Working with Men Outside the Camps.

Director, Section on Men's Work, Social Hygiene Division, Commission on Training Camp Activities

    In the Draft Act of May 18, 1917, two sections were inserted numbered 12 and 13, which authorized the Secretary of War, and subsequently the Secretary of the Navy, to do everything deemed necessary to prohibit the sale or consumption of liquor and the practising of prostitution within the confines of army camps and navy stations, and within a definite zone around them.

    By combining military discipline and strict policing with the conviction that these soldiers,—men in uniform,—are like all other human beings subject to ennui and to loneliness, remarkable results have been attained. The liquor vendor and the loose woman are barred, and in their place, playgrounds, smileage theatres, libraries, hostess-houses and the recreational huts of the Young Men's Christian Association, the Young Men's Hebrew Association, and the Knights of Columbus substituted. Song leaders, athletic directors, musicians and professors all vie with each other in supplying the demands of the men, both serious and frivolous, in whatever field they are made. One rather amusing result is the receipt by commanding officers of letters from indignant wives, sisters and sweethearts asking "Why doesn't Johnny come home when he

(195) can?" The reason is simple, Johnny is having too good a time; he's working enough and playing enough and does not want to go back.

    Whether the making of our camps into "hard military schools with a country club on the side," has decreased the ability of our men to actually fight, is being answered on the historic battle fields of the Marne now. A comparison of the American army's venereal disease rate with that of any other army, past or present, makes clear what the government's combined policy of education, treatment and punishment is resulting in. The American Expeditionary Force, with the lowest rate ever known in history, is the answer.

    In actual service "over there" these facilities take care of practically all the soldier's time not spent at his "work." In this country, however, a different problem must also be met. No matter how good a time "Johnny" is having, and notwithstanding every effort which can possibly be made to keep him satisfied in the camps, a time comes when he must get away, see the sights, and forget the military side of life for a few hours. A new phase, and one of direct interest to civilians, is thus developed.

    When a soldier is granted a furlough, when he has shown his pass to the guard at the gate, and is out,—free for a time from the enforced and arduous grind which military training is even at best, the holiday spirit is in him; he is "out for a good time." The sort of good time he has is going to depend on two things: his background, moral, mental and physical; and upon what is offered by the community he visits.

    It is one of the great failures of society, past and present, that, on the subjects of rational sex hygiene, prostitution, and venereal disease, the very great majority of young men have no background whatsoever, excepting one supplied by the streets and by obscene stories. Following out the same line of reasoning pursued in the camp amusements, i.e., recognizing that the men are after all men, it is at once evident that intelligent co÷peratÝon cannot be expected from them, unless they are given intelligent reasons for it. In other words, since the army and navy cannot and will not tolerate conditions such as have existed in civilian communities for generations, it was up to the government to supply this background not given by their civil life.

    Accordingly, a particular section of the Social Hygiene Divi-

(196) -sion, Commissions on Training Camp Activities, was constituted to do this work in the training camps; to educate these boys and men on the vital subjects of reproduction, sex hygiene, venereal diseases, etc., in the teaching of which their own parents and home communities have been so woefully negligent. As a result it can now be truthfully said that there is no man in the army or navy for any length of time who does not have a background of some kind; does not know what the venereal diseases are and the essential facts about their transmission.

    Notwithstanding what they know, freedom and relaxation are very tempting after the grind of the camp. Men on leave want company very naturally: a street corner with nothing to do near it is at its best not very amusing. They want companionship and particularly personal attention. They are very prone to take it in whatever form it is offered. In other words, a soldier or sailor will almost always take a town as he finds it. The responsibility of civilian communities becomes at once clear; a responsibility vitally affecting the health, discipline and morale of our troops.


    In the typical case, a man is beyond ordinary military control when he passes the cantonment line on furlough. Civilian authority and usage takes its place. Therefore it is an essential desire of the government that the maximum of cooperation exist between contiguous military and civilian zones. In fact the whole government scheme for combating venereal disease demands efficient cooperation on the part of civilians, if it is not to be to a considerable extent nullified.

    That civilians and communities would offer this cooperation to the fullest possible extent when they understood the real facts was not doubted. But how were the several score million civilians in this country to be reached; to be aroused and awakened into action? To be sure, the in many ways remarkable spirit of cooperation which has pervaded the whole nation since the war began, the general recognition of certain basic conditions affecting us all without exception, and the much more tolerant attitude of the general public, promised much.

