"C ll!Hi m i Care and Treatment of the Jewish Blind in the City of New York BY FLORINA LASKER ETTA LASKER LOULA LASKER i NEW YORK BUREAU OF PHILANTHROPIC RESEARCH FEBRUARY. 1918 PUBLICATION NUMBER 3 Care and Treatment of the Jewish Blind in the City of New York BY FLORINA LASKER ETTA LASKER LOULA LASKER NEW YORK BUREAU OF PHILANTHROPIC FIESEARCH FEBRUARY, 1918 ^ .^' (o OFFICERS BUREAU OF PHILANTHROPIC RESEARCH Leo Arnstein, Chairman Adolph Lewisohn, Vice-Chairman Cyrus L. Sulzberger, Treasurer Abraham Oseroff, Secretary CONTENTS PAGE Preface 5 I. Method of Investigation 7 Definition of blind as applied in this study. Com- pilation of a census of the Jewish blind. List of all agencies and institutions dealing with the Jewish blind in Manhattan and the Bronx. Investigation divided into two parts — case study of all blind individuals, study of agencies previously listed. Investigation limited to those phases of the situation largely dependent on the Jewish community for solution. II. General Description of 292 Blind Adults 15 Majority married men and women of working age, foreign bom. About half totally blind, half suffering from partial blindness or defective vision. Sickness and ill health prevalent. A few mentally subnormal. Edu- cation for the most part meagre. Multiplicity of handi- caps suggests vital need for community aid. III. Problems of Relief 25 Complexity of the problem. Study of agencies in the field. Policy of many of these agencies not in accord with modem principles of relief. Essentials of a sound relief policy. Case histories illustrating violations of these essentials. Lack of co-operation between existing agencies. Causes responsible for this failure to co-operate. Conclusion — Unification of administration necessary. IV. Problems of Employment 49 Enforced economic dependence of the blind. Their demand for work. Organized effort essential to meet this demand. Existing effort inadequate. Analysis of industrial histories of 104 blind men. Earnings before and after blindness. Striking decrease general. Occu- pations — Opportunities for Jewish blind in workshop of the New York Association limited. Favorable oppor- tunities in peddling, in newsstand operating, and as commission agents. Technical and professional fields at present overcrowded with sighted competitors. Con- clusion — Imperative need for formation of employment bureau to study industrial and commercial field and special abilities and aptitudes of the blind. 376i5.> PAGE V. Problems of Recreation ■ ■• 67 Vital need for recreational provision for the blind. Agencies in the field. Character of facilities provided. Case histories illustrating present inadequacy. Con- clusion—Need for extension of existing facilities and for intensive personal service. VI. Institutional Problems 77 Care and education of blind children. Care and shelter of aged blind. A. Unusual educational and institutional facilities available for blind children. Existing institutions. Question of a separate Jewish institution. Intensive survey revealed only a small group eligible. Niimber of blind children constantly decreasing. High standard of excellence of existing institutions not soon attainable by small, newly established institution. Present insti- tutions eager to co-operate in providing reUgious educa- tion. Other difficulties also adjustable. Conclusion — Separate institution for blind Jewish children inad- visable; required elements for their care attainable by co-operation with existing agencies. B. Need for additional institutional facilities for the aged recognized. Special needs of aged blind not supplied. Available institutions for Jewish aged and nimiber of inmates. Additional provision in process. Special shelters for aged blind objectionable. Necessity for adapting existing institutions to meet special needs of the blind advocated. Supplementary organized out- side effort required. Conclusion — Extension of existing capacities of homes for the aged recommended, as well as provision of special facilities to meet the peculiar needs of blind inmates. VII. Problems of Begging 91 Proportion of blind beggars. Case histories illus- trating complexity of problems involved. Conclusion — Need for social program to provide for suitable employ- ment, adequate relief, appropriate institutional care, proper recreational opportunities. VIII. General Conclusion 107 Recommendation of a bureau for the Jewish blind to function as a clearing house ; to co-ordinate all existing effort; to centralize administration of relief; to estab- lish a department of employment for this handicapped class. PREFACE Until four years ago there were only two specialized agencies interested in the welfare of the Jewish blind in Manhattan and the Bronx — the New York Asso- ciation for the Blind, a large non-sectarian agency which ministers to the needs of all the blind of New York City, and the Committee on the Blind of the Council of Jewish Women, a body of earnest and devoted women who undertook to specialize in this field, endeavoring to bring the unfortunate state of this handicapped class before the public and to serve them in every necessary capacity. Between two groups of this latter body, there arose differences of opinion as to policies and methods, which finally had their climax in the withdrawal of one group from the Council and in their separate organization and later incorporation as the Guild for the Jewish Blind, with objects and purposes similar to those of the parent body. The Council continued its Committee, but its work for the blind since that time has become of minor importance. But further disharmony arose in the field after the organization of the Guild. There existed at that time a group of blind Jewish people of the East Side who felt that the problems of the blind were not being adequately handled by the existing agencies. Taking the position that the blind themselves had never been given a fair share in the management of their own problems and determining that, henceforward they would take an important part in the direction of their own affairs, this group of blind persons resolved to form an agency of their own and founded The Hebrew Association for the Blind — the fourth specialized agency to enter the field. Unfortunately, for one reason or another, these various agencies have not been able to work out any program of sincere cooperation. Several attempts have been made by interested people to induce all these organizations to meet and discuss their mutual problems, hoping that through such meetings, misunderstandings might be exphiincd, differences lessened, and if com- plete cooperation did not ensue, that at least a working agreement might be reached whereby the situation would be appreciably bettered. One such meeting did indeed take place, but led to no definite results. The effect of this lack of cooperation on the blind people themselves can readily be imagined. The mul- tiplicity of investigations by various agencies all differing fundamentally in theory and practice, the division of authority, with its consequent duplications and ornis- sions — these are but some of the results of a situation which the Jewish community must sooner or later face, if it seek to meet its full responsibilities in connection with this group. It was for the purpose of gathering information upon which to base a constructive program tending to co- ordinate, perhaps to reorganize, work for the Jewish blind in Manhattan and the Bronx, that this survey was undertaken. Begun in November, 1916, the survey was not completed until March of the present year. No startling or remarkable discoveries can be claimed as a result of this investigation, nor the establishment of any theories which will radically change the ideas of those interested in work for the Jewish blind. Yet it is definitely felt that by an impartial survey of the whole field, by patient research and careful interpretation of the material obtained, it has been possible to throw definite light on the problems presented, and, in view of this newly gathered information, to formulate the constructive program which has been the practical object of the study. Abraham Oseroff, Secretary. Bureau of Philanthropic Research, New York. February, 1918. I. METHOD OF INVESTIGATION CARE AND TREATMENT OF THE JEWISH BLIND I. METHOD OF INVESTIGATION Who arc the bhnd coming within the scope of this survey? Obviously, before beginning the investigation it was necessary to define accurately the term employed. The word "blind" is an elastic one and may be more or less inclusive, but for purposes of this study the blind are defined as "all those who because of total loss of vision or defective eyesight are unable to be self sup- porting and to take full advantage of the social and communal opportunities open to sighted persons." It will be seen that this definition is a broad one including within its scope many who, from a medical point of view, could hardly be considered blind. The compilation of a census was the first step taken in the course of this investigation, for no definite infor- mation regarding the number of Jewish blind in Man- hattan and the Bronx was available, previous estimates by those in closest touch with the situation varying from 300 to 800. In order to obtain the necessary information inquiries were sent or personal visits paid to every agency or institution within the area considered which might have the names of any Jewish blind persons on their registers. The following is a list of the various co-operating agencies and institutions, together with the number of Jewish blind persons registered by each:* New York Guild for the Jewish BHnd 200 New York Association for the Blind 170 United Hebrew Charities 114 Hebrew Association for the Blind 96 Department of Public Charities 66 * In this list is not included State institutions or agencies: Manhattan State Hospital for the Insane New York State School for the Blind at Batavia New York State Commission for the Blind New York State Committee for Prevention of BHndness Division of Educational Extension under the State Department of Education 8 METHOD OF INVESTIGATION New York Public Library 45 Matilda Ziegler Magazine for the Blind 34 Rome for Aged and Infirm Hebrews 23 Council of Jewish Women 21 Home of the Daughters of Jacob 18 Department of Education 19 New York Institute for the Blind 14 Free Synagogue 12 Montefiore Home 9 International Sunshine Society 6 City Home for the Aged and Infirm (Blackwell's Island) 6 Young Men's Hebrew Association 4 Home of the Daughters of Israel 4 Young Women's Hebrew Association 3 Custodial Asylum and School for the Feeble-Minded ■(Randall's Island) 3 Society for the Relief of the Destitute Blind 2 Home of the Sons and Daughters of Israel 1 Home of the Sons and Daughters of Jacob 1 City Hospital 1 Metropolitan Museum Unknown Museiim of Natural History Unknown People's University Extension Society of New York Unknown Many delays were encountered and many obstacles had to be overcome before the census could be completed, yet the majority of the organizations approached rendered prompt and willing assistance. An illustration of the method employed in compiling the census is found in the manner in which the number of blind Jewish pen- sioners of the city was procured. The Department of Public Charities, upon being requested to furnish a list of the Jewish blind who were recipients of the city pension, freely offered its co-operation but reported that no record was kept as to the religion of applicants. Simply to choose the names which sounded Jewish was not considered a sufficiently reliable method. Finally, however, the Department itself offered a solution by allowing the investigators to be present at the various stations where the indigent blind received their semi- annual pension, thus making it possible to obtain from the blind individuals themselves their names, religion, and addresses. CARE AND TREATMENT OF THE JEWISH BLIND The lists procured from all sources furnished the basis for a compilation of the complete census, for, though there was countless duplication of names, no single agency offered a nearly exhaustive register. After the duplications were weeded out, a single card was made for each individual, and a record noted on the card of the various sources from which the name had been obtained. The complete verified census includes the names of 422 blind Jewish persons, 349 living in private families and 73 in institutions. In addition to these, there were secured the names of 104 blind persons, whose addresses could not be verified, making a grand total of 526 blind Jewish persons in the boroughs of Manhattan and the Bronx, if this latter group be added to the registry.* The census having been completed, the actual work of the investigation was begun. Unlike previous studies of the Jewish blind in New York, which were more or less superficial in nature, it was definitely decided to make a survey of the situation so detailed and intensive as to cover practically every fact that could throw light upon the condition of the persons coming within its scope. The plan formulated was two-fold : first, to make a careful case study of all Jewish blind persons in Man- hattan and the Bronx; second, to make an intensive investigation of the most important agencies in this area dealing with the group under consideration. For the purpose of the case study the two schedules submitted on the following pages were prepared. Realiz- ing that the social and economic history of the blind individual can not be separated from that of his family, it was decided to use two forms — the first to contain general items of interest concerning the entire family, the second to contain special items of interest concern- ing the blind individual himself. _ Although only those liHnd persons registered by the above agencies or institutions are inckuled in this number, yet it is beHeved that the final figure here given does not fall far short of the actual number of Jewish blind living in Manhattan and the Bronx. It may safely be taken for granted that, with few exceptions, nearly every l)lind person has at some time or other come in contact %yith at least one of these organizations— educational, recreational or philan- thropic. 10 METHOD OF INVESTIGATION z 2 J o o J3 1 m 1^ >H S O H in X 0) J 6 o Z o t/1 B o o p=^ 01 e Ph 'o o J3 O C/2 'So c o o c u ,c o :^ 1 o tS CD 1 o -a c ^ o J o +j C/3 a in ^ aj o 6 o 03 ZHO Q^ I-. P^ >^l o m 1 1 \ l-H 2 dJ S >> .. +-> U3 ■S-iS QJ g ^ C l-H 11 0) be (-* J Ij r° c TD >,ai C O ^1 ^^ u || II bC G o It «^ U 1 u>o 1 2; te M 1 a C >^ w 'a '5 u ^ OS J S TO r :; sW o Pi CJ < o tn ^ HH >^ C ffi cA 1-J .2 o tD s a 3 ^ < O o _e fo O ^ ■r) u5 V-t fc O c > .o o C/2 M '3 p^ c W > o 2 < b ^ -i-> [> 'c3 3 G a •c Z c CO s o Ph G 'T3 < 13 a '55 m G .2 <2 0. PL, 0^ pq 1 1 P^ 1 " cfi — 0) OJ Oj — > c a~A •S- oj 0) O oj 0) *i Ph 11 CARE AND TREATMENT OF THE JEWISH BLIND E CO w w p^ Q Q < CO Pi C/3 Pi u m u J ,J tn ?= Ph m « & .-^ s o5 2 " ^« S g « Q H J o'a f,8-cw , O O 03 01 — ■O S OS ^^ OD O fc* rH .^ — I p^ « 12 m >> ^ Q METHOD OF INVESTIGATION In order to obtain the information necessary for the case study it seemed desirable not only to visit the homes of the blind persons under consideration, but to study as well case histories of blind persons who had applied to charitable agencies for assistance. Access was had to the case records of the New York Guild for the Jewish Blind, the United Hebrew Charities and the allied Sisterhoods — the most important Jewish agencies interested in this handicapped class. These records were carefully studied and analyzed before visits were paid to the persons concerned. It was encouraging to note later in the course of the visits how closely the facts obtained in the interviews tallied with those in the records of the agencies. It is, therefore, safe to conclude that the information obtained regarding those individuals or families whose histories were not previ- ously recorded is equally reliable. The next step in the case study was the actual visiting in the homes. After much reflection it was decided to visit every blind person included in the census with the exception of those aged blind who were at the time inmates of institutions. Although 532 visits were paid, only 339 individuals were interviewed, 303 visits yielding no definite results.* It is gratifying to state that of the 342 persons located only 3 refused interviews, the remaining 339 being only too eager to tell their stories to a sympathetic listener. An effort was made to keep these interviews as informal as possible, the conversations taking the nature of ''heart to heart" talks. * The following is an analysis of the 303 visits from which no interviews were obtained: Number of persons moved to unknown addresses 87 Number of persons out at time of visit 73 Number of persons not living at address visited (these were later traced elsewhere) 63 Number of persons left New York 8 Number of persons dead 24 Number of persons not Jewish 16 Number of persons refused interviews 3 Number of persons whose defective eyesight did not interfere with normal life 17 Other reasons 12 Total 303 13 CARE AND TREATMENT OF THE JEWISH BLIND The final stage in the survey was the study of the work of the institutions and agencies previously listed. While information was obtained regarding all these organi- zations, special attention was centered on the work which is being done by the New York Association for the Blind, the New York Guild for the Jewish Blind, the Hebrew Association for the Blind, and the United Hebrew Charities and allied Sisterhoods. Much of the material for this part of the survey had already been gathered during the course of the investi- gation through the analysis of the case records previously alluded to and through the visits paid to the blind in their homes, when the reaction of the agencies on the clients had been studied at first hand. The material thus obtained was later supplemented by information secured through long and intimate conversations held with the heads of the most important organizations studied. In these interviews not only was the direct machinery and administration of the various organiza- tions explained at length, but in addition general prin- ciples and policies were outlined in detail, so that it was possible to obtain a broad conception of the work being done by these agencies. In the investigation itself, and in the resultant pro- gram, no attempt has been made to study the problems of prevention of blindness and of the medical care of the blind. Nor has the general problem of education of the blind been included in this investigation. These problems, while vital and significant, can not and should not be regarded as special Jewish problems. Not until the community as a whole, working for the improvement of all the blind in New York, is aroused to the general necessities of the situation, can it be hoped that problems of such a nature can be constructively treated. The object of this survey has been rather to stress those phases of the situation which are largely dependent on the Jewish community for their solution, the effort being made to offer broad, concrete, practical suggestions and recommendations, whereby work for the Jewish blind in New York City can be made more compre- hensive and effective. 14 II. GENERAL DESCRIPTION OF 292 BLIND S ADULTS CARE AND TREATMENT OF THE JEWISH BLIND II. GENERAL DESCRIPTION OF 292 BLIND ADULTS In a general description of any group of persons the first facts to be considered are those of age and sex. Although our interest in the blind applies to the young as well as to the old, in the present section our attention will be confined solely to the adult blind, not because the condition of blindness is more tragic in adult life than in youth, but because the problems which must be faced at these two age periods are different and must consequently be considered separately. Of the 330 blind individuals visited during the course of this investigation it was found that 292 were adults — 191 males and 101 females. The accompanying table gives age by group and sex of these 292 blind persons. Age by Group and Sex Nttmber Percent Aee ~ Males Females Males Females 16-45 83 56 43.3 55.5 45-60 61 19 31.9 18.9 60 and over 47 25 24.8 24.7 Not stated 1 .9 Total 191 101 100.0 100.0 It will be seen that we have here divided the blind into three age groups: 16-45 years — the period which may be regarded as the prime of life; 45-60 years — the later period of working age; and 60 years and over — the period of old age. From a study of the table it is perhaps surprising to learn that of the 191 men under consideration 83, or about 43 percent, are still in the prime of life, while of 16 GENERAL DESCRIPTION OF 292 BLIND ADULTS the 101 blind women considered, 63 or about 55 percent, are in this same period. Under normal circumstances it is obvious that most of the men and many of the women in this first age group would be expected to contribute largely to the family support, although under existing circumstances the majority of them find it impossible to earn a living wage. A further examination of the table reveals the fact that of the 191 blind men under consideration, 64 men, or about 33 percent of the number, fall within the second age group — 45 to 60 years — while 19 women, or about 18 percent of the number, are included within this same class. Is it not obvious that many of the men in this second group would under normal conditions also be able to maintain their economic independence, although under existing circumstances most of them earn little or nothing? It will be seen that in the third age group — 60 years and over- — about 23 percent of the men — 44 in all — and about 24 percent of the women — 25 in all — are included. In this group it may be taken for granted however, that there are few wage-earners — actual or potential — and it may well be felt that old age rather than blindness is responsible for this situation. The full significance of the economic tragedy of blindness can only be grasped, however, when facts relating to the conjugal condition of the group are definitely known. This information may be obtained by a study of the accompanying table. Conjugal Condition by Sex Number Percent Conjugal Condition Married Single Widowed Divorced or Separated Deserted Not Stated Total 190 91 100.0 100.0 17 Males Females Males Females 118 24 62.2 26.3 51 34 26.9 37.4 12 26 6.3 28.5 7 3 3.6 3.3 1 4 .5 4.5 1 .5 CARE AND TREATMENT OF THE JEWISH BLIND As only those 18 years of age and over are included in this table, the total number here considered is but 281. It is at once seen that about 62 percent of the men — 118 in all — and about 27 percent of the women — 24 in all — are married. It is difficult perhaps at first glance to account for the discrepancy between the two groups, but noticing the figures in the widowed group, where but 6 percent of the men and over 28 percent of the women are included, the reason for this marked differ- ence between the number of married men and married women immediately becomes clear. Realizing the fact that widowhood is always more frequent among women than among men, it is evident that in order to get a true picture of family conditions, we must compare not the number of married men to the number of married women, nor the number of widowed men to the number of wid- owed women, but the number of men in both these classes to the number of women in both these classes. Making the necessary addition, therefore, it is seen that 130 men — over 68 percent of the total number — and 50 women — over 54 percent of the total number — are included in these two groups — percentages which do not vary so greatly. To these may be added the 7 men and 3 women who are either divorced or separated, and the 1 man and 4 women who are deserted. A study of this table has thus revealed that over 73 percent of the men and over 62 percent of the women are included in the married, widowed, deserted, and divorced groups. Is it not, therefore, safe to assume that at least in a majority of these cases, blindness is a family misfortune as well as a personal tragedy? In the 130 families where the father — the natural wage-earner — is blind, the economic problem is grave indeed — all the more grave when it is realized that in most of these families the children are still too young to contribute to the family income. In the 57 families in which blindness has overtaken the mother, the situation though different is hardly less grave. A blind house- wife often finds it impossible to practice economy, while her children are too frequently deprived of that care which the sighted mother is able to give. 18 Males Females 33 27 60 94 36 130 43 22 65 12 7 19 7 2 9 1 1 1 1 1 1 1 1 1 4 5 GENERAL DESCRIPTION OF 292 BLIND ADULTS The nativity of this group may next be considered. Nativity by Sex Sex Nativity- United States Russia and Poland Austria-Hungary Germany Roumania Holland Portugal Servia Great Britain Not stated Total 191 101 292 An examination of this table reveals the fact that of the 190 men whose place of birth was obtainable, 33 — less than 22 percent — were native born, and 157 — over 88 percent — foreign born; while of the 97 women whose place of birth was obtainable, 27 — less than 28 percent — were born in this country and 70 — over 72 percent — were born in foreign lands. Of the total number of foreign born, 94 men and 36 women were born in Russia; 43 men and 22 women, in Austria-Hungary; 12 men and 7 women in Germany; 1 man in Holland, and the remaining 3 women respec- tively in Portugal, Servia, and Great Britain. The specific land of birth is, of course, of little im- portance. Significant, however, is the information re- garding the number of foreign born brought out by this table, revealing the existence of another factor which complicates an already dif^cult situation. Handicapped as is this group by reason of blindness, this condition of foreign birth is obviously often a further handicap, frequently making it impossible for these men and women to take full advantage of the social and economic oppor- tunities offered in this country. 