[ Pobierz całość w formacie PDF ]
.Figure 4.11.Distribution of bassinets and layettes to mothers who had attendedpre-natal clinics at the Xochimilco unit, 1937.Courtesy of the RockefellerArchive Center.education.Trainees also learned and applied laboratory methods, assessedsocial conditions, and organized the collection of vital statistics.Graduates wereexpected to direct new sanitary units as comprehensive as the Veracruz unit thatBustamante had founded a decade earlier.Bustamante had a second agenda as well: convincing the medical professionof the value of the training stations.In the Gaceta Médica de México, he arguedthat the training endeavor was highly beneficial to medical personnel and to thecommunity, with both gaining from new access to clinical diagnosis, biologicalproducts, laboratory services, statistical studies of the community s disease con-ditions, and preventive measures.159 Bustamante described Xochimilco s socialconditions as  unfortunately fortuitous, for the  reigning ignorance, poverty,and alcoholism, made the public health training work very interesting.But, heassured his medical audience in terms that would appeal to them,  the biologi-cal and medical sciences together transcend social concerns in the age-old bat-tle against disease and infirmity. 160By 1937 when Bustamante left to work at the new Department of InfantWelfare the Xochimilco station was on solid footing.According to Bailey, theDSP with the backing of the medical profession had become  thoroughlyaroused as to the need for trained personnel. The DSP generated an  explosivedemand for training and constantly requested new training stations and sanitaryg'210 you s ay you want an i ns ti tuti ong'Table 4.2.Graduates of training stations at Cuernavaca (C) and Xochimilco(X), 1932 37C 1932 34 X 1935 X 1936 X & C 1937 TotalHealth officers (physicians) 17 40 30 71 158Public health nurses 15 57 72 11 155Sanitary inspectors 23 9 48 38 118Laboratory technicians 11Medical students 55Total 56 106 150 125 437Sources: Annual Reports for Xochimilco Health Unit, 1935 37, and for Cuernavaca HealthUnit, 1932 34, 1937, RG 5, Series 3, Box 145, RFA.units, especially after Siurob s trip to the United States in 1936 (see table 4.2).161Though the IHD was pleased at the  complete confidence and cooperation ofofficials and the public, it was unhappy about the effects of classroom crowdingon the quality of teaching.The IHD preferred to limit admission to a few well-qualified students to keep class sizes small, while the spirit of the Cárdenas erafavored expanded access to education.162 Crowding was exacerbated by short-term attendance by medical students, military officers, and agriculture and edu-cation workers, in addition to a small number of RF fellows from other LatinAmerican countries.To meet the long waiting list, the training period was cutfrom eight to five weeks; and, Bailey believed, many trainees were sent into thefield with insufficient preparation.163 Over the short term, little could be done,however, because limited RF funding (never exceeding one or two thousanddollars per year in the mid and late 1930s) placed the stations  in the hands ofthe Department. 164 In 1937, the backlog of students necessitated both thereopening of the Cuernavaca station and the separation of training courses intospecialized sections for doctors, nurses, and sanitary inspectors.165The education of nurses was of special concern to both the RF and theCárdenas administration, and, by extension, to the training stations.166 Not longafter the founding of the Xochimilco station, Bailey complained that  not onecapable nurse is available. 167 He attempted to convince the National Universityto raise the educational standards and salaries for nurses and create a newschool of nursing because  The need for trained nurses is equal to, if not greaterthan for health officers. A special class was quickly organized in Xochimilco totrain instructors for rural nurses.Although seven nurses qualified as instructorsand the others became visiting health nurses themselves, Bailey argued thattheir poor training disqualified them from service entirely.Nonetheless, by thefollowing year, the nurses proved to be highly competent instructors.Bailey s concerns were corroborated by one of the RF s nursing experts, MaryTennant, who in 1936 made a survey of Mexico s nursing schools.She found theyou s ay you want an i ns ti tuti on 211level of instruction at the three schools in Mexico City to be extremely low, withvirtually no preclinical training, few enrollment requirements, and little awarenessof the modern nursing curriculum.The schools operated on a hospital appren-ticeship model, overseen by doctors unprepared to teach the principles and prac-tice of nursing.Tennant found only the Red Cross Hospital School to be ofacceptable quality, with students who were  young women of intelligence, refine-ment, education, and [who] have a real interest in learning. 168 The other schoolsand the training station were  of inferior quality. The nurses, she lamented,  arenot superior, in appearance, in dress, in intelligence, in attitude toward work or incomprehension of it.The background of these nurses is so limited in educa-tion and nursing and social standards, 169 that they required months of very basictraining.Tennant also observed home visits and concluded that successful healtheducation required nurses  from a higher social and economic level. 170On the heels of her visit, the RF sent five middle-class nurses on fellowships toToronto.At the University of Toronto School of Nursing, the Mexican nurses,most of whom had trained at Mexico City s Red Cross Hospital, were highlyregarded.In addition to their classroom training, they spent time working withthe city of Toronto s Department of Public Health and interned with theVictorian Order of Nurses.Several of the nurses Carmen Gómez Siegler andBertha Heuer-Ritter then spent a year training at the New York City PublicHealth Department, before returning to careers as public health nurses for theMexico City Health Department.Unlike in Venezuela and Brazil, the RFdecided against supporting a nursing school in Mexico.171 If the training stationscould do little to change the class background of nurses or improve basic nurs-ing education, they were able to set an impressive track record in attractingnurses to public health: by the 1940s, nurses usually comprised the largest groupof students (see table 4.3).After five years of Xochimilco s operation, the IHD and Mexican officials alikewere extremely pleased with the training effort.172 Bailey applauded its accom-plishments, hailing the  spirit of the staff and  good will of the public.173 TheIHD was ready to withdraw its support from both stations but continued to play aminor role so that it could  lend a stabilizing influence. 174 In 1941, theXochimilco training station was moved to the Tacuba district of Mexico City, wherethe country s new Institute of Health and Tropical Diseases was located.Modeledon Johns Hopkins University s Eastern Health District in Baltimore,175 Tacubaoffered training, research, and practical settings for work in infectious and chronicdiseases, nutrition, mental hygiene, and other areas.176 Funded by the Mexicangovernment, the Tacuba station received a three-year grant from the RF to carryout a survey of local nutritional patterns.177 In the mid 1940s even as the IHD waspulling out of Mexico it became involved in four other training stations, financ-ing equipment and salaries high enough to attract  first-rate instructors [ Pobierz caÅ‚ość w formacie PDF ]