By Anne M. Filiaci, Ph.D.
Lillian Wald first witnessed the squalor and misery of daily life in New York City’s slums as a medical student. In the spring of 1893, she volunteered to teach health care to immigrant women at a Sabbath School on Henry Street. While giving a class on how to make beds, she was approached by a distraught youngster whose mother who had suffered complications during childbirth. Believing that she had no choice but to render assistance, Wald dismissed the class and followed the child through the city streets to her home. The young medical student was astounded by what she saw—
The child led me over broken roadways,—there was no asphalt, although its use was well established in other parts of the city,—over dirty mattresses and heaps of refuse,….—between tall, reeking houses whose laden fire-escapes, useless for their appointed purpose, bulged with household goods of every description.
It was a rainy day, which according to Wald
added to the dismal appearance of the streets and to the discomfort of the crowds which thronged them, intensifying the odors which assailed me from every side. Through Hester and Division streets we went to the end of Ludlow; past odorous fish-stands, for the streets were a market-place, unregulated, unsupervised, unclean; past evil-smelling, uncovered garbage-cans;….
The youngster’s apartment building provided no respite from the filth and overcrowding of the streets:
The child led me on through a tenement hallway, across a court where open and unscreened closets [toilets] were promiscuously used by men and women, up into a rear tenement, by slimy steps whose accumulated dirt was augmented that day by the mud of the streets, and finally into the sickroom….
In the actual living quarters, Wald found yet more squalor—
…the family of seven shared their two rooms with boarders,—who were literally boarders, since a piece of timber was placed over the floor for them to sleep on,—and…the sick woman lay on a wretched, unclean bed, soiled with a hemorrhage two days old….
Wald says that she experienced “a baptism of fire” as she cleaned and changed the bedclothes of the sick woman. She left the apartment knowing that her life had been forever transformed. “Deserted were the laboratory and the academic work of the college,” she later proclaimed. She would never return. She had found her true calling.
Within months, Wald had moved to the Lower East Side to assume her life’s work of nursing the poor. She soon found that her practical, hands-on daily experience continually and vividly reinforced what she had learned on that fateful day, and what public health and housing reformers had been saying for decades. An unhealthy environment meant contagious diseases could not be controlled, general health suffered, children could not thrive or flourish, adults could not improve their lives, and the workplace—often located in a tenement apartment or “sweatshop,” where people also lived—could not be adequately regulated to address the health and safety of workers.
“Conditions of tenement house sanitation,” Wald would later assert, lay “at the basis of our national and municipal health.” Lavinia Dock, Wald’s sister nurse and longtime housemate, echoed Wald’s concerns. “The older members of the nursing staff of the Nurses’ Settlement in Henry street,” she wrote,
have long been troubled by the question of contagion in the tenements….The conditions of excessive crowding in our neighborhood make complete isolation of contagious cases…absolutely impossible….
As a trusted healer who was welcomed into the tenements, Wald’s “training in the care of the sick” gave her “an organic relationship to the neighborhood.” This entrée put her in a unique position. As she was healing individuals, she was also observing the unsanitary and hazardous environment of their living spaces. She reported these conditions to her donors on a regular basis, and was soon making them known to a much wider audience. The young Wald not only accepted this work of “reporting” what she saw but “rejoiced” in it. She believed that once uninformed Americans learned about the misery of the poor, like her they would act quickly to change it.
Wald’s mentors and colleagues—from the New York City Board of Health to influential reformers like Josephine Shaw Lowell and Jacob Riis —were happy to use her services. The Board of Health allowed her and her colleague Mary Brewster to wear badges proclaiming the title “Visiting Nurse. Under the Auspices of the Board of Health.” In return, “every night, during the first summer” of 1893 on the Lower East Side, Wald
wrote to the physician in charge, reporting the sick babies and describing the unsanitary conditions Miss Brewster and I found, and we received many encouraging reminders that what we were doing was considered helpful.
Josephine Shaw Lowell, a prominent philanthropist and early mentor and friend to Wald, relied on the young nurse to report on the needs of the people she treated daily. On occasion, Lowell also asked Wald to write letters and opinion pieces to newspapers, detailing the plight of her patients and their needs. Wald was happy to oblige.
Jacob Riis, also Wald’s mentor, friend and colleague, sought Wald’s assistance early on, asking her to report any housing violations that she saw in the course of her work. Riis also encouraged Wald with her self-imposed mission “to know and to tell.” In 1896 or 1897, when Wald gave a talk advocating better housing laws, more stringent regulations, and effective enforcement, Riis applauded her efforts, writing “It was a fine speech.”
