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Douglas C. (Douglas Crawford) McMurtrie.

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Federal Board,.



CORNELL UNIVERSITY LIBRARY




924 105 349 777




The original of this book is in
the Cornell University Library.

There are no known copyright restrictions in
the United States on the use of the text.



http://www.archive.org/details/cu31924105349777




CROSSING THE THRESHOLD OF DEPENDENCE TO A FUTURE OF SELF-SUPPORT.

(NAPLES, ITALY.)



Bulletin No. 15

(Reeducation Series No. 3)



The Evolution of National

Systems of Vocational Reeducation for

Disabled Soldiers and Sailors



By Douglas C. McMurtrie



PREPARED AT THE
Red Cross Institute for Crippled and Disabled Men

Issued by the

Federal Board for Vocational Education
WASHINGTON, D. C.



May, 1918






WASHINGTON

GOVERNMENT PRINTING OFFICE

1918



FEDERAL BOARD FOR VOCATIONAL EDUCATION.



MEMBEKS.



David P. Houston, Chairman,

Secretary of Agriculture.

William C. Redfield,

Secretary of Commerce.

William B. Wilson,

Secretary of Labor.



James P. Munroe,

Manufacture and Commerce.
Charles A. Gbeathouse,

Agriculture.
Arthur E. Holder,

Labor.



P. P. Claxton, Commissioner of Education.



executive staff.



C A. Prosser, Director.



Latton S. Hawkins,

Assistant Director for

Agricultural Education.
Lewis H. Cahris,

Assistant Director for

Industrial Education.
F. G. Nichols,

Assistant Director for

Commercial Education.



Josephine T. Berry,

Assistant Director for Home

Economics Education.
Charles H. Winslow,

Assistant Director for Research.



All communications should be addressed to
The Federal Board for Vocational Education, Washington, D. C



CONTENTS.



Page.

List of illustrations 8

Foreword 9

I.

Introduction 11

Principles of rehabilitation 13

Public relation 17

Artificial limbs 18

Placement in employment 19

The auspices of reeducation 20

II.

France 23

Rise of reeducational schools 23

Centers of physiotherapy, prosthetic equipment and reeducation 25

Interests of the different ministries 27

The national office 28

Registry of disabled men 29

Investigation among employers 29

Investigations of schools 30

Programs for centers of readaption 31

Departmental committees 31

Schools: Methods and organization 33

Methods of providing instruction 33

Pupils: When and how obtained 35

Support of men during training 38

Wages 40

Discipline 41

Teachers 42

Curriculum 42

Length of courses 45

Vocational advice 46

Agricultural reeducation 48

Difficulty in obtaining pupils 48

Agricultural courses 49

Kural credit system 50

Farm mechanics 50

Placement 51

Placement work of the schools 51

Private and public bureaus 52

Coordination of placement through the national office 53

Principles of placement 54

Laws conc<<rning the employment of disabled men 54

3



4 CONTENTS.

France— Continued. rage

Prosthetic appliances 56

Government procedure toward men needing a prosthetic appliance.- 66

Appliances supplied 57

Methods of procuring appliances 57

Repair of appliances 58

Different models used 58

List of reeducation schools 60

Law of January 2, 1918: Reeducation of disabled soldiers 63

III.

Belgium 65

The school at Port-Villez 66

Organization of the school 66

The medical service 67

The academic department 67

The department of technical training 69

How a trade is chosen 74

Finances 74

The school at Sainte-Adresse 75

The "Home University.' ' of Paris 76

IV.

Great Britain 77

Feeling its way 80

A move toward unification 84

Settling the pension question 85

Occupational training 86

Trade advisory committees 90

Training in technical schools 91

The Lancashire scheme 95

The Yorkshire scheme 97

In the London district 97

Other schools 99

Financial arrangements 100

Training of munitions workers 101

Training in workshops 103

Advisory wages boards 103

Placement 104

Health insurance 105

Employers' liability 105

Summary 106

V.

Italy 109

Organization 109

National federation 110

National board 110

Legal measures 112

Regulations for schools 113

Artificial limbs 115

Responsibility after discharge 115

Other provisions 116

Medical treatment and artificial limbs 117

Artificial limbs 118



CONTENTS. 5

Italy — Continued. Page.

