Page images
PDF
EPUB
[graphic][ocr errors][subsumed][subsumed][merged small]

Programs of the society reach their climax in the work of the units-in the home community. Here, the circle of activities which began in fund-raising in the community is brought back again in services of the units.

Within the community the ultimate target is the individual and the disease of cancer itself. Cancer will strike about 1 in every 5 of the population. It may strike at any time and who, when, and in what form cannot be foreseen. But as about half of those who will have cancer could be saved with present knowledge by early treatment, a basic aim of the unit is to try to make sure members of the community know enough about symptoms to seek a doctor's care when the cancer is still limited to its site of origin. The corollary step is help for doctors in detection, diagnosis, and treatment. Finally, is the problem of care for those with cancer, the patients. Half could be saved. But only one-quarter survive the disease today and thus many patients become chronically ill and are in varying degrees of medical and social want, depending upon their circumstances. Often whole families are financially engulfed before the disease has run its course. Within the units, these problems are immediate-urgent, personal, next-door.

The units and the volunteers

In 1952, under direction of the divisions, 3,301 organized units of the society were in active operation. Enrolled for programs conducted by this large number of organized units were about 1 million volunteer workers-the largest number engaged in the fight against cancer in any 1 year of the society's history. Approximately one-half were in permanent year-round programs conducted by the units in education for the public and services for persons suffering from cancer. The others joined their ranks in and around April in the work of the annual appeal. In 1952 about 18 percent of the volunteers were men. Types of unit organization

Usually, the basic area served is a county, and the standard name the county unit, division, American Cancer Society. But sometimes district and township organizations are preferred. In metropolitan areas, a suburban or neighborhood or electoral district pattern may be employed. Units may be called branches or chapters.

The organization is flexible, developing more formal patterns with growth in programs. Many units operate through executive committees made up of doctors, hospital and health department representatives, and lay persons. Other units are controlled by boards of directors composed, as are the national and divisional boards, of representatives of the medical profession and laity. In 1952 there were 18,289 persons serving on unit boards of directors-6,203 were physicians or scientists and 12,086 were lay persons.

Unit headquarters

In the larger communities, permanent offices are sometimes maintained, serving as information centers for the public as well as headquarters for the unit. In other cases, the leader's home serves in both capacities. The leader is often known as the cancer lady, to whom everyone may turn for information.

As community programs develop over the years and greater funds become available, units in many areas find it advisable to strengthen their services by employing executive secretaries. Usually they have had training in health and adult education practices, medical social work, nursing, or community organization. They are especially needed in metropolitan areas where the caseload of cancer is heavy and the accompanying economic and social problems of patients are difficult of solution.

Unit service programs

Whatever its form and however the patient's difficulty has become known to the unit, the information center is the point where patients' problems are considered and discussed with the appropriate public agency. Such is the nature of cancer that each case generally presents a different problem. So as to conserve the society's resources, the units may make every effort to see that public means for assistance are used to their utmost. When weak or lacking, efforts are made to make good the deficiencies. Often, joint arrangements are made, the agency assuming a portion of the responsibility for the patient, the unit the remainder. In some areas the office of a county or city nurse, a welfare department, the office of the medical society, or in at least one instance, as in Puerto Rico, officers of home demonstration agents of the United States Department of Agriculture serve as information centers. In other areas, information services are maintained in conjunction with detection centers.

In Pennsylvania, 47 full-time information centers and 17 operated from homes of volunteer leaders serve the 67 counties of that area; 60,773 inquiries were received at these centers in 1952. Thirty-five formal centers are maintained in California, 25 in New York State, 22 in Illinois, 20 in South Carolina, 19 in Connecticut, 13 in New Jersey and Texas, 8 in Florida and West Virginia, and 5 in Wisconsin. Many other divisions maintain a number of full-time centers. In all unit areas, however, some form of organized information service is maintained to serve the needs of cancer patients in want and to supply information to the public.

Detection

A primary service to the patient is in the earlier detection of his disease. Unit detection programs have many forms depending on needs of the community and general policies of the divisions. If the detection center is an approved activity for the area, the unit backs its work with actions ranging from handling requests for examination appointments at information centers, to volunteers who serve as clinic receptionists, interviewers, etc., and in the maintenance of records. In doctor's office programs, the unit refers inquiries to doctors and is often the enabling agency for supporting services such as smear tests for early cancer of the cervix.

