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11/15/1954 - The Centro Mterno-lnfantil by William H. MacLeish

NOT FOR PUBLICAI ION INSTITUTE OF CURRENT WORLD AFFAIRS Casilla WH Arequia Fer The Centro terno lrfntil Rovember Y Walter S Roers Institute Current World A fairs Fifth Avenue New York New York Dear Rgers Around clock Tuesday morning I arrived office Dr David Salazar Ybar Calle Rivero The doctor inner office I whiled studyi_ga sheaf newspaper clippings I accumulated weeks T B HAT IN APQUIPA RISS ountain woman eninitis strioken child T B FOUND IR OUT IISTIA0S headlines Lima LA PRSNSA iOUSES RoT noSPITS RDD IN ARmUllA OF SEFTE BSR S DEATHS AR CHILDREN FR0 ONE TO miGhT YEARS local CIAS Buied article prominent doctorA fpllewng Dr Jos Bustamante ivoro phrase Twenty thousand children living deplorable conditiuns Tey potential ctims plaues epSdemics The clippings reason being Dr Salazar anteroom I called before asked supply details possible concerning proOlem health Arequia The doctor opened Buenos Como I complain doctor I I No I several hours morning I think better start Dispensary children children their arents there We climbed doctor headed toward hisher altin vitimin pills owdered The Centro Materno lnfantil Dispensario Frimera Infancia white building orkers iospital Calle Peral There around flowe nearby cement steps The smell noise immediatel sweat noise children screamin whimpering An attendant brown uLiform hurried Salazar He pointed woman huddled corner hidden under shawl She uechua attendant She speak castellano Salaza woman speaking uechua The frightened tenseness shifted weight under shawl We passed through waltln crowded women wearin petticoats bright shawls bowler serranas Babies crawled floor suckled their mothers messes benches The bright shawls their moving their faces still The w6men turned lookathe grino notebook expensive camera T grino St lookin Salazar office began tiokin facts figures My friend Centro dispensaries legal social sections childrens section hoseital In addition probably doctor His mornings spent Centro afternoons private office The Centro under ountrol inistry Public Health Lima Salazar Our particular dispensary treat children seven years Without charge course At practice reventive medicine hygiene educatiun Now enough ryint treat these wmany children through daily I asked There three doctors average mornin handles eightychildren We reerettyousy yknow hesaid _lauhin Andreis another Workin average child comes clinic about twelve times durin first usually times intestinal infections nchitis sores other results malnutrition Let fiohas He called nurse asked hertoorintherecordsf thepastthreey The nurse brought stack records notebooks forms Inside completed treatments diseases ranGin pneumonia conjunctivitis Salazar finger columns Look hotel See these sufferin intestinal diseaseS A number enteritis their first If survive years usually A illustration survival fittest Let these charts The harts listed figures outside waitin flesh meningitis sores tuberculosis Bronchial neumonia enteritis T B listed killers Dr Salazar again The Queohua woman empty except uniformed attenda We leafed through fichas looking salaries received fathers these children Jose F worker candle factory eight soles cents other children besides child T B Carlos T carpenter soles The average about soles daily We pushed through barefoot women consulting Here doctor nurse relieved mother looked mouth abdomen reached another child It looked slipshod These people rarely incorrect diagnosis Salazar He patted could munkey hmnan infant Hunger pointed stretched forehead This probably T B friend A large proportion of_the CZ snotherAbou deaths caused We walked through where nurses handing vitimin pills shuffling barefootline Thedocvopenedadoorintherearandbee young woman sitting behind He introduced saying The senorlta qualified social worker It those mothers abandoned their husbands extra money Let Sit interview The social worker called A younG serrana beside Her pigtails waist brown bowler pulled across forehead She nineteen years children sister after Did civil marriage asked social worker The consultin8 The child sufferin sores A church marriase Yes church marriage In Por church marriage valid maria prformed civil official holds water courts The social orker looked Salazar The usual She turned Where husband In Lima Last He keeps writin money And Yes I would breakfasts market San Camille Th social worker address Centre touch quickly possible As I asked Dr Salazar would Well We usuallyman sufficient funds Govern start these people small businesses The elling breakfasts short We turned small corridor doctor I He olnte small where girls preparing black table We thousand rations friend This U S powdered straight States Back centra office another cords A nurse knocked doctor there Jo mothers waiting They padding through ducked their heads direction stools One rinned rubbed caked together Salazar examined There nothing wrong decent wouldn He turned other asked She Aymar doctor The rubber ueohua Turn Funo woman asked children Four Are married Where father chicos I Salazar repeated questions Quechua woman tongue She svered nrsin under shawl Four children lived vJith years She This exception saidt doctor these babies ileitimate He dismissedt women trailed leavin smell sweat The nurse ushered