Reeducation 120

Local committees 121

Milan school 122

Agriculture 124

Palermo school 125

Placement 126

National federation 126

Local committees 127

Government measures 128

Wages of cripples 129

Credit 129

Public relation 129

Pensions 129

Publicity 130

Federation 130

Local committees 131

Red Cross 131

Attitude of cripples 131

National association '. 132

VI.

Germany 133

Actual program of work 135

Organization 136

Present organization 140

Medical treatment 141

Process of treatment 143

Facilities 144

Artificial limbs ' 146

Limbs used 147

Investigation and publicity 148

Reeducation 149

Indoor plan 150

Niirnberg 150

Outdoor plan 151

Diisseldorf 153

Schools for one-armed 154

Agricultural schools 155

Public relation: Reeducation 157

Teachers 157

Attitude of men 157

Attitude of employers 157

Insurance associations 159

Attitude of workmen 159

Attitude of unions 161

Vocational advice 161

Cooperating military and volunteer agencies 161

Vocational advice by military department 163

Placement 164

Care committees 164

Public bureaus 165

Public bureau report 165

Government service 166

City governments 167

War department 167



6 CONTENTS.

Germany — Continued. Fa s e -

Public relation: Placement 168

Attitude of employers 168

Attitude of workmen ; 169

Arbitration boards 171

Attitude of cripples to employment 172

Machines for cripples 172

Accident insurance 173

Investigation of employment for cripples 174

Publicity 174

History 174

Publications 175

Exhibitions 177

Pensions 177

Social insurance for war cripples 180

Sick benefits 180

Invalid insurance 181

Capital settlement law 181

General conclusions 182

Attitude of cripples 182

Principles of vocational advice and reeducation 184

Vocational advice 184

1. General principles 184

2. Preparatory measures 184

3. Organization of bureaus for vocational advice 184

4. Aim of vocational advice 184

5. Vocational advice a continuous function 185

Application blank for war cripples used by local care committees of

Freiburg in Baden 185

Application blank for war cripples used by local care committee of

Hesse, Hesse-Nassau, and Waldeck 186

Guiding principles for local care committee 187

Training related with hospital work 187

Reeducation schools mentioned in German reports 188

Agricultural Bchools 191

Schools for the one-armed 192

Employers' and workmen's associations assisting in the placement of

war cripples 193

Authorized land settlement societies 193

General agencies for whole nation 194

VII.

Austria-Hungary 195

Austria 195

Vienna orthopedic hospital 196

Medical care 196

Reeducation 197

Administration 199

Other institutions 200

Placement 200

Hungary 202

VIII.

Canada 205

Reception from overseas 207

Functional reeducation 208



CONTENTS. 7

Canada — Continued. ?*&«•

Artificial limbs , 209

The course of rehabilitation 211

Vocational reeducation 218

Military Hospital Commission survey forms 218

Vocational training statistics 225

Maintenance during training 225

Training in industrial establishments 227

List of occupations 229

Tubercular cases 231

Blinded soldiers 232

Men of imperial or colonial forces 233

Placement 233

Public relation 236

IX.

Other British Dominions 247

Australia 247

New Zealand 250

Local committees 251

Propaganda for employment opportunity 253

Stimulus to undertake training 254

Agricultural training 254

Clerical training 255

Technical training 255

Maintenance during training 255

Training in factories 256

Decision regarding special schools 261

India 263

Union of South Africa 264

X.

Bibliography 267

Publications of the Federal Board for Vocational Education 319



ILLUSTRATIONS.



Facing page.
Crossing the threshold of dependence to a future of self-support (Naples,

Italy) ■ Frontispiece.

French war cripples with double arm amputations, restored to usefulness as

agricultural workers 26

Crippled soldiers and their crippled teacher in a tailoring class at Paris 32

The special appliance supplants the old-style artificial arm for industrial

workers. A cabinet-making class in Paris 40

A soldier with double arm amputation in training as an accountant at a Paris

school 48

Whether minor or severe amputation, reeducation prepares for future employ-
ment (Montpellier, France) 56

The British minister of pensions addressing over four hundred limbless men

at Brighton, England 80

With working arm appliances these men have gone, after proper training, to

employment in the making of submarine fittings and chemical glass-working,

London 86

Training in oxy-acetylene welding, Military Orthopedic Hospital, Shepherd's

Bush 92

Class in motor mechanics, Pavilion Military Hospital, Brighton 92

Training of photographic and moving picture operatives in London 98

Commercial training class as Koehampton 104

Class in magneto assembling in a London technical institute 104

Training dismembered soldiers in typesetting at Naples, Italy 114

Instruction in artificial limb making, Naples, Italy 122

One month's progress in left-handed writing by a man with right arm amputated 128

