pected increase in population. Sewage is discharged untreated into the Savannah River. Stream pollution not believed to be a serious problem.

Food: Present ordinances are outdated and inadequate. It is hoped that within the next year a modern restaurant ordinance based upon the United States Public Health Service suggested code will be enacted. Present control is vested in the State department of agriculture. The Savannah city-county health department is now considering the use of the rules and regulations covering food shops adopted by the State board of health in 1940.

Milk: Present consumption is about 4,000 gallons per day, 84 percent of which is pasteurized. The standard milk ordinance will become effective in January 1941. The State health department has recently employed a well-trained milk sanitarian to assist full-time health units in communities where the standard milk ordinance is in effect.

Garbage: Local ordinance requires storage in tightly covered metal container. In collection, no separation of garbage and refuse is required. Collection is daily from business establishments and twice weekly from residences. Disposal is by hog feeding, land fill, and burning. Facilities with regard to disposal are said to be poor.

Vermin: The incidence of typhus having been high in this area, studies are being conducted by the State public-health service. Practically all types of mosquitoes common in the United States find favorable breeding areas in and around Savannah and Chatham County. Drainage work has been done by Work Projects Administration under direction of the county sanitary engineer.

Housing: The housing situation in Savannah was not considered critical by the chamber of commerce, who feel that the increased population may be cared for without difficulty. A low-cost housing development, "Garden Homes," consisting of 376 units was ready for occupancy. In connection with the air station, 325 units are to be built immediately. Two low-cost housing developments for Negroes were being completed. Private building in city and county was active.

Health organization: A combined city-county unit serves Savannah and Chatham County. Total budget is $127,232. A number of the employees are not responsible to the health officer. A venereal disease clinic is maintained.

Medical care: 112 physicians and 35 dentists are engaged in active practice. About 400 hospital beds are available to the public in Savannah. In addition, there is a marine, Fort Scriven, and Georgia Railway Central Hospital. Hospital insurance plans have contributed to a high occupancy rate. None of the hospitals has a modern or well organized out-patient department. Medical care for the indigent and low-income groups is provided for ambulatory patients of the city through a combination of four part-time city physicians and a city clinic, which is sponsored jointly by the health department, junior league, and the county medical society.

Welfare organizations: The county welfare department employs about a dozen case workers and spends about $2.75 per family per month for relief to the unemployed. There is also a nonofficial family-welfare organization with a staff of 5 persons and a budget of $22,000. Approximately 95 percent of the budget is derived from community chest funds and 5 percent from private contributions. The agency's program embraces only unemployed families and deals with rehabilitation and social adjustments.

Outstanding needs: 1. One of the special problems is that of building an efficient sanitation service in the local health department.

2. A well-trained sanitary engineer worthy of a salary of $4,000 to $5,000 should be employed to direct sanitation and malaria control work.

3. (a) Venereal disease program will no doubt be reorganized; (b) venereal disease clinic night sessions should be increased; (c) adequate police regulation should be exercised to abolish "street walkers."

PASCAGOULA SHIPYARD AREA, PASCAGOULA, MISS.

I. Military area.-Ingalls Shipbuilding Corporation, located on the east bank of Pascagoula River at Pascagoula, Jackson County, Miss. At present the shipyard is employing 2,200 workers and will employ an additional 2,200 to 2,300 men within the next few months.

II. Communities in critical area.—

III. Industries.—Ingalls Shipbuilding Corporation is building cargo vessels for the United States Maritime Commission; paper, woolen, and plywood mills; commercial fishing.

IV. General Character of area.-Most of Jackson County is very flat and the town of Pascagoula is practically surrounded by swamp and low-marsh areas. The soil is of the sandy loam type and is underlaid with a black gumbo clay at a depth of 15 to 18 feet. Ground water is available over the entire county at depths varying from 18 to 70 feet. Few of the wells are provided with satisfactory pumping equipment. The county is essentially rural. It is reported that approximately 97 percent of the population in the area use old open surface privies for the disposal of human excrement. There is very little development along the main highways. Pest mosquito control is a major problem in the area and it is understood that there is some malaria in the outlying districts. The hookworm problem is causing the local health authorities much concern.

V. Summary.-Water: Pascagoula's water supply is secured from three active deep wells having an average depth of 360 feet and two emergency wells of which one is a salt well. The supply is believed to be adequate for present needs and additional wells will provide water for any reasonable future expansion. No treatment is provided. The average consumption is estimated at 200,000 gallons per day. The entire population is accessible and connected to the supply.

