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school clinics, tuberculosis dispensaries, maternity and child welfare centres, and venereal disease clinics will have to be determined. The family doctor must be linked up with the consulting surgeons and physicians, and the hospitals, convalescent homes, midwives, district nurses and mothers' helps, so that his patients may have the benefits of these services in time of need. More lying-in hospitals, more children's hospitals, and open-air schools are required. Especially do we need more hospitals for crippled children on the lines of Lord Mayor Treloar's Hospital at Alton. Besides this, arrangements must be made for dentists to look after the teeth of the children. This has been done to some extent with regard to the children of school age by school clinics, and the system will have to be extended. The Poor Law medical service will obviously become involved in the changes which take place.
Another matter urgently requiring attention is the reform of hospital out-patient departments. These are at present swamped by cases which ought never to be sent there. Mothers who take their children to out-patient departments are frequently required to spend the whole day in the waiting-room, to the great detriment of their homes. Outpatient departments ought to be restricted to accidents, cases requiring special treatment, and those cases which are sent by a general practitioner for a consultant's opinion.
The Maternity and Child Welfare Centre is the institution which chiefly affects babies and young children, and it will be right to say a few words on this matter. County Councils and sanitary authorities are now required to establish maternity and child welfare centres, and the representatives of the citizens must see that these are as efficient as possible. There should be provided advice and hospital treatment if required for expectant mothers; medical attendance under certain circumstances and hospital treatment, if required, during confinement; and advice and hospital treatment, if required, for both mother and baby after confinement, the advice to be continued, in the case of the baby, up to the school entrance age. As regards hospital treatment, I believe the usual way is for the sanitary authority which establishes the centre to make arrangements with the existing hospitals, but some sanitary authorities may find it advisable to establish lying-in hospitals and infant hospitals.
At present we have medical supervision of children from birth up to the age at which they leave school, but no provision has been made for the gap between leaving school and the age of 16 when those who
go to work come under the scheme of the Insurance Act. In many districts there are voluntary societies working in the interests of mothers and children, and it is very necessary that these voluntary workers should be linked up with the work of the Maternity and Child Welfare Centre. Cordial co-operation is needed, also a spirit of tolerance. Voluntary workers sometimes seem to think that an official paid by the sanitary authority must be soulless and void of sympathy. It is, of course, absurd to suppose that a hospital nurse when paid her salary by a voluntary hospital or the Queen Victoria District Nursing Association is sympathetic, and that the same woman, when her salary is paid by a County Council or a sanitary authority, must necessarily become hard of heart and lose her sympathy with the people among whom she works.
Another danger is that the voluntary worker will not appreciate the difficulty in giving sound advice to mothers with regard to their infants. Each infant is a study in itself, and until recently even the medical profession has not appreciated what a large amount there is to be learned about babies. Care is, therefore, needed lest the voluntary worker should develop into a "quack doctor."
In Sheffield until recently there have been no voluntary workers: Since the Insurance Act was started a voluntary association of lady visitors has been established for the benefit of some of the insured persons, chiefly for the purpose of seeing to the interests of the mothers during the time of their confinement. The municipal Maternity and Child Welfare Centre works in cordial co-operation with this society. Another new departure has been made quite recently. A Council of Child Welfare has been formed, including representatives of all the societies which work in the interests of mothers and children, numbering at the present time about forty-five. At the first meeting of this Council it was decided to establish as an experiment women's committees in some of the wards of the city to do work in the interests of mothers and children. The Chairman of the Health Committee is the Chairman of the Council; the Medical Officer of Health is Secretary; and the women sanitary inspectors or health visitors will probably be attached to the Women's Ward Committee of the wards in which they work. If every county council and county borough had its Council of Child Welfare it would be easy to call together a National Council or Parliament of Child Welfare, which would represent all the societies in the kingdom and carry great weight.
In attempting to sketch out a programme I have found it impossible to limit myself to the requirements of babyhood. Obviously we cannot
deal with the baby alone. For example, the income and home must meet the needs of the whole family; and, again, a healthy boyhood and girlhood are important preliminaries to parenthood.
