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Douglas C. (Douglas Crawford) McMurtrie.

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1 Material for this chapter prepared by Gladys Gladding Whiteside.

s Hirscbfeld, Gustave : Tourvielle. Lyon, 1917, pp. 46-4!).

• Carle, M. : Les ecoles professlonnelles de blesses. Lyon et Paris, 1915, pp. 113-129.

23



24 EVOLUTION OF SYSTEMS OF VOCATIONAL REEDUCATION.

work of this kind and took steps to create a national school of
reeducation. A home for industrial cripples at Saint-Maurice, on
the outskirts of Paris, was taken by the Government for this pur-
pose, and in May, 1915, was opened as the Institut national pro-
fessionnel des invalides de la guerre. The Government made this
institut a model school, capable of training 300 men, but it left the
establishment of similar schools throughout France to other agencies.

The realization that the problem of the mutiles could be solved by
reeducation soon became general, and various public and private
agencies began to organize reeducational institutions. In Paris and
in the Provinces national associations for aiding the mutiles, depart-
mental and municipal governments, local committees, chambers of
commerce, trade unions, and private philanthropists took up the
work. All through 1915 schools of various kinds sprang up through-
out the country.*

The minister of commerce was one of those who early perceived
the need of providing trade training for discharged soldiers. He
proceeded, therefore, to do everything possible to adapt the existing
vocational schools under his jurisdiction to the needs of disabled
men. Under instructions from him the department of technical
education made an examination of the trade schools to ascertain in
what measure they could be utilized for reeducation. The result
of this examination was a report, dated June 3, 1915, to the min-
ister of commerce, suggesting a plan and program for the work. 5
The report stated that not all the schools of technical education
could be utilized, inasmuch as some had no capacity for additional
pupils or taught trades not suitable to disabled men or could not
undertake the placement of any more apprentices in their trades.
It was found, however, that a large number of schools could give
instruction to mutiles. In some schools it would be possible to re-
ceive men into the same classes as the regular pupils. In others
special sections for disabled men could be formed. In these last
cases the aid of the municipality or of the trade union was some-
times, but not always, necessary to cover the expense of the addi-
tional instruction and equipment. The directors of a few schools
undertook to organize separate schools for the mutiles under the
control of the minister of commerce and to make them new centers
of special technical instruction.

Ten months afterwards this program was largely realized. 6 In
national schools of arts and crafts, national trade schools, and prac-
tical business and industrial schools courses were arranged to teach
disabled men how to be self-supporting.



» Ibid., and Bittard, A. L. : Les ecoles de blesses. Paris, 1916, pp. 68-125.
» Bittard, A. L. : LeB ecoles de blesses. Paris, 1916, pp. 110-111.
•Ibid., pp. 112-122.



EVOLUTION OF SYSTEMS OP V004TIONAL REEDUCATION. 25

The minister of agriculture also attempted to organize reeducation
in the existing agricultural schools. Unfortunately, many of the
most conveniently situated schools had already been taken over for
hospitals and could not be used for instruction. Some of these have
only recently been given back. The minister of agriculture has, how-
ever, organized sections for the mutiles wherever he could find suit-
able accommodations. 7

The schools of all kinds now in operation for the reeducation of
disabled soldiers number more than 100. Some have no more than
a dozen pupils, while the larger ones can accommodate from 200 to
300 men. 8 A list of these schools will be found in the appendix.

CENTERS OF PHYSIOTHERAPY, PROSTHETIC EQUIPMENT, AND

REEDUCATION.