handsome Quechua She scared office medical instruments Her Ith meningitis His crossed lnnbs sprawling The answered doctor eGitimate Dirhs legitimate September Of course nunber unrecorded illegitimate births would boost figure T qusstions never lookinG She I clicked camera She village above Yura railway Juliaca She lookin6 Arequipa unmarried Bere deadly pattern accountedl mortality figures charts unending procession poverty cities above Arequipa We walked doctor BuicE rehashin morning facts figures Ithinkyoushouldseetchildren ssectionoftehospital saidSalazar That serious cases other dispensary Hospital Goyeneche looks church It forty years yellow plaster beginning outer walls We followed LACTANT until small building This children section As walked downt corridor Dr Salazar there doctors handlin dispensaries pital wards We started inspection intestinal diseases T small swinin still their fixed ceiling One bounced their talkin other The jority runninG sores their faces result omnipresent malnu ition Salazar folded blarkets little The child cried quietly The doctor pointed emaciated He pinched abdomen remained puckered folded Very Dr Sal As about leave little about eight years stood rinned friend Ai called Salazar rinned The creases around disappeared She looks pretty healthy I Oh almost The trouble parents never That cmumon occurence Mothers bothered their children legitimate illegitimate We orphanage after while A doctor introduced section He turned Salazar Perhaps senor would trans fusion We preparin pointed small corridor A middleaged woman standin corner viously htened In center cubicle operatin table youn8 policeman unbuttonin tunic talkin nurses Salazar stepped questionin woman mixed oastellano aymara Where Juliaca How Six months youmursed pointed shawl What Se Salazar pointed breasts shawl The woman silent looking perlexed Salazar spoke shoalder She bright pointed table woman placed ahawl She unknotted 0undle began unwrapping The center wrapped shroud On hands filthy woolen gloves Salazar placed shrivelled abdomen whimpered The policeman rolled sleeve undershirt table A nurse removed about blood transferredt syringe swollen child The policeman atched lunser syringe Then tunic The sfusion Transfusions easier States friend We group donors oliceman It takes bring lanced watch We visit T B Tranf usion We walked downt corridor filled small As entered littlo waved smiled The nurses alazar table X light exert horls shads child lungs practically eaten They always effective treatent friend By their mothers clinic retty Asweleft askedtdoctoro aodsther erintn childrens Slr Fifty octors ulation hundred fifty thousand Still bring incident diseases important br0ouht mortality three hundred thousand hundred thousand I arrived bundle paper notebooks sense respect David Salazar The interviewwith Salazarshede extentof diseaseamon children general causes disease I called Dr Jos Bustante Rivero brother President founder former Centre Materno lnfantil respected I three articles Bustamante local paper arguing change unfinishe T B Sanatorium2 WE change which would Sanatorium general hospital When I Bustamante office therefore I asked about articles InthefirstAlac hesaid Arequipaneedshygieniceducationbadly After general hospital equippedto common eases We T B anatorium stuffed latest instru ments performing operations No T B center completed would result increased population creased danger infection incoming patients increased problems He smiled leaned chair serious large You about hospital What facts report Facts which understand reasons disease among children Bueno I finished study thousand families living central Foot families I block block asking these people about living conditions their salaries Because I doctor I nself truth aggerations My first question usually children The answer Eight doctor Ho living The answer I found average number children family Livin children Bustamante umped handed sheaf papers Look The average family lives ether chickens That seven persons average wedged small I nodded rememberin hovels house where babies chickens share floor arbae whole family lieve themselves earlyomornin aainst dobewall What these people I asked Themealsarebarbarous snortedt doctor Scarcelymore thantwo thousand calories person He ruffled through papers Here average meals Breakfast piece bread Lunch bread Dinner small piece Jos Bustamante Rivero President Republic until Revolution I48 ievolucibn Restauradora which placed power bread about I asked knowing doctor large dairy Chili valley until years The Government price around eighty centavos liter impossible I losteightythousandsolesonmyherdbefore ifinallyoridof Now scattered countryside It agricultor whons three I thought women riding their burros chacras packsaddles loaded women selling How families drink doctor I asked About grams person And about fruit Fruitl Fruit expensive orange costs I remembered figures fichas Dr Salazar shown You fruit eight soles Let figure amount money necessary supply average family minimums month docto First breadj soles little cheese vegetables firewood charcoal rocoto That about soles month The usual soles month center T minimum clothing people month would about soles Transportation obrero worker about The doctor chewed pencil added uphest figures Eight hundred twenty soles month family Your average monthly chacras