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Sunnyside physician publishes story of Permanente Northwest

posted on January 20, 2012

By Lincoln Cushing

Heritage writer

Permanente in the Northwest fills a large gap in the history of Kaiser Permanente – the unique contribution made by the Northwest region, especially in the early years.  Author and retired Northwest internist Ian C. MacMillan, who served 14 years as chief of medicine at Kaiser Permanente Sunnyside Medical Center, demonstrates an insider’s insight and enviable access to details that thoroughly enrich this account.

Before there was a Kaiser Permanente, there was Permanente Metals, the division of Henry J. Kaiser’s construction consortium that built ships during World War II. The medical services offered to those civilian workers was the kernel of what would eventually grow to become one of the nation’s largest not-for-profit health plans, and with two vibrant shipyards in Portland, Oregon, and Vancouver, Washington, the Northwest was a key participant.

The prologue provides a history of the medical care options in the area before 1941 as well as the story of how Sidney Garfield, MD, and industrialist Henry J. Kaiser came to collaborate on their successful model of prepaid industrial medical care. This is followed by a detailed account of the wartime boom – shipyards, housing, and health care rolled into one.

Wartime shipyards in Oregon and Washington

Notable events include the then-new practice of treating civilian tuberculosis patients with streptomycin, the model day care program for workers’ children endorsed by Eleanor Roosevelt, and a rich art community.

Clipping about the completion of Bess Kaiser Hospital, July 1959, Oregon Journal

The demand for medical facilities soon outstripped the capacity of the first aid stations in the yards, and the first Northern Permanente Foundation (NPF) Hospital was built in Vancouver, Washington, in 1942, followed by a second one across the Columbia River in Vanport, Oregon, a temporary community built for shipyard workers, the following year.

That hospital was kept out of the nearby metropolis of Portland through stiff resistance by the local medical establishment, an example of a contentious relationship that would last many years.

As happened in California, the exodus of shipyard workers after the war forced the Northwest medical care program to expand to the broader community. Ernest Saward, MD, who had administered the wartime health care plan for DuPont plutonium workers at Hanford, Washington, became the medical director of the physician group and the Northwest health plan in 1947.

Changes after World War II

Dr. MacMillan explores some of the fractious cold-war dynamics of the medical partnership at that time, including debates about how KP internist Charles Grossman’s political activism was affecting the medical group’s relationship with the community.* (See note below.)

Beaverton (Oregon) medical office building groundbreaking, June 1968

By 1950 relationships had deteriorated to the point that Edgar Kaiser (Henry J. Kaiser’s son) fired them all and formed a new partnership. Dr. MacMillan details other challenges to the Northwest region, including its struggle for legitimacy with the American Medical Association and ostracism by private practitioners.

The first major postwar facility in the Northwest was the Bess Kaiser Hospital in Portland, completed July 7, 1959. (There would not be another until the 1975 Garfield-designed Sunnyside Medical Center at Clackamas, Oregon). Named for Henry Kaiser’s first wife, the state-of-the-art facility featured air conditioning, telephones and televisions in every room, pneumatic medical records delivery, and a drawer bassinet allowing newborns to slide through the wall between mother’s room and the nursery.

Tumultuous times for KP Northwest medical group

The Kaiser Permanente health plan expanded into Hawaii in 1958, and the Northwest physicians played a significant role in helping that region survive a rocky start. Dr. Saward was called out to apply his management skills when friction within the physicians group exploded. Dr. MacMillan explains some of the complex background that led to the struggle, and he chronicles the eventual maturation of the region.

Frank Stewart, administrator; George Wolff, architect, Dr. Wallace Neighbor (pointing); Northern Permanente Foundation Hospital, circa 1942.

A large portion of the book is devoted to the history of various medical specialties of the Northwest medical group, detailing medical arcana more likely to be of interest to practitioners than a lay audience.  The last three chapters trace significant chronological events in the region from the 1970s to the present.

Among these topics are the challenges of recruiting and retaining good doctors (he outlines the need for robust medical infrastructure, clear work policies, and adequate pay), the deep impact of the 1988 nurses’ strike, and the erratic steps taken by KP to institutionalize an effective electronic medical record system.