19 CARE AND TREATMENT OF THE JEWISH BLIND It may be somewhat surprising to learn that of the 217 foreign born men and women 21 years of age and over, 99 had attained full citizenship, 34 had either first or second papers, while only 64 — about one-third of the total number — had never applied for citizenship in this country,* This large proportion of citizens and prospective citizens is, however, most misleading, unless the fact be kept in mind that many blind persons in New York acquire citizenship for the sole purpose of becoming thereby eligible for the city pension for the blind or for a peddler's license — privileges to which non-citizens are not entitled. Remembering this situation, it can hardly be inferred from the figures presented that over two- thirds of our foreign group are "real Americans" — that is, men and women fully adapted to an environment which they no longer regard as strange or foreign. Much more interesting than the statistics just pre- sented are statistics relating to the physical and mental condition of the group here considered. Of the 292 persons in this group it was found that 143 — almost half — were totally blind, while 149 suffered either from defective vision or partial loss of eye-sight. In this latter group are included a number of "borderline cases," though in each instance the attempt was made to apply literally the definition of "blind" previously given. More difficult was the task of defining the term "sick" with regard to the group under consideration. While no attempt was made to apply this term scientifically by^ securing exact medical diagnoses from experts, yet it is believed that by questioning the blind individuals themselves as well as by studying the case records of the majority of those under care of relief agencies, it was possible to obtain the information desired regarding the general physical condition of these men and women. A study of the physical and mental condition of the group revealed the fact that, in a large proportion of cases, physical disabilities other than blindness must * In the case of married women the status of the husband as regards citizen- ship was taken to include that of the wife. 20 GENERAL DESCRIPTION OF 292 BLIND ADULTS be added to the various handicaps already discussed. In a few cases it was found that mental disabilities too must be included in this list. In the case of those men and women 60 years of age or over, it may well be maintained that statistics relating to physical condition can hardly be illuminating, most older men and women of all social classes suffering more or less from physical disabilities. It is, therefore, not surprising to learn that of the 44 men in this age group, 20 — or about 45 percent — are in poor health, while of the 25 women under consideration, 15 — or about 60 percent — are suffering from various physical causes. The list of ailments of which these older people complain is quite a long one. Fourteen men and 9 women suffer from general weakness or senility; 3 of each sex are the victims of rheumatism; 2 of each sex are in a serious nervous condition; 2 of each sex com- plain of heart trouble, of gall stones, and of tuberculosis; while 5 men suffer from asthma or bronchial trouble. Examining next the physical condition of the men and women in the younger age groups — those from 16 to 45 years and from 45 to 60 years — it is surprising to learn that sickness and ill health are no less prevalent in these groups than in the older group previously dis- cussed. Of the 147 men in the younger age periods, 71 — or about 50 percent — appear to be in poor health, while of the 76 younger women, 43 — or about 56 percent — are apparently ailing. Is there, then, any relation between blindness and ill health? Are the two conditions often concomitant? If the figures just presented indicate the truth, an emphatic "yes" must be answered to these questions. Admitting that blind persons are often the victims of heredity, it is fairly safe to assume that this same hereditary taint can often be held responsible for other physical weaknesses as well. But it is not necessary to place on heredity alone the full burden of responsibility for poor physical condition. Other factors in this situa- tion may be discovered if an examination be made of the lives which the blind are but too frequently compelled to lead. Often forced, because of their limitations, to 21 CARE AND TREATMENT OF THE JEWISH BLIND work for little or nothing, their standards of living are necessarily low, so that in many cases poor food and lack of air lower vitality and predispose to ill health and disease. Many blind persons, too, must necessarily lead shut-in lives, unrelieved by exercise or amusement of any kind. Sitting at home all day idle and neglected, brooding over their condition, is it surprising to learn that they are often the victims of nervous as well as of organic disorders? Taking these facts into consideration, it is not sur- prising to note that 25 men and 16 women complain of extreme nervous condition;* 14 men and 4 women suffer from rheumatism; 7 men and 10 women, from anemia or a general condition of weakness; 5 men and 2 women, from venereal disease; 3 men and 3 women, from heart trouble; several of both sexes, from asthma, tuberculosis, stomach trouble, hernia, affection of the kidneys, cancer, mastoid, liver complaint, gall stones, goitre, and diabetes. A formidable list of ailments in- deed — all the more formidable when are added 7 men and 4 women who are deaf and dumb, and 4 men and 2 women who are crippled. Passing from physical to mental disabilities, an examination indicates that 6 men and 4 women are mentally subnormal, the mental condition in a few cases amounting to idiocy. Facts regarding the education of the group may next be considered. Although it was not deemed necessary to apply a literacy test to those visited, information on this subject w^as secured through direct questioning of the blind themselves — information which was, in many cases, supplemented by a study of the case records of blind applicants under care of relief agencies. Of the 292 men and women coming within the scope of this survey, it was learned that 229 were literate and 51 illiterate. In the case of the remaining 12 persons no information regarding literacy was obtainable.! * In this number arc included various cases of neurasthenia, epilepsy, and other acute nervous disorders. t Literate as here applied includes all those able to read or write in their native language, regardless of the extent of their knowledge. 22 GENERAL DESCRIPTION OF 292 BLIND ADULTS Although it is gratifying to find so small a number of "illiterates" included in this group, it must be realized at the same time that many of those nominally literate are, nevertheless, very ignorant, their only claim to this title being based on their ability to read or write a limited number of words. The number of men and women in this group without actual schooling is, of course, very large, a fact which can not be regarded as surprising when it is remembered that many of these men and women became blind before reaching school age, thus encountering another obstacle in the way of securing an education. Of the 229 classed as literate, 185 were able before blindness to read or write in the English language, 61 of these having after blindness acquired the ability to read embossed print. Of those who acquired a formal education after blind- ness 41 attended special schools or classes for the blind — 31, the New York Institute for the Blind, and 10, the classes for the blind in the New York Public Schools. It may be interesting to note that in spite of their handi- cap, 5 of the men and women here considered succeeded in finishing a college course, revealing that in their cases at least, the desire for an education overcame all possible obstacles. Uninteresting as statistics often are, yet they usually serve a real purpose, and it is to be hoped that the facts here presented have made it possible to form a mental picture of this group, throwing definite light on the nature of the problems which they are compelled to meet. Handicapped by blindness, suffering from ill health, over-burdened with family responsibilities, limited by reason of foreign birth and meagre education, the majority of these men and women find themselves beset by diffi- culties on all sides — difficulties which, indeed, they can never hope to surmount unless the community, mindful of its responsibility, makes every effort to give them the necessary care and assistance. 23 III. PROBLEMS OF RELIEF CARE AND TREATMENT OF THE JEWISH BLIND III. PROBLEMS OF RELIEF In a consideration of the many problems which must be met by the community in its effort to make adequate provisions for the care and treatment of its bHnd members, the problem of relief at once suggests itself as a vital one — one which, because of the many difficulties involved, deserves our most careful consideration. That a majority of the group of persons under present consideration are in need of material assistance is of course obvious, for recalling the fact that a large number of these are heads of families in the prime of life — men who are the natural bread-winners of the family but who, on account of their affliction, can no longer assume unassisted the burden of family support — their need for charitable aid at once becomes apparent. Equally apparent, too, must be the need for relief of the majority of the aged men and women in this group — men and women who, handicapped both by blindness and old age, have for the most part outlived their industrial usefulness. It must not be assumed, however, that blindness and old age alone are responsible for the dependency revealed. Not only does sickness, as has already been stated, often go hand and hand with blindness, therefore complicating the problem of dependency, but a careful analysis of the situation revealed the existence of other factors which in many cases contributed to the need for charitable assistance — factors which are well recognized by relief workers as frequent causes of dependency. That widow- hood, desertion, large size of family, shiftlessness and other defects of character are often contributing causes of dependency in the case of blind applicants for relief, as well as in the case of sighted applicants, is a fact which can hardly be regarded as astonishing. Recog- nizing, therefore, the multitude of problems involved in the care of the dependent blind, the dangers and diffi- 26 PROBLEMS OF RELIEF culties entailed in the administration of charitable aid in this field must at once become apparent — dangers and difficulties which can only be safely met by the appli- cation of scientific principles of relief. Before entering, however, into a discussion of these principles, it may be well first to enquire what agencies in the community undertake to make material provision for the needy and dependent blind. The following is a list of the most important of these: The United Hebrew Charities — our large general relief agency which, in carrying out its general object — "to relieve distress among the Jewish poor and to prevent pauperism" — grants relief to needy blind persons on the same basis as to other dependent persons in the Jewish community. Various Sisterhoods which are allied with the United Hebrew Charities. Department o§ Public Charities which administers to "poor adult blind citizens of good character who have lived in New York City continuously for two years preceding application for aid, and who are not inmates of any city institution, a share of the special appropriation made for their support." (This amount averages about $50 a year for each person.) The New York Guild for the Jeivish Blind which names among its objects "the care of the individual blind in their homes." The New York Association for the Blind which, in connection with its other activities, maintains a relief bureau "to succor and relieve the ill, aged, and needy blind." The Hebrew Association for the Blind which in carrying out one of its two purposes — "the improvement of the con- dition of the Jewish blind" — grants relief through a special committee appointed for this purpose. And, "that invisible relief fund" privately dispensed by charitable men and women must also not be for- gotten, a fund which though undoubtedly decreasing, yet in the total reaches no inconsiderable sum. Although the blind from the unusual tragedy of their affliction make an especial appeal to private charitably inclined individuals, nevertheless, as we have just intimated, the sums personally dispensed in answer to this appeal, are in latter years steadily diminishing. A more thought- ful and better informed public is fast beginning to realize the many difficulties and dangers involved in relief giving and, therefore, suppressing its charitable impulse to 27 CARE AND TREATMENT OF THE JEWISH BLIND grant private assistance, is more and more inclined to refer such cases to organized relief agencies for the necessary aid. The responsibility thus imposed on organized agencies cannot be lightly escaped, a responsi- bility which grows greater from year to year. How are these agencies for the relief of the blind equipped to meet this large undertaking? Do they recognize to the fullest extent the complex nature of the problems involved in their difficult task? Do they, in the administration of relief, carefully observe those scientific principles which have been definitely laid down as a guide for those working in this field? With the view of obtaining a satisfactory answer to these questions an intensive study of all the agencies previously listed was undertaken. The very existence of so many agencies in this partic- ular field at once suggests certain difficulties. The extent of these difficulties, however, was only disclosed when the fundamental difference in policies and methods followed by these various agencies was discovered. It must be clearly stated at the outset that although all of the organizations studied are imbued with a spirit of generous sympathy, a keen desire to contribute in the most helpful manner to the welfare and happiness of their blind dependents, yet a careful analysis of their work leads to the definite conclusion that the United Hebrew Charities alone has adopted an enlightened relief policy — a policy which is calculated to protect applicants themselves, as well as the contributing public, from the dangers of granting indiscriminate or inadequate relief. A pioneer in the field; entrusted by the Jewish com- munity for many years with the great task of admin- istering relief to its needy members; provided with more or less ample funds for carrying out its general function; — it is but natural that during the long years it has devoted to this service, this organization should have come to a realization of the difficulties and dangers involved in its chosen task, therefore developing the technique and machinery necessary for meeting the requirements of the situation. That the United Hebrew Charities has often fallen short of its own standards, is a fact which 28 PROBLEMS OF RELIEF this organization would be the first to recognize, but its very recognition of the situation is in itself encour- aging, leading to the definite hope that it will gradually overcome practical difhculties, constantly raising its own standards. Unlike the United Hebrew Charities, the various Sisterhoods allied with this organization have not been fully awakened to the situation. Unconscious of many of the delicate problems involved in the administration of relief, these agencies often fail to observe fully certain essentials of a sound relief policy. The failure of the specialized agencies for the blind — the New York Association for the Blind, the New York Guild for the Jewish Blind, the Hebrew Association for the Blind — to administer relief in full accordance with scientific principles has also been indicated. The reasons for the weaknesses of these organizations can perhaps be better understood when the nature of their growth and development are recalled to mind. Originally established for the general purpose of improving the condition of the blind, these organizations did not at first emphasize the granting of material aid, but on the contrary, directed their interest largely to needs of an- other nature. The assumption of the function of relief giving on a large scale has been more or less gradual, a process of development which is still taking place. Unfortunately, however, this development has not always been accompanied by a corresponding development in organization and technique, a failure which may be held directly responsible for many of the defects dis- covered. What are these scientific principles of relief to which we have so often alluded? What are the dangers involved in the neglect carefully to observe these fundamental policies? Fortunately we need not seek far to discover a simple declaration of elementary relief principles which, it is hoped, will serve our present purpose. In Edward T. Devinc's "Principles of Relief" we find the four following conditions quoted as essentials of a sound relief policy:* * Page 24. 29 CARE AND TREATMENT OF THE JEWISH BLIND 1. Discrimination based upon full knowledge. 2. Disciplinary treatment of those who are criminally responsible for dependence. 3. Relief with intelligent oversight for those who can not maintain a normal standard of living. 4. The refusal of all charitable support to those who can. These same principles have been emphasized by many other recognized authorities in the field and are now generally accepted by all efhcient relief organizations. The necessity for the observance of these principles must be so striking as to cause surprise at their frequent neglect by many of the organizations coming within the scope of this survey. Nevertheless it is a fact that in spite of the excellent constructive and rehabilitative quality of some of their work, these organizations do not generally appreciate the dangers involved in the administration of indiscriminate or inadequate relief. Although it must be admitted that a treatise on relief does not properly fall within the scope of this study, nevertheless it is necessary to dwell at some length on this subject. The dangers involved in the neglect to observe the essentials of a sound relief policy will perhaps be emphasiz- ed by the presentation of a number of case histories, taken from the records of the agencies under discussion. Two cases will be cited to illustrate the dangers in- volved in ignoring the first principle just quoted: "Dis- crimination based upon full knowledge." The first case brings out strongly suffering which may be traced directly to the failure to obtain that full knowl- edge requisite to the exercise of discrimination. Herman X. — The father of several young children not yet of working age, is half blind and bed-ridden, the family being as a consequence largely dependent on charitable assistance. The X's have for some time been known to three charitable agencies, all of whom, after a superficial investigation, readily agreed to give the family material assistance, one by regularly granting the necessary amount for rent, the other two by occasionally sending in groceries, coal, and clothing. Recently in the course of a conversation held by the visitor of one of these agencies with Mr. X's physician, certain conditions were disclosed which had not been previously discovered because of the superficial nature of the original enquiry. Calling attention to the nature of Mr. X's ailment, the physician de- 30 PROBLEMS OF RELIEF Glared that the sick man should have been forced to enter a hospital in order to protect not only his own health, but the health of the other members of the family who were, under exist- ing conditions, compelled to live in close contact with him. The physician's suggestion to try to persuade the sick man to enter a hospital was at once accepted by the agency in direct charge of the case, but when this plan was later proposed to the invalid himself, both he and his wife refused to consider it for a moment. Determined to bring the family to terms, the agency threatened to discontinue its allowance if Mr. and Mrs. X. still persisted in their refusal. Here the case rests for the present, Mr. and Mrs. X. asserting that they will never consent to a separation, the agency declaring that it will carry out its threat should Mr. X. not decide in the near future to accept hospital care. Would it perhaps have been possible to have averted the present tragic development if full information had been originally obtained regarding Mr. X's condition? No one can now say whether or not Mr. X would have consented at the time of application to enter a hospital, but is it not more than likely that if the promise to grant aid had been conditioned on his taking this step, both he and his wife would have been willing to listen to reason? As it is, they sincerely feel that the present plan is an arbitrary one and therefore persist in their refusal to carry it out, hoping that in spite of their refusal to co-operate, the agency will in the end be forced to continue relief. The next case illustrates dangers of a different nature, dangers involved in the granting of excessive relief because of the failure to make a full and detailed in- vestigation. Samuel G. — A family long in receipt of charitable assistance consists of Mr. and Mrs. G. and their two young children. Seven years ago Mr. G., then a young man in his early thir- ties, was forced to discontinue work on account of ill health as well as because of defective eyesight, a medical examination having revealed at the time signs of incipient tuberculosis. Under these circumstances Mr. G. asked a relief agency for full support for himself and family — a request which was granted after a very incomplete investigation had been made. For about a year the record of the case reads smoothly, revealing the fact that the family were regularly assisted, being visited from time to time. Quite unexpectedly however, an unusual item appears, for suddenly the visitor records 31 CARE AND TREATMENT OF THE JEWISH BLIND "Family is apparently receiving aid from other sources. Will call at once to learn the true facts in the case." Appar- ently there was little or no difhculty in obtaining the desired information, for it was soon discovered that two other relief agencies had been aiding ever since Mr. G's first illness, one by granting $4 a month regularly, the other by giving occa- sional aid, while two other agencies subsequently appealed to were sending in groceries from time to time. Meanwhile the history reveals that Mr. G's health had greatly improved so that several months ago he was declared able to accept light work. All efforts so far to induce him to do so