THE PROGRAM 
 
 OF : 
 
 THE INSTITUTE 
 OF 
 
 INTER-AMERICAN AFFAIR 
 
 THE INSTITUTE OF I NTER-AMER I CAN AFFAIRS 
 
 WASHINGTON, D. C. 
 
CONTENTS 
 
 Page 
 
 I. Statement of Purpose 1 
 
 II. The Institute of Inter-American Affairs 1 
 
 1. Present Status 1 
 
 2. Origins 2 
 
 III. Program; Procedures; Basic Principles 3 
 
 1. Nature of the Program 3 
 
 2. Procedures and Basic Principles 3 
 
 (1) The Basic Country Agreements 4 
 
 (2) The "Servicio" 6 
 
 (3) Financial Contributions 8 
 
 (4) Project Agreements 9 
 
 ( 5 ) Completion Agreements 10 
 
 IV. The Present Program in Brief Summary 10 
 
 1. Program in Health and Sanitation 10 
 
 2. Progreim in Education 13 
 
 3 . Program in Agriculture 14 
 
 APPENDICES: 
 
 1. Turee Illustrative Existing Programs 
 
 2. ffecspective Contributions to Operating and Inactive Programs. 
 
THE PROGRAM 
 
 OF 
 
 THE INSTITUTE OF INTER-AMERICAN AFFAIRS 
 
 PRESENT STATUS 
 
 The present Institute of Inter-American Affairs was chartered by Congress as 
 a wholly-owned Government corporation in an Act approved on August 5. 1947 — Public 
 Law 369 , 80th Congress, First Session. 
 
 This statute directed ttie Institute to seek to strengthen friendship and under- 
 standing among tne peonies of ttie American republics through collaborating with the 
 governments of the other republics on "technical" programs and projects in public 
 health, sanitation, agriculture, education and related fields. This work, however, 
 the Institute was authorized to carry forward only for a period of three years — 
 through the fiscal year 1950. 
 
 The President’s Budget for the fiscal year 1950 contains a proposed appropria- 
 tion of $ 5 , 000,000 to the Institute for the fiscal year 1950, which would enable 
 the Institute to continue the 25 programs in the fields of public health, education 
 and agriculture which it is now administering in cooperation with the governments 
 of 16 of the Latin American republics, the work in these programs to be' maintained 
 on the same scale as that of the two preceding fiscal years. Unless new legisla- 
 tion is enacted by the Congress, the Institute will be reouired to terminate its 
 activit'ies and liquidate its affairs after expiration of the fiscal year 19'^0. 
 
 This is specifically provided for in Section 4 of the Institute of Inter-American 
 Affairs Act of 1947, which says; 
 
 "Upon termination of the corporate life of the Institute all of its func- 
 tions shall be liquidated and, thereafter, unless otherwise provided by 
 Congress, the assets shall be transferred to the United States Treasury 
 as the property of the United States. " 
 
 The President has, however, recommended to the Congress that the programs 
 of the Institute of Inter-American Affairs be extended on a larger and more 
 adequate basis. 
 
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ORIGINS 
 
 The present Institute is the successor of two Government corporations (known 
 as The Institute of Inter-American Affairs and the Inter- American tducational 
 foundation, Inc.), which had been chartered under the laws of Delaware under author- 
 ity granted by Congress to the former Coordinator of Inter-American Affairs. The 
 Coordinator's office (which later was renamed the Office of Inter-Amer ican Affairs) 
 was established in the early years of World War II. The Office was administering 
 a broad program designed to develop closer and friendlier relations between the 
 United States and the other American republics. The two named corporations were 
 organized to serve as the administrative mechanisms through which the United States 
 could cooperate with the other American republics on technical programs and proj- 
 ects in the fields of health and sanitation, development of food supply, and educa- 
 tion. Other corporations, now being liquidated, were organized under the laws of 
 Delaware to administer certain transportation and radio programs, while other 
 activities were administered directly by the Office. 
 
 While the improvement of the relations of the United States with other coun- 
 tries in the Western Hemisphere has been a long-standing objective of the foreign 
 policy of the United States, the immediate impetus for the organization of the 
 Office and the corporations was the urgent necessity for immediate improvement in 
 inter-American relationships created by the war. It was therefore, at first, as- 
 sumed that the activities of the Office and of the corporations could be terminated 
 when the war was over. Even before the end of the war, however, it was forcibly 
 recognized that these programs were building great good will for the United States, 
 were proving themselves appropriate and flexible instruments for effectuating 
 United States policy wi thin the Hemisphere, and would probably prove uniquely useful 
 in time of peace as well as in war. 
 
 It was after the war was over — on August 31. 1943 — that the information 
 functions of the Office of Inter-Amer ican Affairs were transferred to the Secretary 
 of State, by Executive order; and shortly thereafter, the Congress enacted the 
 United States Information and Educational Exchange Act of 1948 to make permanent 
 the information activities in Latin America which the Office had been administering 
 directly and which had been transferred to the Secretary of State. It was also 
 after the war was over — on August 3. 1947 — that the Congress created the present 
 Institute of Inter-Americarr Affairs, and directed it to take over the functions of 
 the two named Delaware corporations. Section 2 of this 1947 Act directs that the 
 purposes of the Institute shall be "to further the general welfare of, and to 
 
 - 2 - 
 
strengthen friendship and understanding among, the peoples of the American Republics 
 through collaboration with other governments and governmental agencies of the Amer- 
 ican Republics in planning, initiating, assisting, financing, administering, and 
 executing technical programs and projects, especially in the fields of publ ic health, 
 sanitation, agriculture, and education." 
 
 Section 3 of fho Act, however, granted the corporation succession only for a 
 period of three years. 
 
 NATURE OF THE PROGRAM 
 
 The work of the Institute is confined to cooperation with the other American 
 republics in the development of their basic economies. The early work of the 
 Office of Inter-American Affairs made it quite clear that the strongest need of the 
 Latin American republics was for assistance and guidance on what are, perhaps, the 
 three most fundamental problems of any nation: public health, education, and food 
 supply. It is to these objects that the recent work of the Institute has been con- 
 fined, except for some incidental work on related basic national necessities, such 
 as transportation and communication. 
 
 The concentration on the basic essentials has meant, in- the case of the health 
 and sanitation program, emphasis on the provision of safe water supply systems, the 
 construction of sewerage systems, the construction and equipping of hospitals and 
 health centers, the control of specific diseases, such as malaria, yellow fever, 
 yaws anu the dysenteries, environmental sanitation, health education, vital statis- 
 tics registration, and the training of medical and nursing personnel. The education 
 program has confined itself to elementary and secondary education, vocational train- 
 ing and teacher training. The agricultural program, particularly because of the 
 requirements of the war period, has concentrated on the development of an adequate 
 iood supply, the introduction of better plant and animal varieties, soil and water 
 conservation, agricultural extension work, the introduction of better tools and 
 methods of cultivation, the organization of basic agricultural statistics, nutrition 
 work and the training of personnel. 
 
 PROCEDURES AND BASIC PRINCIPLES 
 
 There are five essential points to note about the procedures that are followed 
 by the Institute in the organization and operation of its programs: 
 
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(1) THE BASIC COUNTRY AGREEMENTS. Since the programs of the Institute 
 are carried out in cooperation with foreign countries, each program must be em- 
 bodied in an international agreement entered into between the Government of the 
 United States and the government of the cooperating republic. These are known as 
 the basic country agreements; they are negotiated by the American Ambassador to the 
 cooperating republic (assisted by personnel of the Institute) and the p'oreign Office 
 of that republic. The agreements they arrive at are expressed in an exchange of 
 diplomatic notes, and these notes recite that a further agreement will be entered 
 into between The Institute of Inter-American Affairs and the appropriate Minister 
 of the government of the cooperating republic that will spell out in greater detail 
 the work to be performed and the procedures to be followed. Since these basic 
 country agreements have the status in international law of executive agreements 
 rather than of treaties, the individual agreements do not require Senate confirma- 
 tion. 
 
 The launching of one of these cooperative action programs originates in a 
 request by the government of one of the Latin American countries. On receipt of 
 such a request, the Department of State determines whether it is desirable on 
 political grounds to have United States participation in the proposed technical 
 program in the particular country. The Department considers, besides the over-all 
 factors pertaining to the development of inter- American relations and to the 
 specific role of the proposed cooperating country, the evidence showing the attitude 
 of the American Embassy in that country to the proposal and the views of the Insti- 
 tute's technicians as to the feasibility and general character of a program to 
 implement the proposal. In formulating their recommendations to the Board of 
 Directors of the Institute and to the Department of State, the officers of the 
 Institute formulate priorities on the basis of the evidence concerning the need for 
 the programs in the various Latin American countries, the degree of interest shown 
 by their governments in initiating such work, the readiness of those governments 
 to begin work at an early date, and the amounts of money they are prepared to con- 
 tribute. The countries and the programs selected in any one year are a product of 
 sifting and weighing all these considerations. The available funds, when appor- 
 tioned among the most urgent activities in the countries most eager and ready to 
 proceed, have always been spread too thin. In no single year in its history has 
 the Institute had available sufficient resources to cooperate in all the countries 
 that were ready to cooperate, on all the programs that were deemed urgently needed, 
 or on an adequate scale. 
 
 In the typical case, the basic agreement will state the period during which 
 the work is to be carried on (usually from 3^-0 5 years), and will provide that the 
 work is to be carried out through a cooperative service that is to be established 
 within the appropriate ministry of the host republic, will define the status of 
 the "field party" which the Institute is to send to the host republic, will prescribe 
 the financial and other contributions to be made to the program by the respective 
 
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governments and the dates on which the installments are to be paid, will define the 
 rates of exchange that are to be applicable between the currencies of the two coun- 
 tries for the purposes of the program, will establish procedures to be followed in 
 the recruitment of personnel, will provide for the maintenance and accessibility 
 of accounts and records, will define in broad terms the objectives to be sought and 
 the work to be done, witha specific provision that the individual projects to be 
 undertaken under the program shall be later defined in project agreements to be 
 drawn up and agreed to by the Minister of the host republic and the Director of the 
 Institute's field party, and, finally, will prescribe the disposition to be made 
 of funds and property available when the work is completed. 
 
 The experience of the Institute has demonstrated that it is virtually impos- 
 sible to carry on operations under basic agreements that run for only one year. 
 
 The minimum effective period is 3 to 5 years, varying with the work to be done. 
 
 In the first place, the fiscal years of many of the Latin American republics run 
 with the calendar year, or otherwise differ from the fiscal year of the Federal 
 Government of the United States. Therefore, while the amount of money that the 
 United States will be able to expend on a program in a given republic may be known 
 shortly after July 1 of a given year, the amount which the other government can 
 contribute may not become known until shortly after the following January 1. 
 
 The nature of the work also makes impossible the planning of operations on an 
 annual basis. Merely to secure the materials and equipment for various health and 
 sanitation projects in the Amazon valley, for example, and to deliver them to the 
 site, requires on the average one full year. Such work cannot be undertaken unless 
 there is assurance that authority and funds will be available in succeeding years 
 to complete the work. The construction of hospitals and health centers, the 
 development of water supply systems, the construction of school buildings, the 
 building and equipping of machinery stations or warehouses, or even the securing 
 and installing of various types of machinery or equipment, may well become necessary 
 so close to the end of one year that it cannot be undertaken unless the agreement 
 runs for more than a year, or may be a process in particular cases that will itself 
 consume 3 fo 5 years. 
 
 The inescapable steps in negotiating an international agreement, in securing 
 its approval at the various levels of government involved in the two countries, in 
 preparing detailed program plans, and in securing the necessary transfers of funds, 
 themselves consume so much time that operations are continually hamstrung when 
 forced to slow down or stop periodically while annual agreements are renegotiated, 
 reexecuted and reapproved. 
 
 The planning frequently needs to be done, although with some tentativeness, 
 over a 10-year period, with operations assured for at least 3 lo 5 years. The 
 health and sanitation program in the Amazon valley of Brazil, to use the same 
 example, requires: 
 
a. Stimulation of local officials to survey their needs and formulate their 
 local programs for building and financing; 
 
 b. Protection of the public health over wide areas by a coordinated system 
 of sanitary works; 
 
 c. Assistance to state and local legislative bodies in evaluating the worth 
 and priority of projects in connection with preparations for construction; 
 
 d. Guidance to the cooperative service in building and maintaining a competent 
 and adequate staff, and providing an adequate budget; 
 
 e. Planning a systematic work program; 
 
 f. The timely procurement and transportation of construction materials, as 
 well as the procurement of labor; 
 
 g. Carrying on construction simultaneously at such geographical points as to 
 minimize travel in investigations and supervision, and to reduce trans- 
 portation costs; 
 
 h. Executing projects at such locations and on such time schedules as to 
 permit the logical and economic progression o^* specialized, skilled workers 
 from one to another; 
 
 i. Advance stock-piling of construction materials (which itself takes about 
 one year for a 25-bed hospital or health center, and from 15 to 24 months 
 for a public water system) to prevent idling of the entire crew of workmen 
 for lack of some equipment or material that is delayed because of low 
 stage in the river or for other causes. 
 
 I 2) THE COOPERATIVE SERVICE OR "SERVICIO". We have mentioned that the 
 
 basic agreement will require the host government to establish within its appropriate 
 ministry (of health, of education or of agriculture., as the case may be) a coopera- 
 tive service usually known as the "Servicio Cooperative" or "Servicio". The devel- 
 opment of this unique administrative device for inter-national cooperation is a 
 significant achievement. The present practice varies slightly, country by country, 
 but the following description is generally applicable to all of the 25 programs 
 now functioning in 16 countries. 
 
 The Servicio is organized as an integral part of the ministry, substantially 
 similar to a bureau in one of the departments of the Government of the United 
 States. The Director of the Servicio is nearly always the chief of the field 
 party sent by the Institute to the particular country to administer the participa- 
 tion of the United States in that program. He serves simultaneously as Director 
 of the Servicio, answerable to the Minister, and chief of field party, answerable 
 to the President of the Institute. His principal staff members and technicians 
 will be made up in part of other members of the field party and in part of nationals 
 
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recruited from the host republic. The great bulk of the staff will be nationals 
 recruited from within the republic. The Servicio is financed from a joint fund made 
 up of an appropriation made by the legislature of the host republic and a contribu- 
 tion made by the Institute. In addition to the funds that the Institute contributes 
 in this manner to the program of the Servicio, the Institute pays the salaries and 
 expenses of its officers and personnel who are members of the field party. 
 
 beginning with the definition of the program and objectives contained in the' 
 basic agreement, the Minister and the Director of the Servicio jointly prepare a 
 detailed program and plan of operation. The specific work to be undertaken and the 
 specific expenditures to be made are then defined in project agreements entered 
 into between the Minister and the Director of the Servicio. 
 
 The genius of this administrative device lies in the fact that it not only 
 makes possible, it actually makes unavoidable, the joint, daily, intimate coopera- 
 tion between our officers and their officers, our technicians and their technicians, 
 our administrators and their administrators, on common problems that arise daily 
 and need to be solved daily. 
 
