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Sara Josephine Baker (November 15, 1873 – February 22, 1945) was an American physician notable for making contributions to public health, especially in New York City. She is widely credited with saving the lives of 90,000 inner city children and her fight against the damage that widespread urban poverty and ignorance caused to children, especially newborns, is perhaps her most lasting legacy.[1] She is best known for (twice) tracking down the infamous index case known as Typhoid Mary, as well as vastly improving hygiene in the immigrant communities of Hell's Kitchen. In 1917, she noted that babies born in the United States faced a higher mortality rate than soldiers fighting in World War I, drawing a great deal of attention to her cause.[2] Early life and education Baker was born in Poughkeepsie, New York in 1873 to a wealthy Quaker family. At the age of 16, Baker decided on a career in medicine after her father and brother died of typhoid.[3] After studying chemistry and biology at home, she enrolled in the New York Infirmary Medical College, a medical school for women, founded by the sisters and physicians Elizabeth Blackwell and Emily Blackwell, and graduated in 1898.[4] In 1901, Baker passed the civil service exam and qualified to be a medical inspector at the Department of Health, working as a school inspector. After working diligently in the school system, she was offered an opportunity to help lower the mortality rate in Hell's Kitchen, which was considered the worst slum in New York at the turn of the century, with as many as 4,500 people dying every week. Baker decided to focus on the infant mortality rate in particular, as babies accounted for some 1,500 of the weekly deaths. Most of the deaths were caused by dysentery, though parental ignorance and poor hygiene were often indirectly to blame.[3] Baker and a group of nurses started to train mothers in how to care for their babies: how to clothe infants to keep them from getting too hot, how to feed them a good diet, how to keep them from suffocating in their sleep, and how to keep them clean. She set up a milk station where clean milk was given out. (Commercial milk at that time was often contaminated, or mixed with chalky water to improve colour and maximize profit.) Baker also invented an infant formula made out of water, calcium carbonate, lactose, and cow milk. This enabled mothers to go to work so they could support their families. She also aided in the prevention of infant blindness, a scourge caused by gonorrhea bacteria transmitted during birth. To prevent blindness, babies were given drops of silver nitrate in their eyes. Before Baker arrived, the bottles in which the silver nitrate was kept would often become unsanitary, or would contain doses that were so highly concentrated that they would do more harm than good. Baker started using small containers made out of antibiotic beeswax that each held a single dose of silver nitrate, so the medication would stay at a known level of concentration and could not be contaminated. Through Josephine Baker's efforts, infants were much safer than they had been the previous year (blindness decreased from 300 babies/year to 3/year within 2 years). But there was still one area where infancy was dangerous: at birth. Babies were all too often delivered by midwives, who did not necessarily receive any training and who often relied upon various folk practices. Baker convinced New York City to license midwives to ensure some degree of quality and expertise. While Baker was campaigning to license midwives, treat blindness, encourage breastfeeding, provide safe pasteurized milk, and educate mothers, older children were still getting sick and malnourished. Baker worked to make sure each school had its own doctor and nurse, and that the children were routinely checked for diseases like lice and trachoma. This system worked so well that diseases once rampant in schools became almost non-existent. Early in her career, Baker had twice helped to catch Mary Mallon, also known as "Typhoid Mary". Mallon was the first known healthy carrier of typhoid, who instigated several separate outbreaks of the disease and is known to have infected over fifty people through her job as a cook. At least three of the people she infected died.[5] Mallon was not the only repeat offender nor the only typhoid-contagious cook in New York City at the time, but she was unique in that she did not herself suffer from any ill-effects of the disease and in that she was ultimately the only patient placed in isolation for the rest of her life. It may have been relevant that the other typhoid carriers were male, and that they were not of Irish heritage.[6] Professional recognition Josephine Baker was becoming famous, so much so that New York University Medical School asked her to lecture there on children’s health, or 'child hygiene', as it was known at the time. Baker said she would if she could also enroll in the School. The school initially turned her down, but eventually acquiesced after looking for a male lecturer to match her knowledge. So, in 1917, Baker graduated with a doctorate in public health. After the United States entered World War I, Baker became even better known. Most of this publicity was generated from her comment to a New York Times reporter. She told him that it was safer to be on the front lines than to be born in the United States because the soldiers died at a rate of 4%, whereas babies died at a rate of 12%. She was able to start a lunch program for school children due to the publicity this comment brought. She made use of the publicity around the high rate of young men being declared 4F (not eligible for draft due to poor health) as a motivating factor for support in her work on improving the health of children. Baker was offered a job in London as health director of public schools, a job in France taking care of war refugees, and a job in the United States as Assistant Surgeon General. In 1923 she retired, but she didn't stop working. Josephine Baker became the first woman to be a professional representative to the League of Nations when she represented the United States in the Health Committee. Many government positions, departments, and committees were created because of her work including the Federal Children's Bureau and Public Health Services (now the Department of Health and Human Services) and child hygiene departments in every state. She was also active in many groups and societies including over twenty-five medical societies and the New York State Department of Health. She also became the President of the American Medical Women's Association and wrote 250 articles (both professional and for the popular press), 4 books, and her autobiography before her death in 1945. Personal life This section does not cite any references or sources. Please help improve this section by adding citations to reliable sources. Unsourced material may be challenged and removed. (December 2011) Sara Josephine Baker wrote very little about her personal life, however she spent much of the later part of her life with Ida Alexa Ross Wylie, a novelist and essayist from Australia, and self-identified as a 'woman-oriented woman'. When Baker retired in 1923, she started to run their household while writing her autobiography. In 1935, Baker and Wylie decided to move to Princeton, New Jersey, together with their friend Louise Pearce. While Baker and Pearce left little documentation |
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