have, however, proved unavailing. Even though unwilling to assist in any way in the family support, Mr. G. does not hesitate to ask constantly for an increase in the allowance, while Mrs. G., too, refuses to carry out any suggestions made. One of the last entries on the record reads — "Family seem to be thoroughly pauperized." Small wonder indeed! Had the various agencies when called on made careful enquiry regarding the character of this family, had they at the time discovered definitely the amount and nature of the assistance each was granting, would it not perhaps have been possible to have provided adequately for the G's, and yet to have protected them from the danger of becoming permanently dependent on charitable support? It is to be hoped that the histories just cited have served their purpose. Bearing in mind the facts in each case, a ready answer can perhaps be given all those who maintain that blind applicants for relief should be granted charitable assistance "without being subjected to the ordeal of an investigation" — an answer also to those who ask, "Is not blindness itself prima facie evidence of need?" Those who argue in this manner obviously ignore the full purpose of an investigation, emphasizing merely its negative side and disregarding entirely the positive results which often follow such an enquiry. How can it be hoped to administer relief discreetly without having first obtained full information regarding the applicant and his family — information regarding the exact earnings of all the wage- earners in the family; regarding the amount of assistance obtained from relatives or friends, or granted by various charitable agencies; regarding the health of the various 32 PROBLEMS OF RELIEF members of the family, their abiHty to work? Is the bHnd appHcant himself able to do work of any kind? Is he ill as well as blind, and in need of medical treatment? Does he crave recreation and amusement because of his peculiar isolation? Such questions as these must be answered before a definite plan for the family can finally be made. Usually this plan involves the granting of material assistance, though sometimes discretion requires that such aid should be refused. Too often, indeed, is it taken for granted that relief is a panacea for all ills; too often is it forgotten that relief may but serve to perpetuate conditions which ought rather to be dis- couraged. Surely it would be but the part of wisdom to refuse relief in all cases when it does not serve as a means to a definite end, the end being either the preven- tion of unnecessary suffering or the raising of family standards. Thus, it is seen that the second, third, and fourth prin- ciples previously quoted are but corollaries of the first. Two cases will now be cited: the one illustrating the dangers involved in the failure to observe the second principle laid down, "Disciplinary treatment of those criminally responsible for dependence;" the other serving to show the success which often follows a strict observ- ance of this principle. Joseph M., a partially blind man, his wife and five young children have through a period of twelve years been practically supported by a charitable agency, although all efforts to improve their condition have signally failed. The history of the family plainly indicates hereditary defects. On the moral side, Mr. M. is lacking in all those qualities which make for respectability, being lazy, untruthful, and devoid of all sense of respectability; on the physical side, he suffers from incipient tuberculosis as well as from defective eyesight. Mrs. M., too, is lacking in both moral and physical strength. Lazy and inefficient both as a mother and as a house-keeper, she complains constantly of ill-health and declares herself unable to improve existing conditions. Of the five children, one is half-blind, one is tuberculous, and one is epileptic. In spite of all efforts made by the relief agency to impress the parents with a feeling of responsibility toward their chil- dren, it has never been able to achieve the desired result. Mr. 33 CARE AND TREATMENT OF THE JEWISH BLIND M. is usually without employment, evading all efforts intended to secure him suitable work. Neither the health nor the education of the children is properly looked after, while in other ways as well their general welfare is neglected. The agency continues to give relief to this family, though fully realizing its inability to improve existing conditions. Although it is true that the unwillingness of the husband and father to accept suitable employment is not the sole cause of dependency in this case, yet Mr. M's refusal to contribute in so far as he is able to the support of his family makes it possible to hold him at least partially responsible for their need. In this case because of the various complicating factors, it would probably be impossible to compel Mr. M. through legal coercion to contribute to the support of his family, but legal aid might be employed with a view of solving the situation in a different manner. By removing the children from the home, their interests could best be protected, while the parents could then be forced either to contribute toward their own maintenance or to accept hospital or permanent institutional care. It must not be assumed, however, that disciplinary treatment always involves legal procedure. Sometimes, indeed, the mere refusal to grant relief or the threat to withdraw aid, may practically coerce individuals or fami- lies to contribute as far as possible to their own support. The following case well illustrates the success which may follow such treatment: Mary G. — living at home with her parents and younger brothers and sisters, suddenly suffered severe pains in her eyes, finally after the performance of several unsuccessful operations, losing her eyesight altogether. Under these cir- cimistances it was, of course, impossible for the girl to return to her former employment nor could she look to her parents for the necessary support. Forced, therefore, to seek char- itable aid, Mary asked assistance of an agency already in- terested in her case. This assistance was temporarily granted, Mary being informed at the time that later, after she had received the necessary training, she would be expected to contribute to her own support. In spite of arguments most sympathetically urged, Mary refused, however, to readjust herself to her changed position, declaring herself unwilling to accept the suggested training. 34 PROBLEMS OF RELIEF Convinced at last that all further efforts to persuade the girl to follow this advice would be equally unavailing, the interested agency finally decided to use other methods, threatening to withdraw relief at once unless the applicant consented to give the suggested plan a fair trial. In this way it was found possible to force the poor girl to accept the proposed plan and to arrange for her to enter one of the training classes maintained by the New York Association for the Blind. During a visit to the Association's headquarters, some months later, Mary was found busily engaged in weaving baskets. In the course of a confidential talk, she frankly admitted her gratitude to the visitor who had practically compelled her to accept the necessary training for work, declaring that her existence would have been unendurable had she been allowed to remain at home without occupation of any kind. The difficulties in the way of securing suitable employment for blind persons are fully recognized, yet in many cases it is possible for blind applicants to con- tribute to their own support. Though the remuneration offered by such employment as is open to the blind is pitifully small, yet it must be remembered that even a small contribution toward the family support may serve a definite purpose, helping to preserve the independence of the blind wage-earner, and encouraging the family to maintain a spirit of self-respect. For this reason, if for no other, relief societies cannot afford, under ordinary circumstances, to relieve blind applicants of all responsi- bility for their own support. In contrast to those blind recipients of charity who are unwilling to contribute to their own support are others who, though eager and willing to work, are forced to seek charitable aid because of their inability to maintain their own financial independence. Here the third prin- ciple declared essential to a sound relief policy may be recalled, "Relief with intelligent oversight for those who can not maintain a normal standard of living."* * It must be noted tliat the word "relief" as here used sliould be broadly interpreted, for though the injunction to grant adequate relief — in contradistinc- tion both to excessive and inadequate relief — is not explicitly stated, it is never- theless implied in the wording used. 35 CARE AND TREATMENT OF THE JEWISH BLIND Two cases will perhaps serve to show the dangers involved in the neglect to observe the principle just quoted; the one illustrating injustice which was caused because of the failure to grant adequate relief with proper supervision; the other illustrating injustice of another nature — injustice of pauperizing applicants be- cause of the granting of excessive relief without the exercise of intelligent oversight. Arthur K. and his family, consisting of a wife and six children, have been known to a charitable agency for six years. At the time of the original application, Mr. K, the only breadwinner in the family, was suffering from acute illness, so that temporary support was required. After Mr. K's recovery and subsequent return to work, it was still found necessary for the interested agency to continue its contact with the family, for because of failing eyesight and general ill health, Mr. K's earnings were insufficient to provide properly for the family needs. Since the time of the original application, the oldest daughter, Rose, has reached working age, so that at present there are two wage-earners in the family. The combined income of these two when regularly employed is $11 a week — an income which is most uncertain however, as Rose's em- ployment is seasonal, while Mr. K too, because of ill health, is unable to work regularly. On this income the family is expected to live, for, although the relief agency still regards the case as active, it is content to send the family coal and clothing, visiting them only on special occasions when emergency aid is asked. During periods of sickness and unemployment the family is allowed to struggle along without outside assistance, until, having finally reached the breaking point, they are forced to ask for increased aid. Under these circumstances it is not surprising to learn that Mrs. K's health has broken down completely, while all the children are suffering from malnutrition. The fact that the relief agency does not deliberately plan to grant inadequate relief in this case can hardly be offered as an excuse for the failure to protect its applicants from unnecessary pain and suffering. Had the necessary supervision been exercised, the existing condi- tions would have been revealed, making it then possible to grant the appropriate assistance. Mr. and Mrs. S. and their two children have also for a long period of years been dependent on charitable assistance. 36 PROBLEMS OF RELIEF When aid was first asked, the necessary amount for the full support of the family was granted. At that time the two children were still of school age, while both Mr. and Mrs. S. were incapacited for work — the one, because of ill health as well as blindness, the other because of other physical dis- abilities. The case record of this family is largely devoted to items of expenditures, revealing the fact that the applicants were regularly sent a liberal pension but were visited only occasion- ally. In one entry a decrease in the allowance is noted — due to the accidental discovery of other sources of income; in another, written at the time when the daughter became of working age, a further decrease is noted. After the lapse of some years the son also reached working age, so that it was then decided to further reduce the allowance, the plan being to discontinue relief altogether as soon as the earnings of both children yielded an income sufficient to maintain the family properly. When the plan was submitted to the parents and children however, they at once became highly indignant. A stormy interview ensued, during the course of which the son declared his unwillingness to start work, even though his school record had not been encouraging, while the daughter complained bitterly of the financial obligation already imposed on her. Strangely enough the parents supported their children in their position, declaring that the future prospects of their son and daughter would be utterly ruined if they were to be held responsible for the family support. It is perhaps unnecessary to add that in spite of these vehement protests relief was soon discontinued. Holding in mind all the circumstances of this case, are we not forced to admit that the relief agency must share the responsibility with the family themselves for the situation developed? Had the representative of this agency, during the many years of contact with the family, constantly sought to impress both parents and children with the desirability of becoming self-maintaining as soon as circumstances permitted, is it not more than likely that it would have been possible to develop a spirit of self-respect and independence, a spirit which is now so strangely lacking? In dealing with blind pensioners, it is unfortunately necessary to take special precautions against the danger of pauperization, not because of inherent differences between blind and sighted applicants — for obviously 37 CARE AND TREATMENT OF THE JEWISH BLIND such differences do not exist — but because of the per- manent nature of the handicap here considered, a han- dicap which often makes necessary the granting of continued assistance. Because of this condition, bhnd apphcants and their famihes frequently come to regard charitable funds as a source of permanent income, often claiming relief even in the face of conditions which have changed and so have rendered unnecessary the con- tinuance of further assistance. To protect blind appli- cants and their families from developing such a spirit, to encourage them to assume, if possible, the responsi- bility of contributing to their own support, is the duty of those who administer relief funds. Thus, a careful study of the principle just considered has emphasized the necessity not only of granting ade- quate relief to those unable to maintain a normal standard of living, but also of exercising careful supervision over families in need of charitable assistance. If a sound social policy demands the granting of relief to those unable to maintain a normal standard of living, it demands at the same time the refusal of all charitable support to those who can — the fourth principle previ- ously quoted. Two cases will be presented as illustrations of the dangers involved in the failure to observe this last principle. Edward N. — a nineteen year old blind boy of great musical talent lives with his older brother and sister, sharing with them a comfortable, well kept home. Anxious to be given the opportunity of earning his own living, the boy applied to a charitable agency for assistance in obtaining the training necessary to become a professional musician. On the re- commendation of two well known professors of music, who by request of the interested agency had granted the blind violinist a hearing, it was decided to give him the opportunity sought. Soon afterwards, therefore, he was entered at a college of music, the necessary tuition being paid by the charitable agency. Inquiry concerning the family income had revealed the fact that the blind boy's brother was employed as a telegra- pher earning $18 a week, while his sister, who was not strong and so could not work regularly, was "helping from time to time as a saleslady" in order that she might be able "to make 38 PROBLEMS OF RELIEF pin money." Nevertheless Edward claimed that his family would find it difficult to support him during his years of train- ing and asked that an allowance for his maintenance, as well as the sum necessary to defray the expenses incident to his education, be given him. This request was granted, the in- terested agency thereby consenting to relieve the boy's family of all financial responsibility toward him. Is it not difficult to defend the policy of the charitable agency in assuming the full burden of the applicant's support when an investigation had clearly revealed the fact that the family were in a position to make some contribution toward his maintenance? The agency, if called on to defend itself, would undoubtedly maintain that the brother and sister had long sacrificed them- selves for the blind boy and were, therefore, justified in their request to be relieved of any further financial obligation to him. But surely such an argument can not be accepted without protest by those who fully realize the issues involved in this case. The policy of forcing responsible relatives whenever possible to contribute to the support of blind applicants cannot be too strongly urged. The disposition frequently shown by blind applicants and their families to demand support from charitable funds as a right, regardless of their own ability to contribute to their maintenance, is one which must, indeed, be discouraged, no less for the sake of applicants themselves than for the sake of the contributing public. Isadore W. and his family consisting of his wife and three children have also been granted charitable assistance though not in actual need. Although the admitted family income has never been less than $19 to $20 a week — a sum which is sufficient for their maintenance — assistance in the form of groceries is from time to time sent them by an agency interested in the family on account of the blindness of the husband. In this case the interested agency might claim that criticism is not justified because of the fact that the assistance given is only in the form of groceries and, therefore, amounts to very little. But is it not clear that the policy of granting relief at all to those not in need of material assistance is a dangerous one, violating as it does an important principle? 39 CARE AND TREATMENT OF THE JEWISH BLIND The dangers involved in consenting to grant unnec- essary relief are so obvious that it is perhaps quite useless to emphasize them. Even more obvious, however, are the dangers involved in offering unnecessary aid to those who have not applied for charitable assistance. But one example of the danger of following such a policy will be given: Bernard T., a young man whose eyesight is fast failing, some time ago came in contact with a charitable agency. Through the efforts of this organization medical care and treatment were secured for the young man, while later suitable employment was found for him. In a conversation held with Bernard's mother on a recent visit to the family, Mrs. T. acknowledged with expressions of deepest gratitude the assistance given her unfortunate son by the interested agency, adding, however, with tears in her eyes, that sometimes this organization voluntarily sent in groceries and that on account of this, the family were regarded by some of their neighbors as "charity people." "The society has been so good to us. I don't like to tell them we don't want the groceries," said the grateful woman, "but it's putting us in a bad light with our neighbors." And then in a tone of pride, "We can manage to get along and we'd rather eat less than receive charity." Who can fail to admire the spirit of this family, a spirit which was evidently not recognized by those whose task it should have been to encourage it? These cases have been presented primarily as illus- trations of the dangers involved in failure to observe the modern scientific principles of relief previously quoted. Several will later be cited as examples of failure in that co-operation between relief giving organizations which is a sine qua non of good case work. This lack of co-operation between existing agencies can perhaps be traced to two causes: First '■ — Lack of standardization. Second — Failure to develop the formal machinery necessary for the co-ordination of effort. The more or less openly expressed criticisms on the part of the specialized agencies as to the work of the general relief agencies testify to fundamental differences of policies and methods. Unfortunately a general feeling 40 PROBLEMS OF RELIEF of mistrust prevails, a feeling which in some cases approaches actual hostility. Thus it was revealed that often each of several agencies interested in the same family tried to work out alone its own plan of treatment, each consulting the other with the view of superimposing its own ideas on the "co-operating" agency or agencies, rather than with the view of working out together a common plan to be carried out jointly by all of them. The difficulties in the way of securing sincere co-operation among agencies which differ totally both in principle and in practice must be easily comprehended. The specialized agencies for the blind often charge the general relief agencies with failure fully to under- stand and appreciate the viewpoint of blind applicants, feeling that the policies and practices of these latter agencies are frequently based on lack of sympathy with the peculiar needs of these unfortunate men and women. The nature of this charge can perhaps be better under- stood by a study of the following three cases — cases which illustrate the attitude frequently taken by the specialized agencies towards plans and policies suggested by other relief societies. Leopold L. — The family first came to the notice of a charitable agency seven years ago, before the death of Mr. L's first wife, when temporary aid was asked, Mr. L. claiming at the time that he was unable to find work. The L's then con- sisted of the parents and six children, all of whom suffered from defective eyesight or other physical disability. Aid was granted for a few months until the death of Mrs. L., when five of the children were placed in an orphan asyltim, only one remaining at the time with his father. About a year later Mr. L. remarried — his second wife being a widow with two children of her own. Two children have been born of this union, thus making ten children in the present household. Ever since Mr. L.'s remarriage the family have been largely dependent on charitable assistance, for although Mr. L. is a tailor by trade he is seldom employed, being apparently both lazy and inefficient. Support has been supplied more or less regularly by two agencies, both of whom have made con- stant efforts to do work of a constructive nature with the family. These efforts have, however, unfortunately met with little success, for in spite of pressure which has been exerted on the parents, they still continue to neglect the health, education, and general welfare of the children. Constant friction prevails 41 CARE AND TREATMENT OF THE JEWISH BLIND in the household, the step-mother, on her side, complaining of the bad habits of her husband's children, as well as of their inability, because of defective eyesight and poor physical con- dition, to assist her with her domestic duties; the children, on their side, complaining that they are both neglected and abused. Recently — matters having gone from bad to worse — one of the interested agencies began to realize the hopelessness of the existing situation, and therefore decided to refuse all further relief. This decision was reached in the hope of bringing matters to an issue, for the two oldest daughters — both wage earners at present — had themselves suggested that their home ought to be broken up, declaring that if several of their younger brothers and sisters could be placed in an orphan asylum, they would themselves be glad to leave their present home to live with strangers in a more satisfactory environment. By refusing relief, it was thought possible that the parents could be indi- rectly forced to accept this plan. Unfortunately however, the second agency interested in the family did not approve of such extreme measures and con- sequently was not inclined to withdraw relief. Little has been accomplished, therefore, by the action of the first agency, for even though the amount of relief given by the second organi- zation is small, nevertheless it serves