 The administrative structure of the Servicio goes entirely beyond the advice- 
 giving situation. Instead, operations become jointly planned, jointly financed, 
 jointly directed, jointly administered, and jointly defended against attack, under 
 conditions in which the word "cooperation" reacquires its original meaning of 
 "co-equal and joint effort". 
 
 During the six years of the Institute's operation, the device has gradually 
 spread from program to program and country to country. It was in June of 1948 
 that the last two cooperating countries, observing its results in neighboring 
 republics, asked for the establishment of the same structure for their cooperative 
 programs. The technicians and field staff of the Institute number 325 and they 
 are providing both technical and administrative supervision to approximately 9,500 
 persons, nationals of the other republics who are employed in the actual operations 
 in the 16 countries. 
 
 This administrative structure is welcomed by the cooperating republics because 
 it makes possible the most effective use of American administrative and technical 
 skill on programs which are jointly controlled and which operate for the direct 
 benefit of the host republic. It also makes possible the securing of an intimate 
 knowledge of the problems of the other republic by the personnel of the Institute; 
 it gives them the friendliest contacts with government officers and personnel and 
 with many thousands of people who directly share in and benefit from the work being 
 done. 
 
 It has been necessary for the Institute to insist that all of its officers and 
 personnel scrupulously refrain from any participation or interference whatsoever in 
 
 - 7 - 
 
partisan politics in the various republics. As a result of this policy, the In- 
 stitute's programs have survived numerous, and in some cases frequent, changes of 
 government. Successive Ministers, although of opposite parties, have repeatedly 
 promptly announced their support of the Servicio's programs, have refrained from 
 interfering with the Servicio's procedures for selecting personnel, and have wel- 
 comed the stability and continuity provided by the Servicio's operations. The only 
 party that has consistently, in all the republics, criticized and opposed the work 
 of the Servicios in those programs has been the Communist Party. 
 
 The basic plan of the Institute has been that the Servicio shall have this 
 special relationship to the general work of the ministry of which it is a part: 
 that it shall explore new problems, new areas and new techniques and shall then pass 
 over for operation and administration by the regular branches of the ministry proj- 
 ects and activities which the ministry is prepared to take over, while the Servicio 
 moves on to open up still newer areas. Pressures of various kinds from within the 
 cooperating republic sometimes postpone transfer of responsibilities from the 
 Servicio to other offices of the ministry but the transfers are continually being 
 made. Sometimes this can be done rapidly, as when the Servicio constructs a sewer- 
 age works and safe water supply system for a medium-size town and arranges for the 
 town government to take over and operate the system, providing assistance, training 
 and supervision for a period of a year or more. In other instances, as in the 
 organization of adequate public health activities over so large an area as the 
 Amazon valley in Brazil, transfer of operations must be made gradually and the Serv- 
 icio must be prepared to be involved for a period of ten years or more. 
 
 (3) FINANCIAL CONTRIBUTIONS. The foregoing discussion makes clear the 
 importance of the two types of financial contributions which the Institute makes to 
 the cooperative programs. The first is a stated contribution which the basic agree- 
 ment will require the Institute to pay in installments to the Servicio. This pro- 
 gram payment, supplemented by the contribution which the basic agreement will require 
 the cooperating republic to make, provides the capital which the Servicio can expend 
 on its work. In addition, the Institute undertakes in the basic agreement to pay 
 all the salaries and expenses of the members of its field party which it sends to 
 the republic to assume the posts of Director and staff members of the Servicio. 
 
 The contribution to the program funds of the Servicio is indispensable because 
 it is that payment, more than anything else, which makes of the Servicio's program 
 a joint and mutual enterprise of the two governments. That program contribution 
 converts the Servicio projects into activities that are jointly financed. The 
 practical and psychological significance of this joint financing is difficult to 
 overestimate. 
 
 In the early years in each cooperating republic the financial contribution of 
 the United States to the program funds has been substantially larger than the 
 
 - 8 - 
 
contribution of the host republic. In every case, as the results of the work 
 received recognition and acceptance, the host republic has increased its contribu- 
 tion, both absolutely and relative to the contribution made by the United States. 
 
 The ratio of the United States' contribution to the contribution made by the host 
 republic has changed from 20 to 1 or 10 to 1 to a present ratio of 1 to 3 or 1 to 
 4, with occasionally an even more favorable ratio; that is, instead of paying all 
 or nearly all of the progreim costs, the United States is today paying from one- 
 fourth to one-third of these costs. It will never become desirable for the United 
 States to reduce its program contribution to the point where it becomes an insig- 
 nificant proportion of the total program expenditure. If that were to be done, the 
 activities would cease to be jointly financed and would soon significantly cease 
 to be jointly controlled. 
 
 The chart on the following page shows the respective contributions to program 
 funds made by the United States, the host republic and local governments within the 
 host republic. 
 
 The second contribution made by the United States goes chiefly to pay the 
 salaries and expenses of Institute personnel. The funds for these payments are not 
 turned over to the Servicio but are expended directly by the Institute. Special 
 projects, administered directly by the Institute rather than through the Servicio, 
 such as the training program or the health movies, are also paid for from the as- 
 sistance funds expended directly by the Institute. 
 
 (4) PROJECT AGREEMENTS. The sum of all of the activities to be admin- 
 istered by the Servicio is generally called its "progrem"; the separate works or 
 activities included in the program are generally called "projects". Before any 
 project is undertaken, a Project Agreement is drawn up between the Minister and the 
 Director of the Servicio, which defines in complete detail the location, character 
 and objectives of the work to be done, allocates money for the project and pre- 
 scribes all the operating and administrative details. It is this step which enables 
 both the Minister and the Director of the Servicio to maintain detailed control and 
 responsibility for all of the work that is done and all of the money that is spent. 
 Agreements for specific projects can be negotiated in appropriate detail three or 
 four years after the basic agreement has gone into effect, so that both long-term 
 planning and timely adjustment of the plan to the immediate situation are made p6s- 
 sible. 
 
 The Institute Manual says that a Project Agreement must state the "who, what, 
 why, when, where, and how" of the work to be undertaken. The typical Project 
 Agreement states the problem and objective, specifies the location, details the 
 plan of operation, specifies the financing, sets up the plan of administration, and 
 specifies the responsibility for administration after completion, for each part of 
 the work to be included in the project. 
 
 - 9 - 
 
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(5' COMPLETION AGhLLMENTC. The hasic agreement requires that upon comple- 
 tion of each project, a Completion Agreement shall be drawn up and executed by the 
 Minister and the Director of the Servicio which shall provide a complete record of 
 the work done, the financial contributions made, the problems encountered and solved 
 and related basic data. The Completion Agreements have come to be recognized as an 
 exceptionally useful device. Their preparation compels a retrospective analysis 
 of the experience derived from building a project. In turn, they provide an exceed- 
 ingly valuable basis for the information program that seeks to inform tne citizenry 
 of the host republic of the achievements of the cooperative program. 
 
 PRESENT PROGR/LTS 
 
 The broad, basic objective of the Institute's program, in all three of its 
 program branches • — agriculture, education, and health and sanitation — is to 
 raise the level of living of the people in the other American republics. People 
 who are disease-ridden, undernourished and illiterate cannot effectively solve their 
 own problems, personal or national. Only a healthy, well-fed and liter-ate popula- 
 tion can contribute to peace and prosperity. 
 
 The Institute views this broad, basic objective, therefore, within the frame- 
 work of the larger objective of securing peace and prosperity in the Western Hemi- 
 sphere. American foreign policy seeks to strengthen democratic institutions and 
 democratic practices in all the American republics. The assistance which the United 
 States is giving in these programs of technical cooperation is thus intensely 
 realistic and practical; by raising the levels of achievement in agriculture, 
 education and public health, it is building the kind of foundation on which a 
 stable, democratic order can be maintained. 
 
 Only the highlights of the existing program will be summarized here. In addi- 
 tion, however, three illustrative cases are presented in greater detail in Appendix 
 1. Part A of that appendix discusses the existing health and sanitation program 
 in Chile; Part B, the education program in Guatemala; and Part C, the agricultural 
 program in Paraguay. 
 
 PROGRAM IN HEALTH AND SANITATION 
 
 The Third Meeting of Ministers of Foreign Affairs for the American Republics 
 was held in Rio ,de Janeiro in January 1942, immediately after the attack on Pearl 
 
 - 11 - 
 
Harbor, at a time when every one recognized the necessity for Hemisphere solidarity 
 and cooperation. One of the resolutions adopted at that meeting called for coopera- 
 tion among the republics on health and sanitation programs as a measure that would 
 assist in mobilizing the resources of the Hemisphere. The health and sanitation 
 program of the Institute was an immediate response to this resolution. 
 
 The serious health problems of Latin America were highlighted by the dangers 
 and the demands of the War. Eighty percent of the people were affected by intestinal 
 diseases. One in every 10 persons suffered from malaria. Fifty-five per cent of 
 the deaths were being caused by diseases that were preventable through vaccination, 
 better sanitation and ordinary medical precautions. Death claimed, within their 
 first year, 1 of every 5 babies born alive. Normal life expectancy was less than 
 45 years. 
 
 Since March 1942, when the program was inaugurated, the Institute has under- 
 taken health and sanitation activities in 18 of the other American republics, all 
 but Argentina and Cuba. The program is active today in 14 of the republics — in 
 all but Costa Rica, the Dominican Republic, Nicaragua and Panama. In these four 
 cases, the Institute's withdrawal was made over the protest of the cooperating 
 republic, but was necessitated by the need for spreading the inadequate available 
 resources as effectively as possible. 
 
 By the end of June 1948, a little over 1940 separate projects and activities 
 had been undertaken, of which slightly more than I3OO were completed and 634 were 
 actively under way. A breakdown of these projects and activities is included in 
 Section A of Appendix 1. It is estimated that these activities have benefited ever 
 23,000,000 people, or 1 out of every 6 Latin Americans. 
 
 The program has placed in operation 107 health centers which are headquarters 
 for community health work, and are staffed by physicians, nurses, technicians, 
 sanitarians, laboratory technicians and health educators of the host republic. The 
 Servicio supervises the operation of these centers until such time as they can be 
 integrated into the national health organization of the country. It is estimated 
 that over 2,000,000 persons are utilizing the facilities of the health centers. 
 Similarly, 86 hospitals have been constructed or renovated, providing modern facil- 
 ities for care of the sick, promoting new techniques in the isolation of infectious 
 diseases and in maternal and child care, and serving as demostration of what can 
 
 be done. A low-cost tuberculosis sanitarium constructed in Chile attracted many 
 
 » 
 
 visitors from neighboring countries and, within a year, the Chilean Government had 
 decided to erect two more sanitoria of the same type in other parts of the country. 
 The 128 other health facilities constructed include schools of hygiene, nurses' 
 homes, nursing schools, laboratories, dispensaries and clinics. 
 
 Work in the field of sanitation is necessity a long-term job, but is now well 
 started and is very popular with the population served because of the obvious 
 
 12 - 
 
benefits. Sanitation projects have included safe wells, sanitary privies, slaughter 
 houses, clean public markets, public baths and laundries. Control of malaria has 
 been a major concern; projects have included the construction of dikes, drainage, 
 ditching and filling, larvicidal work and, more recently, the use of DDT in house- 
 spraying campaigns. In Chimbote, Peru, the incidence of malaria has been reduced 
 from '25% to kib. In Leogane, Haiti, the incidence of malaria has been reduced from 
 71% to practically 0%. In Breves, on the Amazon River in Brazil, the incidence of 
 
 malaria was reduced in two years from 43% to 3/10 of l‘i^>* 
 
 To make health programs effective, it is essential to obtain the support and 
 understanding of the people. Health education is, therefore, a major activity. 
 Organized campaigns for the education of the public in the cause and control of 
 disease are carried on in all the cooperating republics by means of motion pictures, 
 film strips, newspapers, magazines, bulletins, posters, lectures and individual 
 instruction. Millions of pamphlets have been distributed in Spanish and Portuguese. 
 Uruguay is experimenting with telling the health story through a daily comic strip. 
 
 Equally important is the training of the necessary public health personnel. 
 
 According to the most recent information, the l4 field parties of the Institute in 
 
 the health program number only 127 United States employees — including 13 physicians, 
 38 engineers and 30 nurses. They are working with 8578 nationals of the cooperating 
 republics, including physicians, engineers, nurses, practical nurses, sanitary in- 
 structors, technical and clerical assistants and over 5000 workmen. The programs 
 started in each country under a great deficiency of trained personnel. To provide 
 the indispensable staff, a big training program was launched, which has thus far 
 affected over 8900 people. While a little over 1200 fellowships for study in the 
 United States have been made available, more than 7500 people were trained in Latin 
 America through in-service training in these programs. 
 
 Some 17 motion pictures have been developed, including a series of 10 produced 
 by Walt Disney Productions for the Institute, known as "Health for the Americas", 
 and these have been used at hundreds of meetings throughout Latin America. Other 
 special projects have included establishment of clinics for control of venereal 
 diseases along the United States-Mexico border in cooperation with the Pan-American 
 Sanitary Bureau, mobile dispensaries, special medical care for rubber workers and 
 their families in Bolivia, Colombia, Costa Rica, Ecuador and Honduras, special 
 medical and sanitary assistance in the mica and quartz-mining areas of Brazil, and 
 a special mine-labor program in Bolivia. 
 
 The health and sanitation program in Chile is presented in, greater detail in 
 Part A of Appendix 1, as illustrative of all the health and sanitation programs. 
 
 - 13 - 
 
PROGRAiM ItJ EDUCATION 
 
 The educational program has concentrated its activities in the fields of 
 elementary education, secondary education and vocational training, the latter 
 mainly industrial training. In each of these fields, the central activity has 
 been the training of teachers. 
 
 Cooperative education programs have been in effect at various times during the 
 last six years in Bolivia, Brazil, Chile, Costa Rica, the Dominican Republic, 
 tducador, El Salvador, Guatemala, Haiti, Honduras, Nicaragua, Panama, Paraguay and 
 Peru, and are now in operation in 7 countries — Bolivia, Brazil, Ecuador, Guatemala, 
 Panama, Paraguay and Peru. 
 
 The elementary education program deals principally with rural education. In 
 nearly every case, the entire rural education system has required reorganization. 
 
 In general, Latin American rural schools have suffered from neglect, particularly 
 as compared with the urban schools. In most of the republics very few pupils 
 receive education beyond the fourth grade of the primary school; in some countries, 
 the majority receive no more than one to two years. School buildings have been 
 inadeqaate; rural teachers are very meagerly paid; there is an inadequate supply 
 of teachers; and many of the teachers have not only had no teacher training but 
 may not have themselves received more than four to six years of primary schooling. 
 Curricula have been identical with those for the urban schools; rote-learning was 
 universal; text books and teaching materials have been unknown, even blackboards 
 and chalk usually being unheard of; "courses" have been too numerous and planned 
 with no regard for the mental age-level of the pupil; practically none of the 
 instruction has had any bearing upon the pupils' environment and needs. 
 
 The central theme of the educational program has, therefore, been the "community- 
 centered school". The curriculum is gradually revised to give every element in it 
 a purpose and meaning in the national rural environment. Agriculture and health 
 are especially stressed. Hygiene courses give simple instruction in personal, 
 school and home hygiene. Proper diet is taught, and is illustrated by school lunch 
 programs, with pupils participating in planning and preparing the lunches. Courses 
 in elementary agriculture are illustrated in the school garden projects. 
 
