web. 11 Apr. 2012.

CDC, . Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Typhoid Fever. Atlanta: Typhoid Fever, 2010. Web.

Hodge, James G. “School Vaccination Requirements: Historical, Social, and Legal Perspectives.” Center for Law and the Public’s Health at Johns Hopkins and Georgetown Universities. (2002): 1-24. Web. 1 Mar. 2012.

Salmon, Daniel A. “Mandatory Immunization Laws and the Role of Medical, Religious and Philosophical Exemptions.” Johns Hopkins Bloomberg School of Public Health. (2002): n.1-2 page. Web. 22 Mar. 2012.

Lucas, Sally Jean. “Sally Jean Lucas Papers.” Letter 19-25 of Report of all Enteries of All Nursery School Children. Ed. Sally Lucas Jean, Comp. UNC Archives and Ed. . 1st. Chapel Hill: UNC Archives, Folder 74: 19-25. Print.

U.S. Library of Medicine. “Typhoid Vaccine.” Medline Plus. Bethesda: The American Society of Health-System Pharmacists, 1012. Web. 1 Mar 2012.

Report on Segregation to Tule Lake (Part II)

Detailing of Health Considerations Needed for Poston Residents Transferring to Tule Lake

The memo entitled “Segregation to Tule Lake” is part of a larger report detailing the nursing activities from July 15 to September 15, 1943.  In this document, Elma Rood, Public Health Nursing Supervisor, reports the results of an investigation into the health issues of the Poston internees that will be transferred to the Tule Lake Camp. She lists the number of internees that will need special consideration during their train ride to Tule Lake. These special considerations include special diets, Pullman car space so that they may lie down, and medical supervision by a nurse or doctor. She declares that for patients with serious illnesses, the trip will be deferred and that those taking the train should be able to do so “without any unfavorable incidents”.  Rood sent this memo to Dr. A Pressman, the Director of Health and Sanitation of the Poston Camp, on September 18, 1943. During this time, the War Relocation Authority was making the necessary preparations for the relocation of Japanese Americans who were perceived to be disloyal within the Poston Camp.

About nineteen months after the initial imprisonment of Japanese Americans into incarceration camps such as Poston, the government created a loyalty questionnaire to identify those with “tendencies of loyalty or disloyalty to the United States” (PJD 190). In February 1943, the WRA handed out the questionnaire, which asked two critical loyalty questions: if they would forswear allegiance to the Emperor of Japan and swear allegiance to the US and if they would be willing to serve in the US military (PJD 192). These questions were poorly worded and had many unforeseen implications that would affect the internees’ answers. Various reasons for answering “No-No” to the questions included discontent with their treatment, a desire to stay with their family members who were going to be segregated, or an unwillingness or inability to serve in the U.S. military because of personal beliefs or family obligations (PJD 195). If the internee said no to both of these questions and refused to change their answer during later questioning, he or she would be considered a disloyal Japanese American. The WRA decided to relocate the disloyal residents to Tule Lake, starting on September 1943, in order to separate the loyal residents from the “trouble makers” (PJD 208). The residents detailed in Rood’s report were being sent to Tule Lake because of their answers to the loyalty questionnaire or their possibly pro-Japanese activity within the camps.

Tule Lake was already established as a regular incarceration camp before the segregation process. Due to its size and the already large number of resistant Japanese Americans residing there, the WRA selected Tule Lake as the segregation camp for the discontented Japanese Americans. When Tule Lake was designated as such an area, the camp became more militarized. The WRA set up a double eight foot fence and substantially increased the number of guards. The WRA allowed families with clean records who answered “yes” to the two loyalty questions to transfer out of Tule Lake. 6,538 residents transferred out of Tule Lake while 12,173 Japanese Americans transferred in (PJD 208). The now militarized Tule Lake was unable to adequately accommodate this influx of people.

Incarcerees Traveling to Tule Lake by Train

Even though this document shows that the medical staff was aware of medical issues that would need to be addressed during the train ride, Tule Lake was not a suitable camp for people with these issues to reside in. Out of all the incarceration camps, the Tule Lake Camp residents faced the worst conditions. Residents of Tule Lake would later complain of over-crowded and unsanitary housing facilities with no cleaning supplies provided (Petition 6). Rood lists “pregnancy, care and feeding of babies and young children, and chronic illnesses” as conditions that need special medical consideration. However, once the internees left the train, the overcrowded barracks and unsanitary conditions would negatively affect these residents greatly.

