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The Untold Story of Our Public Health 1897 to 2002

March 26, 2011

For Starkville Daily News
Since September 1947, the Pilot Club of Starkville, Inc. has left the mark of its influence on many phases of community life in Starkville and Oktibbeha County. 
Representatives of the Pilot Club met with the County Board of Supervisors in 1947, to discuss plans for obtaining a full time health department and building.¬† Dr. Mary Walker Critz Fletcher, a member of Pilot Club, went before the State Legislature to endorse a change in existing laws so that federal funds might be applied toward the center.¬† The charter Pilots said, ‚ÄúWe‚Äôve just got to make a success of it, so let‚Äôs not let a little thing like getting a law amended stand in our way.‚Ä̬† The Pilots hosted the opening of this facility on November 7, 1949.¬†
Two longtime Pilot Club members, Mrs. Cattie Taylor and Mrs. Ellen Mauldin presented some very interesting information to the Oktibbeha County Historical and Genealogical Society recently concerning the Health Center, which opened in 1949 on Felix Long Drive, which is shared in this article.
¬†Be sure to read the memories below.¬† You will be amazed at the changes in public health given by these public health employees from 1897 to 2002.¬† Dr. Tom E. Waller, Health Officer from 1965-1993, and Marnita Nichols (Mrs. Charles) Henderson, Nurse Coordinator and RN from 1964-2002, share their memories of these years.¬† Dr. J. W. Eckford, Deceased Health Officer in 1897 reported on a quarantine issued due to an outbreak of ‚Äúyellow fever‚ÄĚ in the county.¬†
Delegates from the leading civic clubs of Starkville and State College met with the county Board of Supervisors to discuss plans for obtaining a full-time public health department and building for Oktibbeha County.  Acting as spokesman for the group, Dr. Mary Walker Critz Fletcher stressed the need for a public health unit in this county. 
Dr. Fletcher presented petitions, which were signed by the officers of the civic clubs representing 682 voting members of this community, to the Board. 
It was suggested that Mr. Kroeze, state architect, be invited to the next board meeting to present plans for a county public health building to be erected in Starkville.
The building cost would be about $20,000.  Twenty-five percent would be funded with Federal funds, 60 percent with state funds and the remainder with county funds.
In 1947, the county had a part time public health unit housed in two rooms.  The work was under the supervision of the county health nurse, Mrs. Gloe Cunningham.  The part time venereal disease investigator shared the office with the county health clerk.  The same office served as a waiting room and a consultation room. 
Mr. Williams, the county sanitarian, shared an office with the county health nurse, who used half of the room divided by a wooden partition as an examination room. 
Mrs. Cunningham stated that the department could have obtained x-ray equipment some time ago, but there was no place to store it.  X-rays were then made by the traveling x-ray unit.  Because of the shortage of space at the department, it took three times as long to take x-rays as it would ordinarily if the health unit were equipped properly.
Mr. Williams stored the equipment he used in county work at his home because of the lack of available space.  He stated that there has been a marked improvement in the grade of milk sold in this county during recent years.  Mr. Williams also pointed out that there was a need for improvement in the school lunchrooms and the eating-places in Starkville. 
Several attempts have been made to obtain a full time county health physician.  This post opened in the county in 1940.  Several visiting physicians inquired about the job but due to lack of a building and adequate facilities they declined.
A new health center with adequate facilities would enable the Oktibbeha County Health Department to inaugurate a preventable disease program promoted by a full time health unit and its skilled personnel to protect the public by immunization against such diseases as diphtheria, smallpox, whooping cough, and typhoid fever, as well as promoting the early recognition and treatment of cancer.  It would advocate special prevention and treatment measures in combating tuberculosis, malaria, hookworm, pellagra and venereal diseases.  An industrial hygiene program protects the health of workers by the enforcement of regulations pertaining to sanitation, occupational diseases and ventilation.
A well equipped health center would encourage a sanitation program supervised by the county sanitarian to render public health service to food and milk handlers and give assistance in obtaining proper sewage disposal and protect water supplies, both public and private.  It would also aid the sanitary supervision of public buildings in the County such as schools, jails, courthouse, hotels and barber shops.  It advocates the control of insect-born diseases by securing proper drainage, screening and the use of DDT.
The adequate space in a new health building would permit the compiling of vital statical records of the department valuable in proving American citizenship, in obtaining a passport and in verifying the age for protection in legal affairs.  Death records point out which diseases are the leading killers in this community.  Many births and deaths in Oktibbeha County are never reported.
A new health building will assure the services of a full-time health doctor available to every expectant mother.

Tom E. Waller, M.D., 1965-1993 retired Health Officer, Oktibbeha County Health Department remembers...