to encourage the family, morally as well as financially, to continue its existence as a unit. Each agency in turn is most sincere in challenging the position taken by the other, while the members of the family themselves are divided, some being supported by the first organization, some by the second. Hannah G. — Mrs. G. is an aged widow, sick and blind, living with a son-in-law and married daughter also partially blind and in poor health. The agency which had been assisting the family for some time finally discontinued relief on the grounds that the older woman could not receive proper care in the home of her daughter and so should be induced to enter an institution. This action was, of course, taken by advice of a responsible physician. Withdrawal of relief would have compelled Mrs. G. to accept the institutional care so necessary for her well being and for that of her daughter, but at this point a second agency stepped in, which by providing a small pension has made it possible for the old woman to reject the plan suggested. This second agency maintains that under no circumstances— not even if on the brink of starvation — would the two women consent to be separated, so that it is claimed that all efforts to force the situation are needlessly cruel. Michel B. — Michel is the husband of a sick wife and the father of several young children. Compelled a few months ago because of failing eyesight to discontinue his regular work, 42 PROBLEMS OF RELIEF Michel soon found it impossible to earn enough to provide for himself and family. Upon applying to a relief agency for aid, he was asked in the course of a first interview for the names and addresses of his nearest relatives. Although the reason for the request was fully explained at the time, Michel refused the desired information, declaring that his sisters and brothers were not in a position to give him any assistance and should, there- fore, not be subjected to the annoyance of an interview. Finding it impossible to move the applicant from his position, the visitor then informed him that he would not be granted assistance until he should consent to answer the questions put to him. Undaunted by the refusal of one agency to grant him relief on his own terms, Michel then applied to a second, asking assist- ance of an organization interested in the blind. This second agency soon communicated with the relief society previously applied to, learning from them the full circumstances of the situation. In the face of these facts, however, and in the face of Michel's repeated refusal to furnish the names and addresses of relatives, the second agency decided to grant the asssitance asked for, thus openly supporting the applicant in his position and indirectly charging the other relief organization with lack of sympathy and consideration. We are not attempting at this point to apportion the blame between the agencies for the opposing courses pursued. We are simply endeavoring to stress the un- fortunate situation which inevitably arises when various organizations deahng with the same group differ basically in policies and methods. The failure of the existing organizations to work in harmony with each other naturally reflects itself in the attitude of applicants who, finding themselves supported by one agency against another, often end by refusing to place confidence in either of them. The demoralizing effect of such a situa- tion needs hardly to be emphasized. But disagreement between interested agencies was not always found to be based on fundamental differences regarding policies and methods, for often it was evident that these differences were more or less superficial and could easily have been adjusted had the various co- operating agencies frequently consulted each other with the view of clearing up all points of misunderstanding. The necessity for periodic conferences between organi- zations all working in the same field must at once suggest itself. Only through discussion is it possible to develop 43 CARE AND TREATMENT OF THE JEWISH BLIND broad policies acceptable to all and to apply those policies to individual cases as necessity arises. Nor is it possible to prevent duplication and overlapping of work unless information is systematically exchanged. Up to the present time, however, all attempts to work out a definite plan of co-operation between the various agencies interested in the blind have ended in complete failure. Although it is true that information is frequently exchanged among agencies in opening up a case or later in the course of its development, never- theless there is no definite modus operandi, information not being exchanged systematically and seldom leading to a working agreement between organizations interested in the same family. It is, therefore, not surprising to learn that sometimes two or more agencies assist the same family without even knowing of each other's interest in the case. Thus, it was found that certain blind families were receiving relief which was quite excessive, while others were receiving less than they actually needed. An executive of one of the agencies studied frankly admitted this situation, stating that in cal- culating the amount of relief required, a certain deficit was often left in the income, the agency feeling sure that other unknown organizations were assisting the family in some way. The injustice of such a system can hardly be denied, yet in the absence of the necessary machinery for the systematic exchange of information, a resort to this method of preventing fraud is perhaps natural. And this failure of the agencies to discuss their mutual problems manifests itself in other ways as well. Often as a result of their lack of co-operation various organi- zations interested in the same family fail to work out a definite plan, each unconsciously assuming that the other agencies are holding themselves responsible for this task; or, on the other hand, various agencies inter- ested in the same family often work at cross-purposes with each other, each unconsciously advocating a plan which conflicts with those suggested by other organ- izations. Thus it is seen that many difficulties and dangers are involved in the present system, or rather lack of 44 PROBLEMS OF RELIEF system, existing among agencies which administer rehef to the bhnd. The gravest of these is perhaps the un- necessary suffering of bhnd appHcants, though the useless expenditure of time, effort, and money must also be considered. The temptation to give one last case can not be resisted, a case which strikingly illustrates many of the points just made. Samuel P. — The record studied covers a period of fifteen years, during which time rehef has been given the bhnd man and his family by the United Hebrew Charities, the New York Guild for the Jewish Blind, the New York Association for the Blind, the Hebrew Association for the Blind, the City Depart- ment of Public Charities, as well as by various private in- dividuals. During all these years each of the several interested agencies has suggested to Samuel that he find employment of some kind, but none of them have been aggressive in their attitude, nor have they submitted definite proposals regarding work for the blind man. Meantime Samuel and his family have gladly taken advantage of the situa- tion, evading such suggestions as have been made. Finally each agency in turn having become discouraged with the applicants, has decreased its allowance in the vague hope that others might succeed where it had failed. A decrease in the relief granted by one agency has usually been accompanied by an increase in the allowance granted by a second or by an appeal to an individual or agency not previously solicited. None of the organizations interested has assumed full responsi- bility for the family, nor have they definitely consulted each other in order to co-ordinate their efforts. Each has been content to supplement the relief granted by the other — each has felt that "somebody" should take drastic action. Samuel on his side feels most grateful to all the agencies who have helped him and his family, and is comforted in the belief that when the present aid is discontinued other assistance will be forth-coming. Given at present $4 a month by one charitable agency, supplied with coal by a second and with clothes by a third, granted a regular pension by the city and assisted by his children who are now of working age, the blind man finds no cause for complaint with his lot. To visitors from various charitable agencies, however, he always expresses the hope of finding some day a means of contributing to his own support. Are these expressions accepted seriously by those who now assist the blind man? Probably not, yet relief is continued. It is too late now to take radical steps, and Samuel has an appealing manner, a kindly disposition, and a way of offering excuses which arc often difficult to meet. In all 45 CARE AND TREATMENT OF THE JEWISH BLIND probability self-support plans will continue to drift while the community will continue to shoulder an unnecessary financial burden, thus encouraging pauperism instead of preventing it. Time, money, and effort have all been spent in vain, and yet no one agency can be held responsible for the situation. Can it be doubted that each in turn sincerely depended on the other to work out a definite plan, thus feeling relieved of the necessity for taking aggressive measures on its own account? Conclusion Having analyzed at some length the nature and causes of the existing confusion, a remedy may now be suggested for the situation disclosed. Two distinct alternatives are at hand: First: — Co-ordination of the nimierous existing agencies which administer relief to the Jewish blind. This would entail radical reforms in the organization of individual agencies, as well as the introduction of machinery capable of promoting the necessary co-operation between them. Second: — Unification of administration of relief to the Jewish Blind. This would entail the elimination of many existing organizations so far as relief giving is concerned, centralizing control and administration in one agency — an agency which not only subscribes to the recognized principles of relief, but which is able to evolve the machinery and tech- nique capable of meeting the requirements of the situation. Each method has its own distinct advantages and dis- advantages — advantages and disadvantages which differ, however, in degree as well as in nature. The advantages to be secured through the adoption of the first method are obvious. By accepting this alter- native, it would be possible to continue the existence of all the organizations at present engaged in the field here considered — organizations which it must be admitted have devoted many years of faithful service to their chosen task. Disregarding for the moment the general objections which can be offered against the acceptance of this 46 PROBLEMS OF RELIEF method, certain specific objections growing out of the pecuhar circumstances of the existing situation must be urged against it. The difficulties in the way of securing uniformity of poHcy and clearly defined functions among the numerous existing agencies have already been discussed, difficulties which, it must be plainly stated, appear to be insur- mountable. In theory it might be possible to bring about a change of heart in these various agencies, de- veloping certain standards and policies to be accepted by all, as well as the machinery necessary for translating these principles and policies into actual service. In theory it might be possible to work out an agreement between the existing agencies, assigning to each certain applicants or types of applicants, and drawing certain distinct lines between them. In practice, however, it is feared that such an attempt would be ship-wrecked, as previous attempts have been ship- wrecked, stranded on the rock of discord and mistrust. The advantages to be secured through the adoption of the second method are equally obvious. By accepting this method authority would be definitely vested in one central agency which could, therefore, be held directly responsible for the administration of all relief to the blind. But many will raise objections to such a solution, declaring their unwillingness to deprive existing agencies of the function of relief giving already assumed by them. Without seeking to minimize the extent of the sacrifice entailed, we can not but believe, however, that this is a sacrifice which the interested agencies are prepared to make if once convinced of the need for it. The mistakes of the past will not have been made in vain if they serve to suggest the course to be followed in the future. What that course shall be has already been clearly indicated. Recalling the advantages and disadvantages entailed in the two alternatives previously suggested, it is clear that the second alternative — unification of administration — is the one which must be accepted. Those who undertake to carry out this plan will themselves be able to work out the necessary details. In the end their efforts will be crowned with success in 47 CARE AND TREATMENT OF THE JEWISH BLIND exact proportion with their willingness and ability to act impartially and without personal bias, fearlessly assuming the responsibility for all necessary changes in the situa- tion, steadfastly holding in mind the one purpose before them — the purpose of promoting effectiveness in the administration of relief to the Jewish blind. 48 IV. PROBLEMS OF EMPLOYMENT CARE AND TREATMENT OF THE JEWISH BLIND IV. PROBLEMS OF EMPLOYMENT Amongst the many tragedies besetting the blind man on all sides, none is greater, perhaps none so great, as his enforced economic dependence. His inability to earn a living for himself and his family; among the more am- bitious and gifted, the impossibility of ever reaching a desired standard — worse still, the lowering of standards that ensues when the head of the family loses his sight — all these evils crowd around the blind man so thickly, the other tragedies incident to blindness become insig- nificant by comparison. To the blind youth coming forth with high hopes from the school or institute where he has been trained for work; to the older man compelled to give up an occupation which has strained his failing eyesight almost to the breaking point; to those others whose loss of vision has come so quickly, so suddenly that they are crushed under the unexpected burden — to each and all of these comes the burning, the paramount question: What can I do to contribute towards the support of myself and my family? Where can I find an occupation which without vision I can enter, one that will ensure a fair measure of return for the thought and labor I expend? So far this problem of work for the blind has not been adequately met, as much from the fact that no one agency (with the exception of the New York Association in its workshop) has attempted to handle this question in a large and comprehensive way, as from the inherent difificulties of the situation. And yet the constant cry of the blind man, "Don't give me charity, but help me to get work," is a cry so sincere and heartrending, so often and so constantly repeated, it behooves us to give the subject of employment a thoughtful consideration that will help us to surmount obstacles, innumerable indeed. Unfortunately the day has not yet arrived — it may 50 PROBLEMS OF EMPLOYMENT never arrive — when we can hope to make the majority of bhnd people self supporting, especially those blind persons who lose their sight in later years when the habits of life have already been formed. Yet by the organized effort of the community much can be done to assist them towards this ultimate goal — and it is only by such an organized effort that we can hope, in any measure, to solve this complex and intricate problem. To what extent has this effort already been made? What assistance in securing employment can the blind man or woman expect from the existing agencies? In an endeavor to bring as much light as possible on existing conditions as to employment of the Jewish blind, the work histories of all blind Jewish males between the ages of 16 and 60 included in this survey — 144 in all — have been carefully studied and analyzed.* The field covered includes: I. A study of occupations with earnings before blindness, to determine the social and industrial status before blindness of the group in which we are interested. II. A study of the occupations with earnings after blindness to determine: a. The social and industrial status of the same group after they became handicapped by defective vision; b. The kind of employment into which they have consciously or unconsciously drifted; c. The potential opportunities for self support offered by these occupations, and lastly, d. If, and wherein, the Jewish blind man differs from his co- workers in the industrial world, making the problem of employment for the Jewish blind perhaps some- what different from the problem of employment of the blind in general. To obtain the required data as to occupations and earnings, every blind person coming within the scope of the survey was visited and direct information as to the desired facts was secured. This information was verified by a study of the records of various organizations with whom a majority of the group had at one time or * No attempt has been made to study the work histories of the 75 bhnd women of working age, for it was found that comparatively few of these vyomen had made an attempt to become self supporting, thus nKiking it impossible to draw any general conclusions from a study of their industrial careers. 51 CARE AND TREATMENT OF THE JEWISH BLIND another come in contact. In addition to this the earnings of all Jewish men, who were at the time employed in the workshop of the New York Association, were verified from the pay roll of the Association. It is evident that in order to study our group most intelligently we must first be able to picture them as they were before blindness — before defective vision had materially decreased their capacity for self support. Were these men a representative group of wage earners? Are we dealing with a class of workers who were able to support themselves and their families before they were handicapped by impaired vision or total loss of sight? A study of the table on the opposite page will furnish us with an answer to this question. Although there are in our group 144 men between the ages of 16 and 60, only 114 are listed on this table, the investigation having brought to light the fact that of these 144 men 30 had never been gainfully employed previous to blindness. Of these 30 a majority were either blind from birth or lost their vision in early youth before they had reached working age. Several facts must be borne in mind before an attempt can be made to analyze the earnings of the group under consideration. It must not be forgotten that many of the men here included lost their vision at an early age before they were able to reach the maximum of their industrial efficiency — thus accounting for the unusually low earning capacity of some members of the group. It must also be remembered that many others, though not at the time sufficiently handicapped by defective vision as to be considered blind according to our defini- tion, yet suffered from birth or early childhood with extremely weak eyesight so that they also were never able to earn as much as could normal persons. On the other hand, allowance must be made in the case of others for a somewhat natural exaggeration after a lapse of years as to former earning capacity. Bearing these facts in mind let us now turn to a study of the table. While it was definitely established that all of the 114 men under consideration had been gainfully em- ployed before blindness, exact information as to the occu- 62 PROBLEMS OF EMPLOYMENT H J^-^co SoS O lO 0) o CO (N Tfi (M (M T-4 O -C^ -CO CO -(M •--( CO 't i-H • !M 1-1 O rH 1-4 ■ • C^ lO i-l -CO -1—1 ■ 1— I (M --I -CI • 1-4 --I o (U 'C go C p-i W h rn G . G t-i t-( ;iy'"G<^t:;yi5H^'^ HO PL,Wpqp;<;OOP 53 CARE AND TREATMENT OF THE JEWISH BLIND pations of 14 of these men was not obtainable, thus reducing the number of men with known occupations to 100. Exact information as to earning capacity of 19 of these 100 men was also not obtainable, although the defin- ite statement may be made that at least 7 of these 19 men were known to have been self supporting previous to loss of vision. Of the 100 men whose occupations before blindness are known, 35 earned sums varying from $5.50 to $12 a week, 46 were able to earn from $12 to $20 and over weekly, while, as has already been stated, of those 19 men whose earnings were not established at least 7 are known to have earned fairly comfortable livings for themselves and their families. The median wage of the group under consideration falls within the $12 to $15 class, while the modal wage, that received by the largest number of workers, finds itself within this group and within the next largest group, those receiving from $15 to $18 a week. These figures at a casual glance may seem to be somewhat low, yet when we take into consideration the fact that about half the adult male wage earners of the United States, east of the Rockies and north of the Mason and Dixon line, earn less than $12 a week,* and when we note that the earnings of about one-half of our group fall within this same class — $12 or less — we may fairly assume that we are dealing with a group of workers whose earnings, as a whole, compare favorably with those of other wage earners in the general population. Now let us turn to the other side of the picture, to the economic condition of these men after blindness or total loss of vision has reduced their efficiency in the industrial world. It was found that of the 144 men here considered, 40 had sought no outside occupation after losing their eyesight. In this group are included 31 who suffered from sickness other than blindness which made it impossible for them to seek employment of any nature; 2 recently overcome by blindness and not yet able to find suitable Wage Statistics in the United States, Scott Nearing, pp. 209-211. 