Fighting for Life

by S. Josephine Baker

  At first we concentrated our efforts on cajoling mothers into coming to buy bargain milk from us and learning how to modify it for the baby’s uses. They were not very keen on the idea; we could not have induced them to buy the milk from us without that three-cent difference in price. But, as soon as a few mothers began to see the difference in their babies, they were only too glad to come to our stations. They say it takes word-of-mouth advertising to make a hit of a play or a movie—that is just as true of any public welfare project. Mrs. Slivowitz told the woman across the air-shaft who passed it on to the janitor’s wife and so it went up and down the block like a contagious disease. Presently our hard-working staff of nurses had to stop their canvassing of suspicious tenement mothers because the stations were swamped. It was a beautiful case of snowballing: during my latter years in office we were caring for 60,000 babies a year. And they flourished like so many green bay trees.

  By the time we began developing the Little Mothers’ League idea, we knew enough to start the work in terms of prevention without waste motion. The fundamental idea of this development came to me in 1910 when I read a book by John Spargo called “The Bitter Cry of the Children,” all about the “little mother” and what a menace she was to society as a fertile source of infant mortality. The “little mother” is the girl child of the poor, forced by poverty to take over the care of the next-youngest child because her mother is struggling to hold down the job that feeds the whole family. I understand that the little-mother system works out very well in the remoter islands of the Samoan group—is, in fact, the basis of the whole Samoan tradition of child care. But Orchard Street in New York City is not Samoa and the hygienic emergencies of bringing up a child in an east side gutter are not the same as those in a culture composed of clean sea-water and palmgroves.

  No one had to tell me about the little mother of the New York slum. I had seen her much too often myself—a scrawny child of eight or nine, dirty and dishevelled, lugging a dirtier and more dishevelled baby which alternated between peevish wailing and sucking at something anonymous, crying all the louder when the little mother slapped it in understandable childish impatience with the nagging noise. But I could not dodge the issue by merely agreeing with Mr. Spargo’s point that there should be no such thing as a little mother, innocently and ignorantly killing her thousands of children a year. That was not our slant on things. We could not afford the luxury of saying things should or should not be. We had to work realistically with the raw materials and situations at hand. Since thousands of poor families were in an economic situation which made the little mother necessary, we had to turn her into something that suited our purpose.

  Public school was the obvious point of contact. These girl-children, prematurely saddled with maternal responsibilities, were mostly of school age and the truant-officer made certain that they were in the schoolroom. If the schools would install classes in practical child-hygiene— for whether little mothers or not, most of these girls would eventually become mothers in their own right—our problem would be solved. But the educational authorities did not even bother to laugh at me when I made the suggestion. Reading, writing, arithmetic, manual training, gymnastics—but not child care, that process through which everybody goes and which all women should know as they know how to dress themselves. It was many years later that, in view of the success of our Little Mothers’ Leagues in New York, Chicago installed public school courses in child care which made Little Mothers’ Leagues happily pointless.

  When I got my thick-headed refusal from the New York educational authorities, I went directly to Miss Margaret Knox, the principal of Public School 15, with far more enterprise and imagination than her superiors, and had no difficulty at all in getting her to sponsor the first Little Mothers’ League in her school. Whether the Board of Education had endorsed the idea or not, school after school fell into line and in no time, just to simplify my task of pioneering in child welfare at the same time that I was running a flourishing private medical practice, I had a flock of Little Mothers’ Leagues to care for, though my staff shouldered most of the burden.

  Children are natural “joiners.” If there is nothing else to join, they will form mystic secret societies of their own or street-corner gangs. Added to that is the girl-child’s irrepressible impulse to play mother—with a doll—if she is fortunate, with a live baby if economic handicaps require it. It was a revelation of the fundamental strength of the mothering instinct that having to look after their younger brothers and sisters had not spoiled these little mothers’ eagerness to learn child care as a fascinating game. A Little Mother, with her unwearying desire to make the world more habitable for babies attested by her gold-washed badge of honor awarded as recognition of constant attendance at meetings, had in no time at all become as cheering an object as it has ever been my lot to witness.

  Once the Leagues were started, in simple groups taking practical instruction from nurses in baby feeding, baby exercising, baby dressing and the other parts of baby care, they branched out in directions no one had thought of. These youngsters were among our most efficient missionaries, canvassing tenements for us, cajoling mothers of their acquaintance into giving the baby health stations a trial, checking up on mothers who had backslid in attendance at the stations, telling every mother they met all about what they were learning. They organized fresh-air outings for their own mothers and babies, proudly taking all responsibility for both during a whole day in the country or a trip down the harbor on the St. John’s Guild boat. For the benefit of groups of mothers, they wrote and acted wonderful plays, half mediaeval mystery-play and half vaudeville skit. The favorite plot introduced a crying baby, screaming its head off, and a harassed mother who has no notion whatever of what to do about it. Enter several neighbors, some sympathetically distressed about the mother’s troubles, some furious because the baby is keeping them awake, all making a terrific hubbub with unintelligent suggestions. Just when you are wondering why somebody does not turn in a police riot-call, enter a Little Mother who sizes up the situation at a glance and settles everything by inspecting the baby and removing an open safety pin which has caused all the disturbance. Then, of course, she delivers a practical demonstration of just what to do with babies under any and all conceivable circumstances, and the play closes, with the Little Mothers in the cast bursting with pride in their own superior knowledge and the mothers in the audience vividly impressed with new ideas about fresh air and soap and water.