Several county units of the Indiana division provide free smear tests. The Marion County unit of the same division gives support to a cytology laboratory as do also the Erie and Lawrence County units of the Pennsylvania division. Free smear examinations are provided for medically indigent patients in several areas of Connecticut, parts of Ohio, in parts of New York City, and throughout New Jersey. The Mecklenburg County unit of the North Carolina division supports a cytology laboratory at Charlotte and a smear delivery service for physicians.

The Michigan division received one of the 1952 Crusade Citations for the establishment by 15 units of the Upper Peninsula district of a cytologic laboratory at Menomenee. The citation reads: "In building a regional cytology program, 15 ACS units have served their people well. By striking hard at cancer on one front, they have stimulated the whole cancer control movement in the Upper Peninsula."

Clinics and registries

Besides the financial support extended by the society, the units in many areas regularly support cancer diagnostic and treatment clinics in their community hospitals with a wide variety of voluntary services. Often, as in New Jersey, the clinic is an integral part of the entire service activity, the clinic secretary or medical social worker providing the unit with its day-by-day operating information on needs of indigent patients who have undergone treatment at the clinics. On this information may be largely based the unit's activities in transportation, nursing, and housekeeping assistance, the making of dressings, etc. Unit volunteers also assist in maintaining the all-important records of the incidence and mortality of cancer which to a large extent have their origin in

clinics. The Calhoun County unit of the Michigan division, at Battle Creek, maintains among other activities of the unit a community cancer registry which is a model of its kind.

Transportation

Regular examinations are a "must" for all patients who are being or who have been treated for cancer. Volunteers of the units usually employ their own automobiles to take patients in need to and from treatment centers. In some communities where the hospital must be reached by an overnight journey, expenses of the patient and an attendant, who may be a nurse or a volunteer, may be borne by the unit. Programs of this nature for patients in need are supported in Arizona, Idaho, Montana, and some other areas where distances are great or there is uneven geographic distribution of clinic facilities. In 1952, the Alaska division underwrote the expenses of a trip by a patient to a tumor clinic in the United States.

In some areas vehicles are owned by the divisions and their units, a roster of volunteer drivers being available on call. Four station wagons are operated by the New York City Cancer Committee, one a gift during the past year of the Advertising Club of New York. Another station wagon was presented by the Beta Sigma Phi sorority to the Logan County unit of the West Virginia division. Similar vehicles are operated by units of the Illinois division. In Maryland a motorcade organized by B'nai B'rith women is responsible for transportation. In South Carolina 1,029 trips were made in this essential service for patients who might otherwise have lacked proper treatment or attention for their disease.

Dressings

A service to provide dressings to patients in need is maintained as a program by practically all units. Volunteers, usually members of a club or church organization, meet in groups under supervision of a physician or nurse to cut and sew the dressings from contributed materials. The dressings are sterilized, packed, and turned over to unit headquarters to be delivered to patients through the transportation service. Sometimes bed jackets, bedpads, and other comfort articles are made as well. In 1952, the divisions report 4,751 groups of volunteer women produced 11,341,510 dressing for persons in unit areas suffering from cancer-a service of incalculable usefulness to doctors and nurses as well as to the patients themselves. Dressings for cancer patients may cost above $50 a month when purchaed.

Eighty-eight voluntary civic, social, and church groups participate in the dressings program of the Ramsey County unit, St. Paul, Minn. The unit has 17 places to which dressings are regularly supplied amongst individual patients, rest homes, and hospitals. The smallest organized village in Minnesota, Funkley (population 26) in Beltrami County, has a dressings program. Typical also are dressings groups of the women's auxiliary of American Legion Post No. 253 at Crystal City, Mo., and the Ladies' Aid Society of the Blue Hill Baptist Church, Blue Hill, Maine.

Nursing, home care, housekeeping aid

A variety of home services are offered by the units in assistance of needy cancer patients and members of their households. Foremost is nursing. As the service is professional, volunteers are employed only as aids after adequate training. The usual plan is a subsidy provided a public health agency of Visiting Nurses Association, enabling regular calls upon patients at a fixed charge per visit. In some areas, as has been noted, nurses are employed by the division to instruct public health and county nurses in the care of patients, the units making possible the regular visits of these specially prepared nurses to patients on their lists.