In all, this is a much-needed historical survey of a major region in the Kaiser Permanente constellation. Dr. MacMillan does not shy away from exploring awkward and complicated events in the Northwest Permanente history, and he writes with an insider’s viewpoint that enriches the accounts.

Permanente in the Northwest should be of interest to anyone interested in modern American health care policy, health practice, and the broader history of medicine.

Permanente in the Northwest
Ian C. MacMillan, MD, The Permanente Press, 2010
313 pp, with illustrations, bibliography, and index
To order the book, go to permanentejournal.com

KP Northwest historical materials brought to Oakland

Preservation of the rich history of Kaiser Permanente’s Northwest Region (KPNW) got a boost at the end of 2011 when staff of the national Heritage Resources department in Oakland packed up over 100 cartons of Northwest photographs, clippings, newsletters, and files to fold into the KP archives. These materials will be selectively processed over time and added to the existing collection, greatly enhancing our research capacity. The photographs accompanying this review were drawn from that collection.

Special thanks to KPNW Community Benefit and External Affairs staff Jim Gersbach and Mary Ann Schell for their help.

 

*After leaving Permanente in 1950 Dr. Grossman continued to practice medicine privately, and his political activism continued throughout his life (a path respectfully footnoted in MacMillan’s book in his Afterword titled “What Happened to the Pioneers?”). He was arrested in 1990 during a peaceful demonstration organized by Physicians for Social Responsibility, challenging the presence of a nuclear-armed battleship berthed near the Portland Rose Festival. His court testimony describes the scene:

“I was standing silently with several other doctors and a few others with a sign in my hand saying ‘Rose Festival is a fun time, we don’t need nuclear weapons.’ About 2:30 p.m. three or four policemen approached and asked us to leave. I asked why and was told that we have no right to stand in a city park carrying a sign. . . I put my sign down and said ‘O.K. I am not carrying a sign.’ His response was that if I did not leave within 30 seconds I would be forcibly removed. I said we were creating no disturbance and again asked why such a confrontation was necessary.  While I was writing [down his badge and name] my two arms were forcibly seized, forced behind my back and handcuffs were applied.”

 

 

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Empowered women shape modern maternity care

posted on June 19, 2011

By Laura Thomas

Heritage correspondent

First of two articles

Nurse tends newborns in the Oakland Permanente hospital during World War II

Seventy-five years ago, two-thirds of American women gave birth at home with no painkillers, often attended by a family doctor, as the tradition of relying on midwives and practical nurses was falling away.

The practice of modern obstetrics was on the rise and the trend toward the majority of births occurring in hospitals was just around the corner as the American Medical Association met in Kansas City in May 1936 and hotly debated the benefits of new childbirth analgesics and how far to go in relieving the pain of childbirth.

According to Time Magazine, Dr. Gertrude Nielsen of Norman, Okla., denounced such pain killing innovations as twilight sleep – a combination of morphine and scopolamine – and a synergistic anesthesia accomplished by injecting a mixture of morphine and Epsom salts into the muscles and introducing a mix of quinine, alcohol and ether in olive oil into the rectum.

“An analgesic that is perfectly safe for both mother and child has not been discovered,” she told the convention. She asserted that fear of childbirth contributed to pain and called for prenatal education to reduce fear: “That is the modern physician’s duty.”

Part of the tumult over the issue had been provoked by articles in the press describing these new drugs and their use. Dr. Buford Garvin of Kansas City observed: “American obstetrics seems to be becoming a competitive practice to please American women in accordance with what they read in lay magazines.”

Childbirth trends change dramatically in the 1960s and 1970s

We could fast-forward to the 1950s when hospital childbirths had become the norm, the pain of the experience was reduced by epidural anesthesia and women relinquished control over the process to the physician. When Dr. Sidney Sharzer joined Permanente in Southern California in 1956, he became an early proponent of change.