The food served at Tule Lake was also of a remarkably lower quality than the other camps.  Petitioners in the camp wrote, “Salted herring often served in this center is really fertilizer; it is not fit for human consumption at all” (Petition 6). In response to the petition, which was written by Tule Lake stockade prisoners in 1944, the administration declared, “for the present, you have to be satisfied with what we have in the food warehouses” (Petition 8). Rood’s letter reported that 67 babies needed special food and 15 people needed special diets on the train. When healthy residents are not receiving adequate food, the special dietary needs of the internees cannot be adequately met either.

Along with the inadequate food and housing, the Tule Lake hospital was undersupplied and inefficient. Tule Lake residents needed to bring their own medical supplies for hospital use because they were not adequately supplied by the War Relocation Authority (Petition 5). The residents also complained that only one ambulance was in circulation to service the fifteen thousand people that were in the Tule Lake Camp (Petition 6). According to the petition, the Hospital Director, Dr. Pedicord, maintained a restrictive and seemingly authoritarian control over the hospital (Petition 6). He required the Japanese doctors to have a permit signed by him in order to treat patients yet he was frequently unavailable. Rood, in her letter, discusses segregation trips being deferred due to the severity of illnesses as well as critical heart cases and diabetes needing special attention. The WRA transferred the residents described in the report due to their answers to the loyalty questionnaire at the risk of their health. For the WRA to risk the health of the internees based on an answer to a poorly worded loyalty questionnaire was an unethical decision.

The WRA published a book in 1946 after the Japanese American incarceration ended called WRA: a Story of Human Conservation. This book asserts that the Japanese Americans “were generally determined to make the tasks of the Tule Lake administrative staff as difficult as possible” (WRA 71). Perhaps in the WRA perspective, the claims of the Petition referenced earlier was another attempt to make the administrators’ jobs more difficult. This book claims that the Japanese Americans in Tule Lake after the segregation were disloyal to the United States, uncooperative while neglecting to carefully examine the  possible motives or reasoning for their actions beside for their loyalty to Japan. They make no mention of the conditions at Tule Lake but they do concede that the “residents had been removed from normal environment for so long and had been subjected to so many disappointments, fears, and frustrations” (WRA 72).This indirect glance at the mental status of the residents provides insight into their camp life and suggests that camp conditions and incarceree treatment were not ideal.

Living Barracks at Tule Lake

Despite the poor conditions of the Tule Lake hospital, several oral histories of workers and patients revealed no glaring complaints about the condition of the hospital. Peggi Bain, who worked as a nurse and was a patient in the hospital, did not mention the lack of supplies or poor treatment in her personal experience at the hospital during her oral interview. On the other hand, Yaeko Nakano, who gave birth to child at the Segregation Camp, acknowledged the death of a baby in the hospital due to the poor conditions. Even so, she said that in her pregnancy experience, “they took really good care of pregnant women.” So according to Nakano, the pregnant women, which Rood’s report lists and provides special considerations for, received adequate treatment. However, Nakano said that when her son had a hernia, the doctors at the Tule Lake Hospital refused to do anything about it. They had to go to Nebraska for treatment.

The letter by Elma Rood shows the types of medical conditions the residents had during their transfer and detention at the Tule Lake Segregation Camp. The poor living and hospital conditions at Tule Lake would worsen the medical issues listed in Rood’s report. Such inadequacy in hospital conditions led to the death of a newborn, which Yaeko Nakano and the Petition mentioned. However, some patients and workers were adequately treated, as the oral histories indicated. The WRA did not need to transfer these residents with medical issues and although they did take precautions, they put the residents’ health at risk by doing so.

 -William Tuminski

References:

 

Document: Segregation to Tule Lake, in the Sally Lucas Jean papers #4290, Southern Historical

                Collection, The Wilson Library, University of North Carolina at Chapel Hill

Bain, Peggie, interview by Alice Ito, September 15, 2004, Densho Visual History Collection, Densho.

Petition to American Civil Liberties Union regarding conditions at Tule Lake. September 19,

1944, Segregation and Tule Lake Collection, Densho.

Miyamoto, Frank, interview by Chizu Omori and Emiko Omori, September 25, 1992, Emiko and

Chizuko Omori Collection,Denso.

Nakano, Yaeko, interview by Tracy Lai, July 4, 1998. Densho.