 Special emphasis is placed upon teacher training. In several of the republics, 
 this has required the establishment, from the ground up, of a rural normal school 
 system. Selected teachers are sent by their governments for the complete normal 
 school course. Other teachers must be given shortcourse training in summer schools 
 and in teachers' institutes and workshops. Supervisors are also carefully trained 
 in special courses. Th-e device of practice and demonstration schools is widely 
 used. In some countries, mobile missions move about from one school district to 
 another, giving demonstrations and assistance. 
 
 14 - 
 
The development of text books and other teaching aids, and the training of 
 teachers in their use, has proved indispensable. Such materials as textbooks, 
 flash-cards and teachers' manuals must be created to fit the local scene. 
 
 The school is "community-centered", not merely because its curriculum is 
 devised to reflect the community life of the pupils, but because it is designed to 
 extend the benefits of the school to the entire community. The students are organ- 
 ized into the equivalent of our 4-H Clubs (the CLUBS ESCOLARES). The parents and 
 village officials are encouraged to visit the schools. Parent-teacher associations 
 are formed, and the community is brought into the work of the schools. 
 
 The "nuclear school system" of administration is emphasized, under which a 
 group of 10 to 20 schools in a given area are grouped about a central school, from 
 which emanate the services of supervision and administration. 
 
 The principal problem in secondary education has been to adjust the existing 
 academic curriculum to meet the needs both of the students who prepare for the 
 university, and of those who will not continue beyond the secondary school. In 
 addition, the program involves setting up new divisions to provide commercial, home 
 economics or manual arts training. Here, too, the principal emphasis has had to be 
 on curriculum planning, teacher training and the development of teaching methods, 
 based upon use of textbooks, teaching tools and visual aids. 
 
 The vocational education programs have differed from country to country ac- 
 cording to need. They include training a supply of craftsmen in basic trades like 
 carpentry, plumbing, electrical installation and repair; furnishing skills for 
 earning a living to the thousands who cannot expect to lead a scholarly life; and 
 training industrial workers where industrialization is under way. The vocational 
 education activities include three broad branches; (1) the organization (in some 
 cases, the reorganization) of technical schools, which usually involves planning 
 the school buildings and shops, supervising construction, obtaining and installing 
 new United States equipment and machinery, organizing the courses, preparing teach- 
 ing materials and training teachers; (2) the establishment of vocational education 
 divisions in selected schools, to parallel and supplement the academic divisions; 
 and (3) the development of manual arts, crafts and home economics courses in the 
 elementary schools. 
 
 The educational program in Guatemala is presented in greater detail in Section 
 B of Appendix 1, as illustrative of the educational activities. 
 
 PROGRAM IN AGRICULTURE 
 
 Agriculture is the basis of livelihood for more than two-thirds of the citizens 
 of Latin America. It is the principal industry in nearly every one of the other 
 
American republics. It is the key to their domestic prosperity, and their prin- 
 cipal source of purchasing power in world markets. 
 
 The agriculture of Latin America, viewed as a whole, presents two basic 
 problems: 
 
 (1) There is not enough of good arable land, except in a few countries, 
 to provide the food and fiber needed by the population; 
 
 (2) The tillage, planting and harvesting practices of hundreds of years 
 ago still largely prevail in the production of the majority of the crops. This 
 combination of the use of primitive and inefficient methods for producing crops and 
 livestock on lands that, in any event, are probably insufficient to meet the demands 
 that must be made on them makes exceptionally acute for Latin America the problem 
 of how to provide a healthy balance between population and resources. 
 
 Nevertheless, the situation is hopeful. Modern scientific agriculture can 
 produce on the lands of Latin America all that the population will require of many 
 commodities and most of what they will require of other agricultural commodities. 
 
 The remainder can be secured in foreign trade through export of other commodities 
 which Latin America is producing and can produce, but this desirable goal cannot be 
 reached until the agriculture of the Latin Americas is brought to adequate develop- 
 ment . 
 
 The agricultural program of the Institute (usually called the Food Supply 
 Program, because its emphasis during the War was to increase the food supply im- 
 mediately available for the population of Latin America and for those of the armed 
 forces of the United States stationed in Latin America) has never enjoyed funds 
 adequate enough to be able to cooperate on an agricultural program in each of the 
 republics. Cooperative agricultural prograims have been maintained at various times 
 in only 10 of the 20 republics, and are operating today in only 4 — Peru, Paraguay, 
 Haiti and Costa Rica. 
 
 The program in Peru reveals very clearly what can be done. The Republic of 
 Peru is of about the combined size of Washington, Oregon, California and Arizona. 
 
 It has a population of 7i million persons, 65 % of whom are entirely dependent upon 
 agriculture for a livelihood. Peru's total annual income from agricultural produc- 
 tion represents no less than 75“^ of the real annually produced wealth of the nation. 
 Of this amount 8^% is derived from production on small farms. Despite this emphasis 
 on agricultural production, Peru normally does not produce enough food to satisfy 
 domestic demands. 
 
 The Servicio early initiated a country-wide agricultural development program. 
 Its principal achievement has been the creation and continuous expansion of an 
 
 - 16 - 
 
agricultural extension service patterned after that of the United States. Through 
 field demonstrations and visits to individual farms, agents assist farmers to 
 secure, care for and use needed equipment; to practice good methods of soil con- 
 servation, irrigation, crop production and disease and insect control; to improve 
 livestock breeding, management and feeding techniques. Starting with a nucleus of 
 11 offices in 1943, the Servicio now operates 30 rural offices located in the most 
 important productive areas. In 1945 the rural offices received 9.358 visits from 
 farmers; in 1947, 30,861 visits. In 1945, agents visited 3,210 farms; in 1947, 
 
 10.933. 
 
 A wide variety of materials not obtainable through normal commercial channels 
 is provided to farmers at cost through the Servicio. Since the end of the War, the 
 Servicio has begun to establish agricultural machinery pools. Through these pools, 
 modern machinery is made accessible to small farmers who could not otherwise afford 
 the use of mechanized equipment essential to low-cost production. 
 
 Adequate quantities of viable seeds, although essential to food production, 
 are not yet available in Peru. The Servicio has purchased and distributed 1,500 
 tons of seed, and thousands of fruit trees and other plant propagation materials. 
 Distribution has been made at cost through the extension service. To promote the 
 fruit production industry, the Servicio has made available needed insecticides, 
 spraying and fumigating equipment. 
 
 A general livestock project is in operation in an effort to alleviate the 
 shortage of meat in the coastal areas of Peru. Livestock quarantine stations were 
 constructed in Arequipa, Callao and Lten, the principal ports of entry for imported 
 animals. To increase the supply of good breeding animals a calf-rearing and distribu- 
 tion project was initiated, and several hundred registered cattle have been import- 
 ed from the United States and sold to producers in every part of the country. In- 
 tensive work is being done to control animal diseases. In addition, the Servicio 
 is endeavoring to increase the production of meat, poultry and dairy products by 
 distributin'g high quality hogs for breeding purposes, importing pedigreed chickens 
 for the poultry department of the Ministry of Agriculture, and the recent purchase 
 of two mammoth, continuous hatch incubators in the United States for use at La 
 Molina and Lima. Approximately 65,000 chicks have been imported by air from the 
 United States to demonstrate the practicability of introducing new breeding stock 
 in this manner. Losses have been amazingly small, due to the generous cooperation 
 of United States poultry producers in expediting these semi-experimental shipments. 
 
 To stimulate sheep production the Servicio has imported Hampshire and Suffolk rams 
 for breeding with ewes from the Peruvian Sierra and is conducting a coastal demon- 
 stration of profitable sheep raising. 
 
 The Servicio is also at work in improving land use through the repair and con- 
 struction of irrigation systems, the application of proper fertilizers and improved 
 
 - 17 - 
 
methods of soil conservation; in providing engineering construction services; in 
 developing land rehabilitation and water-use projects; in preparing economic studies 
 and analyses; in organizing a nutrition program; in developing fisheries projects 
 to promote the Peruvian fishing industry; and in developing a warehousing system 
 to eliminate spoilage and avoid seasonal fluctuations in supply. 
 
 In Haiti, abandoned lands are being restored to production; a 1200 acre live- 
 stock demonstration farm is in operation; and special emphasis is being given to 
 the restoration and development of irrigation and drainage systems. Recently, 
 activities have been concentrated mainly in three areas, the Artibonite, the Ponds 
 Farisien and the Damien. In the 150,000 acre Artibonite Valley, a pilot project is 
 successfully demonstrating that the salt content of the soil can be reduced through 
 drainage and irrigation and that food crops can be grown throughout the Valley. An 
 engineering study of the Valley was completed recently and used as a basis for the 
 Haitian application to the Export-Import Bank for a loan of $3,000,000 for agricul- 
 tural development. At Ponds Parisien, an area once irrigated but now almost barren, 
 75% of an irrigation project has been completed; this will provide water for 1250 
 acres in an area of small farms. At Damien, the site of the Ministry of Agriculture 
 and the School of Agriculture, one-half of the experimental and demonstration farm 
 has been turned over to the Servicio for development and use as a demonstration and 
 training center. 
 
 Project activities in Costa Rica emphasize agricultural extension and demonstra- 
 tion work. A corn dryer has been constructed in the Atlantic coastal area to dem- 
 onstrate proper drying and storage, and corn is now being produced in areas that 
 were lying idle after they had been abandoned by fruit growing enterprises. The 
 National bank of Costa Rica is developing in cooperation with the Servicio a program 
 of supervised agricultural credit. 
 
 At di fferent times during the last six years, agricultural programs have been 
 operated on smaller scale in Brazil, Ecuador, El Salvador, Honduras, Nicaragua, 
 
 Panama and Venezuela. The work already done can be built upon when the resumption 
 of these programs becomes possible. 
 
 Tne agricultural program in Paraguay is presented in greater detail, as il- 
 lustrative of all tne food programs, in Section C of Appendix 1. 
 
 Tne outstanding common cnaracteristic of the programs in health and sanitation, 
 education and agriculture nere summarized is tneir unfinished state. It is necessary 
 to build further on what has been done, if tne real fruits of the enterprise are to 
 be realized. The withdrawal of the cooperation of the United States at this early 
 stage would remove guidance, encouragement and support at a time when the need for 
 them is still keenly felt. 
 
 18 - 
 
APPENDIX 1 
 
 THREE ILLUSTRATIVE EXISTING PROGRAMS 
 
 The present program of the Institute is briefly summarized beginning on 
 page 11. In this Appendix i, three illustrative cases are presented in greater 
 detail: The health and sanitation program in Chile: the education program in 
 Guatonala: and the agricultural program in Paraguay. 
 
 A. HEALTH AND SANITATION IN CHILE 
 
 During March 1943, following certain preliminary conversations, His Excellency 
 Claude G. ^wers, the Ambassador of the United States to Chile, informed His Excel- 
 lency Don Joaquin Fernandez Fernandez, then Minister of Foreign Affairs, that the 
 Government of the United States was prepared to contribute $5,000,000 to help in the 
 expansion of public health activities in Chile. 
 
 An agreement was signed on May 12, 1943, between the Government of Chile and 
 the United States. All details for execution of the cooperative health program 
 were turned over to Dr. Eugenio Suarez Herreros, representative of the Government of 
 Chile, and Dr. George C. Dunham, representative of The Institute of Inter- American 
 Affairs. 
 
 Upon request by Dr. Dunham, Dr. Suarez submitted a plan for administration, 
 standards and procedures. This plan was accepted by The Institute of Inter- 
 American Affairs, and has been the basis of operation since that date. The plan 
 provided for a program consisting of separate, well-defined projects and that all 
 projects undertaken should be related to the furtherance of the existing public 
 health program in Chile. 
 
 To carry out these projects the Inter- American Cooperative Public Health 
 Service (known in Chile as the Servicio Cooperative Interamericano de Salud Publica) 
 was established in the National Public Health Service (a division of the Ministry 
 of Public Health, Welfare and Social Security) . As an integral part of the Nation- 
 al Public Health Service, and thus an integral part of the Government of Chile, 
 the Cooperative Health Service and all its personnel enjoy all the rights and pre- 
 rogatives of that Government. 
 
 As of the end of 1948, the Institute's field party included four officers, 
 besides Dr. Theodore I. Gandy, Chief of Field Party and Director of the Coopera- 
 tive Health Service; while 572 Chilean nationals (including 328 unskilled workmen) 
 were employed by the Service. 
 
 When the Cooperative Health Service (referred to hereinafter as the Servicio) 
 was established in May 1943, the most important problems confronting the Servicio 
 were the needs in many communities throughout the country for adequate water sup- 
 plies and sewage disposal systems, for health centers and other public health fa- 
 cilities, and for more trained public health personnel. 
 
 The following is a summary of the work undertaken by the Servicio in Chile, 
 beginning in May 1943. 
 
 HEALTH On July 28 , 1943 a countrywide project agreement was signed, providing 
 
 CENTERS for the construction and equipment of health centers throughout Chile. 
 
 These units were designed to give preventive service to the entire pop- 
 ulation located in the areas in which they were to be constructed. Therefore, the 
 population served in the different areas varies from approximately 30,000 people 
 to more than 70,000 people per unit. Each health center offers the following serv- 
 ices: Infant and preschool clinics, prenatal clinics, tuberculosis and venereal 
 
 1 
 
 1 
 
disease clinics. In addition, space was provided in each unit for an auditorium, 
 demonstration rooms, and offices, with the necessary sanitary installations for 
 visiting nurses, health educators and sanitary inspectors serving the area. Public 
 baths and laundries were installed in two units. The exact number and location of 
 these health centers was not specified but was left to be decided by mutual agree- 
 ment from time to time. For the construction and equipment of the health centers 
 a total of $660,000 was allocated (Project 5), and for their operation a total of 
 $191,299.83 was made available (Project 22 ). 
 
 VALPAHAISO. In August 1943 the city of Valparaiso deeded a partially-completed 
 building to the Servicio. This building was a two-story steel and concrete struc- 
 ture located in the Cerro Baron district of Valparaiso. Approximately 50,000 peo- 
 ple in the low-income bracket were to be served by the health center. The Servicio 
 alloted $156,625 for completing the construction and equipping of the Cerro Baron 
 Health Center. Architectural plans involving certain structural changes in the 
 building were prepared. Construction began in September 1943 and the building was 
 dedicated on December 7 , 1944. All of the equipment except the X-ray equipment was 
 installed by that time. X-ray equipment, however, was not installed until July 
 1946. The unit began operation on January 1, 1945, with all services except the 
 T.B. clinic, which began operation following the installation of the X-ray equip- 
 ment. All activities of a full-scale, modern health center are now being performed 
 by the Cerro Baron Health Center in Valparaiso. 
 
 SANTIAGO. The district of Quinta Normal is located in the northwestern portion 
 of the city of Santiago. It is an area of approximately 70,000 people with very low 
 incomes. The Rockefeller Foundation was already working in the area in 1943« Also, 
 the National Health Department was actively working in Quinta Normal. In June 1943 
 the Servicio signed an agreement to construct and equip a health center in this area. 
 A total amount of $201,490 was allocated for this project. Negotiations concerning 
 the purchase of the site were completed by November 1943. Construction began of 
 December 13, 1943, and was completed in April 1945. The health center was dedicated 
 on May 18, 1945, and placed in operation under the auspices of the Rockefeller Foun- 
 dation and the National Health Department. 
 