A large portion of the speech that Riis praised was preserved in Wald’s official biography. Entitled “Crowded Districts in Large Cities,” it is easy to see that Wald had consciously or unconsciously used Riis’s trademark method of tugging at the heartstrings to make her listeners empathize with the poor. She urged her audience to look underneath statistics, numbers, and abstract descriptions of the buildings. “Read each figure” as “a human being,” she implored, and
read that every wretched unlighted tenement described is a description of homes for people—men and women, old and young, with the strengths and weaknesses, the good and the bad, the appetites and wants that are common to all.
Wald painted word pictures straight out of her daily experiences, vividly describing what it was like to be inside one of the buildings that the poor called home: “The houses are decrepit, filth-infested and dark;” she testified,
old houses, once the homes of the wealthy and fastidious converted to present uses by a process of decay, and maintained at the smallest possible expense to bring the largest returns possible. Rear tenements built upon what was left of the city lots of front houses. Houses facing the street, utilizing the space that was once a garden. The tall new tenements built upon single city lots twenty-five by one hundred feet, with four families to a floor, each single-lot house tenanted by twenty to twenty-four families, with saloon and one store generally in the basement.
Wald invited her audience to imagine walking with her up the stairways in these buildings, “the halls of houses so dark that groping is the method of movement in them. Visiting nurses, she informed them, lived with the constant “fear of trampling on the children” in these hallways, “a sound warning them where to tread, carefully, or sometimes out of the darkness a tiny hand on the railing shocking suddenly with the sense of accident averted….”
Once a nurse navigated the hallways and reached her destination, it was not uncommon to go in the daytime into the closet-room with candle or lamp to be able to see the patient at all; not uncommon to go into the house and see ten or eleven people occupying two small rooms—people who have been working all day, for the night’s rest stretched on the floor, one next to the other, dividing the pillows, different sexes not always of the same family, for here are ‘boarders,’ who pay a small sum for shelter among their own, the family glad of this help to the rent….
When speaking to those more fortunate, Wald often accentuated her description of tenement conditions with stories of individual patients. One such patient was Peter, “a beautiful yellow-haired boy” who suffered from “pneumonia, complicated with whooping-cough.” Peter’s doctor “had ordered bath treatments every two hours,” and Wald visited multiple times during the day to bathe the boy. At eight o’clock, his mother attempted to take over. However, by late at night, when Peter’s temperature tended to be was the highest,” his mother “was worn out.” Wald decided that “active night-nursing seemed imperative,” and hired “Miss S.” for this duty.
Miss S. turned out to be a trooper—the job was much more difficult than it would seem from “the mere telling.” Peter’s parents “were clean and in this were not blameworthy,” but “the vermin in these old houses” were “horribly active at night,” and the “sweet girl” “ended her first vigil with neck and face inflamed from bites.”
Peter’s story had a happy ending—he “had a beautiful recovery, rewarding his nurses by a most satisfactory return to a normal state of good health.” However, he—along with hundreds of thousands of children—continued to face a grim nightly reality of “the crawling creatures” that haunted their homes and feasted on their bodies. Sadly, from the time they were “babes,” these children had become “so accustomed” to these creatures “that their sleep” was “scarcely disturbed.”
Although living conditions continued to be grim for most of the slums’ inhabitants, the work of reformers and the 1894 Tenement House Committee’s efforts did result in some major improvements. In late November of 1896, the New York Times reported that because of “the new laws secured by the committee,…. the death rate” had “materially decreased….,” especially among “children under five years of age”—a demographic that “had before experienced the greatest fatality [rate] in the old tenement houses ….”
Bibliography
Carson, Mina, Settlement Folk: Social Thought and the American Settlement Movement, 1885-1930, Chicago: University of Chicago Press, 1990.
Dock, L.L., “An Experiment in Contagious Nursing,” published in Charities (11 [July 4, 1903]: 19-23), by L. L. Dock, Henry Street Nurses’ Settlement, New York. Reprinted in
James, Janet Wilson, ed., A Lavinia Dock Reader, edited with a biographical introduction by Janet Wilson James, New York: Garland Publishing, Inc., 1985
Duffus, R.L., Lillian Wald: Neighbor and Crusader, New York: The Macmillan Company, 1939.
[Epstein], Beryl Williams, Lillian Wald: Angel of Henry Street, [author’s name on title page is “Beryl Williams”], NY: Julian Messner, Inc., 1948.
“Reform in Tenements: Health and Morals of Their Inmates Improved,” New York Times, November 28, 1896.
Wald, Lillian D., The House on Henry Street, N:Y: Henry Holt & Co., 1915.
Copyright Anne M. Filiaci 2016