WRA: A Story of Human Conservation. Washington, D.C.: U.S. Dept. of the Interior, War

Relocation Authority, 1946. Print.

Survey of Medical Conditions at Poston July-September 1943

Medical Survey at Poston July-September 1943

 

From July to September 15, 1943, Sally Lucas Jean documented different medical conditions existing within Poston. Her report gives the statistics of her patients, their respective illnesses, and a summary of what is being done to treat some of them. Although she reports on several patients and their illnesses, there are a few points of interest throughout the document.

The first point of interest is the number of patients “[crippled] by apparent mental deficiency”. (Poston) The fact that these patients “with apparent mental deficiency” are being treated within this camp is quite surprising. The protocol for people with mental illnesses within the camps was neither desirable nor appropriate. “Retarded children who could have been cared for by their families at home had to be institutionalized. Serious illnesses, such as mental breakdowns, meant removal to state hospitals.” (PJD 164) One can only imagine the terror of Japanese American parents having to leave their children in the hands of complete strangers for an unknown length of time.

The testimony of Kima Konatsu, who was incarcerated at Poston, not only provides an example of the typical treatment of mentally ill persons during the incarceration, but also an example of the vacillating protocol towards the mentally ill and the absolute worst case scenario of the implementation of this protocol. Her husband was not permitted to enter Poston and “during that four years we were separated, my children and I were allowed to see him only once….[M]y husband became ill and was hospitalized. He was left alone, naked, by a nurse after having given him a sponge bath. It was a cold winter and he caught pneumonia. After two days and two nights, he passed away. Later on, the head nurse at the hospital told us that this nurse had lost her two children in the war and that she hated Japanese.” Several people before, during, and after the war, refused to make the distinction between Japanese Americans and the actual Japanese citizens of Japan. (Achieving, p. 107)

A second point of interest within Jean’s survey is the number of patients “having exercises at home under clinic supervision,” who she later writes “includes three convalescent polio patients…who received the Kenny treatment.” (Poston) She also writes some patients that have suffered “infantile paralysis…can be improved with exercises or the assistance of braces.” Poliomyelitis and “infantile paralysis” are different terminologies for the same disease. Better known as polio, it is a viral disease that can affect nerves and lead to partial or full paralysis. Because there is a vaccine now, polio tends to be overlooked as a disease to fear in developed countries (sadly, it is still a threat in some countries) but in the late 19th and early 20th centuries, polio tended to be a fatal, and very real, threat. The common medical practice that some underwent was to strap braces to the person’s legs; once the polio had done enough damage, that person, like the very popular President Franklin Delano Roosevelt, would be confined to a wheelchair.

The Kenny Treatment

Elizabeth Kenny (1880 –1952) was an Australian nurse who promoted a new approach to the treatment of poliomyelitis in the era before mass vaccination eradicated the disease in most countries. Her findings ran counter to conventional medical wisdom and caused much controversy. The Queensland Government Royal Commission evaluated Kenny’s work and concluded, “[t]he abandonment of immobilization is a grievous error and fraught with grave danger, especially in very young patients who cannot cooperate in re-education.”(Treatment) The Commission was recommending that the very young children stricken with polio be strapped down with braces because they were too young to go through what would today be considered physical therapy. Kenny believed there was a need to exercise muscles affected by polio and was adamantly opposed to immobilizing them with plaster casts and brace splints. In 1929, her methods were requested to assist a young woman, aged twenty-one, who had been disabled by polio at fourteen. After two years under Kenny’s care, the young woman was able to walk, work, and provide for herself (Kenny, p. 85). This was and is remarkable for a disease everyone thought to be terminal.  In 1940, Kenny came to the U.S. and stayed for the next eleven years, teaching doctors across the country the Kenny treatment (Kenny, p. 203). Kenny’s principles of muscle rehabilitation became the foundation of physical therapy.

In light of the the fact that the Kenny treatment came to the U.S. in 1940, it seems the physicians that Jean is writing about in 1943 are, in some sense, keeping up to date with medical protocol and technique. This observation cannot necessarily be applied to all other internment camps during this time: many memoirs about life within the camps regard the medical care to be insufficient. This tended to be due to a lack of medical tools, resources, and medical professionals within the camps, but there were incidents like that of Tule Lake and even Konatsu’s husband, where physicians consciously chose to do nothing when they could have. According to this report, the physicians within Poston applied and utilized as much medical knowledge as was available considering the time period, wartime shortages, and the limited funds that were allotted the camps by the government.

