15,697
edits
Changes
no edit summary
__NOTOC__After its founding in 1824 within the War Department, the Office of Indian Affairs (OIA) became responsible for the health and welfare of Indians who were removed to reservations. While some treaties mandated providing tribes with medicines or physicians, Indian agents began to employ doctors in different reservations to treat the panoply of ailments afflicting the Indians.<ref> Article 11 of the 1887 Treaty with the Coeur d’Alene Indians mandated that the government furnish a competent physician to the Reservation. P. 421, Kappler, Charles Joseph, <i>Indian Affairs: Laws and Treaties</i>, Vol. 1 (Washington, 1904) Additionally, some unratified treaties, including a 1864 treaty with the Hoopa, South Fork, and Redwood and Grouse Creek Indian, provided for the appointment of a “competent physician.” P. 135-136, Report of the Commissioner of Indian Affairs for the Year 1864, (Washington, 1865.)</ref> Even though physicians were hired quite early in some situations, the OIA failed to create a formal medical corps to treat Native Americans for almost eighty years. Physicians were hired in a piecemeal and sporadic fashion by local Indian agents, superintendents, and Indian School administrators. By the end of the nineteenth century, the OIA employed only about 90 physicians for almost 200,000 Indians. Sometimes physicians were hired by agents as salaried employees, other times they were simply contracted workers. The OIA struggled to hire competent employees and some of these problems were magnified in their pursuit of qualified physicians. The OIA lacked sufficient funds and was hampered by ineffective hiring practices.
While the OIA was slowly expanding its medical corps, Indians’ continued survival was threatened by smallpox and the advancing specter of tuberculosis. Under the stewardship of Commissioner Francis E. Leupp the OIA attempted to reform its medical corps and create a more unified organization which could meet the needs of reservation Indians in response to the tuberculosis threat. While these reforms did not necessarily solve any of the problems Native Americans faced, they demonstrated that the OIA was cognizant of the health dangers Indians faced on reservation lands and showed they were willing to make coordinated efforts to protect Indians. The tuberculosis threat also provided the OIA with an opportunity to challenge Indian behavior, but provide a rationale for how those behaviors threatened their lives. Even then, the OIA only considered reforming its medical corps after it was clear that tuberculosis threatened the survival of not only numerous Native Americans but whites who lived near reservations.
Unlike smallpox, the tuberculosis threat slowly crept up on the OIA. Unlike smallpox, tuberculosis did not sweep through reservations and kill thousands; it slowly integrated itself onto reservations and in Indian schools. While some Indians quickly succumbed after being infected, most victims lingered on for extended periods of time. By 1880, the OIA had become increasingly centralized and capable of managing its physicians, but its response to tuberculosis was hampered by its lack of institutional memory. Despite repeated warnings from its employees, the OIA did not remember that it had problem. Instead, each new agent, physician, and commissioner was surprised to discovery the presence of tuberculosis among the Indians.
Leupp’s reform efforts gained traction because the tuberculosis threat to Native Americans could no longer be ignored, Roosevelt was interested in health and physical fitness, the OIA was sufficiently centralized to aid a broad reform effort and controlling tuberculosis dovetailed nicely with the OIA’s effort to integrate Native Americans into American society. <ref> Roosevelt served as the president of the 1908 International Congress on Tuberculosis in Washington D. C.</ref> Leupp and Murphy not only sought to reform the OIA’s medical corps, but tuberculosis provided a powerful justification to change the behavior and culture of Native Americans. The OIA could increase its control over its charges under the guise of health reform and eliminate some of their more objectionable behavior. Not only could Indians be taught how to behave in civilized society, but if they failed to follow the OIA’s directives they could claim that their Indian behavior would kill them. ====Conclusion====
The effort at the turn of the century to reform the OIA’s healthcare was largely unsuccessful, but it is significant because it pinpoints a clear change in OIA and its policies. By the 1900 the OIA was finally capable of implementing broad institutional reforms. Advances in medicine would have provided compelling reasons to expand its medical corps. It should not be ignored that these reforms occurred when the government’s relationship to Native Americans changed. By 1909, the United States wanted to control Native American behavior. Tuberculosis provided the OIA with a good reason to educate Native Americans about their potentially dangerous behaviors.