One-armed men operate the shift key of their typewriters by pedals underfoot. 128

German war cripples with arm appliances prepared for bench work 156

Practical training in gas tractor operation: Plowing up virgin prairie in the

Province of Alberta 212

Oxy-acetylene class, Winnipeg 224

Cobbling class, Montreal 224

Training in machine shop, Kelvin Technical School, Winnipeg 232

Training in machine shop, McGill University, Montreal 232

Mechanical drafting is an adjunct to all trades and also a vocation in itself,

Calgary 240

Model office for final practice of commercial workers, Winnipeg 240

Instruction in typewriting and cabinetmaking at the school maintained by

the South African Union, Richmond Park, London 264

8



FOREWORD.



Since its organization in the summer of 1917 the Federal Board for
Vocational Education has been actively and continuously occupied
with those many phases of vocational training which the emergencies
of the war have emphasized as essential to the full development of
our war efficiency, and to the full conservation of our industrial
man power in the face of the devastating casualties that are inevita-
ble as the war progresses.

Vocational reeducation of disabled soldiers and sailors has been,
naturally, a principal interest which has to a very considerable
extent directed the activities of the Federal Board and of its staff
during the past months.

Ih the Research Division of the Federal Board, it may be noted,
two other bulletins dealing specially with the problems evolved in
vocational reeducation have been prepared. The first of these, a
preliminary study entitled " Vocational Rehabilitation of Disabled
Soldiers and Sailors," presents general principles of administration
and control, considering, for example, questions of cost, of coopera-
tion of public and private agencies, and of the proper scope of
military discipline and of civil control. A brief sketch is given of
foreign legislation and experience in Great Britain, France, Canada,
Belgium, Australia, Italy, South Africa, Newfoundland, India, and
New Zealand. The second bulletin, entitled " Training of Teachers
for Occupational Therapy for the Rehabilitation of Disabled Soldiers
and Sailors," presents a course of study and indicates necessary
qualifications for teachers directing vocational therapy. This bulle-
tin defines the field of occupational therapy, and discusses its social
and economic aspects as they appear with a background of European
experiences during the war.

Representatives of the Federal Board have participated actively
in conferences which have been organized for consideration of all the
different problems involved in the civil reestablishment of disabled
men. The Federal Board and its staff have cooperated continuously
with representatives of the Surgeon General's office, the Bureau of
War-Risk Insurance, the Bureau of Labor Statistics, and other Gov-
ernment offices.

One important result of this cooperation has been the preparation
of a draft of a bill providing for vocational reeducation of disabled
men. The Research Division of the Federal Board prepared a num

9



10 EVOLUTION OP SYSTEMS OF VOCATIONAL REEDUCATION.

ber of memoranda which were presented to the joint committee of the
House and Senate at a hearing of this committee on the proposed
scheme of legislation. These memoranda covered in considerable
detail the experience of foreign countries in this work and specifically
outlined a policy for the United States. Representatives of the board
appeared before the joint committee and presented a statement of the
conclusions of the Federal Board based upon its extensive researches.

In the meantime the Red Cross Institute for Crippled and Dis-
abled Men had undertaken the preparation of a manuscript descrip-
tion of the evolution of national systems of vocational reeducation
for disabled soldiers and sailors. This manuscript was offered to the
Federal Board for publication, and was committed to the Research
Division of the Federal Board for press editing and revision. It is
now published as Bulletin 15 (Reeducation Ser., No. 3) of the
Federal Board.

Mention may be made especially of the very extensive and com-
plete bibliography appended to the bulletin, but it seems only fair
to say that the bulletin as a whole, which gives the results of inves-
tigations conducted in different countri es, is probably the most com-
plete account available of the experience of the belligerent countries
in rehabilitating their disabled.

C. A. Pkosser, Director.



I.
INTRODUCTION.



Following upon past wars there has been no general effort of a
constructive character to restore the disabled soldier to useful em-
ployment. The only obligation which governments have acknowl-
edged is represented in the payment of a monetary award in the
form of a pension. Some men have been maintained in soldiers'
homes. The consequence, in either instance, has been an existence
of idleness and dependence which has tended to demoralization
rather than to reconstruction.