The great majority of schools thus formed by public or private
initiative had no connection with military hospitals and received as
pupils only discharged soldiers. The National Institute at Saint-
Maurice was, however, in close proximity and connection with a large
hospital, and its pupils were not only discharged soldiers but also
men undergoing treatment in the hospital. 9 There were two other
notable exceptions to the rule, in two schools organized by the Union
des colonies etrangeres, a group of foreign residents in Paris, who
have raised large sums for the establishment and maintenance of
schools for French soldiers. One of their schools was organized in
the Grand Palais, in Paris, where there is a large physiotherapeutic
hospital ; another is connected with a convalescent depot for amputa-
tion cases at Maison-Blanche, Neuilly-sur-Marne. In both of these
schools the pupils are inmates of the adjoining hospitals. 10

In 1916 the Government became convinced that vocational reedu-
cation should be started before discharge, and it decided therefore
to organize schools in connection with the large physiotherapeutic
hospitals and amputation depots scattered over the country. The
decision was made public in a decree issued by the undersecretary
of state for the medical service (corresponding to our Army Medi-
cal Service), dated June 2, 1916. 11

As the Government did not wish to enter into competition with
the schools already running or to duplicate their work, the under-
secretary of state announced later that he would make use, wherever

* Conference interallied pour l'Stude de la reeducation professionnelle et des questions
qui interessent les invalides de la guerre. Paris, 1917, pp. 205-206.

8 Harper, Grace S. ; Vocational reeducation for war cripples in France. New York,
1918. p. 13.

» Bourrillon, Maurice : Comment r£&Juquer nos invalides de la guerre. Paris, 1916,
pp. 95-96.

10 Reeducation fonctionnelle et reeducation professionnelle des blesses. Paris, 1917, pp.
202-204.

"Journal des mutiles, rtformiSs et blesses de guerre. Paris, 1916, No. 12, p. 4.



25 EVOLUTION OF SYSTEMS OF VOCATIONAL REEDUCATION.

possible, of the schools in the neighborhood of the hospitals by an-
nexing these schools to the hospitals. 12 He has also stated that he
intends to establish hospitals of physiotherapy in connection with
every reeducational school doing effective work. 13 These plans are
being gradually carried out.

At the present time, as a result of the new policy, there is in every
military region of France a hospital, or hospitals, of physiotherapy
to which has been annexed a school of vocational training. Eleven
of these combined institutions are connected with shops for manu-
facturing artificial limbs and other appliances. 14

According to the order issued by the undersecretary in June,
1916, a man needing functional treatment for his injury is to be sent
from the general hospital to the physiotherapeutic hospital into
which that general hospital empties, or to the one nearest his home;
a man needing an artificial appliance is to be sent to the correspond-
ing institution of prosthetic equipment (centre d'appareillage).
While undergoing the needed treatment, or while waiting for his
appliance, he can commence his trade training in the annexed school. 15
A difficulty encountered with this system is that when a man has
received all the functional treatment which will benefit him, or when
he has received his appliance, he expects his discharge. On receiving
it he leaves the institution and breaks off his course of training. In
order to overcome this difficulty the undersecretary of state for the
medical service has stated that he will, when the case demands, defer
the discharge until the course of training is complete. 16

The model hospital of physiotherapy in France has been installed
by the Government in the Grand Palais, in Paris. Treatment ad-
ministered there and in similar institutions is designed to restore
the greatest possible use of their limbs to men who have received
so-called functional injuries. The term " functional reeducation "
is applied to this treatment. It embraces all the different curative
methods included in the general term physiotherapy, such as baths,
massage, electricity, heat, radium, and exercising apparatus. In
this field French doctors are said to have developed a high degree
of skill. A study of French methods would have undoubted value
for American physicians, but, as it is a medical matter, the sub-
ject will not be treated in this report.

The kind of artificial limbs provided is, on the contrary, a matter
of vital interest to everyone interested in the subject of trade training
for war cripples, and will therefore be covered in a later section.



^Office national des mutiles et retormfc de la guerre. Bull. No. 1. Paris 1917 bd

50-51. ' ' vv '

"Ibid., p. 54.

" Harper, Grace S. . Vocational reeducation tor war cripples in France. New York

1918, p. 31. '

"Journal des mutiles, rCformes et blessed de guerre. Paris, 191C, No. lis, pp. 4 _ 5 .

» Office national des mutiles et reformed de la guerre. Bull. No. 1. Paris, 1917, p 51



EVOLUTION OF SYSTEMS OF VOCATIONAL REEDUCATION. 27

INTERESTS OF THE DIFFERENT MINISTERIES.