  “Hear Not the Advice of a Neighbor; or How Babies Die” was the tragic title of one of these propaganda playlets of our Little Mothers. And here is the complete text of a short playlet for the curious in such matters—not a triumph of dramaturgy but certainly very much to the point:

  MOTHER : Baby wants something to eat.

  CHILD : What?

  MOTHER : I guess a piece of pineapple.

  CHILD : Mother, what! Pineapple for a baby?

  MOTHER : What’s the matter?

  CHILD : You do not mean pineapple for a baby, do you?

  MOTHER : Yes, I think baby will like a piece very much.

  CHILD : No matter if the baby will like it or not it is not healthy for babies.

  MOTHER : Who told you that?

  CHILD : I belong to the Little Mothers’ League. They teach us how babies ought to be kept.

  MOTHER : You did not tell me that. I would have stopped giving it to the baby a long time ago.

  CHILD : I’ll tell you what they taught me: how to clean bottles, how to make barley water, and how the babies ought to be taken care of during the summer. You see, mamma, that the doctor in our school is very kind to take a part of the Saturday to teach that to us.

  MOTHER : Baby seems to be getting fatter and better every day since I stopped giving it fruit and the things you told me were not good for the baby.

  CHILD : You see that our club is of good use.

  MOTHER : Thanks ought to be given to the doctor of your school.

  And on another oc
casion when we asked the Little Mothers each to draw up her list of twelve “don’ts” for mothers of young children we found some startling prohibitions among the number: “Don’t give the baby herring”; “Don’t give the baby beer to drink”; “Don’t leave the baby run in the mud-gutter”; “Don’t let the baby eat dirty things from the floor that she threw down at first; also pickle”; “Don’t scream on the baby”; “Don’t try to awaken its intelligence and make it laugh”; “Don’t leave the baby alone in the carriage and play with your friends” (aimed straight at Little Mothers as well as fashionable nursemaids); “Don’t give the baby sour cucumbers”; and, as a lurid touch which probably recalls some harrowing experience of the family next door: “Don’t leave the baby sit on the stove”; and, for finale, “Don’t mind your house —mind your children.” Weird as they are, there is a healthy realism and a solid sense of tenement conditions about these terse bits of advice which still assures me that we trained our Little Mothers pretty well and that they had a lot of common sense of their own to start with.

  Naturally we encountered opposition to our Little Mothers’ Leagues. There is always opposition to anything worth doing. The ignorant and the malicious—it often amounts to the same thing—protested that we were making premature slaves of these children so that their mothers could slide out of their responsibilities and go off to the movies or get drunk. But gradually we induced most people to see that, since the little mother was an inevitable makeshift, she would be far less dangerous to her charges if she were intelligently trained. When letters began to pour in on us from everywhere, not only from this country, Europe and South America, but from India, China, Turkey and Japan, asking us how to start similar movements, we knew that our justification was complete. You seldom cause international sensations with schemes that are fundamentally unsound.

  There was a great deal of discouragement involved in this process of getting the politicians, the public, the whole body of mothers and the medical profession to take up a new idea and carry it out with intelligence and efficiency. I think that, of the whole list, the medical profession made the least intelligent difficulties. As an M.D. in good standing, a veteran of years of private practice and a member of several first class medical societies, I can say that without any suspicion of speaking out of turn. I have a tremendous respect for my profession as a whole and for thousands of its individual members with whom I have worked and to whom I have gone with my own physical ailments. But any large body of people grouped by common interests will never behave with a tenth the intelligence that its individual members will show in their daily lives. That is true of nations, street-corner gangs, prayer-meetings—and large groups of doctors.

  I have already described two or three occasions when my colleagues insisted on getting in our way for what seemed to us the worst of all possible bad reasons. But I never saw the short-sighted psychology of a certain type of doctor, when confronted with public health work, better brought out than by a representative of a New England medical society testifying before a Congressional committee which was considering the appropriation of funds for the newly founded Federal Children’s Bureau. I was down there testifying too—on the other side. This New England doctor actually got up and told the committee: “We oppose this bill because, if you are going to save the lives of all these women and children at public expense, what inducement will there be for young men to study medicine?” Senator Sheppard, the chairman, stiffened and leaned forward: “Perhaps I didn’t understand you correctly,” he said; “You surely don’t mean that you want women and children to die unnecessarily or live in constant danger of sickness so there will be something for young doctors to do?” “Why not?” said the New England doctor, who did at least have the courage to admit the issue; “That’s the will of God, isn’t it?”

