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several other changes, some of them temporary, have been made in the field staff. Among the sanitary supervisors, Dr. Le Roy W. Hubbard was appointed Orthopedic Surgeon in charge of poliomyelitis after-care work; Major Chas. A. Berry was called to active military service; Dr. Edward Clark was appointed to act for Major H. L. K. Shaw, Director of the Division of Child Hygiene, called to service in the M. R. C. U. S. Army; Dr. Stanley W. Sayer, of Gouverneur, Dr. Wm. L. Munson, of Granville, Dr. Edward H. Mar :h, of Brooklyn, and Dr. Halsey J. Ball, of Cortland, were appointed to fill vacancies. Dr. Edward S. Godfrey, Jr., formerly epidemiologist in the Illinois State Health Department, was appointed epidemiologist, and stationed at Albany, and Dr. Herman F. Senftner, formerly assistant epidemiologist in the California State Health Department, acting epidemiologist, stationed at Buffalo, and assigned temporarily to a sanitary district. Dr. Godfrey was also assigned to a district, but the demands for his services as epidemiologist were so continuous that he was soon relieved of this assignment.

The sanitary supervisors Last year, during the widespread epidemic of poliomyelitis, there was for the first time a general appreciation on the part of the public of the advantage of having a corps of trained sanitary officers stationed about the State.

During 1917 the field staff has rendered no less effective, if somewhat less spectacular, service, particularly in connection with the prevention and control of outbreaks of communicable diseases. While certain sanitary supervisors have been called upon to take charge of extensive outbreaks of communicable disease and have rendered service attracting special notice and favorable comment, there has been no member of the staff who has not rendered faithful and efficient service.

It is perhaps not out of place at this time to comment on the fact that practically all of the older members of the staff with reference to length of service - entered the service because of their interest in public health work and their desire to have a part in the constructive work following the reorganization of this Department; that many of them gave up work in which they were established and which was more lucrative, and have cheerfully

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Chart I

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adapted themselves to conditions at times conducive to anxieties and embarrassment; and that the spirit which has actuated such faithful service has contributed in some degree to the recognized success and efficiency of the Department. It is also a pleasure to report that the niole recent appointees to the staff have rendered servioes fully justifying their selection.

A detailed weekly report is required of each sanitary supervisor. Table 1 presents a summary of four important activities : (1) work in connection with the control of communicable diseases; (2) advice and assistance rendered to local health officers; (3) meetings attended and addresses given on subjects pertaining to public health and (4) health board meetings attended. It will be noted that in several instances the number of items is relatively small, owing to the fact that certain of the supervisors were -appointed late in the year, that one was called to military service and others were appointed during the year, temporarily or otherwise, to other positions in the Department.

The accompanying chart (between pages 96 and 97) indicates roughly, for comparison, the relative amount of time devotel by the staff of supervisors during a period of seven months --January 1 to August 1— to different kinds of activities.

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“Office work" appears most prominently, consuming approximately one-fourth of the total number of hours or approximately one and one-half days weekly. Much of the time spent by the supervisor in his office is devoted to official correspondence, study and preparation of reports, preparation of addresses, interviews with health officers and others regarding matters pertaining to health administration, either in person or by telephone, etc. The office of the district sanitary supervisor is usually made a local“ clearing house" for information concerning matters in any way related to public health. For example, the supervisor may, be called upon for assistance in securing the admission of tuberculosis patients to hospitals; for advice to physicians in regard to the treatment of cases of communicable disease; for information to public officials or others in regard to interpretation of the state laws or local regulation. He is often called upon to receive complaints to be transmitted to local health officers; to advise individuals and organizations in regard to the organization of social service projects indirectly related to public health ; to furnish current information to newspapers or to confirm or explain news items secured by correspondents, etc. instances supervisors are directly connected with local activities as members of boards and committees, all of which contribute to their usefulness as officials. A considerable part of the time spent by supervisors in their offices could properly and should be credited under other headings such as "control of communicable diseases,” “ conferences and interviews," “ advice and assistance to health officers," etc.

In connection with the work of the sanitary supervisor there is considerable amount of very necessary routine office work, which, under present conditions, must be done very largely by the supervisor himself at the sacrifice of time which he might well devote to the numerous activities calling for his special training and experience. This could be done by a clerical assistant. A clerk at a small salary could not only perform routine clerical work but could answer questions and attend to matters nou demanding the supervisor's time and attention, keep the office of the supervisor open in his absence in the field, and by being informed as to his whereabouts, make it possible for health officers and for this Department to reach him promptly at all times.

In many

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