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.

Recommendation For Health Education Council

In this document, Sally Lucas Jean makes a recommendation for the creation of the “Health Education Council.” The Council would be created with the purpose of educating the public on matters relating to their health.  The recommendation was written in 1942. At this time, Jean had recently started working in the Poston camp. It is evident that her concern for the health of the interned Japanese-Americans motivated her to advocate for the formation of this organization.

With the creation of the Health Education Council, Jean wished to appoint people to new positions such as a Director of Public Health, a Director of Sanitation, and a Nutrition Consultant. The various positions would be in charge of weekly meetings that would address problems with public health and how to best deal with them through “education in health.” Before this recommendation, numerous medical positions had already been created for the camp. These included a Chief of Internal Medicine, Dentist, Dietician, Optometrist, Laboratory Technician, and many more (“Medical Personnel”). The positions recommended  by Jean seemed to be more geared toward the educational and preventive aspect of the medical field, rather than the actual practices of diagnosing and providing treatment for ailments.

One of the most prominent health issues in the camp at this time was tuberculosis (Lillquist, 401). This was largely due to the location of the Poston camp, which was in the middle of a large desert. The dry air, combined with dust, caused numerous respiratory problems among the internees. According to Jean, there had been 177 diagnosed cases of tuberculosis in Poston by the time she had written this recommendation. However, only 55 people could be treated at the hospital at one time. Jean understandably thought that educating the public on the symptoms of the illness would be beneficial in allowing them to get help if it was needed. Jean also states that the close living quarters of the camp increased the chance of contracting tuberculosis: “The limitations of living space and the close proximity of human beings to each other renders the situation a critical one.”

Poston After Sundown

Jean goes on to elaborate on the issue of disease treatment within the camp. She states that there are more reported cases of venereal diseases than are being treated at the time of the recommendation. There was definitely a problem with healthcare, as the camp had inadequate facilities to treat its large volume of detainees. The problem would be made even worse by the lack of passable supplies in the hospitals. Some of them did not even have penicillin to treat simple illnesses (Sato Interview).

In the case of tuberculosis, the patient would be sent to Phoenix to be treated if there was not room in the camp, but someone with a venereal disease might go altogether untreated. Jean writes, “As the cases registered upon entering Poston exceeds those now under treatment it is obvious that all patient(s) suffering with venereal disease are not under treatment.” Once again, it is apparent that Jean’s work is very important because she reports problems that would likely go unnoticed otherwise.

New mothers would often go to their doctor once or twice and would then be left on their own to figure things out. Jean states, “…it is hoped that a carefully developed follow up procedure, such as has been found essential to assure women returning to the clinic at regular intervals, will be put into action at an early date.” Jean advocates for an educational system that allows the nutrition consultant to work with new mothers to better care for their children. This would be especially important since many of the camps had the very basic food supplies needed. Mothers were also forced to walk many “blocks” in order to feed their infants (PJD, 162).

Next, Jean focuses on accident prevention. “An educational campaign is much needed to develop a change in attitude toward safety measures in the homes, the schools and on the roads of Poston,” she states. Some of the dangerous situations arose in the camps because of improper living conditions. In some cases, buildings designed to accommodate 300 people had to hold upwards of 900 (PJD, 160).

It is worth noting that Jean largely ignores some of the foremost health problems of the camp, like heatstroke and dysentery (Lillquist, 406). It is possible that there was simply nothing that could be done about these conditions because of the extreme heat in this area. However, it seems as though education could aid the detainees in avoiding the heat and the importance of staying hydrated.

Overall, this letter is very significant because it allows us to learn more abut the health problems the internees faced in Poston. It allows us to more accurately analyze the specific problems that some of the Poston incarcerees were forced to overcome. These documents also allow us to learn more about how the camp administration responded to the troubles Japanese Americans were facing.

 

-Seth Beane

 

 

Works Cited

“Health Education Council”. Folder 74: Poston, Arizona-Health Education Council in the Sally Lucas Jean papers #4290, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill.

 

Folder 74: Poston, Arizona – Medical Personnel in the Sally Lucas Jean papers #4290, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill.

 

 

Lillquist, Karl. Imprisoned in the Desert: The Geography of World War II Era, Japanese American Relocation Centers In the Western United States. Central Washington University, 2007. 394-450. Print.

 

Sato, Sarah. Personal Interview. Densho Digital Collection. 09 Apr 1998.