-Jazzmine Willis

 

Bibliography

Maki, Mitchell T., Kitano, Harry H. L., Berthold, S. Megan. Achieving the Impossible Dream: How Japanese Americans Obtained Redress. Urbana, Chicago: University of Illinois, 1999.

Poston Hospital Nursing Activities – July 15 – September 15, 1943 Survey on Crippling, in the Sally Lucas Jean papers #4290, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill.

Sister Kenny. And They Shall Walk. New York: Dodd, Mead, & Company, 1949.

“Treatment of Infantile Paralysis by Sister Kenny’s Method: Report of Queensland Commission.” The British Medical Journal.1. 4023 (1938 February 12): 350. PubMed Central.Web. 28 March 2012. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2085720/?tool=pmcentrez>

Letter from Dept. of Public Health about the Care of the Premature Baby

Poston Public Health Document

A document was sent from the Department of Public Health to an incarceration camp in Poston, Arizona in August 1943, titled “Important Points on the Care of the Premature Baby.”  It explains the steps that need to be taken to carry out three important requirements for the care of a premature baby: the baby should be kept warm, protected against infection, and well nourished.  The instructions provide an insight on how premature infants were cared for in Poston. The document was possibly most relevant to Mrs. Miure, the public health nurse of the camp (“Medical Personnel”).

Although health care in the internment camps was free, it proved to be inadequate in many different ways.  There were frequent shortages in equipment, medicine, milk, and other supplies; additionally, there was a shortage in medical personnel, especially nurses, which caused many overworked doctors/nurses and treatment delays.  The shortage of nurses was so significant that internees were trained as nurse’s aides in a rushed and insufficient training program (PJD 163-164).

By comparing these instructions to those in the American Journal of Nursing of 1945, we see a number of omissions in the Public Health document.  The first requirement that is elaborated upon in the document is the need to keep the baby warm.  The instructions state that upon delivery of the baby, he/she should be wrapped in a warm blanket and placed into a warm bed.  There are many specific points that are left out such as the temperature of the bed.

Cheiko Neeno, a Nurse's Aide student at the Poston Hospital, feeding a baby in the children's ward

According to the American Journal of Nursing, as the infant develops and weighs more, the temperature of the heated bed should gradually decrease.  Infants need to be kept in an environment of a specific temperature based on their weight.  Infants that weigh less than three pounds need a bed that is maintained at 90 degrees (F), infants of 3-4 pounds need 85 degrees, infants of 4-5 pounds need 80 degrees, and infants of 5 ½ pounds need 75 degrees.  Also, the document states that the temperature of the room should be kept at a constant rate between 75 and 80 degrees; however, this is not entirely accurate.

Although a 75-80 degree room temperature works for most infants, it cannot be set in stone for every one of them.  The temperature may be adjusted to cater to the needs of any particular infant based on his/her reaction to the environment.  In addition, as the temperature decreases, the humidity requirement increases; the ideal humidity is noted to be approximately 55 to 65 percent (Wallinger 898).  The humidity of the baby’s environment is just as important as the temperature, however this valuable information is absent in the Public Health document as well.  Although it does state, “If the air is very dry, moisture should be added so as to prevent drying out of the baby’s respiratory tract,” it does not identify/explain the device used to measure the air’s dryness, nor does it specify how much moisture should be added to the air.

However, Poston was located in a dry, hot desert, where aspects of the indoor environment, such as temperature and humidity, may have been difficult to control.  Similarly, the Gila River incarceration camp was located in the middle of a desert.  The incarcerees at Gila constructed their own homemade cooling systems, in which a fan would blow out air that was cooled by a water source.  The makeshift air conditioning system allowed the people to live in 80-degree rooms when the weather was up to 100-115 degrees (Hoshida).  It is reasonable to believe that the incarcerees at Poston may have also had to create their own A/C units to ward off the harsh outdoor heat.  As for the Poston hospital, an exact depiction of the A/C system used there remains questionable, but it may be assumed that it was not advanced and flexible enough to maintain an absolutely ideal environment for all of the premature infants.

To protect the infant from infection, the Public Health document includes a few precautions that should be taken, one being that flies, mosquitoes, and all other insects should be kept out of the room.  This is indicated as a precaution because it may have been a major issue in the hospital due to its poor conditions, which allowed insects to easily make their way into rooms.  Also, it is important to point out that the instructions omitted the necessity of an “observation room” where any seemingly ill premature infants could have been moved to and checked up on; the separation of well-infants and ill-infants would prevent any illnesses from spreading (Wallinger 900).

