Saanich has fine schools and a good class of teachers and children, who are worth our while in doing all in our power to make happy and healthy.“The Health of the School Children” by Dr. C. Denton Holmes, The Daily Colonist June 23 1918
On June 23 1918, The Daily Colonist published a paper by Saanich Schools medical officer Dr. Charles Denton Holmes entitled “The Health of the School Children”. Dr. Denton Holmes had been with Saanich schools for five years and during this time had seen the advent of War, which had made even more imperative the health of the school children.
“In the strenuous life of today, physical soundness and capacity, ability to stand the modern strain and keen competition, is of more importance than superior mental acumen or brilliancy in the race for material success. Let a child be as clever and brainy as you could wish, and not in good health, of what use is it in this world of ours in 1918? Health is a child’s greatest asset in making headway in the present struggle for existence.”
Dr. Denton Holmes’ paper is a good starting point to look at the health of the Saanich school children in the WWI era. This story will look at some aspects of health in Saanich schools, with a focus on medical inspections, the role of the school nurses in Saanich and the role of Saanich parents.
School Medical Inspections
“A healthy child makes a more intelligent pupil”British Columbia Provincial Board of Health Guidelines for Medical Inspection of Schools (1913)
We can learn a lot about the health of the Saanich school children by looking at the annual medical inspection reports of Saanich schools.
British Columbia was the first Province in Canada to pass legislation making medical inspection of school children compulsory. In February 1910, a bill for the medical inspection of schools was discussed in the British Columbia legislature. “It was not only intended to safeguard the children against the possible introduction of contagious diseases in the schools, but arrangements were made of the annual inspection of all pupils for physical defects or incapabilities which might not be suspected by either themselves or their teachers, but which might handicap their scholastic efforts.”
Patrick A. Dunae, specialist in the history of British Columbia education, writes: “In 1910, medical inspections were introduced province-wide under the authority of the Schools Health Inspection Act [10 Ed.7, c.45]. The Act made compulsory “the examination of every child as to the condition of sight and hearing, throat and teeth, or any other physical disability ‘liable to prevent his receiving the full benefit of school work’.” Under the terms of the 1910 Act, city school boards were to required to appoint and pay for a full time medical inspector who reported to the Provincial Board of Health. (The Homeroom, British Columbia’s History of Education website).
These are the terms of the Schools Health Inspection Act [10 Ed.7, c.45]:
Every School Health Inspector shall forthwith upon his appointment, and thereafter at least once in every school year, or oftener if required by the Board of School Trustees, make a thorough examination as to the general health of all children attending school in the district of which he is such Inspector, and of all, teachers and janitors in such district. He shall also carefully examine all school buildings and school surroundings in his district, and shall report to the said Board, fully and in detail, the result of such examinations. An annual report shall be made at the termination of every school year by the School Health Inspector to the Provincial Board of Health.
“The inspection of an average normal child requires about five minutes”Guidelines for the Medical Inspection of Schools (1913)
Guidelines for the Medical Inspection of Schools (1913) gives advice for teachers and medical inspectors how to assess and record the health of public school pupils. (Note – a thank you to the students of Vancouver Island University who transcribed these guidelines and made them available online in The Homeroom website – click on the link to see full instructions.)
Some medical inspection was done by the teachers before the medial inspector arrived. Here are the instructions for filling out the pupil’s medical cards.
- For the school-year the first half of the year may be designated; e.g., the year 1912-13 may be signified as 1912.
- Give the number of the grade for the class. In the case of one grade requiring two years, write Jun. for junior or Sen. for senior after the grade number; e.g., V. Sen.
- In measuring the height, have the child stand erect with his feet together, and the weight on the heels and not on the toes or the outside of the feet. If the boots are worn, deduct the height of the heels before recording.
- Endeavour to give as near the correct weight as possible, ordinary clothes being worn.
- Conduct may be described as good, fair, or bad.
- Endeavour may be earnest or dull.
- Proficiency may be good, fair, or poor.
- Cleanliness may be clean, somewhat dirty, dirty.
The manual instructs: “Kindly make all entries in small writing, using a fine pen and a good quality ink.” A lot of work? The manual commented: “While medical inspection may appear to throw more work on the teacher, yet when carried out satisfactorily it tends to make the whole school-work easier and more efficient.”
