Tag Archives: tuberculosis

Indian Health Programs

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President Taft Speaking at Manassas Court House, Virginia in 1911, courtesy Library of Congress

The Bureau of Indian Affairs tried to address the many health issues developing among tribes who had lost their traditional lands, lifestyles, and occupations. However, funds were always far too short to do much good, and healthcare was not provided with any kind of continuity. As time went on and the country began to use  surveys and statistics as a basis for action, the government surveyed reservations and schools to discover the extent of the sanitation and health issues which were being reported. When President Taft received the information, which showed a high incidence of tuberculosis and trachoma (an eye disease which often led to blindness), along with a scarcity of medical care, he was shocked.

“The death rate of the Indian country is 35 per thousand as compared with 15 per thousand–the average death rate of the United States as a whole . . .,” he told Congress in 1911. “Last year, of 42,000 Indians examined for disease, over 16 percent of them had trachoma . . . . Of the 40,000 Indians examined, 6,000 had tuberculosis.” Taft asked Congress for more money to go toward Indian health care. . . . “It is our immediate duty to give the race a fair chance for an unmaimed birth, healthy childhood, and a physically efficient maturity.”

Appropriations for Indian medical service rose from $40,000 in 1911 to $350,000 in 1918.

A Grandfather and Two of His Grandchildren Infected With Trachoma, Rincon Reservation, Californina in 1912, courtesy National Library of Medicine

Group Picture at the Phoenix Indian School Tuberculosis Sanitorium Phoenix, AZ, circa 1890-1910, courtesy National Institutes of Health

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TB and Native Americans

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Crowded on a Reservation, courtesy Library of Congress

Though TB existed in the pre-Columbian Andean population, there doesn’t seem to be any definitive proof that TB existed in the continental U.S. before Europeans arrived. (Some skeletal remains indicate that it could have existed, however.) What we do know is that explorers and early settlers brought the deadly infection with them, and then spread it to Native Americans. Once Indians were relocated and forced to live on reservations in the 18th and 19th centuries, the disease became much more prevalent.

TB is especially difficult to control when people are crowded together, since the bacteria can live in exhaled breath and transfer to a healthy individual breathing nearby. Crowded reservations and boarding schools became hotbeds of disease, and by the late 1880s, Native Americans had the highest mortality rates from TB ever recorded–ten times the rate of Europeans during their worst epidemics.

Indian Health Service Nurse Showing X-Ray and Explaining TB Treatment to Members of Navajo Nation, courtesy Library of Congress

Sun Treatment for TB at the Jewish Consumptive Relief Society, late 1800s

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Physical Ailments

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Death of Chopin by Consumption

Tuberculosis (TB) was often known as “consumption” during the Victorian era, and novelists conjured up romantic images of beautiful young women wasting away until they offered a last, gentle breath in the arms of their loved ones and suffered no more. The Bronte siblings (Anne, Emily, Branwell, and perhaps Charlotte) died of TB, as did Eugene O’Neill, Dylan Thomas, Henry David Thoreau, Alexander Graham Bell, and Doc Holliday. There was nothing romantic about dying of TB, though. Symptoms could be subtle at first, with coughing, weight loss, and fever very common. Eventually, TB patients developed pockets and cavities in their lungs that could become infected and filled with pus, or bleed. Breathing became extremely difficult and, without intervention, the disease would eventually prove fatal.

Dr. Hummer wanted a separate cottage for epileptics at the Canton Asylum for Insane Indians, but he really needed to separate TB patients from others. He was faulted as late as 1933 for his staff’s sloppy monitoring of TB and their failure to isolate patients with possible TB from healthy ones. Since a healthy person can catch TB by inhaling bacteria exhaled by an infected person, allowing patients with TB to mingle with healthy patients was a serious matter. Isolating TB patients was such an elementary precaution that Hummer’s failure to do so was inexcusable.

TB Anti Spitting Campaign

TB Sanitorium at Phoenix Indian School circa 1890 to 1910, courtesy National Archives

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Another Pill to Swallow

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William A. Jones, Commissioner of Indian Affairs (1897-1905)

William A. Jones, Commissioner of Indian Affairs (1897-1905)

When Native Americans were forced to live on reservations, their health declined. Poor food quality led to malnutrition and put them at risk for disease and ill health. Two diseases in particular, trachoma and tuberculosis, devastated Indian populations.

Government Doctor Giving Trachoma Examination on Stillwater Indian Reservation

Government Doctor Giving Trachoma Examination on Stillwater Indian Reservation

Trachoma is an easily transmitted virus that infects the eyes, and is usually picked up in childhood. It thrives in congested, unsanitary conditions, which developed when tribes were crowded together and prevented from moving around and relocating camps. Children would be re-infected so often that scars made the eyelids turn inward, causing the eyelashes to scratch the cornea. Victims said the pain nearly drove them wild, “as though cinders were in both eyes.”  Permanent blindness often resulted.

Tuberculosis is a bacterial lung infection that causes  death by suffocation from excess fluid (blood or phlegm) or by respiratory failure. Tissue in the lung is killed by TB and eventually the patient simply cannot absorb enough oxygen. By the mid-1800s, the Navajo death rate was ten times the national average. Prior to 1935, most adult TB patients were left to fend for themselves, while children attending boarding schools were either segregated or institutionalized. In 1904, Commissioner of Indian Affairs, William Jones, ordered all infected children out of the schools. Most returned to their reservations and died a slow death.

Group Picture at the Tuberculosis Sanitorium, Phoenix Indian School circa 1890-1910, courtesy National Archives

Group Picture at the Tuberculosis Sanitorium, Phoenix Indian School circa 1890-1910, courtesy National Archives

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