As for the instructions regarding the nourishing of the baby, this section seems more thorough than the instructions for the other two requirements.  The instructions state that the infant does not need to be fed milk or water for up to 12 hours after its birth; however, it could have been up to 18 hours, or even longer, to make sure that the infant developed a gagging reflex before it was fed by mouth (Wallinger 899).  Obviously, it was extremely important for infants, premature and mature, to be fed milk to benefit their health and development.  In the oral history of Aiko Herzig, a mother who had given birth to her daughter in one of the internment camps, as well as a significant leader and activist throughout the redress movement in the 1980’s, she mentioned that her child was born with an allergy to the powdered milk provided by the camp.  Herzig should have fed her canned Carnation milk, but the medical personnel told her that those were only sent to the armed forces.  Herzig, who received minimum salary, could not afford to buy canned milk from outside of the camp.  As a result, her daughter was frequently hospitalized with stomach disorders because she was deprived from the appropriate type of milk.  She lacked much of the nutrition that would have been provided by canned milk during her infantry, which has affected her health for the rest of her life (Herzig interview).  The Public Health document did not distinguish what type of milk would be the most appropriate to feed to the infants because Poston presumably only had powdered milk as well, which only adds to the numerous inadequacies found in the document and in the camp’s health care.

By Tammy Chen

Works Cited

Aiko Herzig, interview by Emiko Omori and Chizu Omori, 20 Mar. 1994, Emiko and Chizuko

Omori Collection, Densho.

Hoshida, George Y.  Life of a Japanese Immigrant Boy in Hawaii &

America.  Self-published, 1982.

“Important Points on the Care of the Premature Baby Aug. 1943” Folder 74, in the Sally Lucas

Jean papers #4290, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill.

“Medical Personnel,” in the Sally Lucas Jean papers #4290, Southern Historical Collection, The

Wilson Library, University of North Carolina at Chapel Hill.

Wallinger, Elgie M. “Nursing Care of the Premature Infant.” The American Journal of Nursing

45.11 (1945): 898-901. Web. 1 Mar. 2012.

 

Infant Care

Direction for Mothers - Sally Lucas Jean Papers

These documents focus specifically on recommended infant care in the camps. They provide an interesting perspective on medical care, as well as nutrition, during the internment of Japanese Americans during World War II. Furthermore, these documents offer a historically accurate source for comparing medical protocol in the camps with that of the rest of American society during the 1940s.

Issued by the War Relocation Authority’s Department of Public Heath, these documents detail the recommendations of health officials in the camps to new mothers on the matter of feeding their newly born infants. According to these suggestions, mothers should incorporate cod liver oil into their infants’ diet before they are even a month old for the prevention of rickets and add orange juice shortly after. Furthermore, mothers should breastfeed their infants every four hours for the first four months, gradually weaning their children until the age of eleven months. At around five months, mothers were advised to begin adding strained cooked cereals to their babies’ diets, adding strained cooked vegetables and egg yolks soon after. Mothers were told to feed their infants strained stewed fruits at around seven months, continuing to increase the variety and amount of their children’s diets as they grew older. By the end of the twelfth month, mothers were supposed to give their infants three meals a day and allow them to begin feeding themselves in a high chair.

Nurse's Aid student caring for infant at Poston Hospital

During the incarceration, life was certainly difficult for new mothers, for they had to attempt meet the nutritional requirements of their new infants in an atmosphere that was hardly conducive to such needs. While the camps lacked resources accessible to mothers outside the camps, several camps, such as Jerome in Colorado, housed a special refrigerator in the mess hall to fulfill some of the mothers’ immediate needs, specifically baby food and formulas (Okumura interview). Yukiko Miyahara, who stayed in the Santa Anita assembly center, appreciated the special baby stations from which mothers could obtain a small amount of baby food and milk when needed (Miyahara interview). However, most camps, including Manzanar, only distributed powdered milk, causing a relative lack of nutrition for infants allergic to this milk substitute, which angered Aiko Herzig-Yoshinaga, mother of an affected infant. Canned milk was typically reserved for the army and those who could afford to pay for it themselves, an impossibility for Japanese American mothers trying to survive on minimum salaries (Herzig interview). Some families in Poston sacrificed their ration of milk at a meal to provide for an infant in the family, since there were no special formulas for infants provided (Okimoto interview). On the other hand, many mothers, including Yukiko Miyahara, chose to nurse their babies for reasons of convenience and personal preference (Miyahara interview). However, despite the inevitable restrictions of life in the camps, the recommendations by health officials there were surprisingly similar to those of physicians in American society.

