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The Southwestern Coast Area

The problem in the southwestern coast region is closely analogous to that in the area directly north. Provision to care for the crippled children of San Francisco and Los Angeles is most satisfactory. In San Francisco is located a fifty-bed Shriners' Hospital, and the two hundred seventy-five-bed Children's Hospital. Educational facilities are provided at both these institutions. Drexler Hall, at Redwood City, and the Stanford Convalescent Home, at Palo Alto, provide convalescent care within fifty miles of the city. In Los Angeles, The Orthopaedic Hospital School and its projected convalescent home will be fully adequate to the needs of the center and surrounding counties. At Santa Barbara, the Cottage Hospital is equipped to provide necessary care for children of the extreme southern coast region. The central inland portion of the state is provided with a hospital for joint tuberculosis at Springville and a well equipped general hospital at Fresno. In Nevada, however, an area of 110,690 square miles is without any special provision for the education or care of crippled children. For inland and northern California, special educational facilities are available no nearer than San Francisco, a maximum distance of nearly 400 miles.

The Southwestern "Desert" States

In a distance of six hundred eighty-five miles between the borders of these neighbor states, one private institution, Dr. Charles Luken's Children's Home and Hospital, is the sole agency to aid crippled children. No special educational facilities whatsoever are provided. The situation speaks for itself.

The Central Rocky Mountain States

About forty-seven per cent of the population of these two states is urban. Only two centers for the care and education of crippled children are provided: Salt Lake City, where the Children's Home acts as a convalescent hospital, and Denver, provided with the Children's Hospital. In Colorado Springs, Colorado, the Glockner Sanatorium and Hospital does some orthopedic work. Thus we may interpret that under normal conditions fully fifty per cent of the crippled children of the central Rocky Mountain States have no special care available within distances ranging from fifty to four hundred miles. No special education is provided for those indigent children who are unable to attend the public schools.

The Northern Rocky Mountain States

St. Vincent's Hospital, at Billings, and The Butte Auxiliary, at Butte, Montana, would very nearly suffice to provide care and education for the crippled children of these two states if numerous organizations such as the one at Butte were constantly vigilant to find cases where such facilities were needed. Any inadequacy which may exist is due to the isolation of these communities rather than to the lack of sufficient hospital beds. A normal ratio of crippled children to population would bring the total number of crippled children of this area to less than 300.

The Northwestern Mississippi Valley Region

-1- When states are divided into two areas, the population and area of each section is approximated at one-half the total figure.

Until 1924, the Twin Cities, (St. Paul and Minneapolis) were the only ostensible orthopedic centers for this entire region. Of course the majority of crippled children, beyond a radius of one hundred miles from St. Paul, were entirely neglected. In the past year, the North Dakota legislature has passed an act which provides for treatment of crippled children at any general hospital in the state upon commitment by district courts. Charges are to be referred to the counties in which the children reside. This legislation will function efficiently in proportion to the degree to which organized society is interested sufficiently to discover cases and bring them to the attention of judicial magistrates. Similar educational legislation should be enacted. The entire state of South Dakota still is devoid of special orthopedic facilities. In St. Paul and Minneapolis, the Shriners' Twin Cities Hospital, the Dowling School, the projected University of Minnesota Hospital and its convalescent institution, and the State Hospital will be adequate for the needs of this locality. In addition, the legislature of 1921 authorized subsidies for special schools for crippled children throughout the state. There remains only the need for social co-operation in organizing these classes and schools, and legislation which will make available the cost of remedying and caring for juvenile cripples in isolated community general hospitals.