Changes

Starting in 1824, the OIA was charged with faithfully implementing federal Indian policy. Historian Paul Stuart described the OIA as “organizationally weak and ineffective in its first half-century.”<ref>Paul Stuart, <i>The Indian Office: Growth and Development of an American Institution, 1865 – 1900</i> (UMI Research Press, 1978), 5.</ref> The OIA was largely unsuccessful during its first five decades of existence because it could not effectively manage its agents and enforce Indian policy on its own. Prior to Before 1880, the OIA was decentralized and could not appoint personnel to its Indian agencies.<ref>Stuart, 11-12</ref> Throughout the nineteenth century, the OIA’s policies for selecting Indian agents, superintendents and other employees were constantly changing , and each change limited the ability of the OIA to manage its employees. Throughout the nineteenth century, other organizations competed with the OIA to dictate and implement federal Indian policy including Indian Commissions, Congress, the Army, and various Christian Churches. Ultimately, the OIA was a weak, decentralized agency which was largely ineffective at lobbying Congress for the funds required to fulfill the United States’ treaty obligations.

Indian agents began to request medicines, such as quinine because they believed that “a very small outlay for medicine” could save Indian lives.<ref><i>Annual Report of the Commissioner of Indian</i> (1847-1848): 139.</ref> Before the Civil War, the OIA employed very few physicians for its tribes. By 1865, only 12 physicians were known to be employed by the OIA.<ref>Stuart, <i>Indian Office</i>, 130.</ref> Even by 1877, the agent for the White River Agency stated that his agency did not have a physician and that the agency’s teacher was forced to practice medicine.<ref><i>Annual Report of the Commissioner of Indian Affairs to the Secretary of the Interior for the Year 1877</i> (1877): 33.</ref> While these numbers would steadily rise over the next four decades to approximately 90 physicians, these doctors were responsible for the health and welfare of over 180,000 reservation Indians in approximately 150 agencies.<ref> Sources, including the OIA, cite conflicting numbers regarding the number of Indians treated by agency physicians. While there were 300,000 Indians according to census numbers, the OIA sometimes does not include the Five Civilized Tribes in its calculations. Needless to say, I have not been able to determine why those tribes are not always included or if the OIA was not responsible for their healthcare.</ref> While the OIA was tasked with administering federal Indian policy, it relied upon the United States Army to fulfill its mission. The OIA’s dependence on the Army was emphasized during the Civil War. During the war, the Army’s role was dramatically reduced and chaos erupted on numerous reservations. Several tribes open revolted because the OIA could not fulfill its treaty responsibilities. The failure of the OIA to maintain peace and order during the Civil War led to a series of administrative reforms. These drastic reforms had a lasting impact on the agency’s physicians.