Negro Health

Of 12,000,000 Negroes in the U. S., one-third swarm in industrial cities, two-thirds huddle on tired Southern soil. Proportionately they have three times as much tuberculosis and syphilis as whites, a maternal and infant mortality rate more than 60% higher. At birth a Negro baby can look forward to a probable life of only 47 years, compared to a white baby's 59. Herewith TIME tells the story of four attacks on this No. 1 public health problem.

Chief financiers of Negro health programs are the U. S. Public Health Service and the Rosenwald Fund for Negroes, established in 1917 by Philanthropist Julius Rosenwald of Chicago. Since 1928, the Fund has given $1,250,000 to build Negro hospitals,* train doctors and nurses, help out the two Negro medical schools--Howard in Washington, Meharry in Nashville.

In the war to liberate Negroes from syphilis and t.b., the generals have always been white doctors, but local battles are now fought by Negroes. Barred from all but a few Northern hospitals and medical schools, pioneering Negro doctors from Harlem to New Orleans have set up a score of model clinics and health stations.

Frederick Douglass. Greatest killer of both Negroes and whites is heart disease. But while tuberculosis has dropped to seventh place among whites, it still holds second among Negroes, killing over 15,000 every year. Like syphilis, the "white plague" is a white man's disease, was unknown in Africa. Some authorities hold that the Negro is more susceptible to tuberculosis than the white man because he has been exposed to the tubercle bacillus for only three or four generations, has not yet developed the white man's age-old resistance. But latest research shows that prime cause of the high Negro t.b. rate is poor living conditions.

Few Negro doctors know much about tuberculosis, few white doctors dare to operate on their "massively" infected Negro patients. Outstanding Negro thoracic surgeon in the U. S. is young, gentle Frederick Douglass Stubbs of Philadelphia. Son of a well-known doctor, graduate of Dartmouth, a leader of his class in Harvard Medical School, Dr. Stubbs spends most of his time at dingy Frederick Douglass Hospital. Here he looks after a ward of some 25 patients with advanced tuberculosis, whose lungs he deflates and drains of pus.

Frederick Douglass welcomes all types of cases, gets along somehow on a State grant of $4,500 a year, dollar contributions from poor patients and friends. Patients live on frankfurters and beans, nurses go for months without pay. Its hundred general beds, says Dr. Stubbs frankly, could easily be absorbed by other Philadelphia hospitals. But he fights to keep 45-year-old Frederick Douglass alive, for it is the only hospital in the U. S. where Negro doctors can undertake thoracoplasty (rib surgery for collapsing the lung). Dr. Stubbs chooses his patients carefully, for they are all test cases. Since 1937, when he started thoracoplasty at Frederick Douglass, Dr. Stubbs has operated on 40 patients, almost all of them "poor risks" (some even over 60), has lost only five.

Macon County. "In Macon County, Ala.," said Surgeon General Thomas Parran two years ago, "even [in 1929] . . . the poverty was worse than anything I had seen in long years of work in the rural South. The houses were tumbledown shacks, many without floors, with no furniture, and only a few rags for bedding. The windows were without glass. When it grew cold, boards were nailed across the opening and the family huddled together in the gloom. In this environment we found the saturation point of syphilis. In about 39.8% of all age groups of the colored population, the blood test was positive."

But ten years later, in 1939, Dr. Parran could point with pride to a medical miracle: only 10% of the 23,000 Negroes in Macon County had syphilis. In. three years, experts predict, the disease will be wiped out. To root syphilis out of Macon County, the U. S. Public Health Service, the Rosenwald Fund and Booker T. Washington's Tuskegee Institute all joined forces. Leader of the campaign is a white man, the county health officer, a former Georgia farm boy who drove a flivver through fields of mud, 36 miles a day to medical school. Last month, deep-eyed, sunburned Dr. Murray Smith began his tenth year in Macon County. "There's not much in this job," said he, "but the love and thanks of the people."

At first the Negroes used to gather in the gloomy courthouse in Tuskegee, while Dr. Smith in the judge's chambers gave them tests and treatment. Later he set up weekly clinics in old churches or schoolhouses, deep in the parched cotton fields. Last fall the U. S. Public Health Service gave him a streamlined clinic truck. The truck, which has a laboratory with sink and sterilizer, a treatment nook with table and couch, is manned by two young Negro doctors and two nurses. Five days a week it rumbles over the red loam roads. At every crossroads it stops.

At the toot of its horn, through the fields come men on muleback, women carrying infants, eager to be first, proud to have a blood test. Some young boys even sneak in to get a second or third test, and many come around to the truck long after they have been cured. One woman who had had six miscarriages got her syphilis cured by Dr. Smith with neoarsphenamine. Proudly she named her first plump baby Neo.