Teachers were required to check the children’s eyesight with an eye testing card. “The test-card is fastened to the wall in a good light, so that the bottom is on a level with the eyes. Twenty feet measured from it and marked on the floor with chalk in the distance at which the child to be tested should stand. With good vision the child should be able to read the line marked D-20. If he fail he should be called upon to read the letters in the line above, D-30. If again unsuccessful, try him with the line above, D-40, and so on up until he is able to read the type correctly. Make a note of each child not having normal vision, marking what line he is able to read, and hand this report to the Medical Inspector when he inspects the children of your room.”
Teachers were usually the first to notice eyesight problems — see this 1918 advertisement from Victoria optometrist Dr. Frank Clugston: “in most cases the parents are not aware that anything is wrong with the child until notified by the school authorities.”
Tolmie School Medical Inspection
The first province-wide medical inspections were published in the First Annual Report on the Medical Inspection of Public Schools of the Province of British Columbia, for the year ending December 31 1911.
The only Saanich school inspected in 1911 was Tolmie School on Boleskine Avenue. Tolmie, the largest school in Saanich, drew its 157 students from the “suburban” (newly subdivided) areas of Cloverdale and Tillicum. This reports gives a good idea of the medical conditions at the time. For more information on Saanich school children’s experience with diseases, see Saanich School Children, Infectious Diseases and the “Flu”.
Here are the results in the Fifth Annual Report (1916) showing the increase in size to Tolmie School (now 366 students inspected)
|Health Issues||Number of children inspected – 366|
|Defective Nasal Breathing||7|
The first Saanich school medical inspector was Dr. H. Rundle Nelson. In the 1913-1914 school year, Dr. C. Denton Holmes was appointed medical inspector and remained in this position for the next five years. Dr. Denton Holmes was also the Saanich Medical Health Officer.
Victorian Order of Nurses and School Medical Work
“We now have school nurses who supervise the children, call at the homes regarding any condition in the child which requires attention, discuss any matters with the parents which concern the health of the child, and generally help and carry on the work of the medical inspector.”Dr. C. Denton Holmes
The scope of the Saanich school inspections (about 15 schools located all around the Saanich peninsula) meant there was only so much one man could do. By the end of 1916, various women in Saanich were hoping to change that situation for the better by getting district nurses in Saanich. There was a big campaign to get the Victorian Order of Nurses (V.O.N.)
A letter from Mrs. Vangie Shaw MacLachlan, Garden City Women’s Institute, was published in The Daily Colonist on October 22 1916: “The school work this nurse could do would not be the least of her services to our coming generation. To quote from a report of the Minnesota State visiting nurse, and I suppose the Victorian Order would do similar work: “They find that one child in four has bad eyes, one in five bad ears, while nineteen out of every twenty have bad teeth. Not that these defects of eyes, ear and mouth are always serious, but they are of the sort which if not attended to, are likely to cause bad health, slow progress in school or even worse results.”
To put this into context, the War had made the physical condition of the children more imperative. Provincial Nurse N. Locke commented in the Fifth Annual Report of Medical Inspection of Schools: “One has to only look at the rejections of men who, in the prime of life, have volunteered for military service, and have been rejected for physical defects.” Mrs. MacLachlan concluded: “If there was a time in our history when we needed “born in Canada” citizens with ‘sound minds in sound bodies’ it is now…” At the December 5 1916 meeting to organize the Saanich Branch of the V.O.N., Saanich Medical Health Officer C. Denton Holmes gave a talk on “Benefit to the School on behalf of the School Children”. He “agreed with one of the preceding speakers as children being the greatest asset to a country.”
By 1917, a branch of the Victorian Order of Nurses had been established in Saanich and was hoping to hire a nurse. The branch continually petitioned the Saanich School Board and the Saanich Council to get funding to achieve this goal. At the March 21 1917 Saanich Council meeting, “A letter was received from the school board asking the Council for a conference, and suggesting representatives of the Victorian Order of Nurses be invited to go into details for having a school and district nurse combined. It was explained that Dr. Denton Holmes suggested that somebody should follow up and carry on the work he has started through his inspections of the schools.” At the May 1 1917 Saanich Council meeting, the Saanich V.O.N. delegation asked for $1,100. Saanich Council could help if the School Board was willing to assist and give a grant. Dr. Denton Holmes had stated he was willing to give part of his salary.