about soles In orker experienced factory Of course every soles month there scores I would average below hundred The doctor tapped pencil paper front There major cause disease money health That under nourished children everywhere children without shoes overcoats That eighty arequxpenos carry intestinal parasites types human I thought myself That fifty S eptembers corpses In order rectif situation Bustamante there either lering prices vital necessities raise wages There housing projects clinic above edutlon I arguing general hospital against T B sanatorium Doctor Bustamante stack books papers One articles aboab foundin organization Centre Materno Infantil This article I wrote Dr Eugene Payne A pepoor cantes popular dishes Per Rocoto enough hands careful about holding Look reading I better picture problem I goodbje walked doctor office The antiseptic The Plaza Armas crovded people their lunch healthy looking people Then I weman corner carrying child hands under armpits I twigs wobbly The facts figures given friends became Tey explained child children dispensary hospital They explained clearly terrible problem Sincerely illiam H cLeish Dr Payne Farke Davis Co translated article describing iraculous results reduced One curing amoebic colitis published Pakistani magazine DICUS July The Camaform Footnote MORTALITY CM DISP PRIRA INF DIAGNOSIS Typhoid paratyphoid T B respiratory system T B other types Infectious diseases General diseases resulting vitimins Heart diseases Circulatory diseases Pneumonia bronchial Diarrhea enteritis Diseases digestive system Diseases urinary system Bronchitis Apendicitis Nephritis eniniitis laria Grippe Measles Scarlet Fever hoopin Cough Diseases system Diseases liver Other diseases piratory system Congenital diseases Violent accidental death Deaths specified Automobile accidents Syphilis Born II DD IN FIRST YEAR III BORN IV GEi ORTALI Y RAT V NimR OF BIRThS AGE OF DECSED General Totals Totals 9i053 24613 251818101 Footnote continucd Statistics Centrp iaterno lnfantil Dispensario Primera Infancia F Total INFT MORTAL T II D IN FST Y III BS D Z4 IV GENE ORTI2Y TE V O BIRT Statistics Centro Materno lnfantil Dispensario Primera Infancia M F Total I INFAiT I0RTALITY II D AD IN FIRST YEu ORN DEAD IV GM i0TLIT RAT V NER OF BIRTHS ZTo GGI0 Eumber deaths caused three common diseases deaths Tuberculosis Pneonia Bronchial Pneumonia Diarrhea enteritls deaths Tuberculosis Fneumonia Bronchial Pneumonia Diarrhea enteritis deaths Tuberculosis Pneumonia Brmachial Pneumonia Diarrhea enteritis Dispensario Primera Infancia S_tati J anua_ry Apri 1994_ Dispensario Primera Infancia I INFANT MORTALITY DINFIT III BOD IV N i0RTIT V ER0FBIRT N F Total S G TE Not rapid increase number stillbirths reo9rded since This attriDuted several doctors increase serrano ulation natural result which standard Footnote The following translation Dr Jos Bustamante Rivero article describing organization Centre aaterno infantil Although itten years Bustamante removed Directorshzp entre afterhis brother deposed article C ntains general truths which still effect today The organization Centre under Dr Salazar under Dr Bustamante Centre aterno nfantll Arequipa The Oentro dependency National Service ternal infantile Protection Ainistry Public Health Scial Ass istance It inaugurated purpose giving medical attention mothers children natives whose opulation A calculatedto around souls Under central authority Centre departments which comprise maternal infantile assistance preventive apeutic social legal fields PreNtAl Service Established order medical attention th0se pregnancy It under ontrol obstetrician nurse assistaut Obstetric Service This service mobile establish those mothers Wio Cannot attended reason maternity hospital Medical attention given equip medicines necessary childbirth recuperation Dental Service Established order attention mothers dr4nHo Other departments Centre service Under dentist laternal Refeotpr This department supplies breakfasts chocolate meant cheese sandwiches undernourished expectant mothers Soon service restaurants which serve lunch Sup breakfasts Bank Here nursing bottles supplied daily charge hundreds children selected departments other doctors proportion dilution required their In Dispensario Primera Infancia medical therapeutic attention giOen Cll years hundreds transfusions performed monthly selected donors drawn purpose Bank Dispensary forider Children Segunda Infanci In differenlokie thisspensarysuples ver7years considered dernourished doctors physical education cialists arious schools Free medic attention supplied necessa medicines The population O0U The restaurants still avaiting completion Footnote continued Foundlins_ hospital_ stablished shelter children years Whose arents durin Hours Break lunch dinner served addition children struction hygiene taught A vluntary committee charge administration service Lesa Ai Seotion This office charge lawyer advises parents matters arising course reatment Centre He arranges settlement pensions reclamations court other related matters Itisinterestingtonotethat4 separationsofhusband wlves caused responsibility poligamy physi cruelty understandin between couples alcoholism sickness As relationship between legal situations avocations involved followin percentages arrived Independent workers Artisans workers Public servants Frmers Private