Part 3

Aside from the help that can be given the individual consumptive, which will be discussed later on, there is much that the leagues can do by concerted action to improve the conditions under which the negro lives. Probably one of the most important factors in the spread of tuberculosis, aside from his habits, is the manner in which the negro is housed. The negro as a rule is a renter. The houses that he can rent are usually located in the poorest and most unhealthy part of the city. They are often poorly constructed, badly lighted and ventilated, and frequently in bad repair. The rooms are usually small and dark, having but one window, and the top sash is seldom arranged to be lowered. Many houses are built on poorly drained ground, and water stands under them after each rain, making the rooms damp and cold. These houses are seldom provided with bathing arrangements or water-closets, thus necessitating the use of privies, or the back alleys, with all the dangers attendant upon such conditions. For such houses, or more frequently for one or two rooms in such a house, the negro pays proportionately more rent than the white race does for better houses in the same community, either because better accommodations are not available, or because he can not, or will not, pay for better. The family, usually consisting of father, mother, and several children, and often friends or relatives, all live, eat, and sleep in these two or three rooms, frequently with the windows and doors tightly closed, and in winter a stove going at full blast.

In the negro section of the city the streets are usually either badly paved or not paved at all. The sidewalks are either in bad repair or missing. The streets are badly lighted at night, garbage cans are not emptied regularly, and the scavenger service is poor.

“There is a reason for these things,” say the landlords, the municipal authorities, and others who have dealings with the negro. The landlord says: “Negroes are destructive; they pull down, but they never improve property. A house rented to negroes will depreciate from 25 to 50 per cent in a year. If you put in plumbing they break it, they deface the walls, they tear off the shutters and the doors, they break and burn the fences. It is useless to give them good houses as they neither appreciate them nor take care of them.”

The municipal authorities say that negroes make no effort to keep their surroundings clean and sanitary. They throw things into the street, choke the plumbing, drains, and sewers with old rags, trash, and dirt, and make no effort to help the authorities keep things in order; therefore it is useless to try to help them until they learn to help themselves. They say that there are exceptions to these statements, but that they are true so far as the great mass of the negroes is concerned. Reference is made to the subject here to draw attention to the fact that the leagues can do much to change these conditions, thereby bettering the condition of the race.

If the things that are said about the negro by the landlords, the municipal authorities, and others are true, then it is necessary for the negro to change these conditions before there can be hope for much betterment. If they are not true, steps should be taken to convince the landlords, municipal authorities, and others that they are false.

It is in this way that the leagues, though aimed at tuberculosis, may be the means of bettering the conditions along many lines. If the negro can demonstrate that he is not destructive, and that he can and does take care of the house in which he lives; if he will keep his surroundings neat and clean; if he shows that he is clean and sanitary in his practices, and that he feels his responsibility as a citizen by trying to keep up the sanitary conditions and the appearances of his home and his city, he will find that many of his troubles will disappear. If a landlord finds that his property is being cared for by his negro tenant, the yard, fences, etc., being kept in order, the rent promptly paid, and tenant is desirable, he will be only too glad to keep him, and to make such alterations in his house as he may desire. If it is demonstrated to the municipal authorities that the negro is as careful of his section of the city as the whites, his wants will receive consideration. The educated negroes succeed in getting surroundings that are far better than those of the average because they have learned to appreciate the above facts, and have put them into practice.

When the leagues have taught their members that it is not healthy to live in dark, damp rooms, with bad sanitary surroundings, and have educated them to the point where they will refuse to live under such conditions, then the landlords will build proper houses for them. The leagues working in conjunction with the health officer can get the city authorities to so frame the building ordinances that only sanitary dwellings will be erected in the city.

What a church league can do for the individual consumptive.—In addition to supplying the members of the league with information in regard to tuberculosis and sanitation, which is the work of the committees, and trying to induce the members to follow the instructions given them, there are other things that the league can do for the individual consumptive.

The chief difficulty that will be encountered by the leagues is the lack of money to help their sick members. It is hoped, however, that as the league demonstrates its value to the community more money will be available, and the work of helping the sick members can be extended. This work contemplates the “class method” of treating patients at their homes, the establishment of dispensaries, and ultimately sanatoria and “tuberculosis farms,” where a patient can earn a living by working on the farm and at the same time be under medical supervision. It is realized that these things are for the future, but it is well to keep them in mind as one of the ultimate aims of the leagues.

Now let us consider what can be done for the members who have consumption. The league should buy a number of the paper spit cups mentioned above, and distribute them to their consumptive members, and urge their use. These cups are cheap and therefore can be burned after being used. If every consumptive can be induced to use these cups and then burn them much will be done toward stopping the spread of consumption.

Whenever a case of consumption is discovered the officers of the league should apply to the health officer to disinfect the rooms occupied by the consumptive, in order to protect the other people in the house from the disease. Then if the consumptive is careful he is not likely to reinfect them. Also when a consumptive dies the health officer should be asked to disinfect the rooms.

Consumptives should spend most of their time out of doors, and if possible should sleep on a porch, or in a shed, or tent. All one needs is something to protect against the weather and keep off the rain and snow, but let in a great deal of fresh air. Patients live out of doors all winter in the north, with the thermometer below zero, and many have been cured of consumption in this way, including negroes. The league may help to provide the shack, shed, or tent, or it may furnish sleeping bags, blankets, etc., and in this way help the patient.

If the patient is very poor it may be that the league can see that he gets proper food which he might not otherwise have. The committees of the league will doubtless find many other means for helping the patient at small expense. The minister in making his pastoral calls can be of the greatest help both to the patient and to the community by seeing that the patient is properly carrying out his instructions, and that he has the proper facilities for doing so.

Dispensary.—As soon as the church league is formed, some physician should be designated who will examine all members referred to him, to decide if they have consumption. Usually there will be found one or more physicians who are members of the league, who will probably act in this capacity. If practicable a tuberculosis dispensary might be established at some convenient point, possibly in one of the rooms in the church, where the physicians could be found on certain days at stated hours, say, twice a week. Here they could see the consumptives, and examine and advise them as to the treatment necessary. They could also examine other members referred to them to decide whether they had consumption or not. Records of the dispensary work should be kept.

It is not practicable at this time to go more minutely into the details of the work of these leagues, which are now in their formative stage.

The writer will be glad to lend any aid in his power to any state or church league that may desire it, and all persons who are interested in this movement are invited to write to him, expressing any views they may have for the advancement of the work. He will be glad to have any aid, advice, or criticisms that may be offered.