During prenatal consultations Sharzer encouraged women to consider breastfeeding, advice which ran counter to the then-popular American pediatric practice of giving “modern” formula.   At the University of Toronto, where he received his degree, breastfeeding was still considered preferable: “It provided early immunity and was just the right formula in that there were no problems with digestion and it was the right temperature,” he said.

Formula was seen as a convenience, especially for many women who remained in the workforce after World War II, and it allowed fathers to take part in infant care. It was also heavily promoted by the cereal companies who manufactured it. Most of Sharzer’s patients were bombarded “with a lot of propaganda, or advertising, as we call it,” he said, and resisted his advice. “If you bottle-fed, you were liberated. And, in those days, you were not going to whip out your breast at a shopping center.”

“Liberated” women demand natural childbirth

Mother and baby "rooming in" in Kaiser Permanente's Walnut Creek hospital 1953

Ironically, it was the “liberated” women of a later era who demanded a more natural approach to childbirth and support for breastfeeding. Those whispers from the 1930s questioning drug use were getting louder.

“The mid-1960s and early 1970s saw a wholesale consumer revolt against highly structured, hospital-centered prenatal care,” Sharon Levine, MD, Northern California Permanente Medical Group executive, testified before a U.S. Senate committee in 1995. “Rooming in became commonplace. Home deliveries returned. Nurse midwives, who had all but disappeared from the American health system, became increasingly commonplace.

“Maternal-infant bonding became recognized as an essential part of postnatal care. Breastfeeding of infants made a dramatic resurgence,” she said in her testimony against a law to dictate length of hospital stay for new mothers.

Some innovation had already occurred at Kaiser Permanente. In the mid-1950s at Permanente founding physician  Sidney Garfield’s behest, the “rooming-in” program began at new facilities in San Francisco, Walnut Creek and Los Angeles. In these early “dream hospitals,” the nursery had been built adjacent to the maternity rooms with slide-through drawers for the babies to be passed in from the nursery through a soundproof wall.

The baby-in-the-drawer configuration allowed a mother to pull the baby into her room to nurse and hold her child as long as she desired. “It keeps mother and baby closer together. Nurses are able to help the new mothers learn better how to care for their infants,” said a Kaiser Permanente newsletter of the era. Most hospitals of the time kept newborns separate from their mothers, under the care of the nursing staff, except for feeding times. 

Bringing dad into delivery room

Around 1961, when he took over as chief of service at Harbor City Hospital, Sharzer made a couple of bold moves. He decided to bring fathers directly into the birthing room, and he began to encourage women to use the “prepared childbirth” techniques. He was inspired by British doctor Grantly Dick-Read’s book, “Childbirth without Fear,” which advocated the use of breathing techniques to minimize pain and increase the joy of the experience.

Lamaze breathing techniques were introduced in the U.S. by Marjorie Karmel after she gave birth in France assisted by Dr. Fernand Lamaze, who developed his techniques based on Dick-Read’s. She started an organization in 1960 – now Lamaze International – that currently focuses less on birthing methods and more on achieving a natural childbirth without drugs or technological intervention.

Sharzer remembers his struggle to get these ideas accepted: “The consumers were pushing for it and it was the right thing…husbands should see what their wives are going through.” At the time, fathers were ushered into a waiting room or went home to await a phone call and while some were thrilled to be invited to watch the process, others were less so. The nurses would good-naturedly chide a reluctant father. “They’d say he was a lousy husband to desert his wife at a time like this. They would appeal to his better nature and then insult him,” Sharzer said.

Outside of Harbor City, it was an uphill fight. When Sharzer first suggested the notion to his colleagues at the five other Permanente Southern California facilities, he was voted down 5 to 1. There was a lot of hostility from both doctors and nurses who assumed the fathers would try to get in the way by second guessing the medical staff, he said. But even their resistance couldn’t stop the forces of history. Fathers were finally allowed in delivery rooms at all Southern California facilities by the end of the 1960s.

Sharzer moved on to West Los Angeles in the 1970s and became assistant medical director: “It gave me the opportunity to be innovative.” There, he was able to inspire younger and more progressive doctors to go along with the trend toward treating childbirth as a natural process.

Natural birth after C-section?