    But this was not sufficient. The questions " Do communities really realize their grave responsibility? Are they aware that the

(197) health and morals of their soldier and sailor visitors are in their care? Are they making themselves worthy of this trust, of the government's faith in and dependence on their ability and willingness to cope with this vital problem?"—these questions were still pertinent. In fact, many cases at first seemed to indicate a decided "no," as the answer. Old customs, out-of-date regulations and habits of mind prevented .the thinking people of communities from grasping the true significance either of the government's far-sighted and history-making stand, or of their vital part in backing it up. For so many generations have all things pertaining to sex, reproduction, prostitution, venereal disease, etc., been considered "dirty," —not fit to be touched publicly by the best men and women in our country,—that even the shock of this war seemed unable to break through the barrier. And this has happened despite the years of hard and thankless work which such organizations as the American Social Hygiene Association have been doing, which has laid a foundation of the greatest assistance to the government, but has not markedly affected the attitude of the general public.

    The degree of success the government's program was to attain, however, directly depended upon the co÷peration supplied by civilian communities, particularly those within a reasonable distance from cantonments. By "reasonable distance" it must be understood is meant not ten or fifteen miles, but seventy-five to one hundred miles or more. The railroad and the " jitney" have made it possible for men to travel such distances with less time and trouble than it took the Civil War fighter to go ten miles.

    In other words, to assure the maximum of success to its work, the government must reach every community of any size within a fifty or hundred mile radius of every camp and cantonment in this country. To all intents and purposes, this meant reaching the whole country, and at the earliest moment possible. A committee was therefore organized, first as a sub-committee of the Committee for Civilian Co÷peratÝon in Combating Venereal Diseases, of the Council of National Defense; and later, to make the work even more effective, taken into the Commissions on Training Camp Activities as the Section on Men's Work of the Social Hygiene Division, whose duty it was to get this subject before communities and thus secure their active, intelligent co÷peration.

    How to do this was the question. The people to be reached

(198) would not read the " copy," even if papers did print it, which was and still is extremely questionable. Only one way seemed open, namely that of writing carefully prepared letters with accompanying material to the leading citizens in communities, and through their interest thus aroused, reaching the necessary officials and the general public. The enormity of this task may be imagined when the size of the country, the number of towns and villages it contains, are considered. No other way existed, however: so early in the summer of 1917 this work was begun. Lists were laboriously collected, suitable material gradually assembled, and letters written.

    Particularly at a time like the present, citizens of prominence are deluged with appeals of all sorts and kinds. Very naturally the majority of these find their way to 'the wastebasket. Unless the busy man or woman is "sold," to employ the familiar advertising phrase, in the first few lines, it is almost certain that he will not reply. Especially is this applicable to any discussion of such a subject as venereal disease, which to the ordinary citizen, is unrefined, and therefore for others to look after. It is only with the greatest of effort and skill that the ignorance and apathy of the typical American is overcome; that he is aroused to work. Almost invariably he goes on the easily arrived at, but never investigated conclusion that his town is no worse than any other, in fact a little better, and that his mayor and officials are "honorable men with families," who will never tolerate anything which should not be. He knows in a more or less vague way that his city has laws of some kind dealing with prostitution, so, of course, "they must be adequate and enforced."

    The question, why not depend on the mayors and law enforcing officials is very natural, and just as easy to answer. Regrettable as it may be, it cannot be gainsaid that a considerable number of duly elected civic officials are entirely unfitted to fill the positions they hold. Whether this is from ignorance, corruption or what not, is of no importance. The fact remains. No way existed for "getting a line" on these men, for gauging their sincerity. A civic official is almost invariably responsive to the wishes of the majority of his constituents, as he understands those wishes. It follows that if through correspondence and other means the government could awaken the influential citizens of any community the mayor would fall in with them and institute the proper "clean-up."

(199) Of course, all officials are not of this type by any means: many of them have stood for enlightened ideas in dealing with prostitution and the other phases of the venereal disease problem. Their help could be counted on in any event.