The National Institute at Saint-Maurice is under the control of
the minister of the interior, and is supported entirely by funds placed
by the National Assembly at the disposal of the minister of the
interior. 17

The schools created by public bodies — departments, municipalities,
chambers of commerce, hospitals, and the like — and those which after
their creation by private committees, have been placed under the ad-
ministration of a public body, are supported in part by the body
which established or now administers them, and in part by the State.
The public body must provide the necessary workshops and a build-
ing to house the pupils or must be responsible for placing the appren-
tices in private shops and lodging them in boarding houses or families.
The body derives its funds from subscriptions and contributions from
official and private sources. Any further funds that may be neces-
sary are provided by the State through a subvention from the min-
ister of the interior, which is paid out of the credit voted to the min-
ister of the interior by the National Assembly.

In order to obtain this subvention from the minister of the
interior, reeducational institutions must submit for his approval
their projected budget, their program, and particulars of their
organization. They must give, among other things, detailed infor-
mation on the trades which they can teach, the probable number of
their pupils, their system of instruction, the weekly teaching sched-
ules, the equipment of the schools, the length of apprenticeship,
probable wages at the end of the apprenticeship, and the degree and
kind of disability compatible with the trades taught.

The state subvention is not limited, however, to schools established
or administered by public bodies. It may be secured by schools
organized and administered by societies or individuals. In order to
obtain the subvention, such schools must present a statement showing
their program, organization, resources, and probable expenses. If
the State decides to grant the subvention, the amount is made to
depend on the number of pupils and the social and economic value
of the work undertaken.

By granting a subvention the State does not bind itself to renew
the grant in whole or in part. By accepting such a grant, however,
the school is bound to submit to Government inspection.

The schools and courses organized for disabled men by the minis-
ters of commerce and agriculture receive grants from the minister
of the interior under the same conditions as other schools. 18



" Norman, Sir Henry : The treatment and training of disabled and discharged soldiers
In France. London, 1917, p. 4.

» Office national des mutilgs et rgiormes de la guerre. Bull. No. 1. Paris, 1917, pp. 7-8.



28 EVOLUTION OF SYSTEMS OP VOCATIONAL REEDUCATION.

The minister of the interior, therefore, through his disposition of
the funds voted by the National Assembly for the support of reeduca-
tional institutions, exercises a control over the greater number of the
schools for disabled men in France. It is true that an interministerial
commission, composed of representatives of the ministries of the in-
terior, war, navy, public instruction, commerce, agriculture, labor,
and finance, was formed in April, 1915, to study the whole question
of reeducation and to assign parliamentary funds, but in actual prac-
tice this commission has been little more than an advisory board under
the control of the minister of the interior. 18

National aid to the mutiles was not, however, completely and for-
mally centralized in the ministry of the interior. The ministries of
commerce and agriculture shared in the work by reason of their con-
trol over the technical policies of their schools. The minister of war,
through the undersecretary of state for the medical service, was con-
cerned in the reeducation of men not yet discharged from the army,
for these men were still nominally soldiers. The minister of war
had, also, founded a placement bureau. The ministry of labor par-
ticipated because the placing of disabled men in trades was obviously
a labor question. 20

This division of authority resulted often in overlapping or con-
flicting activities, in the failure to give a common direction to the
work, and in a credit voted to the minister of the interior by the
work, and in a waste of money and effort. 21

To prevent the continuance of these conditions it was clearly neces-
sary to combine the activities of the different ministries in reference
to disabled soldiers into some central coordinating department. It
was equally clear that there was need of a central board or bureau to
unify the aims and methods of the many schools that had sprung up
during the first year and a half of the war. Through the efforts of
these schools opportunities for reeducation had been opened to dis-
abled soldiers in nearly every district in France. Many of them had
accomplished remarkable results. But they were local and disparate
reactions to an emergency and could not be regarded as a uniform
system of reeducation.

THE NATIONAL OFFICE.

