San Francisco Relief Survey; the organization and methods of relief used after the earthquake and fire of April 18, 1906

by Unknown

The services of the army officers were retained to make reports on conditions until the middle of May, when the division into sanitary districts was abandoned and Colonel Torney’s duties were changed so that he might become chief sanitary officer of permanent camps under General Greely, the division commander. An army medical officer was then assigned to each official camp. He was responsible for the sanitation of his camp, but not for territories beyond its boundaries. He could be called upon to advise the civil authorities who were responsible for the final removal of all camp garbage and refuse after it had been taken from the camps designated to places outside camp limits.

The board of health, acting under orders of the Executive Commission, appointed a health corps which was paid by the Finance Committee of Relief and Red Cross Funds and subject to the direction of the camp commander. The personnel of the corps under the board of health in each camp consisted, varying according to the camp population, of one to two surgeons, one to four nurses, a pharmacist, and from two to ten laborers. There were for service at large one surgeon, two dentists, two sanitary inspectors, one pharmacist, six laborers, and two chauffeurs. The total number in the corps was: surgeons, 24; nurses, 26; dentists, 2; laborers, 89; inspectors, 2; pharmacists, 15; chauffeurs, 2.

Taking into account the character of the camp population, a considerable part of which was of the class that does not understand the need of sanitary precautions, the freedom from epidemic during the first few months is remarkable. A report of the medical department of the army shows that 30 cases of typhoid fever occurred in April, 55 in May, and 10 up to June 23, 1906. As the average number of cases per month reported by the city to the state board of health for the two years previous to the fire was only 12, there is apparently an increase of this disease during April and May. The 30 cases which developed in April must have been due to infection previous to April 18, so that unless the statistics of either the army or the city board of health are incorrect, an increase of this disease must have threatened before the fire. Of the 95 cases which developed between April 18 and June 23 only five developed in official camps. Of smallpox there were 123 cases between April 18 and June 23. Five of these were reported by the board of health as camp cases, but none of them originated in official camps under army control.

In October and November, 1906, there was a decided increase in the number of cases of typhoid fever, the bureau of hospitals alone having charge at one time of 155 cases. The patients came from camps, official and unofficial, and from houses. The epidemic, if it can be called such, was found to be carried not by contaminated milk or water but by flies. The sanitation methods of the board of health had not been good enough to protect the refugees in the various camps. The board of health, therefore, not the Department of Camps and Warehouses, was responsible for the number of typhoid fever cases.

The care of the sick was a minor problem of the relief work. The number of persons seriously injured by the fire and earthquake was but 415. Most of the hospitals stood outside the burned section, and though some of them suffered heavy damage by the earthquake, no demand had to be made for hospital facilities that could not be met fairly adequately. Some of the sick were immediately cared for in neighboring communities, and by the army in its hospitals at the Presidio and at Fort Mason, and in a field hospital established in Golden Gate Park.[91] At one time during the summer following the disaster many of the city hospital beds were vacant, even though numerous chronic cases became hospital charges when relatives and friends were no longer financially able to provide for them.

[91] The establishment of a field hospital in Golden Gate Park is a good instance of the great care that was taken to be prepared for whatever emergency might arise.

The physicians and nurses who came immediately after the disaster to San Francisco to offer their services could not be utilized, as the demand for medical and nursing service was not greater than could be supplied by local physicians and nurses. A party of fourteen nurses that came from Seattle soon after the disaster reported for duty at five o’clock one afternoon. “Have you return transportation?” asked the chairman of the committee that received them. “Yes,” was the answer. “Well, there is a train which starts for Seattle tomorrow morning at nine o’clock,” was the laconic order.

In this incident we see the need of a clearing house of information to be established as one of the very first agencies in a large work of relief. It would in this case have prevented the sending of unnecessary nurses and physicians and would have saved expense. More important, however, would have been its service in standardizing the methods of record keeping and in preventing overlapping of work of the various departments.[92]

[92] See [Some Lessons of the Relief Survey], [p. 369] ff.

There was immediate need of medical supplies to replace the stock destroyed by fire. But the sub-committees on drugs and medical supplies and on care of the sick and wounded, appointed by the Citizens’ Committee, could find little to do in those early days after the disaster, as the army practically took charge of the distribution of the medical supplies and was using the California Red Cross as its agent. This branch of the Red Cross not only cared for some of the sick directly, but did much more important work in collecting information as to the needs of the sick and as to the condition of the hospitals throughout the city.