54 PROBLEMS OF EMPLOYMENT occupation; 2 men of independent means, and 5 others who, though physically fit except for their blindness, refused to do work of any nature, being supported by the efforts of their relatives or by contributions from chari- table agencies. What is the earning capacity of these 104 men who, in spite of their severe physical handicap, have entered the industrial world? A study of the table on the following page reveals the fact that the median earnings, roughly speaking, are $5.50 a week, 38 of the 80 men whose earnings were obtainable earning less than $5.50, while 40 earn $5.50and over. It is perhaps interesting to note that the largest number of wage earners, 15, are found within the $2.50 to $3.50 group, while the next largest number, 13, earn only from $3.50 to $4.50 weekly. When we compare these earnings with those of the same group before loss of vision and realize that the median wage before blindness was $12 to $15 a week as compared with $4.50 to $5.50 after blindness; when we remember that before blindness the two largest groups received $12 to $15 and $15 to $18 a week, while after blindness the two largest groups are able to earn only $2.50 to $3.50 and $3.50 to $4.50 weekly, the eco- nomic tragedy of blindness can better be understood and appreciated. Unable for the most part to earn a decent living for himself, the blind man is thus forced to turn to that charity whose effects are so often dangerous and de- moralizing both to him and to his dependents. Turning from a general consideration of the earnings received, let us now examine the various occupations in which these blind men are engaged. Does a study of this table throw any definite light on the types of employ- ment open to men of this handicapped class? Does it perhaps suggest which occupations should be encouraged and stimulated, which avenues of employment should be broadened and developed by those interested in the economic welfare of this unfortunate group? Turning again to our table we find that of the 104 workers under consideration 61, or nearly 60 percent, are listed in five "occupations:" peddlers, 13; com- 55 CARE AND TREATMENT OF THE JEWISH BLIND :?: w w H m CO Q o OJ 'd a. 71 ■ 3 CO Vh G C "" 3 56 PROBLEMS OF EMPLOYMENT mission agents, 13; workers in the New York Association shop, 13; beggars, 12; owners of news stands, 10. Of the remaining 43, 9 are engaged in their own businesses; 5 are newspaper venders, 6 are employed as office boys or messengers; 4 are engaged as clerks; 3 are lawyers, 3 music teachers, 3 piano tuners; 2 are janitors, while 8 are employed in other occupations which are of a temporary nature and do not offer real opportunities for blind persons. It may be well, at this point, to examine all these occupations in detail, so that their relative importance and potential opportunities may be carefully considered. It has been said that only the New York Association for the Blind has made any important or organized effort to help solve the problem of employment for this handi- capped class — and these efforts have taken, for the most part, the form of training for handicraft work. Although much has been accomplished by the Association in its chosen field, the results, at least as far as the Jewish blind wage earner is concerned, are far from being as successful as is perhaps thought by the general public. The comfortable assurance on the part of those not in close touch with the situation that the economic prob- lems of the blind are being adequately and successfully met, now that chair caning, basket weaving, mattress making, and similar handicraft trades have been opened up to them, has often led to a cessation of interest in the economic problems of this handicapped group by those who would otherwise be deeply concerned in the further- ance of their industrial welfare. A knowledge of the contribution of the New York Association towards the problem of employment for the Jewish Blind is, therefore, of the deepest interest. A study of the table reveals the fact that there are at present just 12 Jewish men employed in the work- shop, not including one blind Jewish workman who is engaged as a teacher of brush making. Of these, 8 work in the chair caning department — the lowest paid of all the trades — while 4 are employed in the broom making department. Six of these men earn only from $2.50 to $3.50 weekly; 2 from $3.50 to $4.50; 1 from $4.50 to 57 CARE AND TREATMENT OF THE JEWISH BLIND $5.50; 1 from $5.50 to $6.50; while only 2 have been able to reach the $8 to $10 class. Considering the small number of Jewish men employed at the New York Association workshop, the low wages received, the fact that only a small proportion of their number ever reach the higher paid industries, the definite conclusion must be drawn that, as matters are at present, employment at the New York Association shop does not offer the Jewish workman a large field for development, nor as great an opportunity for advancement — com- mensurate with the arduous nature of the work involved — as do many other employments and occupations open to him. It should not, however, be understood that work at the New York Association shop should never be sought by blind Jewish men — that such work has not often proved a God-send and a blessing to many who would otherwise have dragged out their days without interest and without employment, to the great detriment of them- selves and their families. Yet it must be asserted that where intelligence and ambition are combined with fair health and some small measure of vision, the workshop does not offer to the blind Jewish wage earner the best means for lucrative and congenial work. There will always be some men for whom handicraft work is best suited in every way and these men should be encouraged to seek training and employment in the New York Association shop. Turning from a study of the wage earning oppor- tunities offered by employment at the workshop, it may now be interesting to consider the opportunities offered by the other 4 occupations which have enrolled about the same number of men. Let us first examine the occupation of peddling.* A study of our table shows that of the 13 men employed as peddlers, only 4 earn $5.50 and over weekly, the earnings of * It should be noted that those blind men engaged in selling matches, chewing gum, shoe strings and other kindred articles, though calling themselves peddlers, have not been included in this group but have rather been placed where they more properly belong, with those blind men who ask alms for a living. All men here classed as peddlers are actually engaged in selling articles for which there is a real commercial demand. 58 PROBLEMS OF EMPLOYMENT 9 falling below this scale. The lowness of these figures may be partially accounted for by the fact that most of the men engaged in peddling have resorted to this occupation be- cause they suffered from other physical handicaps as well as from blindness, their enfeebled physical condition only al- lowing them to work most irregularly. Bearing in mind this situation, the conclusion must therefore be reached that in spite of the fact that a majority of the men so engaged are able to earn comparatively little, yet peddling is an occupation which should be encouraged for certain types of blind men — for the old, for the feeble, for those who find it impossible to carry on regular employment. Charitable agencies have, as a rule, been most co- operative in starting blind men with a stock of goods suitable for peddling — too often, however, regarding their work as completed when the stock was purchased and the blind peddler started on his way. Obviously this is not sufTficient assistance, for the blind man often needs supervision in his work, supervision which can only be supplied by some one who is in close touch with the situation — someone to whom he can bring the many difftculties which he meets in the course of his work. Coming to a consideration of the earning opportunities offered by operating a news stand, the outlook becomes decidedly more encouraging. Here is an occupation eminently fitted for a blind man, one which offers him in most cases, a decent living, in some, even a compara- tively good one. A study of our table discloses that of the 10 men operating news stands, 7 earn $5.50 and over weekly, 6 of these 7 receiving weekly incomes varying from $5.50 to $18. It is true that blind men operating news stands must be constantly assisted in the pursuit of their duties by some sighted relative, wife or child, so that this occupa- tion is not open to all blind persons. Yet the constitution of the family is often such that this situation can be easily met. As is to be expected licenses for operating news stands are eagerly sought by blind men and women, such licenses, however, being extremely difficult to procure, for the field is already overcrowded, a long 59 CARE AND TREATMENT OF THE JEWISH BLIND waiting list attesting the eagerness of many hundreds of persons to obtain these much coveted permits. Reahzing this situation the suggestion has frequently been made that licenses be granted only to handicapped persons, yet that such effort as has been made in this direction has not borne definite fruit is shown by the fact that of the 104 men of working age under consideration, only 10 have thus far been able to obtain the much sought for news stands. Can we not hope to better this situation? Would it not be possible, by a concerted effort on the part of all those interested in the various handicapped classes, to secure from the proper authorities the promise to grant at least a large percentage of these licenses to those un- fortunate persons, who by reason of their physical infirmities can not hope to compete on equal terms with the normal wage-earner? It is such an opportunity as this that the 5 men who are engaged in selling papers on the street without owning a news stand are eagerly awaiting. Although 2 of the blind men so employed have been able to earn $5.50 and over weekly as a result of their labors, it must be realized that this field also is already overcrowded and that it therefore cannot be depended upon to solve the economic problems of any considerable number of men. Another occupation which seems to offer exceptional opportunities for blind men is that of commission agent — an occupation which has been adopted by 13 of our group. A glance at the table does not at first sight bring out the full potentialities of this employment, the earnings of 7 of the 13 commission agents being listed as unknown. Although these 7 men declined to make a definite state- ment as to their weekly earnings, at least 5 of them were willing to state that they made a comfortable living for themselves and their families by the pursuit of this occupation — a statement amply borne out by their surroundings and manner of living.* And, as might be expected, this occupation has at- * It must be noted that in many cases the blind agent finds it necessary to engage a sighted person to act as guide, thus decreasing his net earnings. Earnings here given represent net earnings, payment for guides having been subtracted. 60 PROBLEMS OF EMPLOYMENT tracted some of the most ambitious, the most intelHgent, the most virile of the bhnd men under consideration, for it alone of all the occupations already considered gives scope for that mental activity, that intelligence and energy which are qualities strongly characteristic of the Jew — qualities which he does not lose when blindness or defective vision prevents him from following the trade or occupation for which he had been trained before over- come by this physical handicap. There are in this group book agents, agents for tea and coffee, for string and twine, for pianos, for insurance, and for various other commodities for w^hich there is a real and continuous demand. One or two of these men have been assisted toward this kind of work by philanthropic agencies which have procured a small clientele to start them on their way, but most of those engaged in this occupation have been compelled to build up such custom as they enjoy un- assisted, to any appreciable degree, by outside effort. It cannot too often be reiterated that it is almost impossible to expect a blind man, friendless and without influence, to compete with normal men in the industrial world — that for these men aid and assistance is always desirable, when proffered in the right spirit can always be accepted without loss of self-respect, even by those whose walk of life has never hitherto brought them in con- tact w^ith charitable and philanthropic agencies. To help a blind man to gain customers for an article which has a distinct commercial value is to render him that assistance which is his rightful due — assistance which he bitterly complains is too often withheld by a careless and disin- terested society, unmindful of his legitimate claim on its sympathy and interest. And so we find that for the Jewish blind men, at least for those with special intelligence and ability, here is a field which would well repay encouragement and stimu- lation — a field which has, up to the present time, been cultivated by the blind man unassisted for the most part, but one which offers great possibilities for growth and development, could organized assistance ol the proper sort be brought into play. 61 CARE AND TREATMENT OF THE JEWISH BLIND Although of course begging cannot be considered a legitimate occupation even for a totally blind and perhaps otherwise physically handicapped man, it has nevertheless been included in the table of occupations because, so large a proportion of the blind men considered having turned to this method of "earning a living," it seemed of interest to make a comparison of the earning opportunities offered by begging for alms with those of legitimate occupations open to blind men. The subject, however, will not be discussed at length in this section, as another section of the report is devoted entirely to a study of this question.* It will be sufficient at present to call attention to the fact that 3 of the 12 beggars whose earning capacity is known "earn" $5.50 and over weekly, while the "earnings" of the whole group compare favorably with those of several other occupations, includ- ing peddling and work at the New York Association shop. Is it not perhaps natural, therefore, that many blind men, discouraged by the low wages offered by the legitimate occupations open to men of their handicapped class, often turn from such employment in disgust and choose in preference to beg alms on the street, claiming they have been forced into this occupation because, try as they would, they could find no other employment which offered possibilities as great. As in the case of the commission agents a glance at the table offers very little information as to the earnings of those 9 men engaged in operating their own shops or stores, the earnings of 6 of this group being listed as unknown. Although exact information as to income was not obtainable in these 6 cases, it is, however, definitely known that 5 of these men are making a comfortable living for themselves and their families. Considering the fact that 2 others of this group earn $10 to $12 and $20 a week respectively, it may be stated that of the 9 men operating their own business at least 7 are financially independent. This situation, however, throws no definite light on the business opportunities open to blind men in general, for a majority of the men so engaged owned and * Section VII. Problems of Begging. 62 PROBLEMS OF EMPLOYMENT carried on their own businesses before blindness and are simply keeping on with the work with the redoubled assistance of their families. Yet does not the fact that they have succeeded in keeping their heads above water without outside assist- ance point the way which the community might follow in an effort to aid certain exceptional blind men towards a successful business career? The difficulties attending such a course are, of course, easily recognized, yet the blind man who is by natural intelligence and business experience qualified for an undertaking of this nature has a right to expect that his call on the interest and sympathy of those concerned in his welfare will not be brushed hastily aside on the mere assumption that no blind person can successfully operate a business of his own. Aside from the technical and professional pursuits reserved for final discussion there remain the three occu- pations listed as office boys and messengers, clerks, and janitors. Here attention must be called to the fact that only those possessing quite a fair measure of vision can enter such employments, making it impractical to regard these pursuits as open to any appreciable number of blind persons. It will, therefore, not be necessary to discuss these three occupations in detail. Now what are the opportunities for self support offered our blind group by work in technical and professional fields? During the past few years so much has been written and said about the widening opportunities offered blind persons along these lines; so many tales have been told of successful musicians, piano tuners, teachers, telephone operators, typists, that it may be somewhat surprising to find that only 3 of these occupations are listed on our table and that only 6 of the 104 men under considera- tion have entered these particular fields. A glance at the table shows that these occupations are comparatively remunerative, for of the 3 men listed as musicians and music teachers, 1 earns $6.50 to $8 weekly, while the other 2, whose exact earnings were not obtainable, are definitely known to be self-supporting. 63 CARE AND TREATMENT OF THE JEWISH BLIND Of the 3 men who are following the calling of piano tuning, 1 earns $6.50 to $8 weekly while the earnings of the other 2 range from $10 to $12 a week. Nevertheless it is perhaps not surprising that so few of the blind men under consideration have become music teachers and musicians, for in spite of the often exaggerated tales of their well wishers and friends, it is only in rare individual cases that persons so handicapped are able to compete successfully with sighted persons similarly engaged. These careers must, of necessity, be limited to men and women of unusual musical talent, who have had opportunity for a musical education since early childhood. Yet even persons so qualified have often been doomed to gloomy and heart-breaking failure for the field is already overcrowded and presents little oppor- tunity for successful and remunerative employment. And this same difficulty faces those blind persons who desire to become piano tuners — a career which certainly should offer unique opportunities to the blind man fitted by ability and education for this pursuit. Yet, as has been said, only 3 of the 104 blind men in our group are, at present, listed as piano tuners — this in spite of the fact that the Jew has distinct musical talent and that excellent opportunity for training is open to all blind boys and girls of school age in the city, either at the New York Institute or in the classes for the blind at the New York Public Schools. But 3 men have continued the pursuit of piano tuning, yet several others were found who, with high hopes, after their graduation from school or institute had embarked on this congenial career, only to find the field already so overcrowded and themselves so dis- criminated against on account of their handicap that they were forced to give up this pursuit and laboriously to fit themselves for another career less congenial and less lucrative. Is it not possible for the community to improve this situation? Surely an organized and concerted effort might easily be made to enlighten the public as to the ability of the blind man to enter this particular field on an equal footing with the sighted man, appealing to 64 PROBLEMS OF EMPLOYMENT them to give preference to those blind piano tuners who have acquired the necessary technique and training. Examining now the last calling listed on our table, that of lawyer, it will readily be seen that a detailed discussion of this profession, adopted by 3 of our group, would be of little practical value for obviously those who feel themselves fitted, in spite of their handicap, to follow this career must be prepared to do so without community assistance. Conclusion. What then are the definite conclusions which may be drawn from this detailed analysis of the industrial histories of the 104 blind men considered? As our study has clearly revealed that, at present, the existing agencies are not prepared to meet the needs of the situation; as it has brought to light the fact that the wages of the blind persons under consideration are pitifully small; that the blind often drift into overcrowded employments which offer little opportunity for development, while other fields which might profitably be cultivated are left untouched; that many, in despair of earning a living wage at regular employment turn to begging as an easier and, as they view it, an equally self respecting method of gaining a livelihood, — as all these facts have been revealed by our study, it is clear that if we are to meet the situation adequately the formation of an employment bureau for the blind is a first and imperative duty. Individualization must be the keynote of such a bureau, for obviously it will not be successful unless the applicant's character and ability have first been carefully studied, his aptitudes and personal preferences given due consideration. To this Bureau would fall the important task of educating the public regarding its duty to the unfortunate class here considered, impressing on it the full meaning of idleness to the blind, and seeking its co-operation in the task of finding them suitable employment. With the sincere and hearty co-operation of the public old fields might be broadened and developed; new fields 65 CARE AND TREATMENT OF THE JEWISH BLIND might be opened and cultivated. By organized effort to gain customers for blind men and women; by con- certed action to secure for them monopolies in special industries and callings, much might be done to improve the situation of those who are at present engaged single- handed in an almost superhuman struggle to be self- maintaining. Nor should the needs of those who are at present con- tent to remain idle be ignored. By demanding that they, too, seek suitable employment or training for work, by offering them the necessary aid and advice, the com- munity might well feel that they were meeting the needs of a situation too long neglected and ignored. 66 V. PROBLEMS OF RECREATION CARE AND TREATMENT OF THE JEWISH BLIND V. PROBLEMS OF RECREATION The importance of providing special opportunities for recreation and diversion for those unfortunate individuals who, because of their handicap, are cut off from the ordinary social opportunities available to sighted persons is so obvious as to make any prolonged dis- cussion of this need wholly unnecessary. What are the existing agencies engaged in this special field? What provisions are they making for the diversion of the group here considered? What are the special difficulties in the way of making these provisions? The following is a list of the most important of these agencies : New York Association for the Blind New York Guild for the Jewish Blind Hebrew Association for the Blind All of these agencies, besides other activities, are engaged in offering special facilities to meet the need for recreation and diversion of the blind, each however approaching the problem from a different angle.* The headquarters of the New York Association — the Light House — serve as a settlement, where classes and clubs offering all sorts of recreational opportunities are housed; where musicales, dances and other entertain- ments for blind men, women, and children are held. From the Light House is also sent a staff of visiting teachers qualified to instruct in various occupations those unable or unfitted to work outside their homes, thus helping them to pass away many a weary hour. But a mere enumeration of the various activities carried on by the New York Association is in itself not * Mention must also be made of the activities of the New York Chapter of the Council of Jewish Women, which through its Committee on the Blind conducts monthly entertainments for the benefit of all blind children attending the public schools, regardless of race, color or creed. The fact that from 100 to 150 children regularly attend these affairs — held from October to June — testifies to their popularity. 68 PROBLEMS OF RECREATION significant. The question of prime importance for us is rather how these activities meet the needs of the Jewish bhnd — the particular group in which we are interested. An intensive study of the situation revealed the fact that although much is being done by this organization for the recreation of the Jewish blind, still it can be relied on only to a limited extent to solve this problem. In the daily industrial classes conducted at the Light House only four Jewish women are employed, while only two or three Jewish women attend the weekly classes. Only a negligible number of blind Jewish women are visited by the association's home teachers. As far as the purely social activities of the Association are concerned, it may be broadly stated that the older Jewish men and women do not to any appreciable extent take advantage of these opportunities, although many of the younger people gladly share in the social gatherings held at the Light House. The explanation of this situation is obvious. If we regard the Light House with its activities as a settlement for the blind and remember that none of the teachers or group leaders there speak Yiddish, it can easily be realized that, for the most part, this social center makes an appeal only to those Jewish persons who can speak English and who are able to feel themselves at home in an environment quite different from their own. In so far as the Jewish children are concerned how- ever, it may be stated with emphasis that the New York Association, through its clubs and classes, its facilities for instruction, diversion and recreation, is filling a vital need. Here the problem of difference of language, customs, and ideas does not arise to complicate a situation already difficult enough, the Jewish children being able to accept the advantages offered by the Association on an equal footing with all others. It is true that objection has been made in some quarters to the fact that the social gather- ings for the children at the Light House are held on Saturdays, but as this objection was not voiced either by the blind children or their parents questioned in the course of this survey, it can hardly be regarded as serious. 