A survey of the educational system of the Philippine islands by the Board of educational survey, created under acts 3162 and 3196 of the Philippine Legislature.

HEALTH AND PHYSICAL EDUCATION

467

Examination of the tabulation based on annual reports suggests the
following comments:
The 22 nurses in 1923 did a smaller quantity of work than did the
18 nurses in 1921. There is no report available on quality.
Further analysis of the work reported by the supervising teachers of
hygiene and sanitation is important. In 1923, which is more favorable
than the other years, the average number of children examined was
8,684. Within the school year this would mean that each nurse had
examined daily over 43 children. In addition to this daily examination
of 43 children she had visited from 1 to 2 homes, kept her records and
report, and performed her other necessary duties. The only reasonable
conclusion to draw from analysis of the reports for these three years is
that the work is extremely superficial or that the reports of work done
are extremely inaccurate.
THE HEALTH EXAMINATION OF SCHOOL CHILDREN.-The situation
at the present time may be stated as follows: (1) The Philippine Health
Service is generally ineffective in its work with school children due to
lack of proper organization for the work, and to a tendency to emphasize large numbers of children inspected and to correspondingly neglect
the really important part of treatment. (2) The nongovernmental
agencies can not be relied upon to do more than the essential supplementary work that any organization would desire. (3) The supervising teachers of hygiene and sanitation are now unorganized and
undirected and are consequently inefficient. This does not mean that
individual nurses are not giving intelligent and conscientious service.
But the records for 1921, 1922, and 1923 are sufficient evidence for
the above conclusion. (4) It will probably be impractical to make
any recommendation looking toward any great increase in expenditures.
Proposals for health supervision must be made upon a practical basis.
But it is possible to do this and greatly increase the quantity and
quality of health work in the schools. (5) Examination of the blanks
used by the Philippine Health Service shows that only one item requires
medical skill for recognition of abnormality. The one item requiring
a special technic and instruments for direct examination is adenoids.
The Philippine Health Service does not so examine. (6) The blanks
used by the Red Cross include two item (heart and lungs) on which
its personnel are unqualified to pass judgment. It is superior to the
blank of the Philippine Health Service in the personal, social, and
school history included. (7) Both blanks as types, however, present
items which can be passed upon by nonmedical persons, not with reference to differential diagnosis in all cases, but clearly as regards detection
of abnormality. This position is further supported by the annual reports
of the district health officers. The section reporting on "Medical In