Most of the agencies that leave the problem of diet to the public-health nurse leave to her also the problem of cleanliness, personal hygiene, and sanitation. The majority of the agencies report, however, that their visitors are continually trying to inculcate higher standards. One agency says it is the stock subject of conversation at every visit. No agency reports any attempt to reach the women in a more systematic way than by "preaching." One agency only, that in Topeka, Kansas, reports anything that shows a realization of the peculiar problems of the foreign-born woman in this subject. In Topeka, American methods of laundry are taught to Mexican women in the office of the Associated Charities.
VISITING HOUSEKEEPERS
On the other hand, there are twelve agencies that approach the problem, or at least attempt to approach the problem of household management from a scientific standpoint, so that the work done shall be a serious attempt to adjust the standards of the foreign-born women to the standards formulated by the home economics experts for families "under care." There are several methods used in this work. The first and most common is the employment of visiting housekeepers by the case-work agency; another is that of referring families to another agency especially organized to give instruction in the household arts, such as the Visiting Housekeepers' Association in Detroit; a third is the one used in New York City, that of a Department of Home Economics within the organization, and still another, used in Boston, is a Dietetic Bureau.
The cities in which there are visiting housekeepers in connection with the case-work agency are Chicago, Cleveland, Pittsburgh, Worcester, Fall River, Cambridge, Stamford, and Springfield, Illinois. In Brooklyn the visiting housekeepers are not employed by the case-work agencies, but are student volunteers from Pratt Institute. The visiting housekeeper in Springfield has worked almost exclusively with English-speaking families, and the one in Worcester "has had at different times foreign-speaking families." In other words, in two cities with large foreign-speaking populations the visiting housekeepers only occasionally helped immigrant families to adjust their standards and methods of housekeeping to the new conditions found in this country.
The work that is expected of a visiting housekeeper has been frequently described. As it demands the combined qualifications of a case worker and a skilled worker in home economics, an attempt was made to learn the education and training of the various workers in the field. Information was available in only a few cases, but these cases seem to point to the fact that the visiting housekeeper is usually trained for one phase of her work only—either as a case worker or as a home economics expert. In either case she can be expected to give the type of service her position demands only in the field in which her interest and training lie.
Interviews with the five visiting housekeepers employed by the two largest relief agencies in Chicago in general bear out the impressions obtained from the statements of the agencies in other cities. None of those in Chicago speaks the language of the people with whom she works, though one agency is now training a young Italian girl to be a visiting housekeeper.
Most of the visiting housekeepers claimed very slight knowledge of what the diet of the family was in the old country, although they had considerable knowledge as to what was customarily eaten here. They had made very little study of the habits and tastes of their group; and although they were agreed that in most families the diet was inadequate, they had apparently not looked far for the cause. Ignorance of food values and ways of preparing food seemed to them the chief reason; poverty, racial prejudice, and laziness might be secondary features.
Since the visiting housekeepers deal almost entirely with dependent families under the care of a relief agency, their work in helping the women provide for the clothing needs of the family is quite largely concerned with making over old clothing.
In the effort to raise the standards of cleanliness and sanitation the visiting housekeepers meet with great difficulty. One thinks the greatest difficulty is indifference on the part of the housewife and a lack of anything to which the visitor can appeal; another thinks that her greatest difficulties are that the mothers are usually overworked, that frequently they are kept worn out by having one child after another in close succession, and sometimes a woman has had to contend with a drunken husband. These cases she finds especially difficult to deal with. Some of them lay stress on the economic factor and point to the fact that most of these families are deprived of the conveniences which would make housekeeping a comparatively simple task. As one of the visiting housekeepers has said:
With modern equipment, steam heat, electric utensils, and new and sanitary apartments, it is not a difficult task to keep the quarters fresh and clean, but in rickety, shadowy apartment buildings or houses where the floors are worn and rough, with no hot-water service, and too often without even gas for lighting, we can at once recognize the trials and handicaps which confront the housewife in the poorer districts.[74]