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United States. Office of Indian Affairs / Annual report of the Commissioner of Indian Affairs, for the years 1921-1932

Extracts from the annual report of the Secretary of the Interior fiscal year, 1927, relating to the Bureau of Indian affairs,   pp. [unnumbered]-61 PDF (20.9 MB)

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developed during the past decade have made it more difficult each 
year to find capable young people willing to sacrifice their most 
productive years tq 'a service that offers a restricted social life and 
little opportunity for a successful career. 
The turnover of physicians in the Indian field service for the fiscal 
year 1927 was 56 per cent; for nurses, 122 per cent; for teachers, 48 
per cent; while the average turnover for all permanent employees 
in the service was 67 per cent. These figures can not be ignored. 
They are a definite expression of the conditions underlying the so- 
called Indian problem and have their origin in shortage of funds. 
The constant capitulation between necessities and means brings 
despair to those engaged in the work, because the necessities of the 
human element in the Indian Service should dominate. 
The Indian medical and nursing services should be stabilized. 
More and better hospitals are required throughout, but even if the 
hospital plants and equipment were in excellent condition, much of the 
effectiveness of the health work would be lost if thu personnel con- 
tinues to be subject to-constant change. Benefits will not accrue 
unless doctors and nurses have a tenure of office sufficiently long to 
permit them to become familiar with the medical and nursing prob- 
lems peculiar to the Indians and bring about the application of 
professional fitness to them. 
The frequent turnover of personnel in the medical and nursing 
services has been due to low salaries, poor living conditions, isolation,
and long hours of labor. Four years ago the entrance pay for agency 
and school physicians was $1,200, which has since been increased to 
$2,400 gross and $2,100 net after deducting allowances for quarters, 
heat, and light. This salary is still lower than in other branches of 
the Government engaged in health work, and promotions are slower 
than in the other services. 
The entrance pay for trained nurses is $1,680 gross, with $1,500 
net after deducting the allowances mentioned.     Other Federal 
services pay $1,680 gross for staff nurses, $1,860 for head nurses, and 
$2,100 for chief nurses. All the positions in the Indian Service, ex- 
cept one of head nurse, are in the lowest grade, thus affording prac- 
tically no chance for advancement. 
Quarters in the Indian medical service vary from a comfortable 
cottage fairly well furnished, to one room without reasonable facili- 
ties for bath and toilet. Frequently these quarters are inadequate 
for a physician with a family, and at some places even for a physician 
without family. At one station the physician lives in a three-room 
adobe house without conveniences and with the necessity of convey- 
ing water for domestic purposes a distance of 2 miles. Quarters in 
other medical branches of the Government are comfortable and 
adequate by comparison, with modern bath and toilet facilities. 

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