Sharzer questioned the long-held “once a cesarean, always a cesarean” policy after he observed countless women scheduled for cesarean arrive at the hospital late in labor and give safe births. “If it’s that dangerous, how come these women come in and two minutes after they hit the bed, the baby comes out naturally?” he said.

Doctors feared that the vertical incision made through the large uterine muscle would rupture during contractions and for years women who had had a cesarean were discouraged from having subsequent vaginal births. But an innovation – the transverse incision made across the lower belly – was introduced that reduced the likelihood of rupture and more doctors began to experiment with allowing women to try vaginal births, under close monitoring.

A five-year study of vaginal births after cesarean deliveries in multiple hospitals showed that reverting to a natural birth process could be successful for many women. “Kaiser Permanente conducted the definitive study concluding that vaginal birth after a prior cesarean section is possible and safe … vaginal births are generally safer and less expensive for the mother and infant,” Permanente’s Dr. Levine told senators.*

Sharzer recalls:  “A doctor had to be present all the time and there was a lot of resistance” among the general obstetrical crowd, but at Kaiser Permanente, vaginal birth after cesarean, known as VBAC, was easier to implement because a doctor was always on duty in the maternity ward. “In our setup, it was very good and we were one of the early ones to do VBAC.”

Nurse practitioners deliver prenatal care

In those years, Sharzer also helped establish the first program in Southern California for training nurse practitioners at Cal State Los Angeles and when they graduated, he hired them to work under supervision assisting the doctors with prenatal care.

Retired since 1993, after delivering some 7,000 babies at Harbor City and West Los Angeles, Sharzer attributes the tremendous change in maternity care since 1960 to the Civil Rights Act of 1964: “It also changed the philosophy of equality…and that applied to women in our society.  It had a lot to do with female power.” 

That piece of legislation guaranteed equal rights to women as well as African-Americans. But women, especially those active in the civil rights and anti-war movements, found themselves relegated to supportive roles to male leadership and many split off and created the feminist movement, founding the National Organization for Women, among others. Health care and childbirth became a major arena in women’s struggle for equality and power over their lives.

Next time: How Kaiser Permanente responded to member demands for shorter postpartum hospital stays.

*Flamm BL, Newman LA, Thomas SJ, Fallon D, Yoshida MM. Vaginal birth after cesarean delivery: results of a 5-year multicenter collaborative study. Obstet Gynecol 1990: 76(5 pt 1):750-4.

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Nurses begin quest for professional recognition after World War II

posted on April 30, 2011

By Ginny McPartland

First in a series

Having played a significant role in the Second World War, trained nurses came home in 1945 expecting to be given the respect they earned in the armed forces. Many women had distinguished themselves by saving lives in combat zones, and many achieved the rank of officer.  

Nurses pose on the lawn of the Permanente Oakland hospital during World War II

Like other underappreciated groups who came home to a seemingly unchanged society, nurses were discouraged and hesitated to pursue their chosen profession due to low pay, low status and poor working conditions. Many nurses chose to be waitresses or factory workers where they could make more money and work more reasonable hours. The exodus from the nursing profession created a shortage of qualified nurses, which would intensify in later years.  

Home-front nurses had been content to work without making demands during the war emergency. But after the war, they wanted more. Alameda County nurses had affiliated with the California State Nurses Association (now California Nurses Association or CNA) in 1941 and relied on the association to represent them to East Bay hospitals administrations. But in 1945 these nurses realized that the statewide association had not been effective in bringing them better pay and working conditions.  

The association had developed employment guidelines for the benefit of nurses, but the association had no power to force hospitals to follow the voluntary rules. The East Bay Hospital Conference, made up of administrators from 12 hospitals, adopted a “Statement of Policy” regarding nursing issues in 1941, and dropped it after the war emergency was over.  

Alameda County nurses form their own guild 

Major Edith Aynes, a recruiter from the Army Nursing Corps, gave force to the East Bay nurses’ argument that their profession deserved a better status. Quoted in the San Francisco Chronicle in 1946, Aynes spoke about the military model of the registered nurse as someone who performed patient care, while other untrained staff performed peripheral menial tasks.  