Happily this policy is in process of change. It has been demon-
strated that the cripple, though debarred by his handicap from some
occupations, could, almost without exception, be fitted by special
training for some trades in which he could be self-supporting in
spite of his disability. The great increase in industrial activity
during the past two decades brought about a corresponding incre-
ment in the number of employees crippled in work accidents. In-
juries were particularly frequent in the period before the advent of
the safety propaganda. The state authorities, especially in Europe,
became intimately identified with workmen's compensation, and in
many instances, themselves assumed responsibility for the payment
of the compensation award.

The waste involved in the complete support of thousands of work-
men injured in more or less serious degree became soon apparent,
and the authorities cast about for some means to decrease the per-
centage of disability. The solution was found — notably in Belgium
and France — in trade schools for the reeducation of the crippled
victims of industrial accidents. In these schools the man who has
lost the use of his leg is trained for a trade at which he can work
while seated ; the man lacking an arm is prepared for an occupation
in which two legs and the sound arm suffice for its pursuit. Since
the demand for skilled labor generally exceeds the supply,' it is en-
tirely practical to place at steady employment men trained thor-
oughly in wisely selected trades. Of course there are many difficul-
ties to overcome, but with patience, success is not only possible, but
probable.

The provision of training for disabled men received a tremendous
impetus at the opening of the present war. With the call of the

11



12 EVOLUTION OP SYSTEMS OF VOCATIONAL REEDUCATION.

able bodied population to arms, the ensuing shortage of labor neces-
sitated the draft into industry of women and old men. No potential
productivity could be neglected, and the rehabilitation of the physi-
cally disabled became a national necessity. The dictates of national
gratitude and national economy in this instance coincided, and in
conjunction have stimulated extensive and vigorous activity. The
organization of this work in the various belligerent countries is
described in detail in the following chapters of this volume.

There was little historical precedent for the vocational rehabilita-
tion of disabled men. One of the earliest and most successful
efforts was represented by the Ecole provinciale et Ateliers pour
Estropies et Accidentes du Travail, which was founded in Charleroi,
Belgium, in 1908 by the provincial council of Hainaut. 1 Instruc-
tion was given in bookbinding, cobbling, grass carpet making, willow
work, saddle and harness making, and tailoring. Apprentice pupils
were started on a modest scale of wages one month after admission
and if they remained faithfully at work for six months were then
paid for the first month as well.

Another school of similar character had been organized by the Bel-
gian Province of Brabant, just prior to the outbreak of the present
war.*

After the South African War there were established in Great
Britain by the Incorporated Soldiers and Sailors' Help Society
workshops for the employment of disabled soldiers. This enter-
prise is described fully in the fourth chapter of the present volume.

In 1897 there was established in Petrograd, in connection with
the Maximilian Hospital, a shop for the manufacture of orthopedic
apparatus and for the training of cripples in this trade. 3 Later
other equipment was acquired, and in 1901 residential facilities were
established. Training has been given in the making of orthopedic
appliances, rugmaking, shoemaking, cabinetmaking, turning, brush-
making, willow work, weaving and needlework, saddlery, and
tailoring. Cripples between the ages of 14 and 30 are received for
instruction, and the average course of training is four years in

1 The work of the Charleroi school has been described in several articles, as follows:
Paul Pasteur and Louis Caty, L'assistance aux estropies par la creation d'eeoles

d'apprentissage et d'ateliers. (Abonnement Germinal, quatrieme annee, No. 5) Ganrt
1907.

Emile jeanbrau, L'«cole d'apprentissage pour estropifiB et accidentes de Charleroi
Montpellier Medical, 1910, 1111, 529-538.

Douglas C. McMurtrie. Provision for cripples in Belgium, American Journal of Care for
Cripples, New York, 1916, iii, 121-125.

Douglas C. McMurtrie, Industrial school for the crippled and maimed at Charleroi,
Belgium. Maryland Medical Journal, Baltimore. 1912, li, 21-23.

2 Ch. Dam. L'assistance aux estropies et les ficoles d'estroptes. Progres Medical Beige
Bruxelles, 1914, xvi, 25-29.

'Douglas C. McMurtrie. Industrial training for cripples in Russia. Journal of the
Missouri State Medical Association, St. Louis, 1912, ix, 181-183. Also : American Journal
of Care for Cripples, New York, 1916, iii, 184-189.