 ANTOFAGASTA. In December 1943 the city of Antofagasta offered a site, valued 
 at $11,000, to the Servicio, which agreed to construct and equip a health center on 
 the property. The location was in the central portion of the city. Construction 
 was started during June 1944. The building was completed in October 1945, and was 
 dedicated on December 7, 1945. 
 
 (Operation of the health center by the National Public Health Service and the 
 Servicio began in December 1945. All clinics and facilities of a modern health 
 center are maintained in this unit. All of the X-ray equipment had arrived by 
 November 1947, and this clinic is now in full operation. Total cost for this build- 
 ing and equipment furnished by this Servicio will be approximately $167,000. 
 
 TEMUOO. The city of Temuco, with 44,000 inhabitants and capital of Cautin Prov- 
 ince, is an important railroad center and gateway to the lake district of Southern 
 Chile. In May 1945 the Servicio agreed to construct and equip a health center in h 
 this city. Construction of the new health center began in July 1945* The building 
 was completed in November 1946, and was inaugurated on December 14, 1946. Active 
 work began March 1947, with the exception of the T.B. clinic. The clinic is now in 
 full operation. Total cost of the building is $121,365. 
 
 HOSPITALS TBLILEA(J HOSPITAL. Tuberculosis is the second highest cause of death 
 in the Province of Santiago. Although local social security and med- 
 ical aid services offer facilities for diagnosis as well as medical and surgical 
 treatment in sanatoriums for curable cases, there is a very urgent need for suffi- 
 cient beds to hospitalize more cases. The Servicio allocated the sum of $986,000 for 
 
 1 
 
 2 
 
the construction and equipment of a 500-bed barrack-type hospital with technical and 
 general facilities sufficient for 1,000 beds. The pavilions are distributed in such 
 a manner that additional ones may be built in the future. Construction of the sana- 
 torium was begun in October 1944. All the building construction was terminated and 
 equipment installed and tested by the first part of November 1947. First patients 
 were received November 17, 1947. The Servicios de Beneficencia y Asistencia Social 
 are financially responsible for the operation of this hospital (Project 14). 
 
 CARABINEROS HOSPITAL. The Carabineros are the Chilean National Police Force, 
 and provide, through their medical staff, treatment for the members of the Carabin- 
 eros and their families. Several years ago, this organization constructed a hos- 
 pital and clinical building in Santiago for the hospitalization of Carabineros and 
 their families, but upon completion of the building were not able to obtain suffi- 
 cient funds for equipment. In September 1943 plans were made to equip this hospital. 
 Work began in October 1943 and was terminated during the year 1946. This hospital was 
 completely equipped, including the installation of five elevators - three for the 
 transportation of passengers and hospital beds, two for food and linen transportation; 
 laboratory equipment; X-ray equipment; operating room equipment; obstetrical operating 
 room equipment; refrigerator units; complete kitchen and laundry equipment; and other 
 items necessary for the efficient operation of the hospital. In addition to equipping 
 the hospital, over one hundred and twenty-five structural changes were made in the 
 building to facilitate the efficiency of hospital operations and the installation of 
 equipment. The hospital structure was dedicated on April 27, 1945, but did not re- 
 ceive patients until August 1947. It is at present operating to a maximum capacity. 
 The Carabineros have assumed financial responsibility for the operation of this hos- 
 pital. The sum of $280,000 was appropriated for this work (Project 6). 
 
 SAN JOSE DE MAIPO. On February 26, 1945 the Servicio signed an agreement for 
 the construction of auxiliary buildings for the tuberculosis sanatorium in San Jose 
 de Maipo. The Servicio Medico Nacional de Empleados contributed one hundred per 
 cent of the funds for the construction, while the Cooperative Health Service con- 
 tributed the services of technical personnel amounting to $6,000. This was the first 
 cooperative project for which the Chilean Government, in this case through the 
 Servicio Medico Nacional de Empleados, contributed the entire amount of the funds 
 for the construction of the building. The project consisted of the additional bed 
 space adjacent to the existing sanatorium living quarters for personnel, changes in 
 the kitchen and dining room, a house for the director, and the installation of a 
 dumb waiter. Construction was begun on March 15, 1946 and completed, insofar as con- 
 struction was contemplated under this agreement, during December 1947 (Project 23). 
 
 GUAYACAN. The Chilean Army has a small tuberculosis sanatorium in Guayacan for 
 the use of officers. The Army wished to enlarge the sanatorium in order to be able 
 to provide efficient medical attention to all ranks of Army personnel. On June 30, 
 1945 the Servicio agreed to furnish $235,000 for the construction of a sanatorium of 
 120-bed capacity and the necessary service buildings. This agreement does not in- 
 clude equipment. The sanatorium has been named the "Franklin D. Roosevelt Sanatori- 
 um". Construction on this hospital was begun in May 1946, and is now practically 
 complete. The Army will undertake necessary landscaping and planting. It is esti- 
 mated that final cost of the sanatorium construction will be approximately $300,000 
 (Proj ect 24) . 
 
 SURVEYS An agreement was signed on June 15, 1943, which provided for the hiring 
 of architects to study different types of buildings and to make pre- 
 liminary plans and estimates as a basis for preparing specific projects. Studies 
 were made of various land sites for health centers in Chuquicamata, Concepcion, La 
 Calera, Maria Elena, and Pedro de Valdivia as a part of a general plan for improv- 
 ing health and sanitary conditions. During the month of April 1944, a four-man 
 commission was created by the Chilean Government to study the health and sanitary 
 conditions in the Province of Cautin in the southern part of Chile. The temporary 
 
 1-3 
 
headquarters of this commission was in Temuco, capital of the province, and visits 
 were made to the following towns in this province: Carahue, Cunco, Freire, Las 
 Casas de los Padres, Nueva Imperial, Pitrufquen, and Temuco. A total of $9,990.54 
 was expended for this project - No. 
 
 One of the first projects undertaken by the Servicio was an engineering study 
 of the existing sewage disposal system in Santiago. The sum of $3,000 was provided 
 by project agreement signed August 25, 1943 to make this study. Field work was started 
 during June 1943. to obtain detailed information on the best possible manner of ex- 
 tending the existing system to all unsanitated areas, Investigation of the types 
 and quantities of industrial wastes fjom nnnuf acturing plants was also made to de- 
 termine the type of sewage treatment facilities which would meet the particular 
 needs of the city. The study for the sewage treatment plant for the city of San- 
 tiago was completed in January 1945. 
 
 The original study was extended upon request of the Chilean Government to in- 
 clude a number of other towns in need of sewerage service and an additional sum of 
 $10,000 was made available for this purpose and for completing a report on the study 
 for Santiago. This report was completed in October 1946 and the bound copies were 
 distributed in December 1946. 
 
 Sanitary conditions were studied in Lebu, in the Province of Arauco, and also 
 in Castro, Corral, Nueva Imperial, and Talca. A study for a sewerage system and 
 treatment plant was made in Penablanca for The extension of the Villa Alemana sewer- 
 age system into that community. Much of the work consisted of collection of samples, 
 measurments of flows, field sun^ey of treatment of plant site and routes for trunk 
 sewers. This project - No. 1 - was completed December 30, 1946 with a total expend- 
 iture of $12,974.95. 
 
 OTHEP BUILDING CONSTPUCTION The PROTECTORA DE LA INFANCIA, an institution for 
 AND EijUIPMENT the housing and training of children who have no 
 
 homes, is located on the Puente Alto-Santiago Road, 
 about 2 kilometers from Puente Alto. In September 1943 plans were made for expand- 
 ing and improving existing buildings. Among the facilities provided were workshops 
 to train the children. Two new buildings were constructed, and the three existing 
 buildings were extensively remodelled. Electricity and modern sanitary facilities 
 were installed. Work began in October 1943, and was completed in May 1944 at a 
 total cost of $20,641.37. The building was dedicated on September 9, 1944, when it 
 was officially turned over to the use of the Protectora de la Infancia (Project 7). 
 
 The NATIONAL INSTITUTE OF RADIUM has been in operation for a number of years. 
 
 The Institute treats cases of cancer not only from the Santiago area, but from the 
 Provinces. In order to aid in this cancer control work, the Servicio allocated the 
 sum of $15,000 to install one deep therapy X-ray unit in the Institute to augment 
 the two machines at present in operation. An order for the equipment was placed in 
 the United States in October 1943. The room was prepared by the Institute del Ra- 
 dium in September 1946 and the machine installed and put into operation in November 
 1946. The addition of this machine has greatly enhanced the facilities available 
 for treatment purposes. A total of $11,127.53 was expended for this project - No.3. 
 
 The BACTERIOLOGICAL INSTITUTE is a part of the National Public Health Service 
 and is responsible for the manufacture and distribution of biologicals and arsenicals; 
 
 1/ The surveys discussed in these projects, with the exception of those in Santiago 
 and Penablanca, were made for projects that were not established. Preliminary sur- 
 veys are made for all established projects; these surveys are included with the 
 discussion of the project. 
 
 1 
 
 4 
 
the laboratory examination and epidemiology of the Public Health Service; and gen- 
 eral research in the production of biologicals. A new building to house the Insti- 
 tute had been partially completed in the Municipality of Nunoa, a suburb of Santiago, 
 but construction had been stopped because of insufficient funds. In November 1944 
 the Servicio alloted the sum of $175,000, which was later raised to $222,500, for 
 the completion of this building. This included the finishing of the main building, 
 the power house, the chimney and the construction of fences. The project did not 
 include the purchase of equipment or furniture. Construction began in November 1944, 
 and by December 1945 the main building was practically completed. The additions 
 and finishing of the boiler-house, chimney, etc. remained, and work progressed on 
 these slowly throughout the year 1946. Difficulty was experienced in obtaining the 
 necessary fittings, etc., for the installation of the boilers. It was not until the 
 latter part of December 1947 that the condensate return pumps were received to com- 
 plete the installations in the power house (Project 20). 
 
 The VIRUS BUILDING forms a part of the group of buildings of the Bacteriologi- 
 cal Institute. Originally it was planned not to finish this building, but, because 
 of added activities in the main building, it was not found possible to provide the 
 necessary isolation for the Virus Section and provide adequate assurance against 
 contamination of other processes. Under Project No. 30 the Servicio made available 
 $60,000 and the Bacteriological Institute made available $6,472.49 as well as all 
 available construction materials in the warehouse. Plans were completed early in 
 1947. Actual construction began about the middle of February and the building was 
 completed in December 1947 (Project 30). 
 
 The SCH(X)L OF PUBLIC HEALTH in Santiago is located on the top of the west wing 
 of the Bacteriological Institute described above. In June 1943, an agreement was 
 signed providing for the completion of construction and equipping of the School by 
 the Servicio, including laboratories, auditoriums, libraries, and classrooms. Con- 
 struction began in October 1943* The building was completed in April 1945 at a 
 total cost of $80,633 for the structure and equipment. An additional amount, which 
 brought the total allotment for this project to $93,000.00, was made available to 
 equip a nutrition laboratory and to purchase a bus chassis for field trips. While 
 the School has been functioning since 1945 a certain amount of equipment for the 
 nutrition laboratory is still being awaited. This school is a part of the Univer- 
 sity of Chile and its operation is partially financed by the Rockefeller Foundation. 
 The faculty consists of Chileans, many of whom have received public health training 
 in the United States (Project 4). 
 
 The DIRECGION GENERAL de BENEFICENCIA y ASISTENCIA SOCIAL is a division of the 
 Ministry of Public Health, Welfare and Social Security in charge of the construction, 
 equipment and operation of hospitals. This governmental organization maintains ap- 
 proximately 26,000 hospital beds in Chile, but its work has been handicapped due to 
 lack of necessary equipment. On November 7, 1944, a sum of $2,100 was made avail- 
 able for the purchase of special medical equipment. An electric cautery and cysto- 
 scope, together with the necessary attachments, were obtained from the United States 
 and delivered to the Government of Chile for the use of this organization. The cost 
 was $1,814 (Project 19). 
 
 SALVADOR HOSPITAL. This hospital is owned and operated by the Servicios de 
 Beneficencia y Asistencia Social of the Government of Chile, and maintains a sec- 
 tion for specialized surgery known as the Harvey Cushing Pavillion. This section 
 lacks certain technical equipment for the proper functioning of the surgical unit. 
 Project No. 31 has for its purpose the purchase of equipment with funds provided by 
 the Servicio. A total of $12,000 was. made available and all equipment, which con- 
 sists for the most part of operating room and laboratory apparatus, has been ordered 
 from the United States. 
 
 1-5 
 
TRUDEAU HOSPITAL. While the project agreement for this hospital provides for 
 the construction and certain basic equipment, there remained to be purchased many 
 articles such as linens, cutlery, china, uniforms, clinical equipment, etc. The 
 Servicio de Beneficenca y Asistencia Social, which organization will operate the 
 hospital, has requested the Servicio to assist in purchasing this material and equip- 
 ment, and has made the sum of $45,307.44 available for this purpose. This is another 
 project for which all of the funds are being furnished by the Government of Chile 
 ( Proj ect 32) . 
 
 SEWERAGE NORTH SANTIAGO. During March 1944 construction of a sewerage system 
 
 SYSTEMS for a section in North Santiago was considered. Plans prepared as a 
 
 part of Project No. 1 (See Surveys) were approved by the Department of 
 Public Works. Actual construction was started on June 13, 1944, and is progress- 
 ing rapidly. Plans for the entire system include the construction of 240 kilometers 
 of sewers varying from 100 mm. to 2.3 meters. In this quantity is included prac- 
 tically 45 kilometers of house connections. The Servicio has made available $600,000 
 and the Department of Public Works of Chile has made available $453,074.43, for a total 
 of $1,053,074.43. On this particular project money is alloted as it becomes necessary , 
 as this work is being constructed in four sections. Total cost to date $1,378,057. This 
 system will make sewerage facilities available to approximately 200 ,000 people (Project 13I. 
 
 VILLA ALEMANA. The towns of Villa Alemana and Penablanca lie adjacent to each 
 other on the banks of the Penablanca inlet in the Department and Provincejof Valpa- 
 raiso. Because of the rapidly increasing population of these two towns and because 
 of their importance as sites of tuberculosis sanatoria, construction of a modern san- 
 itary sewerage system and sewage treatment plant was undertaken by the Servicio. The 
 sewerage system is designed to serve the most densely populated sections of the two 
 towns. One fully equipped sewage treatment plant was constructed to serve both towns. 
 
 Actual construction began in February 1944. The total amount allotted for this pro- 
 ject to date is $174,690. By September 1945 the collection system of the outfall had 
 been completed. Work was then begun on the construction of the treatment plant, which 
 consists of an Imhoff tank, trickling filters, secondary sedimentation, chlorination, 
 and provisions for drying sludge. By the end of 1946 the plant was completed, except 
 for the installation of mechanical equipment which was received and installed during 
 1947. Inaugurational ceremonies were held September 27, 1947 , and both the system 
 and the treatment plant were put into use immediately thereafter. The commemorative 
 monument was completed during December 1947. The system consists of some 20 kilo- 
 meters of plain concrete pipe varying in size from 100 to 300 milimeters; 139 man- 
 holes; and 24 flush manholes. The plant is designed for a flow of 57 liters per 
 second as a maxiumum (Project 8 ). 
 