employees vants professional I We influence education standard legal prolems which arise Social Service stablished accolish folloin missions To families those children treated dispen saries clinic economic legal moral problems To endeavor legalize unions TO teach parents Oenefits marriage baptism To suply clothin needy Tu cudinate social community Infantile diseases deaths Arequia their Th diseases commonly found Indians tuberculosis dysentery Amon mestizos hites ricketS dystrophy syphilis diseases order their frequency oomnlc Accordin latest facts T B every Among childrenlesstntwoyearsold arenfeea Andianchildrenare affected frequently A frequent cause death dinrhea enteritis The followin chart mortality Centre thousand children treated Compare these facts those report proper I Footnote continued Diarrhea enteritis ronchial pneumonia T B types Syphil Dystrophy Other diseases The statistics Centre several factors which produce index disease death There strict relationship between sickness standard inadequate housing clothing contribute heavily serious increase disease ioreover women industrial another serious cause infant mortality leave factory child himself Workers Arequipa received salary large enough adequate housing because fiestas religious sickness theworkermisses sixtyworklngdaysoutofthe yearon average An investigation carried Centre revealed folloing facts ofthecases thewageoft workerwasnotfixed ofthevorkers received sufficient salary cover expenses without considering those lodging clothing received sufficient cover necessities family received salary enuUgh cover minimum expenses normal family Areipa needs houses thousand families In investigation families found lived Jo rooms three Only families investigated sufficient number members In thematterofnourishment only20ofthefamiliesinvestigatedcontained calorie person consumed calories daily consuned between calories daily The population Arequipa The production liters daily Of amount liters factory Leohe Gloria subsidiary General Company makin condensed evaporated liters manufacture butter This leaves liters individual consumer The daily consumption persbn Arequipa In Buenos Aires average consumption U S In mother women families usually deficient elements necessary adequate infant nutrition alarmin Workers Sun holidays provided Work The stipend known domiial Footnote continued lnorance contributes equally aforementioned index disease death Behind intentions attempts hygiene sanitation supstition quackery Young girls prepared duties mother Young mothers suffer consequences ignorance prover feding their child result infants receive proper period breast feeding I would reference other factors which contribute heavily disease situation illegitimacy alcoholism We births result illeg itimate unions The mother abandoned father deprived earning power finds herself incapable satisfying minimum necessities child condition physiological resistance victim potential victim classes diseases 0nly9of parents investigated married church state religious marriage andSa civil marriage In cases alcoholismerare among eople moderate education Among Indians alcoholism occasional cessive especially during holidays funerals A large amount alcohol being brought coast sierra contraband The indios prices exchanging cattle liquor The Indianw drinks weakened alcohol indic sierra drink degrees Amon mestizos common drinks chicha fermented rarely stronger alcoholic contentter AmongtB indios another inveterate chewing To Indians cocaia c0mfortaainstafflictionsandsadness andathesame remedy their illnesses lments sierras ba01y owing coca_ habit hence prevalence hepatitis among Indians By suppressing apetit brins malnutrition The organic weakenin caused constant makes obeyer target disease According figures supplied Caja Depsitos Consignaclones 0ffioe Taxation arrobas arroba twenty consmed Department ofPunon years specively The population Department about This gives oularity Indians center Aazs See footnote An excellent brandy tasting little tequilla exico See Footnote continued Customs The aboriginal Per suffered through years consequences habits vJhich their repercussions physical ellbeing Because apathy brought altitude because negli gence preoccupied little personal hygiene The women general little periods pregnable They known birth their household chores In nursing regular schedule control quantity They thsir child sometimes three years proudly calling attention abundancy their In cases mother employ methods artificial lactation rather feetheir babies early These people guided instinct I never Indian babies receiving mixed foods eight months In there breast feeding schedule development indio child above normal rowth curve weight child average mestizo blanco Gen erally speaking children given paghetti bread vegetables cheese fruits before months In Centro aterno lnfantil patients mestizo white predominance mestizo Indian Only those treated Centro blancos AmonE mestixos small businessmen shoemakers masons penters farmers They aided their wives addition their household laundry handmade articles Rare class superstitious lieve spirits santiguadores medicasters chase It supers itiOn augment quency disease death D ustamante concludes article discussion iTojects which would useful rectifying disease situation projects Wiich discussed report proper Received New York