| This dissertation examines the history of Federal health care for American Indians during the period from 1909, the date of the first Congressional appropriation for a national-level Indian health program, to 1955, a year which saw the transfer of responsibility for American Indian health from the Office of Indian Affairs (OIA) to the Public Health Service (PHS). It finds that Federal Indian health programs during much of the first half of this century were driven primarily by a desire both to protect the health of whites and to promote American Indian assimilation, rather than by humanitarian considerations. These goals inspired the creation of an organized Federal Indian health care effort during the 1910s and led, in the 1920s, to the adoption of a dangerous campaign of radical surgery designed to halt the spread of the infectious eye disease trachoma across American Indian communities. They also led, in the 1950s, to the eventual transfer of responsibility for Indian health from the OIA to the PHS.; It was only in the 1930s, during the administration of Commissioner of Indian Affairs John Collier, that the motivation behind Federal Indian health programs began to change. Collier and his colleagues in the OIA saw health programs as necessary to protect Indian health, and not as a vehicle to promote assimilation or to safeguard whites. The result was a significant expansion of the Indian health effort. But while the OIA under Collier was committed to expanding health programs, it was also committed, at least in theory, to promoting American Indian self-determination. And the ideology of Indian community control sometimes clashed with what administrators saw as the demands of Western-style medical care. The OIA frequently solved these conflicts by abandoning self-determinationist ideas.; Based on research in published government documents, in the medical literature of the period, and in the records of the Bureau of Indian Affairs. |
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