 SAN VICENTE de TAGUA-TAGUA. San Vicente de Tagua-Tagua is located in the Prov- 
 ince of O'Higgins. It is the commerical center serving a large agricultural zone. 
 This city has a public water supply system, but had no adquate system of sanitary 
 sewage disposal. Plans for the project were undertaken in November 1943 when an 
 agreement was signed providing $40,000 for this work, Construction began in March 
 1944 and was completed in June 1945 at a cost of $33,949.10. The project consisted 
 of the construction of approximately 7.5 kilometers of sewers including outfall, 
 collection system, and house connections together with the necessary manholes, flush 
 tanks and other appurtenances. The inauguration was held June 24, 1945 at which 
 time the system was put into service (Project 9). 
 
 SAN JOSE de MAIPO. San Jose de Maipo is located on the Maipo River in the Prov- 
 ince of Santiago, about 45 kilometers from the city of Santiago. Because of its loca- 
 tion in the Andes Mountains it has become a center of tuberculosis sanatoria. San 
 Jose has a public water supply system but has no modern system of sanitary sewers. An 
 agreement was signed on November 23, 1943 providing for this work. Because the town 
 is located at a relatively high altitude in the Andes Mountains, snow and bad weather 
 
 1-6 
 
prevented construction work during the winter of 1944. On December 20, 1944 exca- 
 vation of the trench for the outfall sewer was started. By September 1945, the 
 system was completed and approximately 4,000 meters of pipe had been laid with the 
 necessary appurtenances. The cost of this project was $32,500, and it was inaugu- 
 rated in December 1945 (Project 10). 
 
 LA CALERA. La Calera, in the Province of Valparaiso, is the center of the ce- 
 ment industry in Chile and is probably the most important railroad junction point 
 in the country. The National Department of Public Works recently completed a water 
 supply system, but there was no adequate sewage disposal system. The population of 
 the city totals 12,000 persons. About 2,000 of this number live in a new section 
 and are served by a system of sewers that discharges directly into the Aconcagua 
 River. The remainder of the city is served only by open irrigation ditches. Plans 
 were completed during November 1943 for the construction of a treatment plant to 
 serve the entire city and to install sewers to serve the 80 per cent of the popu- 
 lation which at that time was without a sewerage system. The sewage system and the 
 groundwater drainage systems were completed in 1945, at a cost of approximately 
 $204,000. Since then work has continued on the construction of the outfall line 
 between the system and the treatment plant site, and on excavation at the site. 
 Estimated cost of the outfall line and plant is $130,000 of which about $23,000 has 
 been expended (Project 11). 
 
 ANTOFAGASTA. Antofagasta, capital of the Province of Antofagasta, is one of 
 the principal seaports of northern Chile, as well as the terminal of the railroad 
 from La Paz, Bolivia. An existing sewerage system serves the central and older sec- 
 tions of the city, but not the area in the vicinity of the port works. In view of 
 the fact that over 4,500 persons are expected to settle in this port area in the 
 near future, an agreement was signed in February 1944, providing for the construc- 
 tion of a sewerage system for this section, with $55,000 allotted to this work. The 
 project consists of approximately 2 kilometers of sanitary sewers, 525 meters of 
 pipe for carrying sea water for flushing the sewers, and a pumping station. The 
 sewage collected flows to the pumping station by gravity and is then pumped into 
 the main sewerage system for discharge into the sea. Construction of a factory to 
 manufacture concrete pipe was started in July 1944 and was completed in September 
 
 1944. Excavation of trenches began in October 1944. Work was started on the con- 
 struction of the sewage pumping station during December 1944. The entire System 
 was completed in September 1945, and inaugurated on December 7, 1945. Total cost 
 was $49,154*83 (Project 12). 
 
 ANCUD. Ancud, capital of the Province of Chiloe, is located on the north shore 
 of the island of Chiloe. It is the main port of the island and the northern ter- 
 minal of the island railroad. Ancud has a public water supply system, but no mod- 
 ern sanitary sewerage system, so there was danger of contamination of the oyster 
 beds in the harbor. In October 1944 plans were made for the construction of a 
 system to serve the more densely populated sections of the city. The project will 
 consist of approximately 4.8 kilometers of sewers. During December 1944 work was 
 started on the construction of a pipe factory, storehouse, and office for the con- 
 struction force. Work on the construction of the sewer lines was begun in October 
 
 1945. Bad weather conditions hindered the work on this project. To date the outfall 
 has not been completed as it was designed, and probably will not be so terminated as 
 this does not appear as absolutely necessary. It may be abandoned due to the very 
 difficult construction which would be involved in the underwater work in an area sub- 
 ject to rough seas. Cost to date is about $69,300 (Project 16). 
 
 TOME. Tome is located on the seacoast in the Province of Concepcion, approx- 
 imately 30 kilometers north of the city of Concepcion. The city is a seaport and 
 is also the terminus for the local trains between Concepcion and Tome. Tome has a 
 public water supply but the sewage from the so serviced houses is discharged indi- 
 vidually into several small streams passing through the city or into ditches in 
 
 1-7 
 
the streets. These streams and ditches carried the sewage into the harbor of Tome 
 at the public bathing beach and near shellfish areas, thus creating a public health 
 hazard. An agreement reached in November 1944 provided for the construction of 
 sewers, a sewage pumping station, together with apparatus for the screening of the 
 sewage, and other necessary attachments to serve the more densely populated sections 
 of the city. The sewage collected is discharged directly into the sea, at a point 
 sufficiently remote from the center of the city. The city of Tome contributed the 
 land necessary for the construction of the pumping station, a sum of $2,000 in cash, 
 the use of of land for the construction of a temporary storehouse and pipe factory, 
 and of suitable office space within the municipal building. In December 1944 work 
 began on the organization of the project and on the construction of a pipe factory. 
 
 The manufacture of pipe continued throughout most of 1945, and the actual laying of 
 the pipe began in November 1945. Construction of the purifying station, with the 
 exception of the communitor, was completed in July 1947. The official Commission 
 made the inspection of the entire system during August 1947, and it was accepted 
 and put into service the first of December, 1947. The communitor was received in 
 Santiago the last of Dec-ember 1947 and installed. Cost to date has been $98,800. 
 
 The system contains some 10.5 kilometers of collectors and laterals (Project 21). 
 
 NAVAL ARTILLERY SCHOOL, LAS SALINAS. The Naval Artillery School and village 
 of "Almirante Allard" are located in Las Salinas near the city of Vina del Mar. The 
 village serves as the location of homes for officers and non-commissioned officers 
 of the school. The school has a present enrollment of 200, which is expected to 
 increase to 500. The school and housing area was served by small septic tanks which 
 were not functionong properly and effluent was ponding on the surface of the ground 
 at the school and around the quarters, thus creating a public health hazard. The 
 Servicio signed an agreement in September 1945 to provide for the construction of 
 a sanitary sewer approximately 1.2 kilometers in length to collect sewage from the 
 buildings and discharge it by gravity to one of the outfall sewers of Vina del Mar. 
 
 The manufacture of pipe began in October 1945 in the pipe factory of Villa Alemana. 
 
 The pipe was transported to the job by Navy trucks. The lying of pipe was begun in 
 December 1945 and the project was terminated in April 1946 at a cost of approxi- 
 mately $7,460 (Project 26). 
 
 LLAY-LLAY. The town of Llay-Llay is situated in a very fertile, almost level 
 flood plain, the soil of which is very dense. The present population of some 4,400 
 were provided with practically no sanitary services, the usual practice having been 
 to discharge sewage directly into irrigation ditches or open ditches along the side- 
 walks in front of the homes. This unsanitary condition very probably accounted for 
 the high typhoid rate, 20 cases or 400 per 100,000 in March 1946. Future plans for 
 development of transportation facilities for the country include this town as a 
 railroad junction on the line into Argentina. 
 
 A project agreement was signed in April 1946 providing for the construction 
 of about twelve kilometers of sewers and a complete treatment plant consisting of 
 Imhoff tank, trickling filters, secondary sedimentation, chlorination, and sludge 
 drying beds. A pipe-making plant was installed in July 1946, and pipe laying began 
 in November of that year. Progress was slow due to the high ground water table, but 
 the system proper was nearly completed by the end of 1947 . About half of the excavation 
 for the treatment plant had been done and a location line for the plant outfall had 
 been staked. The right of way for this line had been requested of the Minister of 
 Public Works. Approximately $124 , 500 has been spent on this project to date (Project29). 
 
 GENERAL In countries, such as Chile, where there is a scarcity of rainfall in 
 
 SANITATION certain parts of the country, or where the rainfall is seasonal, the 
 
 problem of water becomes exceedingly important. In rural areas, es- 
 pecially, it is difficult and sometimes impossible to obtain a safe and adequate 
 water supply not only for drinking purposes but also in quantities sufficient for 
 bodily cleanliness. Furthermore, the improper disposal of waste materials in rural 
 
 1 - 8 
 
areas not only results in the pollution of local water supplies, but also results in 
 the pollution of waters used in irrigation of food crops. Undoubtedly, this has been 
 one of the outstanding factors for the high typhoid fever and dysentery rates in 
 Chile. The incidence of typhus is also high in certain rural areas, thus constitu- 
 ting a grave public health problem. 
 
 RURAL SANITATION. On October i8, 1944, the Servicio provided $50,000 for a 
 demonstration program in rural sanitation. An area was selected to the south of 
 Santiago which included four towns; Puente Alto, La Florida, San Bernardo and San 
 Miguel, and the communities of La Cisterna and Lo Espejo. This area was selected 
 primarily for the reason that the irrigation canals used in the cultivation of most 
 of the vegetables for Santiago are located here and the method of sewage disposal 
 resulted in heavy contamination of the irrigation water. 
 
 A five weeks' course in sanitation was given at the School of Public Health to 
 prepare sanitary inspectors for the field work to be carried out under the rural 
 sanitation program (See Training). Actual work began in November T944. The primary 
 work is the installation of privies. House to house inspections were made and rec- 
 ommendations for sanitary improvements were given by the inspectors. Also, the loca- 
 tion of privies over the irrigation canals was changed to a land position. In addi- 
 tion, an intensive health education campaign was carried out in this area. This pro- 
 gram was found to be so successful that upon termination of the work in the area to 
 the south of the city it was decided to extend this control to that area just north 
 of Santiago (Project 18). 
 
 By the end of 194? a total of 4,840 privies had been installed and a total of 
 24,200 home visits had been made. Two hundred forty-two septic tanks were installed 
 and numerous sanitary improvements were made, such as 154 absorption pits, 84 sewer 
 connections and 110 water connections to the city system. The area now under control 
 is 122,400 acres. As of May 1947 when this project (No. 17) was transferred to pro- 
 ject 33, a total of i$32, 685.81 had been expended. 
 
 TYPHUS CONTROL. A project was developed to serve as a demonstration in the 
 effectivness of DDT to control typhus, and a total of $10,000 was allotted. Work 
 began in February 1946, consisted of demonstrations in louse-infested areas, schools, 
 theaters, etc. Conferences and demonstrations were held in all of the health centers, 
 and basic equipment was purchased to permit the use of DDT by Sanidad officials. Re- 
 sults from the inception of the program have been gratifying, because of the effec- 
 tiveness and ease of application of the chemical, and also the enthusiastic response 
 and cooperation on the part of the public. As of May 1947 when this project (No. 27) 
 was transferred to project 33, a total of $8,202.09 had been expended. 
 
 FOOD SANITATION. The sanitary conditions under which foods are produced, stored 
 and distributed in the city of Santiago are poor. The typhoid morbidity rate is 
 constantly around 120 per 100,000 despite the fact that water and sewerage are satis- 
 factory for most of the city. The Chilean Government is interested in developing a 
 sound food control program and has made attempts in the past to improve the service. 
 Under Project No. 28 a survey was made of all food handling and producing establish- 
 ments in a densely populated area in the central part of Santiago. The area was 
 divided into six sectors, each under the supervision of an inspector, who makes 
 regular visits to the establishments in his area. Emphasis has been placed on com- 
 plete sanitation of the premises, including the personal hygiene of the food hand- 
 lers. Lecture courses were arranged, including showing of films on sanitation, and 
 demonstrations have been held for the owners of establishments, as well as all em- 
 ployees. Both have responded with enthusiasm, and the results of the work are evi- 
 dent in the eating and food establishments of that part of the city. 
 
 The work is actually being carried out by the Food Control Division of the Prov- 
 incial Health Service of Santiago. The Servicio made $20,000 available for the 
 
 1-9 
 
project. By the end of the year 1947 4,328 establishments were under control. As 
 of May 1947, when this project was transferred to project 33, a total of $5,630.79 
 had been expended. 
 
 CONTROL OF CO-il^UNICABLE DISEASES. As of April 30, 1947, the above three pro- 
 jects for Rural Sanitation (No. 17), Typhus Control (No. 27) and Food Sanitation 
 (No. 28), were all incorporated under a master project, Control of Communicable Dis- 
 eases (No. 33). During 1947, under this master project, 207 talks or demonstrations 
 were given and an estimated sum of 112,462,072.14 pesos, or $79,166.31 dollars, had 
 been invested. 
 
 SCHOLAf<SHlPS Project No. 25 was signed on July 31, 1945 to provide financial 
 AND TRAVEL assistance to doctors or engineers who wish to pursue further 
 
 studies or make observation visits to the United States, or to 
 visit other countries to confer with other party members or colleagues concerning 
 the work in general. A total of $11,475 has been expended to date. Linder this pro- 
 ject the Chief Engineer of the Cooperative Health Service visited Peru, Bolivia, 
 Brazil, Uruguay and Argentina in October and November 1945, observing general public 
 health work in these countries. Assistance has also been given to persons to travel 
 in the United States. 
 
 IPAINING Considerable progress has been made in recent years in the construction 
 of buildings and work for the improvement of public health and sanita- 
 tion within the country. However, the proper functioning of these buildings, works 
 and other programs has not always been successful due to the lack of personnel with 
 proper training in public health and sanitation. 
 
 A Public Health Nursing Officer joined the staff of the Cooperative Health Serv- 
 ice in February 1944. She was consultant to the Servicio, and took charge of the 
 organization or supervision of nurse-training programs and healt^ center activities. 
 
 A program was arranged to provide study and refresher courses for 8 graduate nurses 
 at the Arriaran Nursing School. This course was designed to make supervisors of 
 these nurses and was completed in October 1944. Five of the nurses remained at the 
 school to assist with the teaching (Project 15). 
 
 In view of the shortage of trained public health nurses, a two-month course in 
 
 public health nursing was organized, in May 1944, in the Quinta Normal District of 
 Santiago. The five nurses taking the course received instruction on bag technique, 
 prenatal and post-partum care, and infant care. They also were given opportunity 
 to visit the field with the public health nurses, and later made field visits alone. 
 The course was completed in June 1944. These nurses were assigned to work at the 
 Cerro Baron District of Valparaiso. The amount of this project was $4,232.30 (Pro- 
 ject 15) . 
 