By Fall 1917, the Saanich V.O.N. had two nurses who were busy with school inspections. On October 16 1917, The Daily Colonist reported that “The two nurses … had examined 322 school children, located at Tolmie, McKenzie Avenue, Tillicum, Royal Oak and Craigflower Schools. In this connection they reported that generally speaking, the teeth of the pupils required attention, and that the eyesight was by no means up to the standard, this last being especially commented upon in connection with the McKenzie Avenue School.” Minutes of the Saanich V.O.N. show that in April 1918, one of the nurses did two school inspections of 98 children. In June 1918, 90 school children had inspections. It was becoming clear that the nurses were getting overwhelmed with school inspections. This was a topic at the June 1918 meeting that Miss Russell, the V.O.N. inspector from Ottawa, attended. “On the question of nurses doing school work, she recommended a committee.” At the July 2 1918 meeting, the School Board representative Mr. James Owens thanked the Saanich V.O.N. for the work done in the schools by the nurses. The School Board and the nurses had come to an arrangement about when school inspections would happen:
- Once in 6 weeks: Prospect Lake, Keating, Gordon Head, Cedar Hill, Royal Oak, Strawberry Vale, West Saanich and Saanichton
- Once in 4 weeks: Quadra Street (Cloverdale), North Dairy, Tolmie, Tillicum, McKenzie Avenue
- Each pupil in all schools to have an individual inspection once a year
Between October 1-7 1918, the V.O.N. nurses had inspected two schools of 188 children. But then the school nurses’ work “was badly upset by the influenza epidemic”. Schools were closed from October 8 1918 to January 13 1919. By Spring 1919, inspection had resumed: “That the school inspection work by the Victorian Order of Nurses in Saanich is now being done systematically was the report of Miss Forshaw last night at the regular meeting of the Victorian Order of Nurses at Tillicum School.” (The Daily Colonist May 15 1919) In July 1919, Saanich V.O.N. nurses expected to make 250 visits to school children in their homes. By the 1921-1922 school year, Saanich nurses were visiting fifteen schools; fifty-four classrooms; 2,000 children. “Individual classroom inspection held once each month. Pupils are weighed every month and measured once in the school year by the nurse. Charts are placed in every classroom for this purpose.” (The Twenty-Sixth Report of the Provincial Board of Health July 1 1921 – June 30 1922)
More than just inspection, the nurses’ visits were about health education: “After each inspection the nurse gives a “Health” talk to the class upon such matters as personal cleanliness, care of the teeth, etc. The talks are suitable to the grade. Attractive health posters are being placed in every classroom and children are encouraged to make health posters themselves about fruit, teeth, sunshine, etc.” (Later, the Provincial Board of Health gave prizes for best health poster). The Twenty-Seventh Report of the Provincial Board of Health (1922-1923) notes that a school Roll of Honour was being given each year to Saanich pupils who observe the “health rules”. Saanich health care nurses commented that emphasis was placed on “playing by the rules of the health game”.
Stimulating the parental interest
Six months after Saanich V.O.N. nurses started their work in Saanich schools, The Daily Colonist on November 16 1917 stated “with few exceptions, the parents are appreciative of the preventative purposes of the general physical examinations which are carried out by the Victorian Order nurses. Much unnecessary suffering as well as expense may be saved by the detection and immediate treatment of decayed teeth, astigmatism in the eyes, adenoids, or any of the little troubles which break out among school children.”
In 1916, the Board of Health sent out a letter to school medical officers to find out the impact of the Schools Health Inspection Act. Provincial Nurse N. Locke reported: “We are in receipt of nearly 100 replies…We find the consensus of opinion is that not only is there a marked improvement in the physical condition of the children, but that a greater interest is being taken by teachers in the work, and particularly on the part of the parents is a desire being shown to carry out the recommendations of the medical inspector.” (Fifth Annual Report of Medical Inspection of Public Schools)
These comments may have been somewhat optimistic. Medical inspections highlighted the health of the Saanich school children, but were only useful if the parents would do something about it. As Dr. Denton Holmes put it: “It is useless to find defects unless a remedy is applied”. Perhaps the problem was parent education. Provincial Health Officer Dr. Henry Esson Young reported in the Eighth Report of Medical Inspection of Schools: “We have found that it is not that the parents do not wish to follow advice, but that they do not understand.”