Moss Point water supply is served from five flowing wells, three of which are 850 feet deep and two of which are 1,100 feet deep; there are two additional emergency wells. The supply, exclusive of the emergency wells, will produce approximately 1,000,000 gallons per day and is considered adequate for any present or future needs. No treatment is provided. The average daily consumption is estimated to be 100,000 gallons per day. The supply is accessible to the entire population and 75 percent are connected.

Ocean Springs water supply is secured from two flowing wells which flow directly into the mains. No pumps are provided and the pressure is not adequate. The supply is probably adequate for present needs if provided with the necessary pumping equipment. Under present conditions both supply and distribution system are considered to be unsatisfactory and potentially unsafe.

Sewage Pascagoula. The sewerage system of the town is only accessible to about 5 percent of the population. The system is inadequate for present needs. A new sewer line is now under construction as a national-defense measure to serve 697 units of the naval housing project and some 45 residences. Plans have been prepared to install adequate sewerage in the entire town, with discharge into the Pascagoula River. There is no sewage treatment. Plans have been prepared and approved for the construction of a new modern activated sludge treatment plant as a national-defense measure. About 70 percent of the population is served by septic plants (subsurface irrigation fields not satisfactory in this area). Three hundred privies are reported in the town and are for the most part old surface or pit privies.

In Ocean Springs approximately 300 homes use septic tanks; 140 homes have approved sanitary pit privies; and 60 homes use open-surface privies.

Food: State law with enforcement by county sanitation supervisors. Personnel of State board of health are reported to make one or two inspections a year of food-handling establishments.

Milk supply: Milkshed includes Jackson County and a supplementary supply from Biloxi, Miss. Supply is 775 gallons daily. Sixty percent of milk produced is pasteurized. Supervision of 1939 standard ordinance is the responsibility of the Jackson County health unit.

Garbage: In Pascagoula the city collects and disposes of garbage by hog feeding and low-land fill. Moss Point has refuse collection but garbage disposal is an individual problem: no ordinances are in effect.

Vermin: No special control measures are in effect.

Housing: There are no vacancies either in Pascagoula or nearby points. Twenty-five percent of existing buildings are substandard. The Navy is building 697 dwelling units for 2,300 shipyard workers. Six hundred and ninetyseven dwelling units are not sufficient to meet present demands and probably 200 new units are needed. An additional 500 to 600 units will be needed to meet demands of 2.500 additional shipyard workers.

Health organization: Jackson County total full-time budget, $12,000. Venereal disease and hookworm are problems.

Hospitals: General (35 beds) in Jackson County-.

Physicians: Jackson County-.

Dentists: Jackson County-

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Welfare organization: Jackson County has a full-time welfare organization and a full-time Red Cross secretary.

Outstanding needs:

1. Venereal disease control program.

2. Control of prostitution.

3. Additional venereal-disease nurses and general sanitary personnel.

4. Sewerage system for entire town of Pascagoula.

5. Chlorination of municipal water supplies.

6. Augmented facilities for county welfare association.

7. Increased housing facilities for the expected additional employees.

TESTIMONY OF DR. THOMAS PARRAN-Resumed

Dr. PARRAN. The reconnaissance surveys indicate that, according to present plans for military and industrial defense developments, communities in the areas surveyed will be faced with the necessity of providing housing, health, and medical facilities for an influx of almost 212 million civilians. Many communities will grow by 50 percent or more, and some will practically double in size. Some of the migratory population will settle in communities where facilities are relatively adequate. Others, however, will invade parts of the country where health and sanitation facilities may be described as genuinely primitive and of the sort that characterized the frontier boom towns of past generations.

This does not mean that poor judgment has been used in the selection of defense areas, for military and tactical factors must sometimes outweigh health considerations in choosing a site for a camp or a munitions plant. It is our task to see that health and sanitary needs in these areas are met as rapidly and efficiently as possible.

COMPOSITION OF POPULATION IN DEFENSE AREAS

Those who make up the new population in these areas are, and will continue to be, a variegated lot. Many of them are industrial workers drawn by the prospects of getting a job in a defense plant or on construction projects. Then, too, there is a great army of service workers whose business it is to provide for the many different needs of soldiers on leave and workers during their off hours-small merchants, waiters, bartenders, entertainers, and so forth. There are camp followers of various descriptions. In many instances the expectations of these people for employment or profit do not materialize and they become a burden on the already overstrained community. Even though they cannot pay for medical care and treatment, the health of the community demands that some provision be made for them.

SHORTAGE OF ESSENTIAL FACILITIES

Our surveys indicate that practically all defense areas are deficient in one or more of the essential facilities which they must have if they are to meet the demands imposed upon them by the emergency situation.