Through arrangements with the VNA in the State of Washington, 1,954 visits were made to 234 patients; in Milwaukee, 2,558 visits were made to 146 patients; in Philadelphia, 11,428 visits were made; while in California, 10,000 visits by VNA and other nurses were made to 4,715 patients. VNA service for needy cancer patients is available throughout New Jersey, in most areas of Connecticut through VNA and public health nursing agencies, in 39 counties in Pennsylvania. In all, nursing services for cancer patients were supported in cooperation with Visiting Nurses Associations in 1952 by 28 divisions and 9 other divisions gave support to similar arrangements with other nursing organizations. The Westchester, N. Y., division employs two nurses for clinic service and calls on patients. Sometimes nursing services are supplemented by the employment of a practi

cal nurse, of volunteers trained as nurses' aids or by coaching some member of the household in the care of the patient. The Nassau, N. Y., division has developed a notable program of this character. Often nursing services and home care activities are combined, the nurse limiting her work to supervision of daily routine and the more professional tasks. Twenty women have been trained and certified as cancer nurses' aides by the Jefferson County unit, Steubenville, Ohio, division.

Housekeeping assistance, another service of the units, may be provided by volunteers. The duties may include friendly visits with the patient, cooking, marketing, house cleaning, washing, care of the children, and even in some cases cleaning the walk and taking care of the furnace. The volunteers sustain the patient's courage and the well-being of the home through the period of illness. Loan closets for patients

The commander of the Valley County unit of the Idaho division reports that after a patient had been supplied with a bed by the unit "the patient had a good night's rest, and all the family did, their first in quite a spell."

"Loan closets" as the collections of supplies and comfort articles are called, represent a most welcome service for patients. The materials, often contributed by individual donors, include sickroom necessities such as hospital beds, mattresses, sheets, pillowcases, rubber sheeting, wheelchairs, crutches, canes, bedpans, thermometers, ice bags, shaped cushions, feeding cups, etc., and comfort articles like bed gowns, fans, window screens, bedlamps, reading racks, toys, radios, phonographs and records, books, jigsaw puzzles. Many closets include materials for recreational and occupational therapy, as hand looms, knitting needles, and crochet hooks, paints and brushes, leather and woodcraft materials and tools, stamp kits, and albums. Sometimes a central depot for the more costly items is maintained by the division: The Illinois division, for example, has a supply of 100 hospital beds which are in constant use by units in that division. Nine hospital beds were in use "every day of the year" in Ohio. The closets are the centers from which bandages and dressings made by the volunteers are issued. In all, 812 closets were maintained by units in 1952. Rehabilitation services

Persons who have been treated for cancer are sometimes left with handicaps to which adjustment is needed. If a rehabilitation service exists in the State, efforts are made to employ the facilities. Occasionally subsidies are offered these agencies but more often the action is direct. Notable in the past few years have been the classes, often conducted by former patients, for persons who must learn a means of speech after operations for cancer of the larynx. Many such groups exist in various areas today. New speech clinics are reported for 1952 from the southeastern Michigan division (Detroit), the Nassau (N. Y.) division, Indiana, Texas, and Delaware. Noteworthy was the first international convention for esophageal speakers held in August at Cleveland, Ohio, which was cosponsored by the Cuyahoga chapter of the Ohio division, the Cleveland Hearing and Speech Center, affiliated with Western Reserve University, the Cleveland Academy of Medicine, the Cleveland Otolaryngological Club, and the Ohio Bureau of Vocational Rehabilitation.

In Idaho and several other areas, former patients are helped in finding and keeping jobs. Former patients in South Carolina are aided in learning new trades. In North Carolina, a former patient is employed to train and give encouragement to colostomy patients. In Oregon, doctors and nurses have been supplied with the materials for exercises for mastectomy patients.