69 CARE AND TREATMENT OF THE JEWISH BLIND Considering next the contribution of the New York Guild for the Jewish BHnd toward the solution of the problem of recreation, it is apparent that this agency, dealing as is indicated by its name only with Jewish men and women, is in a position to satisfy certain needs of this particular group — needs necessarily neglected by a non-sectarian agency. To what extent, then, does the Guild take advantage of its peculiar opportunity? The recreational activities of the Guild are threefold, including a series of monthly concerts held at the Edu- cational Alliance from October to May, weekly outings for blind children during the summer vacation, and the sending of a limited number of volunteer friendly visitors into the homes of its clients. Most of the older men and women visited spoke en- thusiastically of the monthly concerts, many of them, however, bemoaning the fact that they could attend but irregularly because of their inability to procure the necessary guides. To the young generation, on the con- trary, it was apparent that these concerts do not make so strong an appeal, very few of the more educated young people attending the musicales with any degree of regularity. The outings of the children are universally popular, every child fortunate enough to be invited to these weekly summer excursions hailing the invitation with delight. The appreciation expressed by those blind men and women who have the good fortune to be visited regularly by one of the volunteers associated with the Guild can hardly be exaggerated. It is to be deplored, however, that the Guild has only been able to enlist the services of a limited number of "friendly visitors" so that it is impos- sible for them to reach more than a very small proportion of those in need of this type of service. This situation is fully recognized and keenly regretted by the Guild which, thoroughly appreciating the nature of the services that volunteers can render in this special field, hope in the course of time further to develop work along these lines. No other existing organization is so well fitted as is the 70 PROBLEMS OF RECREATION Guild for such a task, for it may reasonably be assumed that only a Jewish agency, organized solely for the benefit of blind men and women of this faith, can undertake this type of volunteer service. What are the opportunities for recreation and diver- sion offered by the Hebrew Association for the Blind? Aside from the semi-monthly meetings of this organi- zation, which have a social as well as a business character, the Association undertakes through its Committee on Recreation to make provisions for the entertainment of the blind. This Committee regards the providing of guides, readers, and visitors to the blind as its special function. Eager as is this Committee to extend its activities, how- ever, its services have up to the present time been ex- tremely limited, owing to the youth of the organization and to its inadequate treasury. The regular monthly club meetings of the Hebrew Association are well attended, being regarded by many of its members as special opportunities for entertainment and diversion. On these occasions after the completion of the business meeting, entertainments are usually given and informal gatherings held. The Hebrew Association, composed as it is almost entirely of blind men and women, may well feel itself peculiarly fitted to perform certain social services to its own members as well as to other Jewish blind persons not included in its registry, thus looking forward to the time when an increased budget will make it possible to extend its activities along the lines indicated. A study of the recreational activities offered by the three organizations discussed has therefore disclosed the fact that, important as is their work in the field considered, yet up to the present time only the surface of this work has been scratched, only the merest beginning made to meet the exigencies of the situation. If this situation is to be adequately met, the work thus com- menced must be broadened and developed, extended and amplified. And the blind men and women themselves, what are their views on this all important question? 71 CARE AND TREATMENT OF THE JEWISH BLIND Inquiries made in the course of this investigation brought to Hght the fact that aside from those actively engaged in outside occupations, most of the adults remain at home day after day, unoccupied and neglected, week following week in long monotonous succession. To quote the exact words of one of the older women visited: "I just sit alone all day until by night my limbs grow stiff from sitting." The situation with regard to the children is some- what better, though still far from satisfactory. Ignoring the children who reside either in the Sunshine Home or in the New York Institute for the Blind, and directing our attention solely to those between the ages of 6 and 16 who live in their own homes, a study of the situation revealed the fact that in a majority of cases these children find themselves without adequate social resources. It is true that, with the unavoidable exception of a few, all those in this age group attend school and during school hours are pleasantly and profitably employed, but it is equally true that after school hours most of these boys and girls spend their time in dreary idleness, broken only by an occasional outing or at best by a periodic gathering. The presentation of a number of cases, typical of scores of others which could be cited, will perhaps not only serve to emphasize the needs of the situation, but may at the same time suggest a remedy calculated to meet these needs. The following histories of two aged blind persons will, it is hoped, be illuminating: Mr. B., a totally blind man nearly 70 years, old lives with his wife and grown son. Owing to the inadequacy of the son's earnings Mrs. B. is compelled to contribute to the family income by taking in boarders. Under these circum- stances the busy wife, in spite of her devotion to her unfor- tunate husband, finds it impossible to offer him the companion- ship he so sorely craves. Mr. B. burst into tears when he described his idle, dreary days, ending his tale wistfully with the pathetic plea that the community make some provision to meet needs such as his: "Oh, can't you make the rich people of New York provide some kind of amusement for us poor old blind men and women, who have nothing to do all day but sit at home and think?" 72 PROBLEMS OF RECREATION Never was a request made with deeper longing and more heart-rending pathos. Mrs. A., an intelHgent EngHsh widow without children or relatives in this country, boards with strangers, a relief society making the necessary allowance for her support. Although deeply grateful to this organization for the aid given her, and devoted to the society's visitor, Mrs. A. complains of the monotomy of her existence, stating that when left alone she often becomes morbid and despondent. The old woman gasped with surprise and delight when told of the existence of an organization which offers oppor- tunities for diversion and amusement to blind men, women, and children at a "club house" where periodic gatherings are held. This delight was short lived, however, for soon realizing the fact that she had no one to take her to these meetings, Mrs. A. sadly expressed her regret at the impossibility of visiting the Light House, which she so ardently yearned to "see." No less tragic are the histories of the two following young girls: Anna K. is a poor Russian who is not only blind, but who suffers from tuberculosis and heart trouble as well. Practically bed-ridden since the age of six, this girl, now nineteen years old, seems to the casual visitor but a stupid child. When the conditions of her life, however, have been studied, the reason for such an erroneous impression at once becomes apparent. An only child, living in a poverty stricken home on the East Side with her ignorant, hard working parents, visited only by a trained nurse from the Henry Street Settlement, this girl's horizon is narrow indeed! No one has tried to open up to her the world of books — no one has attempted to reveal to her the real world outside. All day long she rests on her cot — listless and forlorn — denied by a thoughtless community the social heritage which she and her helpless parents are too ignorant to claim. Esther F., 15 years old, lives with her parents and younger brothers and sisters. A regular attendant of a class for the blind at Public School, the young girl boasts of the fact that she is "one of the fastest blind readers in New York." Bright, ambitious, and passionately fond of reading, Esther expressed great regret that she had not been able to secure a book (in embossed print) from the Public Library in several months. Her explanation of the situation was pathetic. Unfortunately a younger sister had torn one of the last books sent her, and though Esther realized the matter would be adjusted could she but tell her tale to the "sympathetic lady 73 CARE AND TREATMENT OF THE JEWISH BLIND at the big library," she found such a meeting impossible. No one in the busy family could take the necessary time to accom- pany her, and to go alone was, of course-, out of the question. And so her greatest diversion — reading books with her "ten eyes" — was denied this little unfortunate. The need for diversion by those in the youngest group is well illustrated in the following two cases: Minnie B., a blind girl 12 years old, spends her free hours after school in lonely idleness. Not long ago Minnie's sister started to work, thus finding it no longer possible to take the little blind girl to the New York Association's headquarters, where she had received music lessons regularly. With longing in her voice little Minnie spoke of the lessons previously enjoyed. "I'm only happy when I play," she said, "for then I forget everything. Now there's nothing left to do but sit and wait till bed time comes." Philip S. is only 7 years old, the youngest of a large family of children. When asked how the little boy spent his free hours, the mother explained that he usually slept, and then added "but at night, of course, he nearly always stays awake." Ignorant and weak, the poor woman admitted that she could not influence Philip's older brothers and sisters to let him join in their play, and as she was unfamiliar with any of the resources provided by the community to meet the little blind boy's needs, she saw no way out of the situation. "I know something should be done," she said, "but who will help me to find the way?" Conclusion Bearing in mind the histories just presented, as well as the situation previously discussed, is the way perhaps pointed toward the solution we are seeking? When questioned as to their most ardent desire along recreational lines, all those visited — old and young, foreign-born and native, educated and uneducated — replied in much the same strain. "Some one to take me out;" "Some one to read to me;" "Some one to talk to me" — some one to help break the monotony of a dreary existence. Many of those who thus expressed themselves are already in touch with existing agencies, yet they feel the 74 PROBLEMS OF RECREATION need for that personal service and attention which only a private individual can offer, A number of those not in touch with these agencies expressed a desire for a "friendly visitor," who would not only be willing to provide in a personal way oppor- tunities for diversion, but who would at the same time make it possible for them to avail themselves of the existing opportunities offered by the various agencies. The efforts of these friendly visitors would, of course, not be confined to the providing of social and recreational activities for those under their care, but would extend in other directions as well, each volunteer visitor holding himself responsible for the general welfare of his blind protege. Those whose lives are filled with ordinary duties and pleasures can scarcely picture the peculiar isolation of most blind persons — their absolute dependence on their ^ore fortunate fellow-beings for all that makes life dear. Unhappily in many cases it is impossible for them to rely on the busy members of their own families to give them the required attention, with the result that too often they are forced to remain at home idle and neglected. Not until every blind man, woman, and child is provided with a sighted "friend" — willing and eager to give him the necessary care and attention, ready and anxious to serve him in a personal and intimate manner — can the community at large feel satisfied that the needs of this unfortunate group are in truth being adequately met. 75 VI. INSTITUTIONAL PROBLEMS CARE AND TREATMENT OF THE JEWISH BLIND VI. INSTITUTIONAL PROBLEMS The institutional problem of the Jewish blind is twofold: the care and education of blind babies and children, and the care and shelter of aged blind men and women whose own families are not able or willing to give them necessary or adequate attention. A. Institutional Problems Relating to Blind Children It may be briefly stated that as concerns the first problem — the institutional care and education of blind children — New York City is very fortunately situated, for it can be emphatically asserted that unusual edu- cational facilities and adequate institutional care are at the doors of every blind child of New York — normal but for this one defect. For those children who do not require institutional care, the blind classes of the Public Schools of the city, yearly improving in facilities for instruction, offer an education to every blind boy and girl of school age ; while for those under school age and for those older children who need or desire institutional care and education, the Sun- shine Home for Blind Babies, the New York Institute for the Education of the Blind, and the State School at Batavia furnish opportunities which, while capable of improvement, compare most favorably with those offered by similar institutions in other cities and countries. It has been said earlier in this report that educational and institutional problems of blind Jewish children cannot be separated from those of the other blind children of the city; that these problems are of such a nature that only the community as a whole, all working together, can solve them adequately and democratically. This view of the situation is not, however, shared by a large group of Jewish people deeply interested in the care and education of blind Jewish children. It is, 78 INSTITUTIONAL PROBLEMS indeed, the present aim and endeavor of this group to separate the bhnd Jewish children from their non-Jewish comrades, placing them in a strictly Jewish institution where they will have the benefit of an education along Jewish lines such as the community offers to the Jewish orphan and the Jewish delinquent. Aside from objections of a religious nature, this group offers other objections to the existing situation. Criticism is made by them of the failure of the New York Institute for the Blind to care for its students over week ends and during the three vacation months. These persons con- tend that the failure to make adequate provisions of this nature often works untold hardship on parents whose burdens are already unbearable, and that some of the homes to which the children are returned are unfit to receive them. They therefore assert it is a necessity to build an institution open throughout the year in order to obviate these difficulties — at least as far as the Jewish children are concerned. As a further argument in favor of the erection of a Jewish institution, this same group asserts that there are many children at present in their own homes, who are not receiving proper care and education and who should, therefore, be taken from these homes and placed in an institution where adequate care and attention could be given their physical and mental needs. Believing that the parents of many of these children would gladly place them in a Jewish home, although they would refuse to allow them to enter a nori-Jewish institution, this group feels it incumbent to offer such parents the opportunity of placing their boys and girls in a Jewish institution for the blind. It has been one of the principal objects of this survey to study thoroughly the question of a separate Jewish institution — while in no way questioning the desirability of educating Jewish children in the Jewish faith, to look at the matter from all angles and to determine, after an intensive study of the whole situation, just what would be gained by the establishment of such a Home and just what would be lost. Several questions will immediately arise in the minds 79 CARE AND TREATMENT OF THE JEWISH BLIND of all those interested in this project: How many Jewish children are there who would fall under the provisions of the new institution? Where are these children now situated — in their own homes, or in the institutions al- ready established for their care? If in their own homes, what are the conditions under which they are living? If in institutions, what is their own and their parents' opinion of the care and treatment they are receiving, and how do these people who are most concerned view the idea of a Jewish home for Jewish children? An intensive survey of the situation which included a visit to the home of every blind Jewish child in Manhattan and the Bronx revealed the following facts : There are at present 47 blind Jewish children under sixteen years of age in Manhattan and the Bronx, 30 of whom are in their own homes, 7 in the Sunshine Home, and 10 in the New York Institute for the Blind. Besides these there are 6 young people between the ages of sixteen and twenty-one, who are receiving a higher education at this latter institution. Of the 30 in their own homes, it may be briefly stated that 9 are in homes which are beyond reproach, the children being well cared for by their own families, attending the blind classes of the Public Schools, taking part in all the activities open to children at the New York Association for the Blind — in short leading lives which under the circumstances are being made as nearly normal as possible. Another nearly similar group is composed of 11 children coming from fairly good homes, attending the proper classes at school, in touch with several agencies for the blind, but still a group which, on account of the ignorance of the mother, or the fact that the parents are foreigners and unaccustomed to our ways, needs advice and help as to medical treatment, recreation, vocational guidance, and a variety of problems arising in their daily lives. Of the remaining 10, 3 are subnormal and would therefore not be eligible for any institution for the normal blind, while 7 others apparently require insti- 80 INSTITUTIONAL PROBLEMS tutional care — care which could, however, easily be found for them at the Sunshine Home or at the New York Institute for the Blind. An analysis of the situation of the institutional children revealed the fact that of the 21 children and young people at present in schools for the blind, only 6 would prefer being in a Jewish institution, while 3 others would gladly avail themselves of such a home during the summer months. There remains, then, the chief argument of those who wish to erect a new institution — the argument that whether the parents of the children or the children them- selves realize it, a definite wrong is being committed by depriving these boys and girls of the privileges of life in a strictly Jewish institution. There are many who will sympathize deeply with this group in its desire to impress Judaism, through a Jewish education, strongly on its little blind proteges. There are many who deeply regret evidences of religious laxness on the part of Jewish children brought up in non-sectarian institutions. Yet even to those who sympathize in theory with this desire to give the blind Jewish children all the heritage of their race, the thought must come: Is it wise — is it good social policy to build an institution, a building which will cost thousands to erect and correspondingly large sums to maintain, for the benefit of such a small group of children as would be eligible to the new Jewish home? Must we not also consider the fact that the number of blind persons, especially of persons blinded in early life, is constantly decreasing, so that we may, without too much optimism, look forward to the day when the need for institutional care for this class of defective children will be almost eliminated?* * This point of view was especially emphasized to the investigators of this study by Dr. Thorne of the Bureau of Child Hygiene. Although all cases of inflammation of eyes or blindness of infants must be reported to this Bureau by the attending doctor or midwife, there was in Dec. 1916 not one such case there registered — a fair basis for Dr. Thome's statement that blindness amongst child- ren is a diminishing problem. This result has been brought about by the great amount of preventive work undertaken during the past few years — work which embraces the fields of medicine, education, and legislation. 