1943 Speech on Public Health (Part II)

Fifth Page of Jean's Speech

On October 12th, 1943, Sally Lucas Jean attended the War Time Public Health Conference in New York City and delivered a remarkable recount of the public health education of the Japanese American internment camp in Poston, Arizona (Jean 1).  The speech, titled “Health Education in A Japanese Relocation Centre,” details Jean’s experiences in public health care during her tenure at the internment facility (Jean 1).

The Poston internment camp opened May 8 of 1942 as the largest relocation facility in the United States, and located on the Colorado River Indian Reservation (Burton, Farrell, and et al). Ironically, the tribal leaders of the reservation “did not want to participate in inflicting the same type of injustice… they had suffered” (Burton, Farrell, et al).  Poston, like its companion internment camps, was constructed hastily and some aspects of life were neglected; Poston’s only schools were arranged and managed by residents because the government had not arranged for them to be built (Burton, Farrell, et al).  Sally Lucas Jean’s work originates primarily in Poston public health, which had not demonstrated the highest standards, as evidenced by resident George Yoshida’s account of filling his own mattress with straw to sleep and the frequent spreading of sicknesses while at Poston (Yoshida).

The second half of the document, beginning in the fourth paragraph of page five, introduces compilations of “child health problems,” as well as general health issues, which were prevalent in Poston (Jean 5).  Along with the communicable diseases that Jean mentions in her speech, she is also explicit in her appreciation for “public health visitors” of the camp (Jean 6).  These “visitors” were Japanese Americans who had been incarcerated and then volunteered as nurse’s aides and public health workers (Jean 6).  When the health officials of Poston did a survey on the infection rate of tuberculosis in their camp, Jean recalls that the public health visitors’ “work is really contributing in important ways to improve the health of all the people” (Jean 7).   She also noted that the volunteers “played a part” in almost all aspects of said survey, not to mention any other public health endeavor posed by their camp environment (Jean 7).  It could be seen as ironic that these volunteers, who Jean herself describes as essential to part of Poston public health, only held the title of “visitor”;  their activity merits a title that reflects such dedication.

Those public health visitors who chose to volunteer were paid a small amount for their actions, but Jean stresses in her presentation that, “regardless of the nature of the work, all service at the Relocation Centers is volunteer service” (Jean 6).  However, the work that incarcerees did in internment camps, including Poston, could almost be seen as forced labor.  Many Japanese Americans lost much of their estates and financial stability upon entering camp, which functioned as strong incentive to “volunteer.”  Also, the compensation assistants in camps received was characterized as “insulting,” far less than the amount paid to WRA workers with similar positions (PJD 167).  No Japanese American would accept such little money, especially when federal government workers were paid far more, unless they were in a position of need.  Weighing the disparity between pay level, as well as the financial need of some Japanese Americans in internment camps, the labor done in centers like Poston was essentially forced labor.

Activities in the camp led by Jean assisted in the “improvement of facilities to permit…hygienic programs,” especially as it pertained to the prevention of disease (Jean 8).   The WRA was known for the “Spartan” lifestyle it imposed upon those in camp, and health care adequacy was one aspect of subpar camp life (PJD 162).  A major issue was the lack of “medical personnel, particularly nurses,” (PJD 164) something that Jean combatted with recruitment of public health visitors and the creation of a nurse’s aide program in Poston (Jean 2).  The aide program, consisting of nearly 200 students at the time of Jean’s speech, was credited by Poston nurse Elizabeth Vickers, who oversaw the trainees, in “contributing an enormous amount of service” (Jean 3).  Vickers goes on to mention the positivity and hard work each of the aides brought to the Poston hospital, where the aides became indispensable parts of their public health system (Jean 3-4).

Overall, Jean’s work with youth in Poston schools and public health visitors at the internment camp had created a community with a lower mortality and morbidity rate “than for the population of the United States as a whole” (Jean 9).  Poston might have become a frightening place to live without the guiding hand and diligent work of Sally Lucas Jean.

David Gorelick

 

Works Cited:

“Health Education in a Japanese Relocation Centre” Speech on Oct. 12, 1943, Folder 75, Sally Lucas Jean papers #4290, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill.

Burton, J., M. Farrell, et al. United States. National Park Service. Confinement and Ethnicity: An Overview of World War II Japanese American Relocation Sites. 2000. Web. <http://www.nps.gov/history/history/online_books/anthropology74/ce10j.htm>.

Yoshida, George, interview by Ito, Alice and Pai, John, 28 Feb 2002, George Yoshida Interview Collection, Densho

 

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.