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CHAPTER VIII

CO-ORDINATION

Inter-dependence of units is characteristic of all society. Under normal conditions, it exists unnoticed and without special impetus. Under abnormal conditions, such as are correlated with the problem of the physically handicapped, the resulting isolation of individuals breaks otherwise normal social relationships. Thus, as we study the problem of the crippled child and learn of the various existing and potential facilities for its solution, we become more and more convinced that the keynote of all efforts in this field should be co-ordination between the various active agencies, and between their component units.

The necessity for such guided and enlightened unity is pre-eminently discernible in this work because the needs of crippled children are so varied as to place demands on many diversified fields of social activity. There is a great army of pediatricians, orthopedists, and general physicians to whom the crippled child is but one of a great mass of individuals requiring physical and constitutional remedy. There are the doctors of preventive medicine and also the associated group of social hygienists, who are interested in improving public health by preventive measures. The physically handicapped form a distinct educational problem. Similarly, those who aim to relieve destitution are constantly confronted with the necessity of aiding these cases. To those who provide vocational guidance and to those who operate industries, cripples have always been a problem.

The great danger in these activities is that the ultimate solution will become a mirage to each crippled individual. Those who would aim to provide remedy without co-operating with educators to make available school facilities, place the child in the position of the prospector who has discovered gold, but has no means of transporting it to metropolitan markets. Those who would educate without co-operating with others who would relieve hunger, are equally culpable. Educational facilities which do not co-operate with the agencies which render vocational assistance are quite ineffective.

The greatest degree of unity in this movement has been achieved within individual institutions. We find the orthopedic hospital, the special class, the social service department, the out-patient department, and the general advisory medical staff combined in the modern hospital school or orthopedic center. Here the local board of education furnishes teachers; the nurses' association provides social service workers; the local Rotary, Kiwanis, or Elks' Club discovers cases and achieves personal contact with the patients; and the convalescent, operative, and medical facilities are in co-ordinated service to the child.

No such unity has as yet been achieved between national or local social agencies. The International Society for Crippled Children has made more progress in that direction than has any other agency in this field; and still it is far from a central binding agency for all institutions and organizations. The Bureau of Information of this society was organized for the purpose of making possible those national contacts, and the Public Relations' Committee is at present endeavoring to complete them. Some organization (similar to the National Tuberculosis Association for those who are endeavoring to solve the tuberculosis problem) eventually must act as a central medium for the exchange of information and a stimulus to co-ordinated activity. It might very well be an existing group, such as the International Society, which may be supported and maintained by all interested individuals and organizations in the United States and Canada.

Hastings H. Hart, Director of the Department of Child-Helping of the Russell Sage Foundation, addressed the 1923 convention of the International Society as follows: "I want to say a word about co-operation. This is a tremendous movement. It is going to take a lot of money and interest. It ought to enlist the co-operation and good will of the entire community I think that you can afford to put in a whole lot of effort to enlist the mutual co-operation of all the different agencies of people in your community.

"Take this hospital proposition. If the Masonic organization is going to build hospitals for crippled children, and the Kiwanians and Rotarians are going to carry on clinic work, unless you are working together you are just as sure to get into an injurious competition as to go ahead. You have seen the jealousy that arises when two hospitals or two organizations have undertaken the same kind of philanthropic work. This can all be prevented by a spirit of conciliation before it be too late to accomplish that thing.