81 CARE AND TREATMENT OF THE JEWISH BLIND In consideration of this decrease of blindness, several experts interested in this problem consulted during the course of this investigation stated that in their opinion it would be a great mistake to build an institution for blind Jewish children. Not only are the present provisions in New York City more than ample to meet all the needs of the situation, but the constant decrease of the dis- ability, together with the better understanding of how to care for blind children in their own homes in co-operation with the Public Schools and other institutions and agencies will, according to these experts, in the not too distant future make an institution for blind children a thing of the past — a last resort only to be used in a com- paratively small number of cases. It would be wise, while remembering the advantages that would accrue to the Jewish children by life in a Jewish institution — even could the minimum number necessary for such an institution be gathered together — to remember also the disadvantages that would arise. In the case of the children eligible to the New York Institute they are at once perceptible. Richly endowed financially, ably administered, with the benefits of half a century's experience in the work of educating blind children, the New York Institute, though far from per- fect, stands amongst the three or four most prominent institutions for the blind in this country. Can it be thought that a strictly Jewish home could soon hope to reach the standard set by this institution? Would it not be depriving the Jewish children of a great, a fundamental right — the right to receive the best education the com- munity affords — to take them out of this institution, in order to place them in a small Jewish home which in the very nature of things could never hope to reach the standard set by the New York Institute? But those who wish to erect a new institution have asserted that the prospective home is primarily designed for younger children, for children not eligible to the New York Institute. Setting aside the fact that the Sunshine Home, to which these children are eligible, has reached a standard of excellence which a very small institution could hardly hope to attain, we may again 82 INSTITUTIONAL PROBLEMS recall the fact that there are only 15 such children known to any agency in New York, and that of these 15 only 7 have found it necessary to seek institutional care. Even if this number were increased by adding all the blind Jewish children under eight years of age in Greater New York, the number would never be sufficiently large for the erection of a Home which could hope to reach the standards set by institutions which have the whole blind population from which to gather their inmates. In a word, the problem of the care and education of blind children in New York City is not extensive enough to be subdivided along racial and religious lines. We may sympathize with the desire for a Jewish education for all, while regretfully acknowledging that, in this particular case, it is not a wise nor a feasible policy to pursue. Is there then nothing that can be done to better the situation, to bring Judaism as a potent force more directly into the lives of the blind Jewish children of New York? We answer emphatically *'Yes." The way has already been pointed. Through the efforts of a Jewish agency interested in this problem and the willing co-operation of those in authority at the Institute, a teacher has recently been sent to the School who gives religious in- struction to the Jewish inmates. That this action has not been followed by a similar undertaking in regard to the Sunshine Home is not the fault of those in charge of the Brooklyn Institution, for when broached on the subject they declared themselves eager to co-operate not only in this manner but in other ways as well. They even expressed their willingness to allow such of their charges as were old enough to attend a synagogue under the guardianship of a Jewish volunteer visitor, should such a plan be deemed feasible. There is every reason to believe that the New York Institute would be willing to co-operate further in an effort to meet the peculiar needs of its Jewish inmates. By calling the attention of those in authority to the various complaints of the Jewish families, special adjust- ments might be made to meet the situation. For example, permission might be granted Jewish children to return to their homes during Jewish holidays, thereby eliminating 83 CARE AND TREATMENT OF THE JEWISH BLIND one objection to life in a non-sectarian institution. Other justifiable complaints would probably be met in the most liberal manner, were those in authority properly approached. Sincere and hearty co-operation with existing insti- tutions for blind children is one way of improving the situation. Are there no others? Why could not a special effort be made to come in touch with the young students during their week-end holidays and then in some manner attempt to arouse and stimulate their interest in Judaism? Difficulties there might be in this effort, but no insuperable ones. As for those few children at present at the New York Institute who ought to be receiving institutional care during the summer months, would it not be possible to arrange for them a summer camp under a trained teacher, where they could enjoy the needed care and instruction, together with the added delights and benefits of country life? This would of course entail considerable expense, but far less than would be involved in the building and maintenance of a separate institution. And for those children in their own homes who need institutional care, but whose parents through ignorance, carelessness or prejudice, have refused to allow them to take advantage of the available facilities, much might be done by personal effort directed toward showing these parents the dangers involved in an attitude which, if persisted in, must eventually result in untold harm and misery to all concerned. Conclusion An analysis of the situation must, we hope, lead to the conclusion that all the elements for successful care and instruction of blind Jewish children already exist in New York City. Is it not now the duty of those interested in these small unfortunates not to build a new institution for their benefit, but to co-ordinate the existing resources, to co-operate with established insti- tutions and agencies, occasionally filling out a gap when this is found to be necessary? In this manner and in 84 INSTITUTIONAL PROBLEMS this manner alone can they feel that they are meeting to the fullest extent their responsibilities toward the blind Jewish children of New York City. B. Institutional Problems Relating to the Aged Blind The situation with regard to the care and shelter of the indigent aged blind is at once encouraging and dis- couraging — encouraging because the community already recognizes the need for increased institutional facilities for all aged persons; discouraging because of the failure of this same community to realize the necessity of adapting Homes for the Aged to meet the peculiar needs of their blind inmates. What are the existing institutions which offer shelter to the Aged Blind? What is the number of their blind inmates? A glance at the accompanying table will furnish the desired information. Homes for the Aged Open to the Jewish Blind, Together WITH the Number of Jewish Blind Residing in EACH ON January 1, 1917. Name of Institution Number of Inmates Men Home for Aged and Infirm Hebrews .... 12 Home of the Daughters of Jacob 9 *City Home for the Aged 5 Home of the Daughters of Israel 1 Home for the Aged and Infirm (I.O.B.B.). 1 Home of the Sons and Daughters of Israel *Isabella Heimath *Home of the Society for the Relief of the Destitute Blind 1 Women Total 11 23 9 18 1 6 3 4 1 1 1 Total 29 26 55 * Homes designated with asterisks are non-sectarian institutions; others not so designated are Jewish institutions. All institutions listed, except the last one, are for sighted as well as blind aged men and women. An examination of this tabic reveals the lact that of the 127 Jewish blind men and women in Manhattan and the Bronx on January 1st, 1917, GO years of age and 85 CARE AND TREATMENT OF THE JEWISH BLIND over, 55 were receiving institutional care, 29 men and 26 women.* Yet the question of institutional care for the aged blind concerns not only the 55 blind men and women who have already found shelter in Homes for the Aged, but is also of interest to many others who have not yet sought entrance into an institution. Visits to the homes of all the blind Jewish men and women 60 years and over, coming within the scope of this survey, revealed the fact that many such persons were living under circum- stances which did not permit their receiving the care and attention demanded by their unfortunate condition. Although a few of the men and women so situated ex- pressed their unwillingness to accept the necessary insti- tutional care, preferring to remain at home even under the most deplorable conditions, yet a majority declared themselves not only willing but eager to enter a suitable Home. Can we depend on the existing institutions to accept all the aged blind at present in need of care and shelter? That the capacity of these institutions is not adequate to meet the needs of the situation was brought out clearly by questioning the superintendents of the existing Homes regarding their ability to accept new applicants for admission. All those approached replied that the institutions which they directed were filled to capacity, five of them adding that there were long lists of persons — both sighted and blind — waiting to enter, f Yet the situation is encouraging when it is noted that an attempt is already being made by a Home for the Aged to enlarge its facilities by rebuilding. This Home, whose capacity is at present 200, has recently laid the corner stone of a new building which when completed will accommodate 600 inmates. Fortunately, those who will direct the policy of the new institution have already expressed their intention to give preference * This number does not include several blind Jewish inmates of Manhattan State Hospital for the Insane. t In this connection it must be noted that frequently blind persons awaiting entrance into institutions for the Aged find themselves at a decided disadvantage, as unfortunately they are often discriminated against in favor of those able to see. 86 INSTITUTIONAL PROBLEMS to blind applicants, realizing that institutional facilities for the care of this handicapped class arc even less adequate than are institutional facilities for the care of the aged sighted. Should the erection of this new Home not suffice to meet the needs of the situation, additional provisions for the care and shelter of the aged blind can be secured either by further adding to the number of existing institutions or by enlarging those already erected. While the erection of new Homes for indigent aged persons in so far as they are needed is warmly advo- cated, the erection of new institutions for the special shelter of the aged blind can not be too strongly opposed. The objections to the policy of segregating the blind in special institutions of their own must be recognized by all. To adopt such a policy would practically be to deprive these afflicted men and women of all contact with sighted persons, thus forcing them to live under the most narrow and confining conditions.* Aside from the question of capacity of existing insti- tutions, the question of the adaptation of these institu- tions to meet the special needs of blind inmates at once suggests itself. These needs fall for the most part under the heading of recreation and diversion, for except for the inability of blind persons to share in the general social life of the institutions in which they reside, their condition is not found to differ radically from that of their fellow inmates. Inquiries made of superintendents of Homes for the Aged regarding special provisions adopted to meet the peculiar needs of blind inmates evoked the admission that this phase of the situation had up to the present time been practically ignored. The gravity of the situa- tion was equally as freely admitted, several of those questioned stating, however, that in their opinion existing conditions could easily be remedied if the com- munity but manifested sufficient interest in the subject. * The superintendents of several Homes communicated with called atten- tion to the advantages which blind inmates enjoy by reason of their contact with sighted ones, stating that frequently those able to sec volunteer to perform services of various kinds for their less fortunate fellow inmates— services which are often valuable and important. 87 CARE AND TREATMENT OF THE JEWISH BLIND The importance of providing special facilities for the diversion of blind men and women residing in Homes for the Aged can hardly be appreciated by those who but seldom come in contact with this handicapped class, though the few who realize the peculiar isolation of this unfortunate group can readily comprehend the value of all efforts calculated to relieve — even to a small extent — the monotony of their existence. Limited on all sides by reason of blindness and old age, compelled to submit to the narrow routine of institutional life, these affficted men and women yearn for the simple pleasures enjoyed by their normal fellowmen, and are deeply grateful for every opportunity afforded them for entertainment and diversion. Yet, as has already been suggested, there would be little difficulty in improving the situation. Much could be done by those directly in charge of Homes for the Aged ; more could be accomplished by organized outside effort. By encouraging the sighted men and women to hold themselves responsible for the comfort and cheer of their less fortunate fellow inmates; by providing simple games of amusement fashioned in raised type, such as dominoes, checkers, etc., the lives of these unfortunate men and women might be rendered less sad and dreary.* Although much might be accomplished along the lines suggested, the outlook would nevertheless be far from satisfactory were no effort made from the outside to supplement such pleasures and diversions as could be provided by the institutions themselves. The need of all blind persons for contact with "friendly visitors," discussed in a previous section,! is doubly emphasized in the case of blind inmates of institutions. At present this field of service is practically neglected, for the number of men and women who visit regularly in the Homes for the Aged is negligible. Can it be doubted that organized effort could be made to secure * The suggestion to provide books in raised print is not made as most of the Jewish inmates of the institutions here considered are illiterate, or if literate, able to read only Yiddish. t Section V — Problems of Recreation. 88 INSTITUTIONAL PROBLEMS the services of a corps of volunteers to visit regularly blind inmates of all institutions, reading to them, enter- taining them, perhaps in special cases teaching them to knit or to weave? Such visitors might also hold them- selves responsible for a series of entertainments through- out the year, entertainments which could be enjoyed by sighted as well as by blind inmates. Is not this a field which might well be cultivated by those persons of leisure who desire to be of social service, to devote them- selves to some real and vital need of their less fortunate fellow beings? Conclusion Extension of the existing capacity of Homes for the Aged by the building of new institutions or by the enlarging of old ones and special adaptation of facilities of existing institutions to meet the peculiar needs of their blind inmates — these are the two definite recommenda- tions which grow out of a study of the existing situation as regards institutional care and shelter for the Aged Blind. By a sincere and hearty effort to improve the situation along the lines suggested the last days of these afflicted men and women might be comforted and cheered, bright- ened and illumined. 89 VII. PROBLEMS OF BEGGING CARE AND TREATMENT OF THE JEWISH BLIND VII. PROBLEMS OF BEGGING No study of the blind would be complete without focusing special attention on those problems which are associated with the practice of begging, a practice too often resorted to by many of these unfortunate men and women. How many of us have ever passed a blind beggar on the street without experiencing an emotion mixed of pity and resentment? We are touched by the sad figure we behold, yet we can not help but regard his very presence on the corner as an intrusion of his misery, an intrusion from which we ought to be protected. Some of us perhaps subscribe liberally to various charitable and philanthropic organizations, and there- fore feel justified in wondering why the needs of this unfortunate and afflicted creature are not being met in a proper manner. Nor must it be imagined that our irri- tation is caused by an unwillingness to give the few cents so pitifully asked for. Rather is it due to a recognition of the inadequacy of such a response. To give a small sum and to pass on is to leave the object of our pity little better off than when we encountered him ; to refuse to give is to ignore an appeal which perhaps should be met with generosity. How often have we longed to know the full histories of those who beg on the corner, mentally including in this class those who perhaps prefer to be known as peddlers or street musicians, but whose occupation is in fact begging under another name! We wonder if these poor blind creatures are forced to seek funds in this way; if they are unable to earn anything by legitimate employ- ment; if, unable to work, they are denied the relief which should be theirs. Perhaps a study of the industrial and social histories of a small group of blind beggars may be illuminating, helping us to measure, to some extent, the responsibility 92 PROBLEMS OF BEGGING of the community, as well as the responsibility of the blind persons themselves, for the situation we deplore, assisting us at the same time to discover some means of meeting this situation. It may be remembered that in a previous section* a number of men were listed whose "occupation" was given as begging. To the 12 men thus listed should be added 3 men over 60 years of age and 2 women, as well as 3 younger men also known to be beggars, but not included in this investigation because of the fact that it was found impossible to obtain their correct addresses. Undoubtedly among those listed in the census as "not located," still others are included who, if visited, would be discovered to follow the practice of begging. Even if such men and women were included however, the list of Jewish beggars would undoubtedly not be a long one, yet long enough to warrant our concern. An analysis of the histories of the 17 blind beggars located, reveals the fact that 3 men of this group were too old at the time of becoming blind to make possible any plans for self-support. Morris L., the oldest of the three, is not only blind, but suffers from an acute nervous condition as well. Applying for relief to two charitable organizations, he was refused assistance because of the discovery that he was a professional beggar — an attitude on the part of the relief agencies which rather ironically encouraged him to continue the very practice they condemned. Morris may, therefore, still be found living in the same miserable way, sharing with three other old men rooms in a dark and insanitary basement so cold in winter that the old man is often forced to seek protection in a synagogue or other public place. Correspondence between the two agencies appealed to reveals some discussion of the suggestion to secure Morris' admission into a Home for the Aged. The suggestion was, however, not followed further, the agencies fearing that the blind man would be refused admission on account of his per- sonal habits which were known to be filthy and generally objectionable. Clearly, in this instance, both charitable agencies completely evaded their responsibility, for it is obvious that either relief should have been granted, so enabling * Section IV— Problems of Employment. 93 CARE AND TREATMENT OF THE JEWISH BLIND the half bhnd old man to live decently in a private home, or, if found suitable for institutional care, his admission into a Home for the Aged should have been secured. Equally wretched is the condition of David M. When first his eyesight began to fail, David was frequently assisted by a charitable society. Afterwards, unable to find work of any kind, he was regularly granted the amount necessary to cover his rent, the agency deciding that by peddling shoe strings and hair pins — an occupation which was merely begging under another name — the blind man could earn his own living expenses. For six years relief was granted regularly, until information obtained in an interview with a subsequently discovered daughter caused the relief society to discontinue further aid. Stating that her father was a gambler and a drunkard who had deserted his wife many years previous in Europe, the daughter refused to interest herself in the old man's condition. Relief having been discontinued, the agency advised David to enter a Home. He refused this advice, how- ever, preferring to live miserably on the meagre alms which he is still able to obtain. The old man probably feels fully justified in supporting himself by begging, for was he not driven to this method of "earning a living" by the inadequacy of the relief granted? The relief society may also be criticized for finally withdrawing all assistance. Because of the information given by David's daughter regarding his character and past history, was it proper and wise to refuse him further aid, thus forcing the community to support the blind old man in a more indirect manner? Fortunately the history of Emanuel M. illustrates a less difficult social problem. A widower, living alone, Emanuel became totally blind at the age of 64. Too old to support him- self, he was given a home by a married daughter who was apparently able and willing to provide for her unfortunate parent. Here Emanuel lives in comparative comfort, though too frequently left alone, for his daughter works irregularly, while her young children are at school. Endowed with a sociable and happy disposition, having a fondness for out-door life, the old man usually spends his mornings on a street comer where he may be found selling pencils to sympathetic passers- by. Undisturbed by conscientious scruples regarding this form of indirect begging, he thus earns about $3 a week — a sum which secures for him many an extra little comfort. 94 PROBLEMS OF BEGGING Under these circumstances may it not well be asked if Emanuel should be discouraged from an occupation which is regarded by him as both employment and diversion unless an effort be made at the same time to provide in some other way for these needs? To the list of those too old to find legitimate employ- ment should be added the name of a fourth old man. In this case, however, vision was lost in early manhood, so that the problem presented differs from those previ- ously suggested. Albert S., becoming totally blind at the age of 22, was suddenly brought face to face with difficulties which at first appeared truly insurmountable. Having obtained no assistance in those early years toward finding work which he could per- form, having tried and failed to earn a living in various legiti- mate ways, the blind man at last discovered a way out of his troubles. He found that by appealing for alms in an indirect manner he could "earn" sufficient to provide for his meagre wants. By praying in the synagogues in inclement weather and by peddling pencils on the street comer on fair days, Albert has been able for the past 15 years to bring home $4 or $5 a week. A single man, boarding with strangers, he finds it possible to exist on the alms he receives — alms which are supplemented by an occasional basket of groceries sent by a charitable agency. Perhaps it is too late to suggest now any other em- ployment which might be followed by the blind old man, yet can it be doubted that suitable work of some kind could have been discovered for him years ago, for Albert is a man of intelligence and education, who had planned to become a teacher before overcome by his affliction? Can it be truly said that Albert deliberately chose the occupation he now follows, or must it rather be admitted that he was indirectly forced into such a course? Equally difficult to solve are the problems of the three blind men handicapped in finding employment because of poor health, as well as because of blindness. One of these, Leon F., suffers from kidney trouble, and for several years has been content to beg while nominally peddling notions, thus adding about $2.50 a week to the family income. Finally appealing to a charitable agency for assistance he was refused relief because of the fact that there were three other wage-earners in the family. Although the organization 95 CARE AND TREATMENT OF THE JEWISH BLIND appealed to took a sincere interest in the blind applicant, procuring for hini proper medical treatment and assisting him to secure his citizen papers so that later on he might be able to obtain a blind pension from the city, no effort was made to induce him to give up the occupation followed. Was it the duty of this organization to try to dis- suade the bhnd appHcant from continuing an em- ployment which was virtually begging under another name? Perhaps so, yet had this course been followed, Leon would probably have called attention to his need for occupation to help while away the weary days, at the same time emphasizing his very natural desire to help defray in some way the expenses of the family? Nathan L. is another sick blind man, wholly unfit to work. The description given of him by his wife suggests that he is mentally irresponsible as well, having apparently lost both physical and mental control. Filthy in his habits, profane in his language, and violent in his actions, Nathan was finally forced by his wife and children to leave their home and seek another place in which to live. Though occasionally given a few cents by a member of his family who may chance to meet him on the street, the sick blind man is largely dependent on alms for his existence — a hand to mouth existence, indeed, for Nathan's only bed is a counter in a small shop where he is permitted to spend his long and dreary nights. This present condition is not known by any of the three agencies which include his name on their registries, for when last heard of by these organizations Nathan was cared for by his family, his physical and mental condition being less acute at that time. But even were the interested agencies in touch with the existing situation, it is doubtful whether any of them could succeed in solving the problem presented. Would it be possible to induce the family to relent, persuading them to allow the unfortunate old man to live again under their roof? Or would it be possible to secure Leon's entrance into a Home for the Sick or the Blind? Perhaps neither of these plans would prove practical, yet only the actual attempt to meet this particular situation could demonstrate whether, or not a more or less satisfactory solution in this case could be found. Very similar to each other, though somewhat different from the three previous cases, are the histories of the two other men suffering from other physical disabilities as 96 PROBLEMS OF BEGGING well as from blindness. In each case the claim of ill- health and consequent inability to contribute to his own support is made; in each case the agency appealed to, though admitting that the applicant is handicapped