 Prior to the completion of the Cerro Baron Health Center, the Servicio estab- 
 lished a public health nurse training program in Valparaiso. In view of the short- 
 age of trained public health nurses, a two-month course was started in May 1944, The 
 nurses were trained to make home visits, collect data, keep records, and work in 
 collaboration with the preventive clinics already established in the Cerro Baron 
 District. Upon completion of the training period, the nurses began preliminary sur- 
 veys and gained a knowledge of the people in the area. At the same time, the people 
 were furnished with information concerning the services that would be given in the 
 new health center. With the inauguration of the new building, the nurses transferred 
 their activities to the health center proper (Project 15). 
 
 Close supervision was given to the public health nursing service in Cerro Baron, 
 and periodic visits were also made to Antofagasta to supervise the work. Upon the 
 opening of the health center in Temuco in December 1946, preparations were made to 
 organize the public health nursing staff for Temuco. 
 
 1 
 
 10 
 
In July 1945 three nurses from Uruguay were sent to Chile and assigned to Cerro 
 Baron for a two-month training course in public health nursing. Four nurses from 
 Colombia arrived in Chile at the beginning of April 1947 for a four-month field 
 training course in public health nursing. They spent two months at the Quinta Nor- 
 mal Health Center and two months at the Cerro Baron Health Center. On November 1, 
 1947 sixteen graduate nurses were sent to Chile from Argentina for field training 
 in public health nursing. Eight of these students were assigned to the Quinta Nor- 
 mal Health Center and eight to the Cerro Baron Health Center. 
 
 During October 1944 the sum of $5,000 was made available for the awarding of 
 scholarships to persons who are actively engaged in public health work or who re- 
 quire training to enter the employment of a public health organization. Funds have 
 thus far been sent to provide scholarships for 15 sanitary inspectors taking a short 
 five-week course in sanitation at the School of Public Health (See also Rural Sani- 
 tation). In addition, four nurses were granted stipends of 1,000 pesos per month in 
 1945 to allow them to continue public health training. In 1946 nine more nurses 
 were granted stipends and two in 1947. They were required to sign a contract to 
 work in health centers where their services may be required. This has aided mate- 
 rially in solving the problem of public health nursing personnel (Project 18). 
 
 In November 1945 the Servicio was requested to furnish technical advice for the 
 organization of the nursing service at the Carabineros Hospital. A member of the 
 Institute field party was made Director of the Nursing Service and began organizing 
 the auxiliary help for the hospital. Courses of instruction were given, as well as 
 practical demonstrations. 
 
 The Director of the Nursing Service was transferred from Carabineros Hospital 
 to Trudeau Hospital in January 1947, in charge of the organizing of the nursing 
 service, housekeeping and instruction of personnel as nurses aides. This latter 
 instruction was necessary due to the lack of sufficient graduate nurses. The hos- 
 pital services of Chile were not organized to include a housekeeping service, but 
 due to the eimount of equipment installed in this hospital, such was deemed neces- 
 sary. A total of 48 auxiliaries were trained, as indicated, and were prepared for 
 their duties in anticipation of the opening of the hospital in November 1947. In 
 addition, organizational instruction was given to a selected group of 8 chief nurses 
 who were sent from various other Chilean hospitals and who upon completion of the 
 training returned to their respective posts to set up similar courses of instruction. 
 
 Each year from June to October a specialized course is given at the School of 
 Public Health for doctors. The Service has been responsible for assisting in the 
 planning and conducting of this course. Attendance has been as follows: in 1944, 
 ten doctors; in 1945, sixteen doctors; in 1946, sixteen doctors, and in 1947 eight- 
 een doctors. In addition to this, since 1944 certificates have been given to the 
 following: 31 sanitary inspectors; 14 laboratory technicians; 54 doctors in sta- 
 tistics; 29 statisticians; 45 inspectors in food control; 20 auxiliary laboratory 
 technicians; and 57 health education workers. All told, a total of 310 students 
 have received training or instruction in the school since its opening. 
 
 During the period of operation of the Service in Chile, assistance has been 
 given in the training of professional and technical personnel by The Institute of 
 Inter-American Affairs through the giving of sixty-four fellowships and travel grants 
 for training of Chileans in the United States. These fellowships include training 
 in such subjects as Medical Statistics, Tuberculosis, Food Control, Epidemiology, 
 Public Health, Chest Surgery and Sanitary Engineering. As of December 31, 1947 all 
 these trainees had completed their assignments and had returned to Chile. 
 
 HEALTH In July 1943 a Health Education Section of the Servicio was established. 
 
 EDUCATION Activities included press relations, panel discussions of health pro- 
 blems, film showings, radio broadcasts and lectures. Other health 
 
 1 
 
 11 
 
education work included a workshop for rural teachers, an eight-month course for 
 teachers of rural primary schools in the Province of Santiago, and a correspondence 
 course for rural teachers in all parts of the Republic. 
 
 In January 1945 the Health Education Section was changed to the Section of 
 Public Relations. Consumers' Leagues were organized to educate housewives in terms 
 of buying, eating and general living habits. A Mothers' Club was organized at the 
 Cerro Baron Health Center and a Clubhouse provided for under-privileged children of 
 the Quinta Normal District. Public Health film showings, radio talks and press re- 
 leases have continued. A course of nine sessions of two hours each, covering topics 
 of health education, was given to the summer course of High Secondary teachers in 
 the Universidad Technical Santa Maria in Valparaiso. Assistance was given in ar- 
 ranging publicity and educational material for the Typhus and Food Sanitation pro- 
 gram. 
 
 The field partys' Health Education Officer was assigned in August 1996 to study 
 local conditions in health organizations in order to prepare a course in health edu- 
 cation at the School of Public Health in Santiago. A course in public health educa- 
 tion was initiated at the School on November 11 of that year. The course was di- 
 vided into three parts as follows: Basic Material on Problems and Principles for 
 the Control of Public Health; Basic Principals of Public Health Education; and Sem- 
 inars covering selected subjects relating to the first two mentioned. Classes were 
 held five days per week, and were conducted by Chileans specialized in their lines. 
 
 It was not the purpose of the course to train professionals in health educa- 
 tion, but rather to teach public health workers and others the value of using sound 
 public health education principles in their every-day work. A total of 54 students 
 attended the course. These people returned to work in 25 different areas. 
 
 At the time of the initiation of the above course in November 1946, the Health 
 Education Section of the Servicio was reestablished. In February 1947 the Section 
 began systematizing education in the field of tuberculosis for the various health 
 centers. To do this, conferences were held with the Directors and Nursing Staffs 
 of two centers, Cerro Baron and Quinta Normal, to get their ideas as to the educa- 
 tional needs of the people attending the tuberculosis clinics. In addition, obser- 
 vations were made of the progress of the individual through the clinic to see what 
 opportunities for education existed, by whom it might be done, as well as where, 
 when and the amount of time available. 
 
 As a result of these activities, a plan of education was developed which in- 
 cluded: (1) extent of the problem in Chile, (2) nature of the disease, (3) respon- 
 
 sibilities of all individuals in the control of the disease, and (4) responsibili- 
 ties of the patient in the control of the disease. 
 
 To avoid duplication and omissions and to insure uniformity in the development 
 of the educational work by the staff, two things were done. First, a model dis- 
 cussion of the various points of the program was developed to give an idea of the 
 way to discuss the problem with the individual, in the home or clinic. Second, a 
 systematic plan of teaching was organized in which the various parts of the pro- 
 greim were taught in the following order: 
 
 1. First visit in the home by the nurse 
 
 2. First visit to the clinic by the family 
 
 3. Second visit to the clinic by the family 
 
 4. Second visit to the home by the nurse 
 
 1 
 
 12 
 
This individual education of the various members of the family was supple- 
 mented by; 
 
 1. Classes for the caretakers of tuberculosis patients 
 
 2. Classes for contacts of tuberculosis patients 
 
 3. Night meetings with educational program for those 
 away from home during hours of nurses' visits 
 
 The above systematized program was to be implemented with; 
 
 1. Picture album for nurses to use in home 
 
 2. Film strip, based on picture album, to be used in 
 the clinic and with group meetings 
 
 3. Six-page pamphlet about responsibilities of indivi- 
 duals in the control of tuberculosis 
 
 4. Leaflets about the responsibilities of the tuber- 
 culosis patient to be used in the home 
 
 At this date the film strip and six-page pamphlet are in existence and are 
 being widely used with great satisfaction. Production of the other two materials 
 is being deferred for lack of funds. The cost of the picture album is high unless 
 produced in quantity. 
 
 Following the development of the above system of education and materials, re- 
 quests were received from the tuberculosis section of the "El Salvador" Hospital 
 and the "El Peral" Sanatorium to adapt them to the needs and facilities of those 
 institutions and to instruct their staffs in the use of them. The Servicio de 
 Beneficencia y Asistencia social has asked for assistance in extending the pro- 
 gram to all the sanatoria under its management. 
 
 While these activities were going on, the Health Education Section prepared 
 for the Typhus Control Project of the Departamento two six-page pamphlets , "Combata el 
 tifus" and "Libre su hogar de insectos peligrosos a base de D.D.T.", and for the 
 Control of Communicable Disease Project another six-page pamphlet, "Asi se transmite 
 la Tifoidea". These are now in their second printing. 
 
 Another important work of the Health Education Section has been cooperation 
 with the Education Division of the Institute in elaborating and putting into oper- 
 ation a program of school health at the secondary level in the experimental schools 
 of the Education Division. School health examination was instituted, parent-teach- 
 er groups organized, and school health committees have started to function. 
 
 At page 12 of the memorandum, in the summary of the existing health and sani- 
 tation program, it is stated that by the end of June i94bj a little over 1940 sep- 
 arate projects and activities had been undertaken in the program, of which slight- 
 ly more than 1300 were completed and 634 were actively under way. A breakdown of 
 these projects and activities follows; 
 
 1-13 
 
HEALTH AND SANITATION DIVISION 
 
 Activities reported June 30, 1948 
 
 Number of Activities 
 
 TYPE OF WORK Total 
 
 TOTAL, ALL ACTIVITIES 1948 
 
 LOCAL TRAINING COURSES 
 Nursing 
 
 Administration 18 
 
 Undergraduate 11 
 
 Public Health 17 
 
 Orthopedic 1 
 
 Nurse aide 
 
 Visiting 12 
 
 Hospital 11 
 
 Practial 6 
 
 Midwifery 5 
 
 English classes 2 
 
 Sanitation 
 
 Engineers 5 
 
 Sanitary Inspectors 34 
 
 Graduate Medicine 
 
 Public Health 7 
 
 Tropical Diseases 5 
 
 Yaws 1 
 
 Other 
 
 Health education 
 
 Teachers 14 
 
 Lay Workers 3 
 
 Laboratory techniques 13 
 
 Industrial hygiene 2 
 
 Hookworm control 2 
 
 Malaria control 2 
 
 Rat control 1 
 
 Inter-country Training 
 
 Study grants 15 
 
 Travel grants 3 
 
 HEALTH EDUCATION 
 
 Preparation and distribution of 
 
 health materials, such as; 33 
 
 Newspaper stories 
 Magazine articles 
 Bulletins 
 Pamphlets 
 
 Posters 
 Exhibits 
 Health Museum 
 
 Radio programs 
 
 Lectures 
 Demonstrations 
 Panel discussions 
 Forums 
 Contests 
 
 Public address automobile 
 
 Active 
 
 634 
 
 8 
 
 6 
 
 9 
 
 3 
 
 1 
 
 1 
 
 2 
 
 1 
 
 2 
 
 1 
 
 1 
 
 2 
 
 2 
 
 7 
 
 1 
 
 14 
 
 Completed 
 
 1314 
 
 10 
 
 5 
 
 8 
 
 1 
 
 9 
 
 10 
 
 5 
 
 3 
 
 1 
 
 4 
 
 26 
 
 5 
 
 4 
 
 1 
 
 13 
 
 3 
 
 11 
 
 2 
 
 2 
 
 1 
 
 8 
 
 2 
 
 19 
 
 1 
 
 14 
 
Number of Activities 
 
 TYPfi OF WORK 
 
 Total Active Completed 
 
 HEALTH EDUCATION (Continued) 
 
 Moving pictures 
 Film strips 
 Lantern slides 
 
 Organization of national education 
 
 work or division of health educa- 
 tion in health department i 
 
 Public health education in schools 12 1 
 
 Organization of health clubs 3 
 
 Establishment and/or reorganization 
 
 of public health library 4 3 
 
 1 
 
 11 
 
 3 
 
 1 
 
 INVESTIGATION, PREVENTION, TREATMENT 
 SPECIFIC DISEASES 
 
 Disease studies 
 
 29 9 
 
 20 
 
 Control Specific Diseases 
 
 Bartonellosis 
 Diphtheria 
 Hookworm 
 Lep rosy 
 Malaria 
 Plague 
 
 Rickettsial diseases 
 
 Schistosomiasis 
 
 Smallpox 
 
 Tuberculosis 
 
 Typhoid fever 
 
 Venereal diseases 
 
 Yaws 
 
 92 
 
 27 
 
 65 
 
 HEALTH CENTERS 
 
 Construction 
 
 S6 
 
 9 
 
 77 
 
 Operation 
 
 107 
 
 74 
 
 33 
 
 HOSPITAL CONSTRUCTION 
 
 86 
 
 16 
 
 70 
 
 OTHER HEALTH SERVICES 
 
 Operation - Laboratories 
 
 16 
 
 5 
 
 11 
 
 Mobile dispensaries and launches 
 
 12 
 
 3 
 
 9 
 
 Aid to Health Departments 
 
 20 
 
 16 
 
 4 
 
 Medical Care - Health Posts 
 
 262 
 
 99 
 
 163 
 
 Operation - Hospitals, Dispensaries 
 
 57 
 
 26 
 
 31 
 
 CONSTRUCTION - Other Health Facilities 
 
 Dispensaries 
 
 25 
 
 2 
 
 23 
 
 Clinics 
 
 3 
 
 - 
 
 3 
 
 Laboratories 
 
 9 
 
 3 
 
 6 
 
 Medical Schools & Schools of Hygiene 
 
 5 
 
 - 
 
 5 
 
 Nursing Schools 
 
 5 
 
 2 
 
 3 
 
 Dormitories 
 
 12 
 
 2 
 
 10 
 
 Launches 
 
 3 
 
 - 
 
 3 
 
 1-15 
 
Number of Activities 
 
 TYPE OF WORK 
 
 Total 
 
 Active 
 
 Completed 
 
 SANITATION 
 
 Water Supplies 
 
 123 
 
 57 
 
 66 
 
 Sewerage 
 
 69 
 
 27 
 
 42 
 
 Community Sanitation 
 
 Slaughterhouses 
 
 13 
 
 1 
 
 12 
 
 Incinerators 
 
 2 
 
 - 
 
 2 
 
 Laundries 
 
 16 
 
 - 
 
 16 
 
 Markets 
 
 7 
 
 3 
 
 4 
 
 Privy construction - rural 
 
 sanitation 144 
 
 10 
 
 134 
 
 Other Sanitation 
 
 55 
 
 3 
 
 52 
 
 Engineering Plans and Surveys 
 
 7 S 
 
 45 
 
 33 
 
 INSECT CONTROL - DDT 
 
 (Mosquitoes, flies, lice, etc.) 
 