“Instead of taking temperatures, serving (food) trays, making beds and carrying bath water, the nurse is free to change dressings, give medications, care for sick patients and in general supervise the entire ward,” Aynes said.  

Article published in the San Francisco Chronicle in 1946

Alameda County nurses took Aynes’ message to heart and decided to form their own nurses union in November of 1945. “The objective of the guild will be to establish standards relating to salaries, personnel practice and conditions of employment and to maintain an economic security program for registered nurses, members of the guild,” Kathleen Koepke, president of the guild, told the Oakland Tribune.  

In March of 1946, the guild asked the U.S Conciliation Service to recognize the guild as bargaining agent for the nurses in negotiations with the East Bay hospitals. In April of 1946, guild members voted to affiliate with the Public Workers of America (PWA) and the CIO (Congress of Industrial Organizations), a federation of unions. This was at the same time the CIO and AFL (American Federation of Labor), then separate groups, were fighting in Sacramento over political endorsements for state offices.  

Guild appeals to public for support 

Soon after joining the CIO, the guild began a public relations campaign to win community support for their demands for better pay and working conditions. “You Needed the Nurse…Now the Nurse Needs You” was the title of the pamphlet the new Nurses’ Guild of Alameda County’s leaders developed and delivered to 8,000 trade unions, teachers, doctors, dentists and other professionals in Alameda County.  

In the pamphlet, the nurses laid out their demands: “The immediate goal of the Nurses’ Guild is a collective bargaining contract that will guarantee the nurses a decent wage, reasonable amount of leisure, and fair working conditions …living symbols of our American Way of Life. Standing united, the nurses are determined that, no matter how long it takes, the hospitals must finally recognize the justice of the nurses’ case by signing the contract.  

Alameda County Nurses' Guild circulated this pamphlet in 1946.

“The nurses’ requests are for your protection!” the pamphlet declared, appealing to the public’s self interest in quality care. Specifically, the guild was asking for a better salary (minimum of $200 a month), a 40-hour work week, down from the standard 48-hour week for nurses, designated holidays, vacation with pay, reasonable sick leave with pay, adequate maternity leave, pre-employment and annual health examinations, protection under the Social Security Act and protection under the Unemployment Insurance Acts. The nurses also demanded the right of collective bargaining through “organizations of her own choosing without discrimination or intimidation and a job as an American Citizen, regardless of race, religion, color, ancestry or national origin.”  

The guild leadership invoked the words of a prominent economist of the time, Varden Fuller, to bolster their case: “There will be no real end to the shortage of nurses in Alameda County until nurses can be guaranteed decent working conditions in hospitals,” Fuller was quoted in a guild press release. “It’s no wonder that so small a percentage of nurses coming out of the armed forces are returning to hospital work. A nurse can go to work in a warehouse or a cannery and earn as much or more money as in a hospital.” The nurses augmented that claim in the pamphlet, declaring that a woman paring and peeling in a cannery made $202.50 and a grocery clerk made $241 per month, while nurses were making $175.  

KP’s chief physician Sidney Garfield makes history by signing first nurse contract 

The Nurses’ Guild leaders urged the public to write to the hospitals and “let them know you’re in complete sympathy with the nurses’ just requests.” On the list of hospitals whose nurses had voted to be represented by the guild was the (Kaiser) Permanente Foundation Hospital at Broadway and MacArthur in Oakland, the first Permanente hospital, opened in 1942. Permanente administration distinguished itself by being the only hospital representatives that allowed a secret ballot for its nurses to select an organization to speak for them in labor negotiations. Sidney Garfield, MD, Permanente’s founding physician, was also the first to sign a collective bargaining contract with the newly energized nurses’ organization.  