The object of holding a National Baby Week is to bring home to every member of the community the importance of our babies. It is a trite saying that every baby is a national asset. Do we really regard it as such? On the babies of to-day depends the future of our British Commonwealth. If we are legislators we should ask ourselves if the laws need to be altered so as to give all children a better chance. If we are councillors, are we doing what we can to give the next generation of citizens a healthy start in life? If we are guardians, do we ensure that the children who are thrown upon our care are given the chance of becoming efficient citizens, and do we see that widows with a family. of young children have an allowance which is adequate to maintain them properly? If we are simply parents, do we do what we can with our existing resources to see that our children have a healthy and happy childhood, and the opportunity of growing up to be human beings better physically and mentally than ourselves? None of us can be so self-satisfied as to be content with children as good as ourselves. We must have an ideal. We must make for evolution and try for supermen and superwomen in the best sense. Some of us, such as school teachers, nurses, and doctors, have special opportunities, but all. of us, whatever our occupation, can do something in the cause of the children. It is surely no ignoble ideal to put before ourselves-the rearing of a race stronger, better, and more efficient than any in history.
SEX EDUCATION IN CHILDHOOD AND YOUTH.
By The REV. H. NORTHCOTE, M.A.
Author of "Christianity and Sex Problems."
THERE is, of course, a considerable time in every human life when there can be no question of any direct teaching of sex matters; but it must not be inferred that there is therefore as yet no sex consciousness. It is there, but incipient. The rapidity of the growth of the sex instinct depends largely on temperament and heredity. Consequently there is room for influencing indirectly and by anticipation the psychical side of the sex nature, over and above the supervision of its physical aspects. Observation of child-life in other countries than Britain has made me appreciate more than ever the efforts which British women usually make to teach modesty to their children from the first. The British woman, when a small child has to perform necessary acts, will lead it aside and show it how to arrange things in the most decent way. The women of some other countries seem to think this is not worth while. They expose the child in the frequented street, and do not even trouble to turn it round. That is probably why later on adults in those countries sometimes exhibit an unpleasing lack of modesty; and the dirty aspects of life are made more prominent than they need be.
Some young children are inquisitive, and have a naive way of experimenting on themselves. This is not necessarily a bad or alarming fact; it may indicate cleverness, and foreshadow inventiveness and resourcefulness. But it might not work out well to begin with, as far as the sex nature and system are concerned. Anomalies of the sexual instinct, or perhaps we should rather say the accentuation of some one of the psychical factors composing it, are more common than is generally recognized. The causes of such developments, which vary considerably in intensity, are obscure and frequently remote; but it seems established that mismanagement or no management of the sex nature in early youth may contribute to their occurrence.
But now sexual development comes before us in its further issues, and a leading question occurs. What is the power that saves humanity from false progress or from no progress, from arrested spiritual growth, and the evils it involves? Many would answer: religious faith.
Others, looking back over the long reaches of time in which humanity
has laboured at controlling the forces and processes of Nature, would reply that if anything has saved and is to save, it is knowledge, the progressing and ever growing scientific recognition of truth.
But in fact these two principles balance each other in the saving of humanity. They form a beneficent unity. Faith works by the a priori method. It forms working hypotheses for the solution of the problems of life. Knowledge co-operates, accumulating data, testing, verifying or revising the working hypotheses. That is how man becomes master of the world or any department of it, as the phenomenon of sex. He must have faith in the invisible, in the future, in the transcendent factor, in God; and his faith must keep touch with the data of experience, assimilating thereby an ever richer content. So faith is power, and knowledge is power. Together they are irresistible, and the most massive obstructions of the world-process must yield to them. They have already received the highest of sanctions. If, as the profoundest of religious books, the Fourth Gospel, tells us, we may know, and are indeed called to know, the supreme fact of the universe, a fortiori we may know all subordinate facts. There is the religious charter of the freedom of scientific inquiry. No province of knowledge can be set apart as taboo or forbidden ground. Even if among the facts of that province there are some ugly facts, we may yet examine them. Shall we dismiss some of life's facts as not worth our scrutiny, as so inherently vile that they must surely be contaminating to any voluntary contact whatever? If we have begun to think so, let us reflect that the foullest things may hide values-nay, even interests and beauties. If one were asked to name in scientific literature something analogous to an epic in poetry, he might fitly answer by citing Fabre's great work on insects. And how did the great entomologist find some of the best of his material? Was it not by stooping over and examining patches of excrement?
Thus we perceive what spirit should inspire one who would teach the things of sex. It is a spirit that is both religious and scientific. Its possession presupposes the effort to understand the phenomenon's manifold bearings.
It may not be generally possible, indeed, to acquire a great mass of detailed information. But the mastery of a subject does not necessarily mean that. It means that one should get the information relevant to one's own purposes, and that that information should be true and right. Most serious students of sex think that even adults are often considerably deficient in sound sex knowledge. This well