    Because of all these factors, the scheme above outlined was adopted. To date, many tens of thousands of letters have been written and several thousand active and interested correspondents from all quarters of the United States obtained. When aroused to the enormity and seriousness of this problem, the citizen's first query is " What can I do?" The answer was contained in a notable four-page leaflet called "Suggestions for a Citizens' Program for Combating Prostitution and Venereal Diseases." This leaflet is, as its title indicates, only a "suggestion." The personnel of a satisfactory committee of citizens, so far as professions go, is outlined; also the following divisions under which its work naturally falls: law enforcement, control of venereal diseases (medical), public education, protective work for girls, recreation work.

    Next, this leaflet mentions those local agencies whose help is indispensable, namely, the chief of police, the city health officer, the school board, the mayor, the leading citizens, and lastly, it gives some concise, definite information, of general educational value on venereal diseases. With such an outline to follow, citizen committees have organized successfully and begun work on the problem of cleaning up their own communities,—wherever possible with the mayor's assistance, but if necessary in spite of him.

    It is not even pretended that final solutions, or 100 per cent efficient results have been attained. But that the whole disgraceful problem is known to many, many thousands of citizens who never heard of it before, and that the general moral tone of many cities has been raised, and their citizens made receptive to further work, is beyond a doubt true. Such committees of citizens act both as spurs to the local officials, and as assistants to the government law-enforcement representatives, now working with ever increasing effectiveness throughout the country. They also form live points of contact with the general public for the spreading of further information on the whole subject. Through their reports, supplementing those of the government field men, it is possible to keep in close touch with those conditions which surround the soldier on leave, so that where necessary, action can be demanded from the

(200) mayor, under threat of federal interference. In these and other ways they are doing their bit, not only to safeguard the man in uniform, but also the citizen of today,—the soldier of tomorrow, whose health is and should be safeguarded.


    Perhaps the greatest value of these committees, however, lies in their possibilities as a medium of education. Under the stress of the present, the government is able to deal with facts and figures relative to venereal conditions in a frank and open way never before possible. It is doing this, and these thousands of correspondents, members of citizens' committees or only individuals, are being educated to a new attitude, a new point of view. They are thus realizing gradually the true significance of the government's stand, and how it both depends upon them and effects them.

    This one phase, coupled with the exemplary and, in many cases, uniform state laws which have passed under federal guidance or suggestion, is certainly one of the wonders worked by the Great War and which makes the present perhaps the most noteworthy era in the whole story of these age-old plagues of man. A new page in their history has been opened; one bright with possibilities for the welfare of humanity. In a way never so clearly marked before, it has been brought home to all the nations now participating in the great struggle that army really means nation; that the "behind the lines" work is just as vital as the actual battle-line fighting. It has been made equally clear that effective man power is one of the most vital factors in the successful prosecution of the war. The side with the preponderance of effectives, other things being equal, assumes the offensive,—which is synonymous with ultimate success.

    Very naturally, therefore, after the more pressing case of the health and effectiveness of men in uniform had been considered, and machinery started, the question of the efficiency of the man behind the gun arose. The draft had shown a tremendous venereal rate in our civilian young men. Of the more than 80,000 cases of venereal disease treated by the army to date, the large majority have been brought in from civil life. To the question, did this condition affect our industrial efficiency, there could be only one answer—it must.


    In the army, the scheme of combining education with treatment and punishment has given the remarkable results above noted. Suitably modified, and with the punishment clause left out, of course, this same general idea was utilized in the preparation of an ôIndustrial Program," through which the great mass of workers, the industrial back-bone of the country, could be reached. The plan of the program is simple. Employers of any considerable number of men are written to, a complete summary of the program being included in the letter, the intention being not only to put the facts of the case before him, but also the remedial measures proposed by the government.

These measures are : —

1. Distribution of literature, posting of bulletins, placards, etc.

2. Confidential interviews between employes and superintendent, foreman or other individual entrusted with the execution of the plan.

3. Examination by competent doctors of all employes who have or think they have a venereal disease.

4. Investigation of health conditions in the families of infected married men, and provision for care of wives and children.

5. Disposition of cases for treatment either by individual physicians specially engaged, or at a hospital clinic, or plant clinic.

6. Provision of leave of absence with pay for employes who are in the infectious stages of a venereal disease, with the requirement that they report daily to the superintendent or foreman.