By the stimulation of the parental interest we can hope to have many of the defects which heretofore have been neglected…Dr. Henry Esson Young, Provincial Health Officer
In Saanich, the “parental interest” was definitely stimulated by a number of community groups (of both men and women) who wanted to improve the happiness of their children. School Inspector for Saanich W.H.M. May commended “…the Saanich schools, where, through the influence of Parent-Teachers’ Associations and Women’s Institutes, the parents are demanding the best instructors for their children and the right conditions at the school-houses.” (Forty Sixth Annual Report of the Public Schools of British Columbia)
Circa 1915, Craigflower School was one of the first schools in British Columbia to start a parent-teachers association. “Almost every mother in the district belongs to the P.T.A. and nearly all regularly attend meetings held on the first Wednesday afternoon of the month…Fathers as well as mothers are interested in the school, as was shown by their attendance at the father’s night, recently held.” (The Daily Colonist July 1 1916)
In 1916, the Gordon Head Athletic Club was started by community members who wanted to bring recreational facilities to the young people of the district, such as tennis courts at the school, a football play field and swimming lessons in the Summer holidays.
At the beginning of 1918, the Tillicum Women’s Institute was formed with a focus was on children’s health and education. Their inaugural meeting of February 7 1918 featured an address by Dr. H. E. Young on preventative medicine. At the February 20 1918 meeting, School Inspector W.H.M. May spoke to the mothers on the value of co-operation with the teachers. May “urged more social intercourse between the parents of pupils and the teachers. Teachers had frequently declared that they learned more of a child in the few moments spent with the mother when she brought the child to the school, than in months of contact with the child alone.” (Victoria Daily Times February 20 1918) “The present day conditions revealed the necessity for the parent’s knowledge and the realization of removable physical defects in children.”
On March 6 1918, Dr. M.J. Keyes (physician and surgeon, “practice confined to eye, ear, nose and throat”) “spoke for about forty-five minutes upon the care of the ears, nose and throat, and dwelt upon the need of the removal of diseased adenoids and tonsils, and explained the harm resulting in later life from neglect of this precautionary measure. He also dealt with the question of vaccination, pointing out the need and safety of the practice. At the conclusion of the address, the doctor was bombarded with questions, showing the keen interest that had been taken in his address. (Victoria Daily Times March 7 1918)
On June 29 1918, the Tillicum W.I. and the Saanich V.O.N. collaborated at a “Home Products / Garden Show / Health Fair” at Tillicum School. In one classroom was the health exhibit “where posters with facts and figures, advice and enquiries met the gaze. Literature on the general health, children’s health and community health was arranged on the desks for distribution, along with different bulletins from the Food Controller’s office, and all under the charge of the Victorian Order of Nurses.” (Victoria Daily Times July 3 1918)
At the January 1919 Garden City Women’s Institute, “A short talk given by Nurse Forshaw, the Victorian Order Nurse for Saanich. The nurse showed how greatly every woman can help in reconstruction and also in the conservation of life, and mothers should all be willing to co-operate with doctors and nurses in the well-being of the children of the nation and in the effort to eradicate disease. When the influenza epidemic is over the Victorian Order nurses expect to hold a chain of Child Welfare clinics throughout Saanich, when it is hoped that the parents will take advantage of these examinations to obtain health cards for their children.” (The Daily Colonist January 10 1919)
Another form of health cards was used – to invite parents to the school medical inspections. In May 1919, the children of West Saanich School had a visit from the school nurse: “Late in the afternoon the school nurse, Miss Forshaw, came to distribute health cards and to say that the doctor would arrive the next day to examine the pupils.” (The Daily Colonist May 25 1919) The health cards were a new concept for 1919. “Cards were issued to Medical Inspectors to enable them to notify the teachers of the date of their visit to a particular school, and a request was made that through the teachers and pupils an invitation be extended to the parents to visit the school on the day of the medical inspection. Some slight response to this request has been received — as much as we can expect immediately following the initiation of such a movement.” (Dr. H.E. Young, Eighth Report of Medical Inspection of Schools)
To conclude, we’ll see how medical inspections, school nursing and parental interest came together in the “case of the bad teeth.”