On July 1, 1965, I became Health Officer for Oktibbeha, Choctaw and Clay counties. The major programs were
‚ÄĘ Sanitation - protection of water, food, and milk and issues such as sewage disposal;
‚ÄĘ Nursing and medical - visiting clients in the home, services in the clinic, immunizations, child care, prenatal care, granny midwife supervision, treatment of venereal disease, tuberculosis, and investigation of communicable diseases;
‚ÄĘ Clerical - record-keeping, registering births and deaths, repository for immunization records.
Many of the people that came for service had between eight and 12 children and occasionally more. Maternal deaths were a serious concern. There was no Medicaid and the pregnant woman had to make arrangements with the lay midwife or with a physician who delivered babies. The physicians and HD cooperated in providing care for these women. HD clinics provided care for uncomplicated cases until the last month of pregnancy when the local physician took over. Nurses worked with the women in the home in preparation for the deliveries. There was no WIC program to provide infant formula and there were feeding problem with some babies due to formula and feeding. As the children grew, the HD became a place that people came to ask if they were sick enough to see a physician. The HD did not have daily medical service available and the local physicians preferred to see sick people at the beginning of illness rather than after the HD had attempted to initiate some treatment that they were unaware of.
Mother’s of pregnant daughters often came in crying about their daughter’s being pregnant. It was still important to this culture that the mothers should be married and their counsel was very heart felt. As more family planning methods became more diverse, family planning became a major program. We began to see women stopping with five to six children. Longer intervals between pregnancies allowed children to grow and for mothers to be better prepared for the next pregnancy.
Venereal diseases - Gonorrhea replaced syphilis as the most common VD. Syphilis is more damaging to babies and adults than gonorrhea. Investigators traced contacts to get infected people into medical treatment. Over the years AIDS brought in efforts to screen people and later to provide medications. Legal procedures were used in an attempt to slow or prevent the spread HIV.
When Medicare come in the HD were set up to provide home health services. There were few if any other providers initially. Basically HD nurses were asked to return to bedside nursing.
Tuberculosis was an important illness in the county. HD provided the limited number of drugs that were available at the time. Follow-up exams and encouragement to stay on treatment were the main tools that were available. The Sanatorium was still open at that time, but not everyone was able or willing to go there. Patients were asked to take close to 32 tablets a day for two to three years. They were then required to be followed with chest x-rays for 2-3 years. Some patients remained infectious for many months. Permanent cure was not even assured after all the pills and all the follow-up.
To me the change to directly observed treatment in treatment of tuberculosis is one of the most astounding advances in medicine during the past 40 years. The directly observed treatment included a nurse watching the patient take their medicine for just a matter of weeks. If the patient did not show for the treatment, the nurse went to the patient. In combination with the newer drugs patients became non infectious in a matter of days and many were cured within sixmonths.
While in the old building we were able to be one of the first counties to have a pediatric nurse practitioner trained. Not too long after that we were able to have a OB/FP practitioner trained. Their pioneering work put the HD on the tract of having these specially trained nurses to provide prenatal care and family planning care to a number of people that would not have been able to be seen at our limited number of clinics.
By the time the newest HD was built, Oktibbeha was in a 10 county district with the District office being in Starkville.
The first obstetricians to come to Starkville agreed to work the maternity clinics at the Health Department over time they preferred to see all the Medicaid patients in their clinic. I doubt that any county had as good care for these patients as we had in Oktibbeha County.Feeding programs for women, infants and children (WIC) became a major program requiring much more space and personnel. Medicaid program paid HD’s to screen infants and children and to refer those who needed them. These activities became a significant proportion of our budget.
Immunization rates reached some of the highest in the state. The HD were able to implement a method that allowed them to follow just people due shots rather that attempting to contact every child who would need an immunization.
These more general remembrances do not tell the personal side that our clients allowed us to share with them. Nor does it recognize the dedicated nurses and clerks that were mostly a joy to work with. Nor the sanitarians, and special investigators who faced many unsuspected situations during their attempt to improve the health of citizens of Oktibbeha County. What a great place and time to have worked.

Marnita Nichols Henderson, 1964-2002, Retired, Nurse Coordinator and RN, Oktibbeha County Health Department

