Intermediary Medicine in Harlem
Registered nurses, serving as intermediary links
between the community and the hospital, represented a vital component within
Harlemās development from the mid-1920ās onward. A creature of the northward
migration, Harlem comprised of a great number of immigrants from varied regions
and backgrounds across the United States and from abroad. When contemplating
this fact, and in researching the medical background of such a region, the inevitable
resistance to medical institutions in the form of strong religious beliefs,
preconceived notions of hospitals, and a great distrust of outsiders becomes
apparent. This resistance and the importance of overcoming a variety of other
social barriers to the community created the need for medically trained intermediaries.
Public Health Nurses
As
registered nurses employed by the New York City Department
of Health, public health nurses worked within
public schools and public clinics, following up on those interactions with home
visits. The primary objectives of Harlem public health nurses were the identification
of, diagnosis for, and referral to treatment of potential health problems within
the community. In addition to theses primary obligations, they adapted themselves
to the work of social service, cultural coordination, and religious ambassadorship.
The nursesā vital role as an intermediary made possible education and treatment
to a number of medically and non-medically related problems effecting the greater
Harlem community.
Visiting Nurses in the Homes
Unlike public health nurses employed by the city health department, visiting
nurses worked for the private Visiting Nurse Service. As registered nurses,
licensed by the state of New York, they provided treatment-based medical care
to patients convalescing from hospitals or those who were ill but not admitted
for some reason or other. Among other invaluable services they provided patients
within their homes, visiting nurses administered prescribed medications, gave
injections, bathed patients, gave enemas, dressed wounds, whatever was needed
to treat the patientās illness. Like the public health nurses, the visiting
nurseās role as educator and detective, combined with their services as an intermediate
health agent within the homes of those unable or unwilling to attend a hospital,
provided as an integral service within the greater Harlem community.
Other Intermediaries
Despite the best efforts of public health nurses to bring general health education to the Harlem community,
and visiting nurses within the homes of private patients, some segments of the community undoubtedly received little
or no influence from public health community. For a portion of these segments of the community, the local area
druggist, always tagged as ćDocä, was the first to be consulted for advice and relief. Invariably he came up what
he claimed was just the medicine to fit the need. Often times his advice, based on a hack knowledge of clinical
and traditional treatments, harmlessly enough treated the mild symptoms described by customers, thus providing
a service within the local community. Unfortunately though, this was not always the case.
The favorite remedy for abdominal pain was a purgative, a medicine for purpose
of evacuation of the bowls. In the presence of appendicitis, taking of a purgative
contributed adversely to the progress of the disease. Such prescription from
local area pharmacists, acting on their own volition, and other sources unaware
of potential consequences of such treatment, represented a significant enough
overall portion of such cases as to prompt a study from the Harlem Hospital.