With this need of coordination in mind, the ministers of war,
labor, and the interior created in March, 1916, by an interministerial

" Todd, John S. : A report an how France returns her soldiers to civilian life, in
American Journal of Care for Cripples. New York, 1917, t. 30.

» Norman, Sir Henry : The treatment and training of disabled and discharged soldiers
in France. London, 1917, p. 4.

a Office national des mutiles et rSformes de la guerre. Bull. No. 1. Paris 1917
pp. 3-4.



EVOLUTION OP SYSTEMS OF VOCATIONAL REEDUCATION. 29

decree, the Office national des mutiles et reformes de la guerre. 22
This national office comprises a central office with headquarters at
Paris, and departmental offices or committees located in the eighty-
odd departements, or administrative districts of France. The func-
tion of the central office is to coordinate the work of reeducation all
over the country; that of the departmental offices to see that the
work done in the several departments is in harmony with the plans
of the central office and has internal unity. The activities of the
central office are divided among a committee of administration, a
committee of reeducation, and a "committee of improvement," the
last being a group of eminent men and women connected with reedu-
cational work, who look after the general interests of the mutiles.

The committee of administration is made up of representatives
from the ministries of war, labor, and the interior — two from each
ministry. It has two presidents, the minister of labor and the under-
secretary of state for the medical service. Serving as vice presidents
are the director of statistics, the director of the bureau of public aid,
and the head of the pension bureau.

Registry of Disabled Men.

As a basis for intelligent effort on behalf of the mutiles, the com-
mittee of administration has undertaken to keep a registry of every
invalided soldier. To this end it has prepared a registration blank
on which can be indicated a man's residence, his dependents, his civil
or military status, his schooling, the nature of his disability, his for-
mer occupation, the reeducation, if any, that he has received, and the
kind of employment he desires. This blank is filled out by the medi-
cal service for every man in hospital before he leaves. To it is
attached a card of " medical observation," describing his prosthesis,
if he has one, his functional capacity, and his aptitude for vocational
reeducation. The blank and the card are then sent back to the
national office. When a man finds employment, a placement card de-
scribing his situation completes the record. In order to include in
the registry men who were discharged from hospitals before this
system was started the national office has asked the prefects of De-
partments to see that the disabled men in their Department fill out
the registration blank and return it to the office. The office asks also
the reeducational schools to supply facts from their records. In
these ways an effort has been made to obtain some information about
every pensioned soldier listed in the Journal Officiel.

Investigation Among Employers.

Along with this registration work the committee has gone into the
question of possible occupations for men of various disabilities. By

= The following account of the Office national des muUMs et rtformes de la guerre Is
based on Its Bulletin No. 1. Tarls, 1917.



30 EVOLUTION OF SYSTEMS OF VOCATIONAL REEDUCATION.

means of extensive inquiries among placement agencies, labor inspec-
tors, and manufacturers, it has been able to draw up tables showing
on the one hand the occupations open to men with all the different
disabilities, and on the other the disabilities compatible with different
occupations. The investigation brought to light many cases in which
men who had suffered industrial accidents were earning good livings.
These cases the committee has held up as encouraging examples to the
victims of the war.

The manufacturers have also been informed of ways in which they
may help in the rehabilitation of disabled soldiers. It has been sug-
gested to them that they reserve a certain number of places for sol-
diers ; or, if the work in their shops is unsuited to cripples, that they
introduce the special devices which have been invented to adapt ma-
chinery to men of various disabilities. Large industrial concerns
are asked to install special workshops in which war cripples can
serve an apprenticeship in either their old trade or a new one.

Investigations of Schools.