Briefly stated, the amounts of money in addition to present expenditures from all sources which will be needed to provide the necessary facilities in the areas surveyed are:

For public health activities budgets---.

Hospital facilities:

Capital outlay_

Operating cost, 1 year..

$12, 609, 830

51, 188, 600 2,557, 800

Garbage and trash collection and disposal (yearly cost)

Sanitary privies___

Wells

Mosquito control:

Ditching

Yearly maintenance_

Ditching and maintenance in ninth area. Rodent control__.

Total__.

$5, 005, 000 715, 000 170, 874, 294

1, 524, 436, 000

13, 643, 500 20, 742, 225

24,036, 175 37, 958, 100 4,555, 852 2, 122, 123 2,377, 200

5, 008, 645 1,595, 647 120,000 5,591, 900

1,885, 137, 891

It should be noted that of this sum, the largest single item, $1,524,436,000, or almost 81 percent, is needed for additional housing. The next largest single item, $170,874,294, is needed for medical care and treatment over and above what the communities are now equipped to provide on the basis of present expenditures from all sources. When these two large items are deducted from the total amount needed for all purposes, a balance of $189,827,597 remains, which is the amount required for hospitals, clinics, and those facilities traditionally regarded as public-health and sanitation services.

APPROPRIATIONS FOR EMERGENCY NEEDS

Incorporated in this statement are more detailed estimates of the facilities and funds required in the surveyed areas in each of the nine Army corps areas.

A beginning has already been made toward meeting the needs in these critical areas. In addition to the usual activities of the United States Public Health Service during the past year, the provisions of the urgent deficiency appropriation made possible a program of cooperative activity with State and local health departments whereby the facilities of health departments serving vital defense areas could be supplemented or augmented by additional personnel and equipment furnished directly by the Public Health Service. On March 1, 1941, an appropriation of $525,000 was made available to the Public Health Service for emergency health and sanitation, of which $98,000 was utilized by the Industrial Hygiene Section of the Division of Scientific Research for the development of industrialhygiene programs among employees of vital defense industries.

A further appropriation of $1,235,000 was made to the Public Health Service for emergency health and sanitation in the regular Federal Security Agency Appropriation Act, approved July 1, 1941. This was supplemented by an additional appropriation-a further appropriation of $1,940,000 in the second deficiency appropriation of July 3, 1941.

TRAINING COURSES

In order that personnel employed by the Public Health Service under the emergency health and sanitation program might have the

advantages of knowledge of the practices, procedures, and policies of the Public Health Service, an orientation course was established at the National Institute of Health at Bethesda, Md. All categories of professional personnel are required to attend this course of instruction, which consists of didactic work, demonstrations, and field training activities, and is of 6 weeks duration.

This course is designed to acquaint the student with the publichealth problems encountered in national-defense areas. Medical officers, engineers, nurses, and laboratory personnel have been and are being recruited.

Requests from State health officers for personnel have been reviewed and those areas in which the need is determined to be most urgent have been supplied as personnel became available from the training courses.

ASSIGNMENT OF MEDICAL PERSONNEL

Personnel assigned to States for duty in national-defense areas are required to complete their field training by undergoing a period of orientation of from 10 to 14 days at the State health department of the State to which assigned.

At the expiration of this time, personnel are assigned at the request of the State health officer, to vital defense areas where additional aid is considered necessary. Personnel assigned in this manner are subject to the rules and regulations of the State and local health departments to which they are attached. Traveling expenses, in most instances, are furnished by the States.

Three groups have completed the orientation and training at Bethesda and the field training at Baltimore, and have been assigned to vital defense areas. Twenty-six physicians, 33 engineers, 40 nurses, and 5 chemists and laboratory workers are now on field duty in defense areas. In addition, 8 physicians, 12 engineers, and 5 nurses are occupied with the administration, teaching, and supervision of the field-training activities. A fourth group is now attending the orientation class in Bethesda, and consists of 25 physicians, 26 nurses, 9 engineers, and 6 chemists and laboratory workers. To date a total of 65 doctors, 48 engineers, 65 nurses, and 16 chemists and laboratory workers are devoting their activities to emergency health and sanitation measures.

MOSQUITO CONTROL

The Public Health Service is assisting in a mosquito-control program in cooperation with the States and the Work Projects Administration. Engineering supervision and technical advice are furnished by the Public Health Service; labor and materials by the Work Projects Administration.

One phase of the program is concerned with the control of mosquitoes in areas contiguous to extra-cantonment zones and nationaldefense industries. It is expected that about 300 engineers and engineering aides will be needed to carry out the provisions of the pro

gram.

It is estimated that at least 35 additional medical officers, 50 nurses, and about 20 chemists and laboratory personnel will be em