PROGRAM TO SAFE- GUARD THE MORALS AND HEALTH OF SOLDIERS FROM THE OFFICE OF THE SURGEON GENERAL WAR DEPARTMENT Originally published in the "Official Bulletin," August 14, 1917. Reprinted for distribution by The American Social Hygiene Association, 105 West 40th Street, New York City. Publication 122 The Surgeon Generals Office has authorized the following statement on the Social Hygiene Program of the War Department in relation to other agencies In its popular interpretation, social hygiene has been used as a phrase to refer inclusively to all efforts for protection of the population from prostitution and venereal disease. Prostitution in its various forms affords the chief opportunity for disseminating the venereal diseases and pro- moting sexual promiscuity. Neither the military nor the civil authorities have been able effec- tively to combat this medical social evil alone. The assembling of troops in the vicinity of civil communities has always introduced a difficult social problem on the one hand and on the other has attracted the promoters of organized vice, who have established the commercialized activities known to increase the supply and de- mand for prostitution. The civil authorities within whose jurisdiction these practices were carried on were inexperienced in dealing with the situation, and the military authorities had no legal power under which to take action. Can Secure Co-operation During the present war there is for the first time the opportunity to secure full co-operation between military and civil forces in applying the medical, social, moral, and economic knowledge which has been demonstrated to have a bearing on the repression of prostitution and the reduc- tion of the prevalence of venereal diseases. Pub- lie opinion will now support a sound program, and sufficient authority has been secured through legislative and administrative action to promise important results. Measures Proposed The paramount national issue is the winning of the war, and every resource, both military and civil, must be applied toward this end. The social hygiene program has, therefore, been cen- tered administratively on the protection of the military, naval, and other governmental forces. The success attained, however, is equally to the advantage of the civil population. So far as these administrative measures relate to the United States army they may be grouped under five headings:— I. Army Medical Department.—Military measures for combating the venereal diseases. 2. United Slates Public Health Service.— Epidemiological measures for the control of venereal diseases in the civil sanitary districts. 3. War Department Commission on Train- ing Camp Activities.—Law enforcement and recreation measures in the extra cantonment zones established by the Secretary, educational work, and protective work for girls. 4. Civi7 Authorities.—Law enforcement, recreation, facilities for treatment of venereal dis- eases, and protection and control of women and girls. 5. Non-official agencies.—Social hygiene activities of volunteer organizations recognized for special services. Each of these groups includes a variety of activities carried out by widely different agen- cies that have been available at the moment of necessity, and having proved useful have con- tinued to function. The Army Medical Department The Medical Department of the Army is lim- ited in its strictly official capacity to measures for the prevention and treatment of venereal dis- eases inside the military encampments. Unoffi- cially the Surgeon General and his staff are in full accord and >o-operation with the agencies to which reference has been made. A section has been organized to devote its attention to this problem, with an officer in charge of labora- tory investigations, one in charge of medical work, and one in charge of educational and environmental measures and sociological studies. These officers will have the co-operation of the officer who is in charge of sanitary inspections, and the officer who directs the division of train- ing camps. While the creation of a special section is new it should be stated that similar work has been carried on by the Army for many years. The activities of the section may be sum- marized under the following:— I. Educational work adapted so far as practicable to the individual needs and responsi- bilities of the men and officers, and conducted through personal interviews, group talks, illus- trated lectures, exhibits, pamphlets and library reference books. 2. Prophylactic stations for minimizing the number of infections developing after exposure, and for personal advice and warning directed toward lessening the number of future exposures. 3. Diagnosis and treatment facilities for cases of syphilis and gonococcus infections which develop in spite of efforts to prevent them. 4. Enforcement of penalties against those who ignore advice and instruction to avoid sex- ual intercourse and venereal disease. 5. Epidemiological studies of the venereal diseases to discover any new measures which may be applied. Public Health Service The United States Public Health Service has been charged with the responsibility for health conditions in civil sanitary districts surrounding military establishments. The work will be done in co-operation with the state and local authori- ties and with the American Red Cross through an advisory board. The venereal diseases, as dangerous communicable diseases, are included in the program. The following are the prin- cipal lines of activity to be undertaken in rela- tion to these diseases:— 1. Promotion of public opinion in support of the social hygiene program agreed upon. 2. Survey and standardization of dispensary and hospital facilities for venereal diseases. 3. Co-operation with private practitioners in minimizing the dissemination of infections. 4. Extension of laboratory, clinical, and ad- visory service for venereal diseases in communi- ties under civil auspices. Efforts along each of these lines will simplify and render more effective the Army measures. Commission on Training Camp Activities In order to deal effectively with social hy- giene in all its phases the Secretary of War has created the Commission on Training Camp Activities to carry out the law enforcement regu- lations promulgated by him under the authority of Congress and the President. This commis- sion has also been charged with important activi- ties in furnishing instruction and recreation for the troops. Under these divisions the commis- sion's work as it indirectly bears on the control of venereal diseases may be summarized as fol- lows :— A. Law enforcement measures. 1. Elimination of commercialized prostitution in the cantonment zones. 2. Repression of clandestine prostitu- tion. 3. Control of alcohol and other aids to prostitution. 4. Combating of gambling, use of drugs and other harmful prac- tices. Instruction in social hygiene. I. Graphic instruction through ex- hibits, placards, stereopticons and stereomotorgraphs. 2. Lectures by accredited physicians. 3. Preparation and distribution of pamphlets and leaflets. 4. Advice and instruction by exhibit attendant. 5. Supervision in the camps of the social hygiene work by private organizations. Recreation measures. 1. Social and educational activities of recreation huts in the canton- ments, and of recognized agen- cies in the cantonment zones. 2. Theatrical and other entertainment programs. 3. Athletic contests, tournaments and games. 4. Reception tents for visitors. 5. Libraries of popular books and other facilities provided under the direction of the commission. D. Protective Work for Girls. 1. Appointment of protective officers with police power. 2. Establishment of houses of deten- tion where delinquent girls may be held while their cases are pending in courts. 3. Securing probation officers to deal with convicted girls. 4. Securing additional facilities in re- formatory institutions. 5. Promoting educational work for the protection of girls through lec- tures and leaflets. Civil Authorities It is recognized that neither the measures within the military establishments nor the sup- plementary measures in specified zones can achieve the largest success without full co-oper- ation of civil authorities in enforcing equivalent measures in all communities accessible to the personnel of the military forces. The carrying out of the following program, which has been inaugurated in many cities and towns, is of great importance to the Army and to national efficiency:— I. Enforcement of laws and ordinances against prostitution and alcohol. 2. Establishment of proper facilities for ad- vice and treatment of persons infected with vene- real diseases. 3. Provision of attractive recreation and en- tertainment for the leisure hours of the popula- tion. 4. Moral protection and education of women and girls. Non-official Agencies The complicated interlocking of military and civil interests in the protection of soldiers and civilians from vice and disease affords an op- portunity for many useful activities of volunteer agencies. This is particularly true in the field of social hygiene. In the interest of efficiepcy and avoidance of confusion and duplication of effort a small number of such agencies have been recognized as clearing houses for military- civil work of a very large number of organiza- tions in their respective fields. (1-18J