Mother with infant and child during evacuation

As these documents advocated the use of cod liver oil and orange juice, physicians outside the camps similarly recommended these substances as a means of obtaining Vitamins A, C, and D (Whipple 169-170). While the age recommendations for solids such as cereal, fruits, vegetables, and egg yolks are relatively similar to those in the camps, meat, as well as toast, was typically incorporated into infants’ diets around the age of seven months in American society, while mothers in the camps were not told to feed their young babies this delicacy within the first year. Perhaps this was due to a shortage or relative lack of such expensive food in the camps, or perhaps officials genuinely did not believe meat needed to be incorporated at such a young age (Whipple 173-178). The most reasonable explanation for this disparity is the rationing of meat, as well as canned milk, among civilians during World War II by the War Food Administration (Collingham 114-117,417-423, 431-432, 478). Regardless of the motives behind this exclusion, one cannot help but find it interesting that typical recommendations for infants’ diets both within the camps and in American society differed only in those areas involving foods considered more expensive and significantly less available during wartime.

Mother waiting in line with children

When examining the nutritional recommendations for infants during the decades surrounding World War II, one must also recognize the increasing popularity of baby foods at the time. Especially in the post-war era, many mothers and physicians believed their infants would benefit from solid food as early as possible. Thus, while breast milk and cow’s milk were considered sufficient sources of nutrients for infants in the 1920s, opinion dramatically shifted in the 1930s with the rising availability of canned baby foods such as those produced by the Gerber’s company. Evidently, in the years before World War II and the incarceration, the focus of mothers and physicians throughout America drastically shifted from breastfeeding to an accelerated incorporation of solids to meet infants’ nutritional requirements (Bentley).

In summary, these documents from the Sally Lucas Jean papers provide an intriguing account of life during World War II, particularly when analyzing infant care in the internment camps. Moreover, they serve as a useful resource when comparing the treatment of infants in the camps to that of babies living outside the camps in American society. Though one can conclude that standards of infant nutrition in the camps were relatively similar, though slightly modified due to the availability of supplies, to those outside the camps, many oral histories of mothers in the camps suggest that most of these needs were not actually met during the incarceration.

 

Laura Hanson

 

Works Cited

“A Guide to a Baby’s Feeding the First Year” Folder 74: Poston, Arizona, Japanese-Americans, 1942, in the Sally Lucas Jean papers #4290, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill.

http://dc.lib.unc.edu/u?/ead,217651

 

Bentley, Amy. Booming baby food: infant food and feeding in post-World War II America. Michigan Historical Review Fall 2006: 63. Online.

http://go.galegroup.com/ps/i.do?action=interpret&id=GALE%7CA156290842&v=2.1&u=unc_main&it=r&p=AONE&sw=w&authCount=1

 

Collingham, Elizabeth. The taste of war: World War Two and the battle for food. London: Allen Lane. 2011. Print.

 

“Direction to Mothers” Folder 74: Poston, Arizona, Japanese-Americans, 1942, in the Sally Lucas Jean papers #4290, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill.

http://dc.lib.unc.edu/u?/ead,217608

 

Herzig, Aiko, interview by Emiko Omori and Chizu Omori, March 20, 1994, Emiko and Chizuko Omori Collection, Densho.

[Densho ID: denshovh-haiko-02-0010]

 

Miyahara, Yukiko, interview by Kirk Peterson, April 10, 2009, Manzanar National Historic Site Collection, Densho.

[Densho ID: denshovh-myukiko_2-01-0008]

 

Okimoto, Ruth Y., interview by Tom Ikeda, April 8, 2011, Densho.

[Densho ID: denshovh-oruth-01-0010]

 

Okumura, Toyoko, interview by Tom Ikeda, February 15, 1997, Japanese American National Museum Collection, Densho.