Medical care programs, loan funds

While it is not the policy of the society to pay doctor's fees, some provision is made in a number of divisional and unit areas to pay when no other source of funds is available for the drugs, medicines, and some of the treatment procedures needed by patients. Thus, in certain areas the costs of X-ray and radium treatments may be underwritten for patients in great need. Narcotics and the hormones employed in the palliative treatment of several forms of advanced cancer may be supplied. Prosthetic devices are sometimes furnished. Over the various areas, though a principle very hard to enforce when faced with dire need, such assistance is limited to an average maximum in very exceptional cases of about $200 per patient. In a few areas this difficult problem of medical expenses that are not included in the doctor's professional services is met by a small interest-free loan. So as to help patients in great need, 35

divisions maintained medical care programs of some nature in 1952 and 12 divisions reported loan-fund programs.

Unit public education programs

The year's accomplishments in education have been sketched in the sections of this report dealing with the divisions. It will be understood that the aggregate educational accomplishment of 1952 as measured in individuals reached, audiences for films, danger signal messages, and pamphlets distributed, etc., represent countless programs carried out by unit volunteers.

750 county and State fair programs

In 1952 the units participated in 750 county and State fair programs for which there was an estimated aggregate attendance of 3,116,887 persons and during which 2,111,070 leaflets carrying cancer's danger signals were distributed. These activities involved the construction of booths and their decoration with posters and other display materials of the society, the showing of films, talks by volunteer doctors, and conduct of information desks for the public. Groups of volunteers from the unit headquarters staffed the activities. A partial rollcall by divisions of fair programs conducted in 1952 is impressive: 65 programs were conducted at fairs in Arkansas, 55 in Iowa, 45 in Ohio, 42 in Michigan, 40 in North Dakota, 35 in New Jersey and Virginia, 31 in Indiana and Wisconsin, 27 in Texas, 25 in Kentucky, 20 in Colorado, 18 in Oklahoma.

Amongst noteworthy individual projects was the "Happiness House" exhibit prepared by the Southeastern Michigan division for the Michigan State Fair at which Man Alive! was shown to full houses 8 times daily over a period of 10 days. In New Mexico the division cooperated with four other voluntary health agencies in a joint exhibit at the New Mexico State Fair at Albuquerque. In Florida the Dade County unit (Miami) cosponsored a float which carried the society's message in the Orange Festival parade New Year's Day (1952), seen by tens of thousands of winter visitors. The Delta County unit (Michigan division) trained a group of housewives to act as film projectionists for a club and group program. They tried out their skill with great success at the Upper Peninsula State Fair before large audiences of Michigan people.

Theater film showings

Breast Self-Examination was designed for clubs, organizations, and for special groups of women. But one of the encouraging developments of the year was the larger audiences being reached in unit programs through presentations at offhours in theaters and auditoriums to women without group affiliations. addition, Man Alive! the society's new film-was being widely shown in theaters as a popular feature of regular programs.

In

In California the Sacramento branch, among many other showings, arranged two showings for Breast Self-Examination in the civic auditorium, each well publicized in advance through department stores, beauty shops, etc. Panels of volunteer doctors were on hand to answer questions. Six thousand women attended the first meeting, 3,500 the second. In the same State the Kern County branch conducted a similar popular demonstration at the Harvey Auditorium in Bakersfield. In Philadelphia 6,000 women saw the film in 24 continuous showings at a special theater set up at the home show. In Ohio several theaters presented the film at special cancer matinees; in Canton over 4,000 women saw the film in 1 day. In Virginia 1 theater showed the film to audiences of women on 4 consecutive Saturday mornings. Morning presentations in Indiana proved highly effective. The RCA Exhibition Hall at Rockefeller Plaza, New York, shows the film the first Thursday and second Wednesday of each month. Man Alive! enjoyed high popularity as a theater feature. The San Francisco branch, California division, arranged showings in many first-run and neighborhood theaters in San Francisco and nearby towns. In Pittsburgh the picture was shown in two downtown theaters and community theaters of surrounding Allegheny County. In Illinois the film was shown in 58 theaters in 19 counties, running 3 days in each theater. Prints were donated by the Illinois Women's Golf Association. The units promoted the showings through lobby displays and other activities. At Pocatello, Idaho, the Bannock County unit arranged showings in three theaters. Business and industry programs; labor-union aid; military installations

Educational programs were carried out in many units for General Electric, General Motors, and Bell Telephone System employees. Noteworthy was a program for loggers at a lumber camp in the Potlatch National Forest, Idaho; a

« PreviousContinue »