Case Study – Bad Teeth
At least 50 per cent of the children in Saanich have decayed teeth. It is really heartbreaking to see the filthy state that some of the children’s mouths are in.Dr. C. Denton Holmes
School medical inspectors were required to examine children’s mouths and throats. Here was how to do it, from the British Columbia Provincial Board of Health Guidelines for Medical Inspection of Schools:
“In the examination of the mouth and throat, wooden tongue-depressors are to be employed. These depressors must never be used more than once. The number of decayed and missing teeth, the condition of the tonsils, and the probable presence of adenoids are all noted. In recommending treatment for tonsils, temporary enlargement must be differentiated from permanent enlargements, which require operative treatment. Digital exploration for adenoids is not recommended, as it tends to frighten the child and renders it more difficult for the Medical Inspector to perform his general examination.”
Saanich medical inspector Dr. C. Denton Holmes didn’t like what he saw inside Saanich school childrens’ mouths — terrible teeth! “At least 50 per cent of the children in Saanich have decayed teeth. It is really heartbreaking to see the filthy state that some of the children’s mouths are in,” he observed in June 1918. A year later, the Victorian Order of Nurses for Saanich reported “that there are several hundred cases of children suffering from tonsillitis, defective eyesight and defective teeth…” (The Daily Colonist June 12 1919)
Medical Inspection results for 1913-1918 show an increase in the percentage of poor teeth among the children at Tolmie School
|School Year||Cases per children||Percentage|
Bad teeth was not a Saanich-specific problem, but a province-wide concern, and continually referred to in annual school medical inspection reports. Here is some context: On May 1 1914, Provincial School Nurse Blanche Swan inspected the schools adjacent to Victoria as far north as those in the vicinity of Nanaimo (so she would have covered the Saanich schools). The following conditions were ascertained: “The teeth are badly neglected” and “conditions were found in children which are caused by defective teeth.” (Sixth Annual Report on the Medical Inspection of Schools)
“No single defect of the school child is responsible for more trouble than decay of teeth, and nothing will give more satisfactory results to the child than early attention to this matter. (The Daily Colonist June 23 1918) Provincial Nurse Swan: “There is a great need of educating parents of caring for the teeth of young children. When one considers the suffering and disease induced by neglected teeth and realizes that these conditions lead to indigestion, heart, throat and ear complications, too much importance cannot be attached to this branch of Medical Inspection.” (Sixth Annual Report on the Medical Inspection of Schools) Bad teeth had negative educational consequences: “A child suffering from its teeth is from one year to a year and a half behind in school work. (V.O.N. meeting reported in The Daily Colonist June 12 1919)
Pierre went down to see Dr. Nash after school.Thursday May 22 1919 diary entry of Mrs. Helen Malon, 68 Burnside Road, Saanich
Saanich children did have access to dental care — Greater Victoria was not without dentists at this time. Here is the entry from Henderson’s 1918 Greater Victoria City Directory
But location could be a problem. The directory shows that dentists were located in downtown Victoria. Convenient for those school children who lived in the “suburban” Saanich but less convenient for those up the Saanich Peninsula. Plus, the cost of dental work could be an added factor. Dr. Albert. E. Clarke, specialist in children’s dentistry, said “It costs very little if defective teeth are treated in time.” Mrs. Helen Malon of Burnside Road could afford to get her children’s teeth “stopped” by Dr. Nash, but she was in a comfortable financial position. For many Saanich parents during the economic depression of 1914 and the War years, extra medical expenses may not have been an option. Dr. Denton Holmes commented: “In Saanich most, if not all, of the teachers ask the children every morning whether they brush their teeth or not, and I think it would not be a bad investment to provide the children with toothbrushes at a cheap rate…” (suggesting the possibility that parents may not have even afforded tooth brushes!) (The Daily Colonist June 23 1918)
Advertisements in the 1918 newspapers show toothbrushes at 15 cents and toothpaste at 25 cents (brands included: Carson’s Charcol Toothpaste, “Rexall” Brand and Forhan’s Pyorrhea Toothpaste). As a price comparison, a child’s seat for a matinee at a local moving picture house was 10 cents.