 In 1964 I began my career in Public Health Nursing.  I had been working in a hospital for about a year after graduating from nursing school.  I was first hired in Lowndes County. 
Public Health was a whole new world from hospital nursing.  In just a few months I knew I had found my true calling.  I fell in love with getting to know my patients on a personal basis and they were my friends as well as my patients.  In 1966 we moved to Bolivar County and I transferred to their Health Department. 
I found even though life was different in the Delta, I still loved my patients and my jobs. 
In 1973 we had the opportunity to return to our beloved Starkville.  I was blessed to be able to again transfer to Oktibbeha County. It truly was a coming home experience.  Oktibbeha County had three Public Health Nurses on staff. 
I had the privilege of working for Gloe Cunningham, the Nurse in Charge and Dr. Tom Waller Health Officer. 
Gloe had a vast knowledge of how to help people help themselves, and to me this is what Public Health is all about.
We would often go into a home and someone had delivered a very small baby.  We assisted the family in learning how to give small frequent amounts of formula, how to keep the baby warm since it needed extra heat. 
Even though I worked all areas of Public Health, mothers, babies and Communicable Disease have always been closest to my heart. 
During my 38 years as a Public Health Nurse, I have seen many changes in services and facilities for providing services.  
In the early years if someone was diagnosed with Tuberculosis they were often facing years on living in the Sanatorium away from their family.  With the discovery of newer and better drugs for treatment, people were allowed to be treated at home.  With theses changes TB became a much less dreaded disease. 
 We provided maternal and child care.  We saw the pregnant women each month providing their routine checks of weight, blood pressure, vitamins and encouraged good diet and healthy living. 
Often a physician would see the patient in the last month of pregnancy and deliver the baby with an overnight stay in the hospital. 
Others would deliver at home with a Granny midwife.  The ones delivered at home we visited within twenty-four hours to check mama and baby.  If we found problems we made a medical referral to the local physician.  This was all prior to Medicaid.    
Medicaid revolutionized medical access.  We now had a payment source for illness and problems we found in our patients.  About this time another revolution in medical service arrived, HEADSTART.
They had money to pay for vision care, dental care as well as providing educational services. 
For years dental cavities were a significant cause of pain and illness in children, now many more children began to receive visits to the dentist.  Therefore when we checked a child you would find fillings in their teeth instead of a lot of teeth with holes in them. 
By the early 1980’s our building was overflowing with employees and patients. 
The District Staff began to research ways to improve facilities, funds were located and Mr. Tom Jones was selected by the county as Architect. 
Plans were drawn and Sam Oswalt and Co. received the bid to build a new building on site just below the present site. 
On September 1983 we moved into our new Health Department at 203 Yeates Street.  It has 5,188 square feet and cost $321,428 which was $51.88 per sq. ft.  We had an Office Manager, three Clerks, Nurse Coordinator, four Nurses, one Sanitation, one Communicable Disease Specialist, one WIC Nutritionist, and one Social Worker. 
 In 1984 I transferred to the local District Office as Epidemiology Nurse.  I supervised the communicable disease follow up in 10 counties.  Much of my time was spent in immunization follow up.
 In 2002 after 38 years I decided to leave (not a job) but a life that I loved, to go home and begin a new career of retirement. 
I can truly say Public Health was a ministry for me but I received far more than I gave. 
One of my favorite stories was about a child born with paralysis of her legs. 
When I went to visit at home after delivery I applied to the cripple children fund for assistance.  She was fitted with braces and about the age of two she was sent to University Medical Center for rehab. 
They said they were going to teach her to walk.  I laughed to myself.  This child would not cooperate in trying to do anything. 
Well, about a month later the mother called and said the child was coming home.  I helped get a bus ticket for the mother to go get her.  I met the bus when it got to Starkville and off came the mother carrying the child and the smallest walker I had ever seen.  Put the child down and off she went on her walker.  I just cried. 
 Another memory was years ago of  a girl of about 15 who came in pregnant. She was upset because she was a good student and hoped to get an education. 
I told her it was still possible and she went back to school after delivery.  She promised me she would not have any more children until she completed her education.  She was true to her word and received a doctorate from Mississippi State University. 
I do not know if she ever had any more children because I lost touch with her after graduation. 

J. W. Eckford, MD, Deceased Health Officer’s Report of July 11, 1897, Oktibbeha County Health Department

The Board of Supervisors of the County of Oktibbeha and State of Mississippi met in called session at the courthouse in the town of Starkville on Thursday the 17th Day of September 1897. 
Present R. A. Lampkin, President, Isaac Winston and H. A. Fox. 
Absent J. A. Fulgham and G. B. Hutchinson.
Members M. D. McIlwain, sheriff by his deputy J. J. Neely and C. E. Gay, clerk by his deputy W. Lampkin.
The president brought the matter of establishing a quarantine against the public on the account of prevalence of ‚Äúyellow fever‚ÄĚ in some parts of the state and the following recommendation of Dr. J. W. Eckford as health officer was presented and adopted.
As health officer I recommend that no person or firearms be allowed to get off any train in Oktibbeha County except train crews to switch, get water, or orders when necessary. 
That the railroads be notified that the conductors on all trains must keep locked the doors of all cars carrying passengers while in the county. 
That no freight received from any infected point or any point south of here. 
That no one be allowed to come into the county from any where except those coming to bring produce or trade who are in the habit of so doing. 
That the citizens of the county be notified that we are in danger from an infectious disease and required to cooperate with officers in the discharge of their duties. 
That health and county officers be instructed to enforce this order rigidly and make no exceptions. 
This is a matter which will permit no delay and I urge that the board take action at once.

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