The nurses’ initial campaign for labor representation came to a close on August 1, 1946, with the announcement of Garfield’s signing. “Permanente’s historic contract gives working nurses a 40-hour work week for the first time in Alameda County hospitals,” the Guild press release stated. “Besides reducing the former 48-hour work week to 40 hours, the Permanente agreement raises the former basic wage of $175 to $185. The basic rate will go up to $190 on October 1 and $200 monthly on January 1, 1947.” Meanwhile, the California State Nurses Association was negotiating with other East Bay hospitals. Spokeswoman Edna Behrens told the Tribune their contracts called for a 44-hour work week beginning July 1 and a 40-hour week as of January 1, 1947. She said the shortened week would not mean a reduction in the minimum salary of $200 per month.  

While nurses felt empowered after the war to pursue higher positions in the field of medical care, not everyone was anxious to embrace them in new roles. A case in point is neurosurgeon Howard Naffziger, who spoke in 1947 at a two-day conference of the Association of California Hospitals at Hotel Claremont in Oakland. “Highly specialized nurses should be called something else, because they have specialized themselves right out of the care of the sick.” He said nurses could learn all they needed to know in two years, or even one year of training. “The needs of the public for nurses exceed the ability of the public to pay,” the renowned neurosurgeon said.  

Marguerite McLean, then superintendent of nurses at Highland Hospital and later director of the Permanente School of Nursing, countered his remarks: “Doctors …have had to spread themselves so thin that one wonders what would happen if nurses hadn’t been qualified to step in and take care of the situation,” McLean told the Oakland Tribune. She added that even the practical nurse with less training would need a living wage, which would have to be close to the $200 basic monthly pay of the trained nurse. “Nurses feel they are best qualified to know and understand nursing requirements.”  

(Next time: In 1966, Kaiser Permanente nurses stage first work action in California history.)

For more on Kaiser Permanente nursing click here.

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Health care coverage for workers’ families didn’t come easy

posted on January 16, 2011

By Ginny McPartland 

Affordable health care was an elusive commodity in 1930s America. Medical practice was becoming more sophisticated, and qualified doctors were in great demand. Consequently, private professional care was out of reach for many Americans. Employer-sponsored health plans started to spring up in the late 1930s and early 1940s, but even those progressive prepaid plans were slow to add workers’ families to the coverage.  

In 1944, during World War II, the issue of family health care reached a critical point on the West Coast. War industry yards and plants were frantically producing ships, aircraft, tanks and other war materiel; thousands of migrant workers and their families flooded rapidly expanding communities. Many workers were sick when they arrived, and many became injured as they worked at breakneck speed to meet production deadlines. 

Permanente medicine, developed by industrialist Henry J. Kaiser and enterprising physician Sidney Garfield, was launched to take care of workers in Kaiser’s West Coast shipyards. The two had done this before: Garfield had set up a prepaid plan for workers on the Los Angeles Aqueduct project in 1933, and he and Kaiser had teamed up to care for workers at the Grand Coulee Dam in Washington state in the late 1930s. 

The Kaiser-Garfield prepaid, group practice plan for shipard workers was progressive and exemplary by all accounts. Unlimited medical care for the individual workers was provided for 50 cents per week. But Garfield and his doctors had their hands full, so initially only the worker – not the family members – was covered by the health plan. 

Young patient seen in Fontana Kaiser Steel plant clinic

Stuart Lester of “Medical Economics,” writes in the February 1944 issue: “The principal threat to the permanence of the Permanente Foundation – which provides virtually unlimited medical care for 130,000 Kaiser shipyard workers in two states* is the workers’ complaint that it makes no provision for their families.” 

The article continues: “The family problem is especially acute in the shipyard town of Richmond, Calif., where the ratio of physicians to population is something like 1 to 4,000 and where the only hospital facilities of any consequence are those provided by Kaiser’s Richmond Field Hospital.” 

In Richmond, Portland (Oregon) and Vancouver (Wash.), nonsubscriber family members were treated for a fee.  Office visits were $2.25. For maternity, $200 covered prenatal care, delivery, hospitalization, C-section if required, postnatal care, and care for the newborn. Employees at the Kaiser Fontana steel plant in Southern California were the exception. In 1944, Fontana workers could purchase complete coverage for a family of four for $1.80 a week. 