The reeducation committee of the national office is a continuation
of the old interministerial commission and has the same duties,
namely, to study the subject of reeducation in all its aspects and to
advise the minister of the interior in the matter of subventions.
In order to obtain precise information about the work of the various
schools the committee sent out twice in 1916 a questionnaire asking
the schools for the details of their organization and accomplish-
ments. The information desired covered the following points: The
number of boarding and day scholars in the school, the composition
of its teaching and directing staff, the machinery and tools used, the
school's financial situation (receipts and expenditures), the trades
taught, the number of disabled men reeducated during the last six
months, the number of days of attendance, the list of men placed
in positions on the completion of their course, with a note to indi-
cate whether these men were placed in their former trade or in a
new one. Analysis of the answers has given the national office a
general view of the state of reeducation in France. A repetition of
the investigation will enable the office to follow the progress of the
work. It will also give ideas for the future. It will, for example,
give definite facts, by the light of which the office can decide whether
new schools should be organized and whether a certain kind of in-
stitution should be developed at the expense of another.

The committee of improvement is composed of the members of
the committee of administration, of certain senators and deputies
who have shown their interest in the problem of the mutiles, and
of the heads of prominent aid societies for the mutiles. It en-
deavors to improve the legal status of disabled men and to secure
their social betterment.



EVOLUTION OF SYSTEMS OF VOCATIONAL REEDUCATION. 31

Programs for Centers of Readaptation.

The three committees of the national office, united in a general
session, have drawn up a plan for a system of reeducation to be
spread over the whole of France. There should be, they have said,
in every important part of France a " center of readaptation,' 1 by
which they meant a group of those activities by which wounded
men are restored to functional health and economic independence.
In most of the districts this group was not to be localized in one
town or city, but was to be distributed over several. A complete
center of readaptation should comprise (a) a hospital or hospitals
of physiotherapy, where the invalided soldier receives his func-
tional reeducation and finishes his treatment; (b) an institution of
prosthetic equipment, where artificial limbs are made and dis-
tributed; and (c) a school or schools of reeducation, where there is
provided agricultural, commercial, or trade training. The office
has grouped all the schools in France into 30 of these centers, and
has defined clearly which departments should be tributary to each
center. In practically every case each center includes several schools,
but in a number of instances several centers depend upon a common
institution of prosthetic equipment. It is recommended that the
number of these institutions be increased and that there be a con-
siderable addition to the number of local prosthetic workshops for
repairs, where the mutiles can have their appliances repaired or
altered, with little inconvenience to themselves.

Departmental Committees.

The composition and functions of the departmental and local com-
mittees have been set forth in a notice issued by the national office,
dated June 30, 1916. In general, the committees shall consist of
representatives of different civil and military administrations and
certain other interests. For instance, the minister of labor may be
represented by the local labor inspector and by the head of the
departmental employment bureau; the minister of war, by a dele-
gate of the general in command of the regional subdivision, by an
officer of the pension bureau, and by an army medical officer. The
departments of agriculture and education will be similarly repre-
sented. Other members of the committee are to be chosen from
medical men, employers' associations, trade-unions, insurance socie-
ties, and rural credit banks. Members will be appointed by the
prefect of the department, and the president of the committee shall
/i, the prefect, or a person delegated by him. Existing departmental

Timittees will be gradually reconstituted to represent these interests.

The first task of the departmental committees is to see that each

junded soldier receives the training of which he is in need. It is



32 EVOLUTION OF SYSTEMS OF VOCATIONAL REEDUCATION.

recognized that each man should be offered a chance to acquire a
trade suited to his capacities, and that every effort should be made to
induce him to take advantage of the opportunity. To this end rep-
resentatives of the committees call on the men in hospitals and point
out the advantages of trade training. If the visitors are men of the
same trade as the injured man, they can often convince him of the
possibilities for work still open to him.

A second task for the departmental committees is to investigate
the labor situation in order to discover which trades are least
crowded, and in which, therefore, disabled men will have the best
chance of finding employment.

Each departmental committee is expected to maintain close rela-
tions with the reeducational school, or schools, in the department.
If no school exists in the department, and if there is none in a*
neighboring department which can serve the purpose, it is the duty
of the committee to organize a school. The national office will in-
form the committee of what cooperation and support in organizing



Online LibraryDouglas C. (Douglas Crawford) McMurtrieThe evolution of national systems of vocational reeducation for disabled soldiers and sailors → online text (page 3 of 38)