A few years later, Dr. Denton Holmes had his wish! See this comment from the V.O.N. nurses in 1924: “Much attention has been given by the School Nurse to toothbrush drill, each child being provided with a toothbrush at a nominal rate. The nurse stands in front of a class; each child has a toothbrush. The nurse instructs them by actual practical demonstration, placing the brush in her mouth, brushing all aspects with an up and down movement, taking two minutes. The children have several practices at this game and then are examined.” (Twenty-Eighth Report of the Provincial Board of Health, July 1 1923 – June 30 1924)
But ultimately, Dr. Denton Holmes hoped “before long we shall have a school dental clinic, where every child can, and will have, his teeth attended to.” It took three years for this to happen, coincidental with building the Saanich Memorial Health Centre.
On Saturday May 7 1921, a tag day was held to raise funds for a children’s dental clinic in Saanich. The tag day was being run by the parent-teacher associations, the I.O.D.E. at Cedar Hill and the Women’s Institutes at Gordon Head, Keating, Strawberry Vale and West Saanich. The day before the event, The Daily Colonist reported: “great enthusiasm exists and good results are anticipated.” Riley’s drug store (Cloverdale) was the headquarters. About one hundred and fifty school children canvassed house to house. “Motor cars were stopped and the occupants asked to donate. In one case a rope was placed across the road to hold up traffic. The passengers leaving the interurban cars at the city terminus were solicited.” (The Daily Colonist May 8 1921). The money was counted at Tolmie School in the evening. Though still waiting for results from the rural Saanich Women’s Institutes, a sum of $338.87 had already been realized.
Six months later, The Daily Colonist on November 9 1921 noted “The undoubted success of the newly instituted dental clinic for school children at Saanich Health Centre…When the school doctor discovers children whose teeth require attention, he sends them to the health centre where an estimate of the cost of the work is given them and this is taken to the parents who may avail themselves of the dentist’s services. The cost is at a minimum. All those who have had work done at the clinic have paid rapidly.” The dentist, Dr. Henry J. Henderson was at the centre 9 a.m. to noon five days a week and attended to approximately 25 pupils a week. In October 1921, Dr. Henderson performed 92 operations on the children, some of whom required more than one operation on their teeth. In November 1921, 85 school children were examined and 106 fillings put in. In September 1922, Dr. Arthur Poyntz was appointed to the dental clinic at a pay of $150 a month.
In addition, “operations at the Health Centre have already begun in the adenoid and tonsil clinic when in one day Dr. J.P. Vye performed operations on five children.” (The Daily Colonist November 24 1921) The tonsils clinic was held on the last Friday of the month. “We aim to have at least five tonsil operations done. The children are put to bed and cared for, and remain from six to thirty-six hours, until quite recovered.” (The Twenty-Sixth Report of the Provincial Board of Health, July 1 1921 – June 30 1922)
The Saanich dental clinic had made a positive impact on children’s health. Here is a statement by Mrs. C.A. Lucas, Nurse Superintendent of the Saanich Health Centre, published in the Twenty-Eighth Report of the Provincial Board of Health: “We no longer have to rush after parents at the last moment for permission to take the child to the dental clinic which has previously been denied us – our appointments are booked weeks ahead of time. The improvement of the health of the child who has been treated is so apparent to the parents and the neighbours that it would appear all our difficulties in the matter with dealing with ignorance of the people is at an end if a child in that particular part of the community happens to have attended our clinic.”
In June 1918, Saanich school medical officer Dr. C. Denton Holmes concluded his paper on “The Health of the School Children” with this call to action: “Saanich has fine schools and a good class of teachers and children, who are worth our while in doing all in our power to make happy and healthy.” It really seemed that doctors, nurses, community members and parents were indeed doing all in their power to have happy and healthy Saanich school children!
This story is part of a look at community, health and education in World War One era Saanich B.C. Thank you to Saanich Archives for sharing Saanich School Board accounts. Read more about school health in Saanich School Children, Infectious Diseases and the “Flu”.