Health Care in Day Nurseries and Kindergartens

Among the most important merits of modern education is its concern with the preschool age. Until the recent past it confined its effort to the school age, neglecting the first five years of the individual's life; and by neglecting the most important stages of life it recorded grave errors against itself, whose degree of influence on the personality of adults the workers in education have since made plain.

Among the most important manifestations of the activity that modern education displays to make good these errors are the spread of day nurseries and kindergartens, and the treatment of this unit as an essential part of the structure of the educational institution.

The concern of those laboring to direct and refine the mind at this sensitive stage has been accompanied by a great concern on the part of those laboring in the field of health; and after long trials, the workers of education and of health together came to see that bodily care must accompany mental care, so that the child of preschool age may be provided with the conditions of complete growth and sound development. The role of the nurse and the doctor in kindergartens has become an essential role, no less important than the role of the teacher.

What, then, are the responsibilities that fall upon the doctor charged with the work of health care in kindergartens? And what are the conditions of the best care that the school can render to the child of preschool age?

Scientific effort has shown us that the powers of immunity in the individual are affected by many factors, among them age, nutrition, temperature, and the individual's direct exposure to the source of infection. If we study the points of rise and fall in the line of immunity, we find its highest point in the first six months of life; thereafter the height begins to descend until the preschool age. It is known that the powers of immunity at this stage are affected by the processes of rapid growth through which the child is passing, just as they are affected by a rise in the rate of his exposure to sources of infection as the horizon of his contact widens with the widening of the environment in which he lives. With his passage from the atmosphere of the home to the school, his circle of contact changes rapidly in kind and in quantity, producing in his soul and his body profound effects that oblige him to a new adjustment, and lead those concerned with him to resort to every means of care and resistance, that the child may be strong enough to cut his path and proceed along the course of steady growth.

Therefore, this being the case, the requirements of modern health care prescribe an annual medical examination, whose aim is the discovery of illness or defect and the endeavor to root it out at the beginning. They likewise prescribe daily observation to detect the signs of infection among the children—chief among them the signs of skin diseases and of communicable diseases such as smallpox, measles, whooping cough, croup, and others—and the endeavor to keep the stricken among them away from the healthy, in order to limit the spread of infection.

In its positive direction, the plan of health care drawn up for attending to kindergartens goes a step further, prescribing prevention by way of vaccination, and advising that this preventive work be carried out in a steady, organized manner, without waiting for the arrival of a particular epidemic. Its positive character likewise leads it to carry out missionary health work in the home: some of it accomplished by personal contact, the responsible nurse making a home visit when needed, its purpose to confer with the mother upon the points of health weakness in the child himself, and to study the means and possibilities of cooperation between the home and the kindergarten, whereby the two institutions together may grow strong enough to create a suitable atmosphere that eases the child's way in overcoming them; or by gathering the mothers at fixed times of the school year, to examine the points of health weakness in their children and to guide them to the methods of proper care. It may occur to us that this attempt is difficult to realize; yet the trial carried out by the model kindergarten established by the Lebanese Women's League in Beirut has brought extremely good results. Since its founding, this kindergarten has made it its practice to invite the mothers at least once each year to attend meetings presided over by the school doctor, in the course of which he undertakes to raise important points of health—such as the care of the teeth, the methods of resisting colds and chest diseases, the treatment of flat feet, and the remedying of weakness of the senses, chief among them the senses of hearing and sight—and to open the way for answering the questions the mothers put to him.

This model kindergarten, by following such a positive course in the field of health care, is cutting a new path not for itself and its pupils alone, but for society in its broadest and most general form. For while it accomplishes its educational mission, it strives, by way of sound cooperation, to fill the vacant gap between home and school, and takes the mother as a means of bringing into the atmosphere of the family the principles and rules of modern health care and the methods of applying them in a simple, scientific way.

In mentioning a course followed by the model kindergarten of the Lebanese Women's League, I did not mean to slight the kindergartens of the other institutions of their due; rather I intended to call attention to a sound work that I have watched at close range, and whenever I followed it I found in it a sound course—that we may perhaps be able to lead private and public institutions to apply it, especially as kindergartens and day nurseries have begun to multiply in our society. They are without doubt on the way to further increase, so long as modern education continues to give the preschool age a share of its essential concern, out of its conviction that this sensitive stage is a formative stage, and that the bodily, mental, and psychological impressions that come upon the individual at this age are what determine the kind of personality by which he will be distinguished afterward.

And if the good intentions in us are agreed upon raising up a sounder generation, a generation in which the powers of mind and body are proportioned and balanced, let us give health care in kindergartens and day nurseries a serious share of our concern, and give the child of preschool age the rights of true health care that are owed to him from us.