EVOLUTION OF SYSTEMS OF VOCATIONAL REEDUCATION. 13

length. During the Kusso-Japanese War the workshop was con-
siderably enlarged.

There were established in France in 1899 by M. Marsoulan, under
the auspices of the Department of the Seine, subsidized workshops
for cripples and incurables of both sexes. 4 The occupations carried
on are the making of grass carpet, chair caning, toy making, and the
like. These shops are more in the nature of relief agencies than
training schools.

The system of rehabilitation in no two countries is the same. Each
has had to work out an individual problem with no historical basis
of experience upon which to build. We may now proceed to a de-
scription of the organization and methods evolved.

PRINCIPLES OF REHABILITATION.

Most of the experience, however, has been developed since August,
1914. It may be well to sketch some of the general conclusions of the
experience before passing to a categorical description of the methods
of vocational rehabilitation in force in the various warring countries.

The wounded soldier comes through the field and base hospital, and,
finally, if his disability is such as to disqualify him from further
military service, he is returned from overseas to a convalescent hos-
pital at home. Certainly at this point, if not perhaps earlier, prep-
aration for his social and economic rehabilitation should begin.

Before deciding what can best be done for him, the recent experience
of the crippled soldier must be taken into account. In the first place,
he has been away from home influence and environment for some
time — perhaps one year, perhaps three. During that period he has
led a life in the open, free from the many routine responsibilities of
the civilian. He has been provided automatically with every neces-
sity of life — mandates of military discipline. After his injury he has
been given every care which the medical corps and its auxiliaries have
been able to provide. Every effort has been made to minimize worry
or exertion on his part. These influences have the effect of deaden-
ing his initiative and his sense of social responsibility, and readjust-
ment to civil life becomes in consequence more difficult.

The new handicap usually throws the man into a state of extreme
discouragement. The loss of a hand, an arm, or a leg seems to the
man formerly able-bodied an insuperable obstacle to his future eco-
nomic activity. The prospective pension is the only mitigating feature
of this depressing outlook, and he begins to calculate how he can exist

* The work of these shops Is described in the following references :
Emlle Jeanbrau, L'gcole professionnelle des blessgs de la xvi™" region a Montpelller,
Montpellier, 1917, p. 24-26.

M. Carle. Les ecoles professionnelle de blesses, Lyon, 1915, p. 19.
Revue d'Hygiene et de Police Sanltaire, Paris, 1915, xxxvii, 92.



14 EVOLUTION OF SYSTEMS OF VOCATIONAL REEDUCATION.

on the meager stipend which will become his due. He has basis for
this expectation, for has he not known in the past several men each
of whom lost a limb through accident ? It was necessary for them to
eke out a living by selling pencils on the streets, or in some similar
enterprise of makeshift character. Again, life will hold no pleasure
in the future; he will always feel sensitive about his missing limb.
Besides, nobody has any use for a cripple.

Such a state of mind will be encountered in the convalescent sol-
dier. It must be met and overcome. With returning health, initia-
tive must be reawakened, responsiblities quickened, a heartened ambi-
tion must replace discouragement. We can go to him and truth-
fully say : " If you will yourself help to the best of your ability, we
will so train you that your handicap will not prove a serious disad-
vantage; we will prepare you for a job at which you can earn as
much as in your previous position. Meantime your family will be
supported and maintained. You will be provided with a modern
artificial limb so that a stranger would hardly know you are crip-
pled. Finally, we will place you in a desirable job."

The first reaction to this program is fear that an increase of earn-
ing power will entail a reduction of pension. When reeducation of
war cripples was first begun in both France and Germany it was
found that many of the men were unwilling to undertake training
in apprehension of prejudicing their pension award. The solution
of the difficulty was official announcement that such would not be
the case, but that pensions would be based on degree of physical dis-
ability alone, without reference to earning power. In Canada, a
placard to this effect is posted in all military hospitals and conva-
lescent homes.

The choice of trades in which war cripples may wisely be trained
is of primary importance. In addition to considering whether men
with certain types of physical disability can engage in a given trade
its present and prospective employment possibilities must be taken
into account. If it is a seasonal trade, if the number of workers in



Online LibraryDouglas C. (Douglas Crawford) McMurtrieThe evolution of national systems of vocational reeducation for disabled soldiers and sailors → online text (page 1 of 38)