 107 
 
 94 
 
 13 
 
 MALARIA CONTROL 
 
 Permanent 
 
 140 
 
 5 
 
 135 
 
 Temporary 
 
 47 
 
 - 
 
 47 
 
 MISCELLANEOUS 
 
 (Construct ion 
 
 Doctors' Houses 
 
 Lodging House (replaced) 
 Offices for SCISP 
 
 40 
 
 Restaurants 
 
 Schools 
 
 Warehouse 
 
 13 
 
 27 
 
 Playgrounds 
 
 Construction, Supplies, Maintenance, Repair 23 
 
 7 
 
 16 
 
 Medical Supplies and Equipment 
 
 12 
 
 2 
 
 10 
 
 1 
 
 lb 
 
B. EDUCAIION IN GUATEMALA 
 
 The purpose of the agreement signed on August 12 , 1944, between the Education 
 Division of the Institute (then known as the Inter- American Educational Foundation, 
 
 Inc.) and the Ministry of Education of Guatemala, was to plan and carry out a re- 
 organization of Guatemala's rural education system. 
 
 Guatemala, by far the largest Central American republic, exerts considerable 
 influence throughout that region. Her population of over 3,500,000 includes some 
 400,000 children of elementary school age, of whom only 141,000, or about 35%, were 
 enrolled in school according to figures compiled in 1945, and a large part of those 
 in school were in the towns and cities. The illiteracy rate for the country was 
 about 67%. Rural schools are few in number, inadequate in size, inappropriate, for 
 the most part, for use as school buildings. Rural teachers are also in scarce sup- 
 ply; those in service have had, in a great many cases, no more than four to six 
 grades of elementary schooling, and are so meagerly paid as to make it necessary 
 for them to seek other part-time work to supplement their income. The curriculum 
 has been the same as for the urban schools, and has been based upon the course of 
 study in the schools of Spain and Metropolitan France. Instruction under the tra- 
 ditional system is entirely by rote— the teacher reading or reciting the lesson for 
 the day to the pupils, who are then expected to learn to repeat it perfectly. The 
 content of the traditional courses has no relation, for the most part, to the daily 
 life of the community, or to the life problems which the children will face. Text- 
 books have been virtually unknown, and even such equipment as blackboards, pencils 
 and paper, generally are lacking. Sanitation and hygiene have been largely ignored. 
 Seating and lighting arrangements in the school room are bad. In general, under the 
 traditional system, the pupil came early to school and stayed throughout the school 
 day without lunch— sometimes without benefit of breakfast, either. There was no 
 adequate way of bringing school problems to the attention of Ministry officials, 
 because the rural school system had no special officials in the Ministry whose func- 
 tion it was to advise on rural problems . 
 
 The basic agreement to establish the program provided for formation of a Serv- 
 icio within the Ministry to be charged with responsibility for planning and execut- 
 ing the program. The Special Representative of the Education Division was to be 
 named Director of the Servicio. 
 
 It was planned to start the program on a regional and exploratory basis, through 
 organization of a rural normal school in the Cakchiquel region, where principles 
 would be developed, put into practice, tested and demonstrated; and that the program 
 would then be extended into other areas through establishment of other rural normal 
 schools and through work in the rural schools themselves. The normal school was ten- 
 tatively established in the plant of an abandoned agricultural school on the Finca La 
 Alameda, near the town of Chimaltenango. Some emergency repairs and alteragions were made, 
 the staff of United States technicians, together with a few Guatemalans, took up res- 
 idence there, and the first class of students was recruited from among the more prom- 
 ising Guatemalan teachers already in service. 
 
 In spite of the mild climate, and the beauty of the site, living conditions at 
 La Alameda were a bit rugged. Rooms were small and few, with no provision for heat, 
 nor running water, and some eletric current at night only. Modern sanitation, of 
 course, was completely lacking. Nevertheless, both North Americans and Guatemalans 
 settled to their task. 
 
 That task involved, in the first place, the formulation of a guiding philosophy 
 which should underlie Guatemalan rural education. The Insititute's conception of 
 the community-centered school won acceptance by the Guatemalan teachers and officials, 
 and they proceeded jointly with the planning of a "functional" curriculum, in which 
 
 1 
 
 17 
 
the courses which would be taught in the rural schools, and consequently in the nor- 
 mal schools would have a direct and intimate bearing on the life of the rural com- 
 munity. Personal, school, home and community hygiene, better methods of agriculture, 
 fundamentals of proper nutrition, and the means to attain it — these were to be the 
 central themes. The content of the 3 R's was to contribute to the overall purpose. 
 Simple, balanced lunches were to be given the pupils, many of whom walked long dis- 
 tances to school; and in the normal school much attention was given to instructing 
 the teachers in the importance of a balanced diet, and how to give it to their stu- 
 dents— also how to instruct the parents. School gardens were planned for each rural 
 school, where improved methods of agriculture within the reach of the rural popula- 
 tion could be taught, new crops introduced, and some of the vegetable supplies for 
 the school lunches produced; the resources of the Finca gave ample scope for stu- 
 dents in the normal school to learn at first hand agricultural principles they would 
 be expected to teach. Instruction in home economics, hand crafts, physical education, 
 and recreational programs were closely allied to the central theme of rural home 
 life, health and agriculture. 
 
 Side by side with development of the new curriculum for the rural schools, train- 
 ing had to be provided in teaching methods. The teacher-students at the normal 
 school were trained to recognize the importance of proper seating and lighting in 
 the classroom, of school sanitation and cleanliness. They learned to improve their 
 teaching by the use of textbooks, blackboards, flash cards, tests related to the 
 subject matter actually taught (that is, in place of tests prepared in Guatemala 
 City for general use throughout the Republic, which had been the former practice), 
 and pupil-participation and recitation in place of mere rote learning. They learned 
 to grasp the relation between the school subjects and the daily life of pupil and 
 community, and to direct their teaching toward applying that relationship. 
 
 A practice school was established at the normal school, attended by children 
 of the students and of employees on the finca; later, a group of regularly estab- 
 lished rural schools in nearby communities were also taken over as practice and 
 demonstration schools, where the normal school students could gain experience in 
 putting their newly-learned theory into practice. 
 
 Throughout, the Guatemalan teachers and supervisors in attendance at the nor- 
 mal school, and others who came in for short courses and summer schools, were play- 
 ing their full part in the planning of the curriculum and of the teaching materials 
 which support it. They helped to make equipment for the school room, and to devise 
 means of constructing such equipment out of materials locally available. They learned 
 to construct tests for their pupils' use; and in time, the Ministry called upon them 
 to prepare and to administer tests for rural schools elsewhere — itself a significant 
 departure from custom. 
 
 The teaching materials project has developed almost into a program of itself. A 
 group of North American specialists, headed by the able writer, Ann Clark, has 
 collaborated with a group of specialists drawn not only from Guatemala, but from 
 Central American republics as well, in planning and preparing a graduated series of 
 readers, and other materials, specially written to fit the Central American scene, 
 in such a way as to make them easily adaptable to republics other than Guatemala, 
 or even to be used in those republics without change. Workbooks, and other supple- 
 mentary materials, are being developed along with the texts themselves, and it is 
 expected that the new series will be in use by the opening of the school year in 
 January, 1949 
 
 During the progress of the program, the plant at La Alameda has been consider- 
 ably enlarged and improved, with better living quarters and living conditions gen- 
 erally for both students and faculty, and with improved classroom facilities. It 
 has now been decided to establish the regional rural normal school permanently at 
 La Alameda. At nearby Santa Maria Cauque, another plant is being constructed 
 
 1 - 18 
 
because the program has revealed the lack of preparation, for many of the Guatemalan 
 teachers in service, for entrance to the normal school. Santa Maria Cauque will 
 therefore be used to prepare students for admission to La Alameda and to other rural 
 normal schools, to be established later. 
 
 Meanwhile, in accordance with program plans, a new Division of Rural Education 
 has been established in the Ministry of Education, and given a definite portion of 
 the regular budget of the Ministry with which to work. Close liaison is provided 
 between the new Division and the Servicio. 
 
 The phase of the program limited largely to work at La Alameda and its immediate 
 vicinity is now complete. The first graduating class at the normal school has re- 
 ceived its certificates, and the graduates are now either applying their work in 
 rural schools in various parts of Guatemala, or are working with their North American 
 colleagues on development of further stages of the program. Teachers not regularly 
 enrolled in the normal school have been brought in for special courses or for 'Work- 
 shops"; and both North American and Guatemalan technicians connected with the pro- 
 gram have made many visits to schools in other parts of the republic. Now comes the 
 phase of expansion, in which it is hoped to extend the reorganization throughout 
 Guatemala. 
 
 The "nuclear school" system already tried out in Bolivia and other countries 
 has been introduced into Guatemala under the program. A "nuclear school" is selec- 
 ted, on the basis of its location, size and importance, and then some twenty schools 
 in the neighborhood are grouped around it to form a nucleo, each member school of 
 which receives from the central school the services of administration and supervi- 
 sion. This not only simplifies the administrative problem in general, at a saving 
 in costs, but makes, possible, through concentrating attention on the central schools 
 first, the more rapid extension of the reorganization program into the other schools 
 of the nucleo. 
 
 There are about 2000 rural elementary schools in Guatemala, and thus far only 
 one rural normal school — that at La Alameda. The next phase of the program will 
 provide for the organization of a few other normal schools to serve other regions 
 (both from the standpoint of geography and from that of language), and for the ex- 
 tension of the work into the rural schools themselves through the nucleos. Twenty 
 nucleos have just been set up, involving some 400 schools. Others will be organ- 
 ized as the program proceeds, though somewhat more slowly. The central schools of 
 the nucleos, and some of the local schools, will be staffed, as far as possible, by 
 graduates of La Alameda, until the newly-planned additional normal schools can begin 
 to supply teachers and administrators. 
 
 1-19 
 
C. AGRICLLIURE 
 
 December 31, 194b marked the completion of six years of experience for STICA 
 (Servicio Tecnico Interamericano de Cooperacion Agricola), the cooperative agricul- 
 tural Servicio created in 1942 by the Paraguayan and U.S. Governments to work out 
 solutions for Paraguay's agricultural problems. Organized as an integral part of 
 the Paraguayan Ministry of Agriculture, STICA is staffed by both Jnited States and 
 Paraguayan personnel and is financed by joint contributions of the two governments. 
 Under the terms of the present year ' s contract , the Institute contributes Sioo,ooo 
 to program operations; Paraguay, j>357,o87. 
 
 BACKGROUIN'D 
 
 Paraguay is a land-locked country possessing tremendous agricultural resources; 
 a tropical climate suitable for production of most temperate and tropical zone crops, 
 wide expanses of fertile soil awaiting development, abundant virgin forests, and one 
 of the world's greatest concentrations of undeveloped hydroelectric energy. Despite 
 these natural advantages, agricultural production is insufficient to satisfy domestic 
 demands, much less to provide a surplus for foreign markets and to build up dollar 
 supplies. Its subsistence-type economy, based on farming, cattle raising and timber 
 exploitation, supports a population of over one mmllion, most of whom know little of 
 modern agricultural techniques. STICA' s task has been to build a program, based on 
 these conditions, which will serve as a beginning for an integrated agricultural 
 economy. 
 
 EXTENSION AND CHOP DEVELOPMENT 
 
 SUPERVISED CREDIT 
 
 Such a program has now been established. Its nucleus is a Farm Supervised 
 Credit Project established in 1943 by the Paraguayan Government with the assistance 
 of STICA. This project encompasses all forms of financial and economic aid re- 
 quired for the development of Paraguayan farms and is similar in function to the 
 Extension Service of the United States. By the end of 1948 it is anticipated that 
 5000 farm families will be participating in this service, which combines practical 
 education with the power of credit to enable farmer^ to obtain the resources neces- 
 sary for farm improvement. Through its facilities loans are extended for crop pro- 
 duction, the acquisition of livestock and equipment, or the amortization of existing 
 debts. Technical advice and supervisions are made available to help the loan recip- 
 ients practice modern methods of agricultural development. 
 
 In accordance with the terms of the program's basic agreement, STICA helps to 
 administer this project and trains the credit supervisors. Since the beginning of 
 the project 90 supervisors have been graduated from the training school conducted 
 at the National Institute of Agronomy. 
 
 NATIONAL INSTITUTE OF AGRONOMY 
 
 Creation of the National Institute of Agronomy was one of STICA' s first under- 
 takings. In addition to its function as a training center (there is no agricultural 
 college in Paraguay) , it is designed to serve as a base for Supervised Credit activ- 
 ities. Here improved seeds are produced, tested and labeled for distribution to the 
 farmer-borrowers, and various experiments in crop production are conducted to deter- 
 mine the modern agricultural methods most adaptable to the needs of the country and 
 the means of the farmers. During 1947 a plan was initiated to stimulate the future 
 production and distribution of field and vegetable crop seed in Paraguay. This plan 
 included the building of a laboratory and seed storage house at the National Insti- 
 tute of Agronomy at Caacupe, as well as the distribution of foundation stocks to 
 
 1 
 
 20 
 
selected farmers, multiplication of the stocks by those farmers, field inspection, 
 grading and testing, introduction of seeds from other countries, and seed distri- 
 bution. Regular inspections are made of the crops grown for seed for the Agronomy 
 Institute. Technicians are taking advantage of these periodic visits to discuss 
 with the growers methods of controlling plant diseases and preparing inexpensive 
 fertilizers and to promote the cultivation of green manure crops for their soil 
 building qualities. 
 
 TECHNICAL BULLETINS 
 
 During the period from July 1946 to August 1947 the Food Supply Division of 
 the Institute was able to secure the aid of the head of Iowa State College's seed 
 laboratory. Dr. R. Howard Porter, who acted as advisor to the Institute of Agronomy 
 while a member of STICA's staff. Under his leadership the crop development activ- 
 ities of the Institute were greatly intensified and more than a score of technical 
 agricultural pamphlets and circulars were issued for use of cooperating farmers. 
 Patterned after the information bulletins of the U.S. Department of Agriculture, 
 they represent the beginning of a national agricultural literature in Paraguay. 
 
 MODEL COLONY 
 
 STICA has tackled the problem of redistributing some of the farm population, 
 to bring into use some of the valuable, but idle, agricultural land in Paraguay. 
 Fifteen farmers were chosen in June 1946 as the nucleus for a colonization project 
 under which it is hoped that eventually 100 families can be settled near Piribebuy 
 and taught to farm efficiently on 2000 hectares of Paraguay's most fertile soil. 
 Seeds tested at the Institute and essential machinery are made available to these 
 settlers at reasonable prices, road construction has been undertaken, and well-drill- 
 ing equipment has been acquired in an attempt to solve the water supply problem. 
 
 As a start toward establishing industries at the Colony, equipment for the manu- 
 facture of mandioca starch has been procured and construction of a factory begun. 
 
