Margaret Sanger, "National Health Training Service for Girls," July 1940.

Source: "Margaret Sanger Papers, Library of CongressLibrary of Congress Microfilm 130:203."


National defense against the threat of total war requires that every factor in the national life be secured against breakdown. National security depends as much upon the health and vigor of the civilian population as upon that of men in the armed forces. The nation cannot afford to have any worker handicapped by preventable diseases or distress, either in himself or in the members of his family. It is obvious that good health stands high among the requirements for assuring high morals and ability to stand heavy strain.

To integrate the defense of health, it is essential that large numbers of women and girls be trained and mobilized for everyday service in health protection and for special service in time of emergency.

Moreover, in modern wars, the care of refugees creates an emergency of such titanic vastness that an increasing number of persons trained in medical care is a crying present need. President Roosevelt recently declared that hundreds of thousands--millions perhaps--of refugees will have to be looked after at the end of the present conflict. This problem has been increased since his words were spoken, and the end is not in sight. In America, the refugees of the depression are already a source of national weakness, which cannot safely be neglected in view of what may come later.

The American Health Service would be organized to provide to thousands of young girls a year’s intensive training in medical and humane services. The girls, who in general would be the sisters of the boys now working in the CCC or in the Army, would be given a preparation for playing a valuable role for the benefit of the nation in war or peace.

In every state, young girls applying for work would be referred to the NYA for an opportunity to enlist in the Health Service corps. Incidentally, they would be in this way removed from the labor market for a year, and returned a year later with a training that would have greatly increased their ability to enter useful employment.

After mental and physical examination, the girls would be registered by the NYA in public hospitals and welfare institutions; given attractive uniforms to assure their sense of important service; assigned board and lodging and $25.00 per month. $15.00 of this to go to parents or dependents, and $10.00 to be for personal use.

The personnel of the American Health Service would be organized into units ordinarily transferred from one type of training to another every three months. The training would be in four three month terms, as follows:

FIRST TERM: First three months Examination for physical defects and therapy indicated. . . Personal hygiene and cleanliness. . . Home sanitation. . . Making beds, cleaning of floors, plumbing, toilets, baths, etc. . . private and public sanitation and hygiene. Lectures in sanitation and health protection. . Nature of contagious and infectious diseases. . . Technique of prevention. . . Extermination of vermin. . Practical economy of cleanliness in all fields. . . Inculcation of ideal that there is nothing menial nor demeaning in any task or chore upon which national well being and defense depend. . Development of spirit of loyal team work and patriotic service. SECOND TERM: Second three months Nutrition and simple dietectics. Cleaning, preparation, cooking and serving of simple meal. . . Study of food and nutritional values. . . Lectures and examinations of chemistry of food stuffs. . . Marketing and stewardship. THIRD TERM: Third three months Essentials of practical pediatrics and care of maternal cases after birth. (It is not generally recognized that one million maternal cases in this country each year receive no post-natal care) The AHS units would not supplement the mid-wife or nurse in maternal cases, but would supplement with care, under the direction of properly constituted authorities. . . The AHS girls would be trained in bathing, dressing, hygiene and general infant care. FINAL TERM: Last three months Regular service in hospital wards as assistant to nurses and doctors. . Bed making, serving of trays to patients. On call to bells and training in general hospital service, general first aid instruction for accidents and emergency illness.

The training would be aimed not at professional status, but at general competence in the performance of everyday tasks, with an ideal of human service. In the absence of local emergencies, the chief value of the training will be to facilitate a broad and rapid improvement in the health conditions of low income families to which most of the girls to be trained belong. There would be no professional competition with trained experts, since the girls in general lack the educational background to qualify as trained nurses or satisfactory midwives. On the other hand, in case of emergency, when trained personnel is required to be drawn away from ordinary civilian service, the American Health Service girls could be used as assistants to the remaining heavily overburdened staffs.

Even at the present time, as is well known, many hospitals are seriously overcrowded. In some cases one nurse may be assigned to fifty patients, and many patients are without ward bells and have no way of notifying the nurse in case of emergency needs. A corps of partly trained assistants would be of great help in alleviating the suffering that now results from overloading the regular staff.

The plan is presented as one of the essential “improvements in our own social and economic life,” which, as the president urged in his Charlottesville address, are “a component part of national defense itself.” with patriotic appeal, with attractive, simple and stylish uniforms, and a corresponding attitude of appreciation from the government and the public, the girls will develop a loyalty and pride in their service. Because of the intensely humane character of this training, it will not only be useful in the strain of war, but will remain as a net gain in the years following, when so many of the temporary effects of war enthusiasm inevitably collapse.

Federal, State and local institutions should be encouraged to cooperate with the American Health Service in a manner similar to the cooperation of the schools with the NYA. The patriotic motive should of course be reinforced by organizing the work so as to give a maximum of valuable aid to the cooperating organizations in full recognition of the national value of their regular services. The units would be under their own directors but subordinate to the functions of the organizations to which they might be assigned.

It appears obvious that the objection of expense, sure to be raised at the first suggestion of a new large-scale program, will rapidly evaporate in the heat of present events, as the danger and the nature of total war become more apparent to the American people. Plans for a program of the kind suggested should therefore, proceed as rapidly as possible, with the assurance that the recognition of their necessity will tread close on the heals of the plans.

This service will tend to eliminate the fears and prejudices of race color, creed, and sex in the service of humanity.

Margaret Sanger Slee July 1940

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