With syphilis now under control, Dr. Smith is trying to haul down Macon's high maternal mortality rate. To drive the old pipe-smoking "grannies" out of the midwife business, Dr. Smith last year put trained-nurse midwives into competition with them. Three Tuskegee-trained nurses live in lonely outposts, far from the red-mud roads. Every day they trudge through the backwoods, examining prospective mothers, if all is safe & sound, delivering babies on kitchen tables. Last year, said Dr. Smith, the grannies' business dropped from 700 to 500 babies; this year it will be far lower.

Flint-Goodridge. Eight years ago, the only place for sick Negroes in New Orleans was the halls of ancient Charity Hospital, where patients slept two and three in a bed. And there was not a hospital a Negro doctor could practice in. In 1931 the Rosenwald Fund, the Congregational and Methodist Episcopal Churches started a fund to build a hospital for New Orleans' 130,000 Negroes. Cotton Merchant Edgar Bloom Stern, son-in-law of Julius Rosenwald, boomed up a campaign for more money. In a town where only two charity campaigns had reached their quota in 15 years, Mr. Stern got $200,000 from white citizens, $50,000 from Negroes.

With $500,000 Mr. Stern and a group of white and black doctors built Flint-Goodridge Hospital, a solid, severe, sun-flooded plant, with 100 beds, complete X-ray and clinical facilities for 30,000 patients a year. As superintendent they chose a Negro real-estate agent and insurance salesman, bland, 35-year-old Albert W. Dent. When Mr. Dent moved his family and furniture into a second-floor ward, Flint-Goodridge had neither patients nor staff. Most Negroes thought a hospital a place to come and die in. Of the 35 Negro doctors in New Orleans, only about 20 were graduates of approved medical schools.

To Mr. Dent's aid came the late, great Gynecologist Charles Jeff Miller, who gathered a staff of white experts from his own Tulane, and from Louisiana State University Medical Center. The white doctors took charge of the hospital's various departments, worked in the clinics with the Negro doctors, who had no rank. When the colored doctors were trained, they were moved up into the white doctors' places. Flint-Goodridge, says Mr. Dent, has fewer staff squabbles than many all-white hospitals in New Orleans.

To get patients to come, Mr. Dent organized venereal disease lectures in factories and clubhouses, started mothers' clubs, ran lawn parties, sent nurses into poor homes. To compete with the grannies, who delivered 20% of all Negro mothers, he offered confinement and hospital care for $10, lowest fee charged by midwives. Result: fewer colored women than white now use midwives in New Orleans, a situation probably unique in the U. S.

Flint-Goodridge also boasts the cheapest, most complete hospital insurance plan in the U. S. Cost: one cent a day. Most similar schemes, covering three weeks' hospitalization, charge at least three cents a day. If he can convince his doctors, Mr. Dent will soon start a two-cent-a-day plan to provide complete medical care as well.

So smoothly going a concern is Flint-Goodridge that other hospitals in the North have borrowed Mr. Dent to supervise reorganization plans. Highest praise of all comes from white doctors in New Orleans, who point to Flint-Goodridge as the "cleanest," most effective small hospital in town.

Harlem. To nightlifers, Harlem, the Negro metropolis, is a glittering island of creepjoints, honky-tonks, jive halls. But for its 245,000 inhabitants, jammed into some 230 narrow city blocks, Harlem is a virtual pesthole. The t.b. mortality rate in Harlem is ten times higher than the rate in more prosperous sections of New York City. It is not uncommon for Harlem doctors to be stricken. Confined to a tuberculosis sanatorium at present is brilliant, contentious Skull Surgeon Louis Tompkins Wright, former surgical director of Harlem Hospital, considered by many the outstanding Negro physician in the U. S.

Head of the bustling Central Harlem Health Center is young Dr. John Baldwin West. No chair-warmer, Dr. West often marches into theatres, churches, basements, schools, apartment houses, exhorting Harlemites to visit the Health Center for X-rays, Wassermann tests, infant care. In the last three years, Dr. West and his staff of 200 have X-rayed 250,000 people, have lowered the infant mortality rate from 100 per 1,000 to 52, the maternal mortality rate from 18 to five. Over 500 patients a day visit a venereal disease clinic in the Center. But for all his efforts. Dr. West has scarcely dented the terrific t.b. figure. Medicine has no specific for poverty and overcrowding.

* There are 13 approved Negro hospitals (for internship) in the U. S. Three largest: Homer G. Phillips Hospital, St. Louis; Harlem, Manhattan; Freedmen's, Washington.

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