7. A certificate of each treatment signed by the treating physician should be required of every patient.

    One of the great errors hitherto made in work on this subject, has been in the type of literature prepared. Unless particularly interested, the typical individual is only going to read such material as is printed in his own vernacular. Almost without exception, social hygiene subjects have been treated, up to the present, in an exceptionally "highbrow" manner, which was all right for the student, but completely above the ordinary worker. This literature was written, therefore, in the language of the everyday man. The placards and booklets are accurate and true, not at all involved, and have as a result proven immensely popular. In putting this plan into effect, the following sequence is the correct one:

    On the day a pamphlet called " Your Job and Your Future" (of which in four weeks over 120,000 have already been ordered) is given out, and placards headed "Beware!" posted in all places where the men gather, a notice is put up for all employes to read,

(202) which states that "at the request of the War Department, the —— Manufacturing Company, is helping in the campaign against venereal diseases, gonorrhea and syphilis," and which particularly emphasizes the need for co÷peration of the workers, the plant, and the government. This notice serves to center the attention of all employes on the material which is given them, and stimulates interest. The booklets are then given out to each employe, placards posted and, as is invariably the case, the numerous cases uncovered given accurate information in the shape of circulars included in the plan, and either given the proper care by the plant doctor or referred to a place where it can be obtained. Follow-up material is also provided in the shape of pay-envelope enclosures, which being distributed now and then, keep the whole problem alive.

    The question of medical treatment is a very vital one, and one which changes with each locality or situation. That some sort of adequate medical attention is necessary, goes without saying. The government's material is very emphatic in its warning against "quacks" and their ilk, but so long as something better is not provided, they are bound to continue under one guise or another. The obvious answer is a clinic, properly equipped. The vital need of some such provision in the application of this scheme is time and again emphasized. Depending upon the size, it can be operated by the single plant alone, or in conjunction with other ones in the same locality. Or, if any state, municipal or private clinic is already in existence, arrangements can be made with it to care for the plant cases. The main feature is that some provision should be made, the details being left to subsequent correspondence.

    In the development of this feature, the cooperation of every local and state board of health is being sought. Already, such representative ones as the State Boards of Massachusetts and Minnesota have recognized the opportunity for co÷rdinating and making more effective their work, and have organized to assist the employers of their respective states. Thus, the beginning of a new alliance against these enemies of mankind is made; an alliance which should go a long way towards guaranteeing a permanent, effective national campaign. Perhaps the whole program is best described by a quotation from a leading industrial publication, as "a plan, unquestionably . . . . in the forefront of any similar effort for the essential upbuilding of the health of labor."


    Notwithstanding all these movements and in spite of interested citizens and officials everywhere, the public generally was largely ignorant of what was going on. There has seldom been anything more romantic than the cool way this country has overturned tradition, "rolled up its sleeves," and faced the whole disgraceful problem of venereal diseases. Stories of the first magnitude could be written about it, but they are not. Why? Because unless so veiled and beclouded as to become largely meaningless they would not be printed.

    In American industries it is the custom frequently to publish a "House Organ," a little trade booklet going to employes and customers, often with an enormous circulation. An appeal has recently been made to them. Would they publish a prepared story, at the request of the War Department, dealing with the Venereal Disease Campaign?

    An emphatic affirmative was the almost unanimous reply and in two months about one hundred fifty of these little magazines have printed the story called " V. D., The Enemy at Home," the history of the government's program against venereal diseases, in story form. No terms were camouflaged, yet almost without exception it was printed verbatim. It has already attained a circulation, by this means, of over 1,500,000, and is still mounting.

    If this has shown nothing else, the fact is clear that where editors are not afraid of offending their advertisers, they will gladly print this sort of material. The response being generally awakened (by this story) from the public also makes plain that today people want information; that the time is rapidly approaching when the veil of prudery which has hidden the seriousness of this problem from the sight of even broad-minded, sensible people, will be gone.

    Nothing final has been attained in this civilian work, nor was it expected. The general bases of a program of common sense, conservation, efficiency and prevention have been laid, chiefly through the agency of the present emergency, and on them will be built the constructive work of the future. In this there is a part for every agency from the federal government to the individual. In direct proportion to the cooperation of these many factors will be the rapidity with which success is attained.


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