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The Northern States of the Mississippi Valley

It is interesting to note that a horizontal line drawn through the center of these two states will divide them approximately into active and inactive belts. Michigan is by far the more advanced of the two in facilities to aid crippled children. The chief orthopedic center of the state is naturally Detroit, where activities center around the Children's Hospital of Michigan. State aided special classes, are located at the Leland School for crippled Children, of Detroit, and in Saginaw and Grand Rapids schools. Convalescent homes are located at Farmington (affiliated with the Children's Hospital of Michigan) and at Port Huron. Rotarians have organized the Michigan Society for Crippled Children and clinics have been held throughout the state. Legislation provides for commitment of indigent crippled children to the University Hospital at Ann Arbor, for treatment, and to the State Public School at Coldwater, for education. The Michigan Children's Aid Society frequently renders service by "placing" handicapped juveniles in "boarding homes."

Wisconsin legislation closely resembles that of Michigan in providing for education at the State Public School at Sparta, and treatment at the State (The Bradley Memorial) Hospital at Madison. Milwaukee is the only other orthopedic center in the state. The northern and less populous areas of both states present the same problem as those of the Rocky Mountain Region, namely, the task of locating the little ones in isolated communities and making facilities available at sufficiently convenient distances to ensure effectiveness.

The Northeastern Mississippi Valley

Ohio probably cares for and educates as large a proportion of her crippled children as does any state in the country. This is due to advanced legislation and the widespread social interest of Rotary Clubs (who have organized the Ohio Society for crippled Children), and Kiwanis Clubs, which are active in co-operating with agencies throughout the state. Although there is not a single special orthopedic hospital in the state, legislation making available the price of care and cure has thrown open the doors of general hospitals everywhere. Toledo, Cleveland, Elyria, Akron, Dayton, Lima, Cincinnati, Columbus, Canton, and Youngstown all function as orthopedic centers. Local clinics are held periodically, and patients are treated at the nearest available facilities. Public school classes for crippled children have been organized in all of the cities named above, and in addition at Ashtabula, Barberton, Piqua, and Springfield. This state is still in need of further convalescent facilities and at least one custodial institution for incurable crippled children.

The Central Eastern States of the Mississippi Valley

The states of this region have several characteristics in common. They all are attempting to solve the problem of the crippled child on a partially de-centralized plan. Rotary Clubs in all three have organized State Societies. All of them are confronted with the problem of bringing patients for treament from isolated mountain communities to cities. In Kentucky, Louisville is the outstanding center, crippled children receiving treatment at the Louisville Children's Free Hospital and the J. N. Norton Memorial Infirmary. The Korsair Temple of the Imperial Shrine is building a home which will provide the needed convalescent care. In Tennessee, Memphis is the outstanding center and also serves several of the central states of the South. Nashville is provided with a convalescent home which aids in solving the problem of that city. West Virginia is the only one of these states in which legislative action has been directed toward orthopedic services. The West Virginia legislature has provided for the admission of crippled children at the several state Minors' Hospitals (Welch, McKendrie, Fairmont). In addition, excellent facilities exist at Huntington and Wheeling. The characteristic deficiency of all three states is the lack of special educational facilities. Future efforts of state societies and all interested individuals probably will be turned toward the establishment of special classes in public schools.