by reason of his physical condition, nevertheless contends that he is at present a mendicant by preference rather than by necessity, asserting at the same time that relief formerly granted only resulted in the pauperization of the blind man and his family. Michel B. lost his vision years ago, having previously suffered from weak eyesight. Soon after he found himself compelled to give up his regular employment the blind man secured industrial training at the New York Association Shop, where because of his poor physical condition he was able to earn but $2.50 to $3 a week. In spite of the fact that his meagre wages were supplemented by relief, Michel became discoiuraged at this work and after two years gave up his employment at the Workshop. Effort was then made to find him other occupation, the interested agency supplying him later with a small stock of tea and coffee in the hope that by peddling his wares he could be made partially self-supporting. Business aid was continued over a period of two years until it was suddenly discovered that Michel was not always employed in the legitimate business of peddling, but was spending much of his time roaming around office buildings, soliciting alms from from good-natured occupants. A third attempt was then made to secure suitable employ- ment for the blind pensioner. This time Michel was estab- lished at a news stand — an enterprise which also soon ended in failure, partly because of Michel's poor physical condition and partly because of his wife's refusal to give him the necessary assistance. At this point the charitable agency refused to continue regular relief, offering, however, to co-operate in any self- support plan. Mrs. B. was urged to accept employment in the agency's Workshop for Women, but she persistently refused to consider all suggestions to find her suitable occupa- tion, claiming that she was not strong and so should not be expected to add to the family income. The B's arc at present, therefore, living on alms, supplemented by an occasional basket of groceries sent in by a second charitable agency. Who can be held responsible for this sad stat{^ of affairs? Certainly it must be admitted that much tinu- and thought was expended in a fruitless effort to make 97 CARE AND TREATMENT OF THE JEWISH BLIND this family self-supporting, yet the responsibility for the failure of these attempts is not easily placed. Is it fair to expect a half-sick blind man to work under the most trying circumstances for a weekly pittance which must still be supplemented by relief? Should relief be dis- continued in all cases where the wife refuses to co-operate in a plan for self-support? No general response can be made to questions of this nature, for experience has shown that each individual case must be judged separately on its own merits. Harry F. also feels that he is being denied a living which the world owes him, although it is true he has been assisted on more than one occasion by an agency which made a sincere effort to secure him suitable employment. After citizen's papers had been obtained for the blind applicant he was enabled to secure a peddler's license and was then furnished with a stock of notions, the agency hoping that in spite of his double handicap of blindness and ill health, by peddling his wares on the street he would be able to add a small simi weekly to the relief granted. But peddling soon proved to be begging under another name, although the blind man always carried a tray of shoe strings so as to avoid being arrested by a suddenly vigilant police. This state of affairs continued for five years when the agency, discovering the true nature of Harry's employment, and learning as well of other concealed sources of income, decided to discontinue relief. The record of this case indicates clearly that the family had become thoroughly pauperized during the years in which they had been granted assistance. May not the charitable agency however, as well as the applicants themselves, be blamed for this situation? The blind man may well claim that he had been given an opportunity to beg rather than a chance to earn an honest living, and he may well add that the business plan suggested by the relief society — if business plan it could be called — was an impractical one, for he could never have hoped to earn more than a negligible sum in this way. Only a fuller study than was made by the relief society of the applicant's physical condition and business ability could have revealed the possibilities for self-support in this instance. In another case relief was temporarily offered, though 98 PROBLEMS OF BEGGING refused by the blind applicant because of his unwillingness to make an effort to contribute to the family support. Julius S, partially blind but in good health, recently applied to a relief agency for financial assistance toward the support of himself and family. Following an investigation, the applicant was told that temporary relief would be granted — only, however, until he should be able to find remunerative work of some kind, the plan being that the earnings of the blind man, together with those of two other wage-earners in the family, would ultimately put them in a position to be independent of further charitable aid. Although assistance was offered in finding Julius suitable employment, the suggested plan was summarily rejected by him. Under these circum- stances relief was refused, the large family being consequently forced to live on the small earnings of the two grown children, occasionally supplemented by small sums obtained by the blind father who now begs irregularly on the street. Some day perhaps Julius will be arrested as a vagrant. It may then be hoped that he will be compelled to do work of some kind, thus adding in a legitimate way to the family income. Unlike the previous histories are those of two other blind men — both single — who, in spite of their affliction, have never asked for relief. Both, however, though nominal peddlers are virtual beggars, living largely on alms rather than on actual earnings. But in both cases, begging was only accepted as a means of support after sincere effort had been made to earn a living in some other manner. Adolph L., after losing his eyesight some years ago was, through the effort of two philanthropic organizations, estab- lished at a news stand. But the business enterprise was un- successful because of the poor location of the stand. After its failure Adolph began to peddle songs on the street corner, earning from $3 to $6 a week and supporting himself since in this way. It is perhaps not necessary to add that most of Adolph 's patrons have little or no use for the articles they purchase, often in fact refusing to accept them in payment for the small amounts given him out of sympathy for his sad condition. Harry L., too, was formerly given business assistance by a charitable organization. Furnished by this agency with a small stock of pocket-books, it was hoped that the half-blind young applicant would be able to earn a living by peddling his wares — 99 CARE AND TREATMENT OF THE JEWISH BLIND a hope which proved to be ill founded however, for this ven- ture soon ended in failure. At present Harry may be found "peddling matches" — an occupation which under any cir- cumstances can hardly be called suitable for a young American boy who has succeeded in finishing grammar school. Judging from the facts presented in these two cases does it appear that nothing more could be done for these young men, both of them apparently intelligent and eager to earn a living in a more self-respecting manner? Surely failure to support themselves with the assistance once given them should not discourage further efforts to help them find suitable occupation. Such occupation could in all probability eventually be found, although its nature could only be determined after a careful study in each instance of the particular situation had been made by an expert in handling industrial problems of this kind. That begging in one guise or another is often a most profitable form of employment, competing favorably with legitimate occupation, is illustrated in the four following instances: Louis H., a totally blind man, 27 years old, has for several years been able to support himself and family, con- sisting of his wife and three young children, as a street musician. Early in the morning and late in the afternoon Louis takes his stand on a crowded street comer where, by playing on a harmonica, he appeals to the nimierous men and women who pass him by on their way to and from work. When questioned regarding his attitude toward this occupation, the blind man declared that he considered himself a musician not a beggar, but at the same time expressed a strong desire to find some other means of earning a livelihood. Intelligent, well educated and apparently energetic, Louis declared that he ought to be given an opportunity to find remunerative work of another kind, complaining that all such efforts on his part had here- tofore been fruitless. Various philanthropic organizations applied to for business aid had been unable to submit any plan whereby he might earn an honest livelihood. Under these circumstances is it just to class the blind street musician as a wilful beggar, or do the facts in the case rather support him in his assertion that he is forced to "earn his living" as best he can? 100 PROBLEMS OF BEGGlJ^G' ''' '".• *■ ^''^ Daniel E. also supported himself and family by playing on the street, until recently persuaded by an interested asso- ciation to discontinue this employment. After the partial loss of his eyesight four years ago, Daniel purchased an organ and soon found that he could make from $15 to $18 a week at this occupation. Inspired by her husband's success, Mrs. E. too became an organ-grinder, both husband and wife not only supporting themselves and seven children on the money thus obtained, but accumulating, at the same time, savings which finally amounted to $1200. It was only after Mrs. E. was arrested as a vagrant and referred by the court to a charitable agency that the family finally came in contact with a relief society. Daniel was then persuaded by this organization to invest several hundred dol- lars of his savings in a small candy store and soda-water stand, a business venture which is too recent to permit any definite conclusions to be drawn. The prediction may well be made that should Daniel eventually fail in his present enterprise, he will finally resume his former occupation, preferring employment of a kind which proved to be so profitable to any other at present available to a blind man in his position.* Unlike Daniel E., Emil X. has steadily refused to dis- continue begging, although several times given the opportunity to earn money in a self-respecting manner. When three years ago Emil suddenly lost his vision, he and his family applied for support to a charitable agency. The necessary relief was promptly granted, Emil being told that full support would be regularly granted until such time as he should be able to find remunerative work of some kind. On the advice of the relief society Emil entered the workshop of the New York Association in order to learn the trade of chair-caning. After a few months however, he refused to continue longer at this work, claiming that he was discouraged because of the small amount which he was able to earn in this way. Meanwhile further investigation made by the interested agency revealed the fact that the applicant's past history had been a disreputable one. Several years previous he had been convicted of felony, while he was known by many at the time of enquiry to be both a gambler and a heavy drinker. Mrs. X., too, bore an unsavory reputation in the neighborhood, being * Later entry on U. H. C. record under date of July '17 states that man feels fully satisfied up to the present time with his business venture, bemg able to earn a fair living for himself from the profits of his stand. 101 CARE AND TREATMENT OF THE JEWISH BLIND regarded as immoral. The relief visitor apparently found herself unable to cope with characters of this kind, for the record of the case shows clearly that she was thoroughly intimidated by the demands and even threats of the applicants. In spite of the fact that the blind man had already proved his unwillingness to do legitimate work, having refused an offer previously made to establish him at a news stand, the visitor recommended that further aid be granted him so that he might purchase a stock of pencils to peddle. Wearing a sign "permanently blind" and accompanied off and on by one of his young children, the blind man soon "earned" from $7 to $8 a week by "peddling" his wares. Regular relief was later discontinued, though occasionally small sums are still granted in order that Emil may from time to time replenish his stock — sometimes of pencils, sometimes of chewing gimi. Clearly the policy pursued by the relief association in this case has been a mistaken one. Should not effort have been made to secure court action against both Emil and his wife, either compelling the parents to better their ways, or depriving them of the custody of their children? Fanny O., too, can testify to the profitable nature of begging. Several years ago Mr. O., since deceased, became a chronic invalid, no longer able to support his blind wife and crippled daughter. When application was made to a relief society a liberal allowance was granted the afflicted family, an allowance which was continued regularly over a period of 15 years. Only after the death of the husband two years ago was it discovered that all three members of the family had been begging regularly while supposed to be practically unable to leave their home. In the course of time $2000 had been accumulated, for the family had lived most frugally, putting aside a great part of the money received in the form both of relief and of alms. When the true facts were learned by the charitable agency, relief was, of course, discontinued, the mother and daughter at present living for the most part on "savings" which had been safely deposited in a bank. Is it a matter for surprise that this family, finding it so easy to impose on the community, cleverly took advantage of the situation? Surely, relief agencies must be doubly careful in their supervision of handicapped pensioners, realizing their frequent temptation to make capital of their affliction by beseeching from private 102 PROBLEMS OF BEGGING individuals that support which has already been pro- vided. In the case of another blind woman begging was re- sorted to as a means of livelihood. Hannah G. — a widow without children — supported herself for over 16 years as a finisher of men's clothes. At last, how- ever, the eyesight of the old woman began to fail, although she still persisted in continuing at her work, often leaving her home in the morning with twenty or more needles which had been threaded by the janitor's young daughter. Only after Hannah's vision was almost gone did she give up her employ- ment, forced in tne end to apply to a charitable agency for assistance. In the course of the investigation made by the relief society several brothers and sisters were discovered, able and willing to give the unfortunate woman a home. But Hannah refused to accept the proferred assistance, stating that she had been estranged from her family for years because of their harsh treatment and so could not entertain the thought of a reconciliation. The agency considered it unwise, under the circumstances, to grant relief to the destitute, nearly blind woman, who, on the other hand, preferred to endure untold hardships rather than accept the support tendered by her relatives. By offering candy for sale on the street comer the old woman found that she could make an appeal to passers-by, thus obtaining from them the few cents a day on which she manages to exist. Must we, in this instance, support the relief agency in its attitude, or must we take issue with its decision? In view of the circumstances of the case many will per- haps sympathize with the viewpoint of the applicant who considers herself fully justified in following her present occupation. Conclusion Recalling the varied histories of these rnen and women — old and young, weak and strong, partially and totally blind — can it be said that any light is shed on the problems which their unfortunate condition j^tresents? Has a study of these histories revealed what should be 103 CARE AND TREATMENT OF THE JEWISH BLIND our attitude when appealed to on the street? Should we, in the future, turn our heads away as we pass a poor blind beggar, or should we drop a coin into the out- stretched hand? Should we, perhaps, follow a third course, seeking to find and interest the appropriate agency in his behalf? It has unfortunately been discovered that such an agency does not always exist, for a study of several of these histories has revealed a need which has already been discussed in a previous chapter, the need for a specialized Jewish agency to furnish suitable training and employ- ment and give appropriate business aid to those hand- capped individuals who can not compete with normal men and women. Several of the existing philanthropic agencies, it is true, sometimes undertake these functions, yet more often is the responsibility evaded. Often these agencies grant relief without making an effort to force applicants to contribute to their own support; often they even encourage applicants to supplement relief by beg- ging in a direct or indirect manner. Relief agencies may well claim to be discouraged by the frequent failure of efforts made to help blind appli- cants to contribute to their own support. But does all past experience indicate that the situation is a hopeless one? A careful analysis of such attempts as have been made by charitable associations to assist blind men to earn a livelihood would perhaps reveal the causes of failure, while, at the same time, pointing the way to a larger measure of success. In some cases, in all probability, the causes of failure would prove to be of such a nature as to discourage any further efforts to make blind men, under certain con- ditions, even partially self-supporting, either because such cases had revealed an unwillingness on the part of these applicants to co-operate sincerely in any self-support plan, or because certain inherent difficulties in the situa- tion, not to be overcome, had been discovered; in other cases, however, the causes of failure would perhaps but emphasize certain weaknesses on the part of the inter- ested agencies, weaknesses which could probably be elimi- nated to a great extent. It would perhaps be found that frequently relief agencies submit business propositions 104 PROBLEMS OF BEGGING which must necessarily end disastrously, based as they often are on insufficient knowledge of the particular situation to be dealt with. Only after a careful study has first been made of the applicant's character and ability, only after a careful investigation has first been made of the business and industrial opportunities open to one in his unfortunate condition, can the relief agency hope to be in a position to take action, for only then can it be determined if a practical self-support plan can be found. While it is true that at best the industrial and commercial field open to the blind must necessarily remain a narrow one, nevertheless much could be done to better the existing situation. Not until this situation is improved can it be hoped that the prac- tice of begging will be less often followed, a practice which, though degrading, yet frequently offers the blind man a chance to "earn" a relatively large sum, while giving him at the same time an opportunity to vary the monotony of his dreary existence. But granted that the problems of many could be solved by securing suitable employment — supplementing earnings by relief when necessary — what should be done for those destitute blind men and women who, further handicapped by old age or ill health, can not hope to find remunerative occupation? Obviously a decent living must be assured these unfortunate individuals. Those who require institutional care should be placed in institutions for the sick or aged; those who are able to procure proper care in private homes should be granted adequate relief under careful supervision. All those unfit for work — whether dependent or supported by their own families — should be discouraged from asking alms. Only by offering them, however, additional opportunities for recreation and diversion, can it be hoped that they will be induced to discontinue this practice. Suitable employment, adequate relief, appropriate institutional care, proper recreational opportunities, — only after the community has adopted a social program mindful of all these needs, is it justified in resorting to those coercive measures sometimes suggested as a means of suppressing the practice of begging. Only as a last resort should the policy of refusing occupation licenses to 105 CARE AND TREATMENT OF THE JEWISH BLIND all those handicapped individuals who would in all prob- ability merely regard these licenses as permits to beg be adopted, — a policy which would also involve the arrest- ing as vagrants of those, who without licenses, would nevertheless persist in asking alms of a sympathetic and often deceived public. 106 VIII. GENERAL CONCLUSION CARE AND TREATMENT OF THE JEWISH BLIND VIII. GENERAL CONCLUSION Having covered the fields of relief-giving, begging, employment, recreation and institutional care with rela- tion to the Jewish blind, what are the practical suggestions which grow out of a study of the whole situation? These suggestions can be embodied in one specific recdmmendation — the recommendation to establish a Bureau for the Jewish blind with the following definite functions: 1. To act as a clearing house for the blind, directing all blind Jewish men, women, and children to the various agencies and institutions which at present exist, but which in many cases are not utilized by this group either because they do not know of their existence, or because they fail to realize their significance. When it is remembered that there are some thirty agencies and institutions in Manhattan offering services to the blind, and that a large number of these organiza- tions are practically unutilized by the Jewish blind, it will readily be seen that advice and guidance along these lines would become an important function of the Bureau. 2. To co-ordinate all existing effort in this field, preventing duplication of work, and to co-operate with existing agencies and institutions, encouraging and stimulating them to extend and amplify their activities along suitable lines. In the fields of recreation, education, prevention of blindness, medical care and shelter for the blind, much can be done by the existing agencies, whose activities in these directions might well be aided and encouraged by a central bureau. 3. To centralize the administration of relief in one agency. The advantages that would accrue from unification of this nature have already been discussed at length and need not again be emphasized. 108 GENERAL CONCLUSION 4. To establish a Department of Employment, perhaps in conjunction with an employment agency for other handi- capped groups. This department should be developed along the lines already suggested, and should work in close co-operation with the New York Association for the Blind, the New York Commission for the Blind, the United Hebrew Charities, the New York Guild for the Jewish Blind, the Hebrew Association for the Blind and the Special Com- mittee on the Blind of the Council of Jewish Women. No attempt will be made to work out the details of the suggested Bureau other than to emphasize the nec- essity for a trained, experienced, broad-minded executive at its head, and to suggest that its Board of Directors include men and women representative of all interested groups. The Jewish community owes it to itself, no less than to the unfortunate class here considered, to adopt a comprehensive program calculated to deal justly and broadly with this neglected and handicapped group. 109 PRESSOR CLARENCES. NATHAN, INC., NEW YORK. THIS BOOK IS DUE ON THE LAST DATE STAMPED BELOW "•*™ tliVlsltiJ^^^^^ CENTS THIS BOOK Sn ?S DA^/n"-"'''" ^° "^^""N WILL. INCREASE TO SO CEN?r- """"^ ^^'^^''^^ DAY AND TO $I.OO OM TM ^^ """^ ''°'''''"" OVERDUE. ^ ^"^ SEVENTH DAY LD21-I00m 7,'33 376)5' lY. UNIVERSITY OF CALIFORNIA LIBRARY w f