 Sixtji farmers are now renting and working plots on the land, which has been 
 divided in accordance with long-range plans for the area's development and which 
 will eventually be owned by the colonists. A member of the U.S. Embassy staff in 
 Paraguay who visited the colony in October 194? reported; 
 
 "The work done so far is extraordinary. The farms themselves are little 
 
 models They have some very nice looking crops and they are now 
 
 starting to build homes for farmers who have remained on the property 
 for at least two years and have proved their worth. These houses are 
 also being put on a credit basis and will eventually be paid for by the 
 farmer himself." 
 
 HOME IMPPOVEMENT 
 
 Another major activity of the Supervised Credit Service is the provision of 
 assistance for the farm women of Paraguay. 
 
 DOMESTIC WORK CENTER. The first effort to provide such aid was made in October 1944 
 when a Domestic Work Center was established at Capiata (a village 25 miles south- 
 east of Asuncion), by a member of STICA's staff. Subsequently two additional centers 
 and two subcenters have been organized in other rural communities. Built along the 
 lines of the typical Paraguayan farmhouse, yet incorporating easily-made improve- 
 ments, these Centers afford country women and their families and opportunity to 
 learn new methods and skills which make their homes more pleasant and healthful. 
 
 Each is staffed by outstanding women of the community, especially selected and 
 trained to provide basic instruction in the domestic arts, hygiene, child-care ano 
 nutrition. 
 
 1 
 
 21 
 
Although the Domestic Work Center is a step forward in the movement to secure 
 better homes for Paraguay's rural population, its usefulness is restricted to fam- 
 ilies living in the immediate vicinity. So the Credit program, under the guidance 
 of STICA, set about to develop a corps of young women capable of going into the 
 homes of borrowers, wherever they might live, and not only suggesting improvements 
 but helping to carry them out as well. 
 
 SCHOOL FOR SUPERVISORAS. During the summer of 1946 plans were formulated to estab- 
 lish a school for rural women supervisors for this purpose and after weeks spent in 
 surveying the needs of the country people and in handpicking a staff qualified to 
 teach social work, agriculture, health and hygiene. La Escuela de Supervisoras 
 Rurales opened on October 1 at Caacupe. After careful screening of scores of 
 applicants, 35 young girls had been selected to train as Paraguay's first rural 
 home supervisors. All spoke Guarani (the native Indian tongue), and had extensive 
 practical experience in the home or in the field of teaching; each of them was a 
 skilled horeswoman, since many borrowers live in country traversable only on horse- 
 back. 
 
 By January 1947 the theoretical and practical courses designed to equip the 
 supervisora to meet the needs and desires of thd rural families of her territory 
 were completed, and each was allotted a farm home for actual field practice. At 
 the end of a month, improvement programs for 34 farm homes had been put into oper- 
 ation and three girls' clubs, similar to 4-H clubs, had been organized. Since that 
 time 8 more clubs with an average membership of 25 girls have been started and all 
 11 are now functioning in Paraguayan districts. 
 
 A short time later, on the day before graduation for the girls, a tour of these 
 farm homes was made by Government officials and others, who found that the standard 
 of living in these 34 homes had been markedly improved in the course of a few weeks. 
 Spontaneous remarks made by the various cooperating farmers and their wives ex- 
 pressed complete satisfaction with the program and with their new way of life. 
 
 The attitude of the officials making the tour can be summed up in the statement 
 of the President of the Board of Directors of Supervised Credit; "What we have seen 
 today surpasses even our most optimistic hopes for the rural home economics program. 
 I knew that they had accomplished considerable, but again, what we have observed to- 
 day, goes far beyond anything we were able to visualize." 
 
 In July 1947, STICA' s director of the supervisoras program, was presented the 
 Medal of "Honor al Merito" by the Paraguayan Government for her work in training 
 these girls who now form the nucleus of a home improvement effort which may be a 
 compelling force in lifting the nation's standard of living. 
 
 CATTLE DEVELOPMENT 
 
 Although probably more meat is consumed per capita in Paraguay than in any 
 other country of the world, and while it is well known that the cattle industry 
 constitutes the nation's largest source of revenue, methods of cattle breeding 
 and care have undergone little if any modernization during this century. Conse- 
 quently one of STICA' s major efforts has been devoted to helping livestock owners 
 adopt new techniques in this field. 
 
 RANCH AT ESTANCIA BARRERITO. At this 27,000 acre ranch with approximately 
 6000 head of cattle which is owned by the Government of Paraguay in the southern 
 Misiones region, STICA conducts a visual demonstration in livestock breeding and 
 
 1 
 
 22 
 
pasture managjement designed chiefly to help the country's larger ranch owners. In 
 May 1947 a five-year breeding program at the ranch was inaugurated with the impor- 
 tation of Zebu bulls for crossing with Angus and criollo cattle, to develop a better 
 local beef breed; sale of cattle raised here to farmers for improving their stocks 
 keeps the ranch on a self-sustaining basis financially and makes possible the estab- 
 lishment of numerous improvements to demonstrate modern pasture management. These 
 include facilities and planting of forage crops. 
 
 MODEL FARM AND DAIRY. Smaller cattle owners and farmers have been encouraged 
 to adopt modern practices through demonstrations at the San Lorenzo model farm and 
 dairy established by STICA in 1943 on property belonging to ENAME, the nation's 
 secondary agricultural school. Organized to supply milk, dairy products and pork 
 to the school and to the Asuncion market, the dairy farm has facilities for 100 
 cows while the pasteurization plant has a capacity of 2000 liters of milk a day, 
 sufficient to make effective contribution to the local market out not large enough 
 to be completely a self-sustaining enterprise. A unique institution in Paraguay, the 
 dairy supplies the only bottled pasteurized milk in the country, besides serving as 
 an educational center for dairymen in the Asuncion area. Offspring of the dairy's 
 cattle, which are imported Holstein, are sold to Paraguayan farmers who will agree 
 to follow the feeding system proved best by STICA and who will maintain milk pro- 
 duction in accordance with dairy standards. These farmers are also encouraged to 
 plant in their pastures the grasses which have proved most successful on STICA 's 
 farm. 
 
 Recently the cultivation of row-crops at the farm has been abandoned in favor 
 of laying out all cultivated land in pastures. This will enable the dairy farm to 
 function as an economical self-supporting unit. 
 
 BREEDING SERVICE. Another STICA service to cattlemen in the Asuncion area is 
 the Puestos de Monta or Bull Ring Project, under which superior bulls for breeding 
 are made available to cooperating farmers at 18 service centers. In connection 
 with the establishment of these centers it has been possible to introduce new tech- 
 niques for dairy sanitation. Farms to be used as puesto stations are cleaned and 
 the cattle tested for tuberculosis and other ailments. Neighboring dairy herds are 
 checked to assure 50 to 7o sound cows for each bull designated for service in a 
 particular district. Within 76 working days one veterinarian, accompanied by a 
 field assistant and a laboratory technician, cleared 993 animals for 49 such districts. 
 
 Additional aids offered by STICA in its cattle development projects include the 
 preparation at the Model Farm of balanced feed for milch cows, the sale of immunized 
 cows and heifers, and the services of an itinerant veterinary technician. 
 
 COIVPLEMENIAPY PROJECTS 
 
 Early in the development of STICA' s program of agricultural aid it became 
 apparent that certain projects were needed to complement those designed to help 
 Paraguay's farmers directly: 
 
 STORAGE. Adequate marketing and storage facilities were lacking to insure 
 proper use of the farmers' produce.. In a survey underteiken in 1943 by STICA at 
 the request of the Ministry of Agriculture it was revealed that absence of means 
 for storage and refrigeration cost sub-tropical Paraguay thousands of dollars an- 
 nually in damage by insects and climate and was on of the nation's important agri- 
 cultural problems. STICA thereupon recommended the construction of grain elevators 
 in major grain-producing areas and a 2500 ton cold storage plant and market in 
 Asuncion, and a contract was let to a U.S. firm. The work on grain elevators lo- 
 cated in Asuncion, Villarica, Encarnacion, and Paraguafi, and on the storage plant 
 and market is almost completed. Shortages of materials and labor difficulties have 
 slowed down construction to a great extent, but it is expected that these buildings 
 
 1-23 
 
can all be finished in the near future so that a year-round supply of perishable 
 and semi-perishable food commodities can be insured, thus eliminating waste in 
 marketing, improving quality of produce, and contributing to stablization of prices. 
 
 SURVEYS. The almost complete lack of authentic statistics regarding Paraguay's 
 geography and the mode of living of its people which existed when STICA began to 
 work, made accurate diagnosis of its agricultural programs impossible. Project 
 plans at first had to be based on impressions and deductions rather than on a sci- 
 entific appraisal. In an attempt to secure accurate facts to be used as a basis for 
 program planning, STICA has conducted a number of special surveys for the Paraguayan 
 Government . 
 
 FARM CENSUS. An agricultural census, the first ever taken in Paraguay, was 
 completed in 1947 by STICA' s staff atid is now being prepared for printing with the 
 assistance of the U.S. Census Bureau and the Inter- American Statistical Institute- 
 Presenting an over-all picture of Paraguay's farms, how they are operated and what they 
 proauce, this census is of help to officials planning the hemispheric census sched- 
 uled for 1950. During the first year's work on the survey, more than 100,000 small 
 isolated farms were visited by a mobile corps of 1,135 census takers trained oy 
 STICA. During the following three years a staff of skilled workers with the aid of 
 IBM machines compiled and summarized the vast amount of data collected. In order 
 that the public might be informed of the progress of the census, agricultural 
 statistics were released to the press by departments as it was compiled. 
 
 SOILS. In the final stages of completion is a survey of the main Paraguay 
 soil types. Information obtained will provide the basis for a soil classification 
 map showing Paraguay's significant soil characteristics, important vegetative types, 
 principal adaptable crops, and a list of minimum practices necessary for soil and 
 water conservation and increased crop production. Through the cooperation of the 
 United States Army Air Corps, staff members working on the survey were flown over 
 inaccessible parts of the Chaco areas and those regions just east of the Rio 
 Paraguay to obtain data which would otherwise have taken a party of soil surveyors 
 at leaist four years to complete. 
 
 FORESTS. Even though the fprests of Paraguay have been exploited for several 
 centuries, wooded areas still cover nearly half the entire area of the country. In 
 an effort to assist Paraguay in planning the orderly development of its forestry 
 inc^ustries, STICA completed a study of the forest resources of each department and 
 district of the country. This includes information concerning the several forest 
 zones, the total amount of timber available, the degree and manner in which the 
 zones have been exploited, saw-mill facilities, cost of producing sawn lumber and 
 other pertineur data. The report of this survey has been publisnea as one of the 
 Division's Special Reports. An additional discussion of Paraguay's forest products 
 has also been printed as one of a series of STICA commodity reports, which include 
 pamphlets on hides and leathers, sugar cane, coco oil, and vegetable oils. 
 
 POOD CONSUMPTION. In order that more accurate plans could be made for the pro- 
 duction of Paraguay's food requirements, it was decided early in STICA' s program 
 to conduct a food consumption survey for the purpose of collecting data on the types 
 and quantities of food eaten and the nature of the dietary deficiencies in the 
 country. Under the direction of a nutrition economist from the United States and 
 with the aid of four Paraguayan women assistants, statistics were acquired over a 
 period of two years and were then compiled and jinalyzed for issuance as a Special 
 Report of the Food Supply Division. 
 
 MEDICINAL AND AROMATIC PLANTS. Among the serious difficulties which confront 
 Paraguayan economy is the high cost of transporting its products due to the land- 
 locked condition of the country. It is evident that permanent benefit would be 
 derived from the establishment of a basir industry with an exportable product, the 
 
 a 
 
 24 
 
volume of which might be small and therefore suitable for air transport, but of high 
 unit value. For this reason STICA has for some time been conducting an investiga- 
 tion of the commerical possibilities of various plants indigenous to Paraguay which 
 yeild essential oils and of the prospects of introducing other such plants there. 
 
 Among these plants with which experiments have been conducted at the Institute 
 and on several plantations near Asuncion are lemon grass, mint, patchouli, caraway, 
 and vanilla. One of the most promising is a small plant yielding vegetable sac- 
 charine which lacks the undesirable characteristics of the coal-tar derivative. 
 Another outstanding plant, known as Capii Cedron, has an essence of excellent quality 
 that has aroused the interest of New York perfumers and may well provide a new source 
 of revenue for Paraguayan farmers. 
 
 SPECIAL ACTIVniES 
 
 From time to time STICA is called upon by the Paraguayan Government to help in 
 solving emergency problems or to provide short-term technical assistance of a highly 
 specialized nature. Organizing a nationwide defense against grasshoppers and pro- 
 viding the services of a specialist to assist in the government's current rice pro- 
 duction campaign are representative of this specialized phase of STICA's program. 
 
 GRASSHOPPER CONTROL. When grasshoppers invaded Paraguay a year ago control 
 efforts launched at the Model Colony by a STICA technician proved so successful the 
 Ministry of Economy asked the Servicio to organize a permanent technical service to 
 check the spread of the insects and to prevent future plagues. Although this serv- 
 ice was launched at least two months late, quick action on the part of STICA person- 
 nel substantially reduced anticipated crop losses. A countrywide defense plan has 
 now been devised and dry poison bait, prepared under STICA supervision, has been 
 distributed throughout the agricultural areas for use in the event of subsequent 
 invasions. 
 
 RICE PROMOTION. Since the campaign was launched to make rice Paraguay's prin- 
 cipal crop as a means to better nutrition and a more diversified economy, STICA has 
 taken an active part in providing technical assistance to the Government planners. 
 
 In July a U.S. rice specialist was added to the Servicio staff to serve as advisor 
 on modern rice production methods and to direct the establishment of the Model Rice 
 Colony which will serve as the center of the rice program. 
 
 TRAINING 
 
 By means of action projects such as these in the fields of extension and crop 
 development, home improvement and cattle development, storage and vital surveys, 
 
 STICA has for six years demonstrated and offered training in the advanced techniques 
 which must be employed to increase Paraguay's agricultural production and improve 
 her standard of living. More important than the physical changes wrought as a re- 
 sult of this program the dairy and pastures of San Lorenzo, the fences and corrals 
 at Barrerito, the gleaming Institute buildings and terraced plots, the whitewashed, 
 windowed farm homes or Colony houses, domestic work centers and credit offices are 
 the ideas STICA has spread in its contacts with farmers and other young people. It 
 has tried to teach new methods of approach, the value of "learning by doing", and 
 the fact that the practical skills acquired in working with one's hands, while not 
 superior to book knowledge, are indispensable complements to it. In its classes for 
 rural credit supervisors and home improvement supervisoras, in its scholarships 
 granting U.S. study for a small number of Paraguayans, and in its contacts with the 
 men in the fields, it has tried to emphasize the need for and to train responsible, 
 enlightened and experienced Paraguayan leaders who will be available to carry for- 
 ward STICA's objective after U.S. technicians withdraw - the building of the agri- 
 cultural economy Paraguay needs and can support. 
 
APPENDIX 2- -RESPECTIVE CONTRIBUTIONS TO OPERATING AND INACTIVE PROGRAMS 
 
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THE INSTITUTE OF INTER-AMERIC\N AFFAIRS 
 APPENDIX 2 --RESPECTIVE CONTRIBUTIONS TO OPERATING AND INACTIVE PROGRAMS (Con’ 
 
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