  Those Congressional hearings were usually productive of something worth remembering. I was always going down to testify at hearings on Children’s Bureau appropriations because Miss Julia Lathrop, the Bureau’s brilliant first chief, thought I was a good ally. I was called Doctor instead of Miss and so could escape from the eternal remark always coming up among Congressmen about giving money to an old-maid to spend. I remember one occasion when the pending bill about funds for child welfare, for some reason which I could only conclude was a bad pun that somebody had taken seriously, had been referred to the House Committee on Labor. It was a hundred and ten in the shade, a fine, bracing summer morning in Washington and, to spare the committee, I suggested that they should ask me questions instead of letting me make a speech that would probably smother us all with boredom. As it was we nearly all went to sleep anyway—that is the only way I can account for the fact that when, in answer to a question, I said that there were six maternity deaths for every thousand labors, a Congressman spoke up angrily. “Now come, come, doctor,” he said, “we’re not going to bring labor into this. There’s too much talk about the laboring-man anyway.”

  Nevertheless it was not impossible to get a certain stimulation out of stupid opposition, whether political or professional. Charts and statistics gave the Bureau staff encouragement inside the office as things started working. But the city at large did not comprehend what we were after for quite a while and that tended to make us feel pretty blue at times. I remember how I felt when, after we had our baby health stations established and doing well in the Brownsville section of Brooklyn, a petition was forwarded to my desk from the Mayor’s office, signed by thirty-odd Brooklyn doctors, protesting bitterly against the Bureau of Child Hygiene because it was ruining medical practice by its results in keeping babies well, and demanding that it be abolished in the interests of the medical profession. I was feeling pretty low that day—something urgent had gone wrong and I had been wondering if all this trouble we were going to was just so much waste motion. That petition cheered me up like a cocktail. I reached for a pen and endorsed it in great big letters:

  “This is the first genuine compliment I have received since the Bureau was established. I am profoundly grateful for having had an opportunity to see it,”—and sent it back to the Mayor’s office in a hurry.

  I never heard of it again. But it had had its tonic effect. The only thing that would have done better would have been a similar protest from an undertakers’ association.

  The work itself occasionally suffered from the blundering of doctors to whom it had never occurred that, if you went about things with insufficient preparation, you were likely to provoke riots among parents and children who would have been amiable enough if intelligently handled. In our tonsil-and-adenoid riot, for instance, I found myself in accord with the rioters. That was the culmination of several years of trying to make operable tonsil-and-adenoid cases in the public schools fit into our limited facilities for taking care of them. Hospital clinics were being swamped with cases referred by school medical inspectors, and postoperative treatment was out of the question; time and again I was called up in the middle of the night to reassure a frightened nurse about another case of post-operative septic sore throat or haemorrhage. It was not my line— I was a pediatrician, not a nose-and-throat specialist—but anyone working with a Bureau of Child Hygiene has to know a good deal about everything that can go wrong with human beings, except possibly senile dementia.

  Since the clinics were so overworked, a brilliant staff member in a big hospital suggested that the doctors would do far better to go around and perform tonsil-and-adenoid operations en masse in the schools themselves instead of cluttering up the clinics. The Bureau knew nothing about this decision. I first heard of it when I got a ’phone call that there was serious trouble at one of the public schools on the lower east side and went down to investigate. The school yard was clogged with a mob of six or seven hundred Jewish and Italian mothers wailing and screaming in a fine frenzy and apparently just on the point of storming the doors and wrecking the place. Every few minutes their hysteria would be whipped higher by the sight of a child ejected from the premises bleeding from mouth
and nose and screaming with sheer panic. In view of what I saw when I had fought my way inside, I would not have blamed the mothers if they had burned the place down. For the doctors had coolly descended on the school, taken possession, lined the children up, marched them past, taken one look down each child’s throat, and then two strong arms seized and held the child while the doctor used his instruments to reach down into the throat and rip out whatever came nearest to hand, leaving the boy or girl frightened out of a year’s growth and bleeding savagely. No attempt at psychological preparation, no explanation to the child or warning to the parents. In ten seconds I was in the middle of it, shouting that it must stop at once. When that point was carried, and it required a good deal of pointed language to carry it, I turned to pacifying the mob of mothers and getting them to go home. It was an outrage—as cruel and as stupid as an initiation ceremony in an African tribe. You would have thought these children were so many fox-terriers having their ears and tails clipped, and that does not mean I approve of clipping them either.