[Densho ID: denshovh-otoyoko-01-0012]

 

Whipple, Dorothy Vermilya. Our American babies: the art of baby care. New York: M. Barrows and company, inc., 1944. Online.

http://babel.hathitrust.org/cgi/pt?id=coo.31924003492653;page=root;view=image;size=100;seq=1

 

 

 

 

 

Report on Health Care Facilities and Living Conditions

Report #1

The document titled “Report #1” of the Sally Lucas Jean Papers gives a general synopsis of Sally Lucas Jean’s first impressions of the Colorado River Relocation Center, a Japanese American internment camp located in Poston, Arizona. She begins the report with a description of her arrival at the camp, where she was welcomed with much hospitality and taken to her living quarters. She then describes the climate, geography, and living situations in the camp. Jean also gives an overview of the education and health care facilities available. Two of the main focuses, however, are Poston’s public health facilities and the living conditions of the staff compared to the living conditions of the Japanese American internees.

In the report, Jean puts a large emphasis on the internment camp’s health facilities. Jean, a public health educator and nurse, arrived at Poston on September 30, 1942, to work for the camp’s Public Health Department. Upon her arrival, the camp’s health facilities were still developing, even though the first Japanese American evacuees arrived at Poston almost four months prior, in May 1942 (Burton 216). She compliments the development progress, however, stating that a “well-equipped and excellently run hospital” has been established thus far (“Report #1”). The hospital staff consists of Japanese nurses and doctors who, according to Jean, “cooperate fully and efficiently.” There are also seven trained Caucasian nurses, whom Jean describes as “splendid.” She reports that her secretary is an “intelligent Japanese girl,” and although she is inexperienced, she is “eager and competent” (“Report #1”). Jean seems to be surprised by the excellence of the hospital facility, and is very grateful to work with such a qualified staff.

Japanese American Nurses at Poston, 1943

The camp’s medical workers were continuously taking action to improve the facility. In February 1943, the first Poston Medical and Public Health Conference was held to determine ways to advance the health department’s growth and to increase the quality of service to patients. After a five-hour meeting, the camp’s physicians, nurses, and public health experts decided on a few ways to improve Poston’s Public Health Department as a whole. Obtaining more hospital beds, hiring more nurses, ordering general healthcare supplies, and increasing tuberculosis testing were some of the proposals made (“Poston Medical”). Jean’s report mentions that improvements in the health facility were needed, and that this conference was especially helpful in the enhancement of Poston’s medical services.

In addition to the public health facilities, Jean’s report also focuses on the living conditions in the camp. She has a very positive reaction to the barracks, mentioning the “excellent three-quarters bed” and that the furnishings are “sufficient for comfort and convenience” (“Report #1”). Jean and other Caucasian workers lived in separate barracks from the Japanese American internees. Staff housing was much more accommodating than the housing of the Japanese American evacuees, with amenities such as indoor plumbing, painted walls, cooling systems, and refrigerators (PJD 158).

Exterior view of a barrack at Poston

The barracks occupied by the Japanese American evacuees were in comparably poor condition, but they tried to make the best of their living situations. Jean states that by the time she arrived in Poston, many families had already decorated their barracks, showing “indications of culture” in the camp (“Report #1”). Nonetheless, it was hard to disguise how dirty and barren the barracks were.

In most of the evacuees’ housing, there was a single light bulb hanging from the ceiling, and the only furnishings were a few small cots and makeshift bookshelves and tables (PJD, 159). Compared to Jean’s barrack, which housed only 12 staff members, the evacuees lived in cramped quarters where “whole families lived together in roughly divided spaces.” Sometimes over six families would live in one block of barracks (“Report #1”). Because of racial prejudice, Poston’s staff members undeniably resided in higher quality housing than the Japanese American internees.

Jean’s initial report on the circumstances at Poston War Relocation Center is significant because it gives outsiders a quick glimpse into what life was like in the camp. By giving a reliable description of the barracks and health care facilities with no embellishments, readers of the report are able to better understand the circumstances faced in Poston, both positive and negative.

Ellen Gould 

Sources:

Burton, Jeffery F. Confinement and Ethnicity: An Overview of World War II Japanese American Relocation Sites. University of Washington Press, 2002. Google eBooks. Web. 25 Feb. 2012.

“Report #1,” Folder 74, in the Sally Lucas Jean papers #4290, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill.

“Poston Medical, Public Health Conference Successfully Held in Unit One.” Poston Chronicle. 18 Feb. 1943. Densho Digital Archive. Web. 1 Mar. 2012. <http://archive.densho.org/main.aspx>