Physicians debate how to cover families 

“Medical Economics” writer Lester refers to three possible solutions proposed at the time: an expansion of the Permanente plan to include family members; an expansion into the Richmond area by the California Physicians’ Services (CPS) prepaid plan as operating in other war industry communities; or the development of a prepaid arrangement for families through a private physician network. 

The California Medical Association (CMA) launched the CPS in 1939 to offer prepaid care to low-income families in California. Initially, the physicians association’s plan offered a “full coverage contract” that included all outpatient physician services. In 1942, CPS excluded the first two doctor visits from coverage to make the plan financially viable, according to the April 1943 issue of the CMA’s “California and Western Medicine.” In 1943, CPS, the precursor to Blue Shield, had 39,000 commercial members, 5,100 government rural health program subscribers and a total of 32,000 war housing resident members in Vallejo, Marin, Los Angeles and San Diego. 

Permanente Richmond Field Hospital

“Dr. Sidney R. Garfield, Kaiser’s medical director, sees two obstacles to an extension of his program to include families: One is opposition by the local medical societies. The other is lack of facilities – particularly in the hospital at Richmond,” Lester wrote in “Medical Economics.” The article noted that expansions of the Richmond Field Hospital and the Permanente Foundation Hospital in Oakland were under way. 

The second proposal – having CPS provide family coverage for Richmond area workers – had been tried previously and failed. In 1942, CPS  had offered a family plan in nearby El Cerrito and was not able to attract enough members. The coverage for non-Kaiser workers was enticing: a $5 flat fee no matter how many family members. It wasn’t practical for Kaiser employees, however.  To take advantage of the CPS plan, a worker would have to buy his or her own coverage for $2.16 a month and then pay $5 for the rest of the family. 

According to the “Medical Economics” article, solving of the family care issue by fee-for-service doctors was doomed from the beginning.  A shortage of private doctors and inadequacy of medical facilities made any such plan unfeasible.  Also, California private practice physicians were admittedly just tolerating the Permanente model of prepaid, group practice with salaried physicians. One private doctor told the magazine: “The Kaiser-Garfield groups are doing a job right now that is aiding the war effort, and are doing it well. But we don’t like their system.” 

Kaiser extends coverage to shipyard families 

In the spring of 1945, the Permanente medical plan, now with expanded facilities to accommodate more members, was extended to the families of all Kaiser shipyard workers. “Medical Economics” reported the details of the Permanente family care plan: for $117 a year ($2.25 per week) for a family of four, coverage was extensive. It included 111 days of hospitalization, complete diagnostic services, necessary drugs, physician services at home or medical office, major and minor surgery, and ambulance service within a 30-mile radius. Members paid an extra charge of $60 for comprehensive maternity care, $15 for a tonsillectomy and $2 for a house call. 

“Medical Economics” concluded the article with this statement: “Insurance men pointed out that the total annual cost for a family of four, $117 a year, is an amount which has generally proved to be too high for any wide participation on a voluntary basis.” 

Workers who left the shipyards could maintain coverage for a “slightly higher” premium as long as they continued to live in the service area. This retention provision foreshadowed Kaiser and Garfield’s plans to keep the Permanente medical care plan alive after the war industries shut down. 

*Kaiser shipyards health plan actually took care of workers in three states, California, Washington and Oregon, and enrolled up to 190,000 members at the peak of the war.

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Laid-off shipyard workers dilemma: Should I stay or should I go?

posted on December 22, 2010

By Laura Thomas    

(Second of two articles)     

Lon Van Brunt Kaiser Richmond Shipyard worker 1945 from "Fore 'N Aft" newsletter

As the holiday season of 1945 approached, Kaiser shipyard workers faced an uncertain future on the West Coast. Interviews with workers in the “Fore ‘n’ Aft,” the Richmond shipyard newsletter, reflected some anxiety: “What do I think about the end of the war?” said laborer Lon Van Brunt. “Let’s study about that: I look for it to be hard times.”  

The local press reports, often tinged with sentimental hope, insisted that the Dust Bowl migrants were tossing mattresses back on their cars, packing up pots and pans and leaving wartime housing in droves.  

“Many couldn’t wait to get ‘back home’ after the war, but they found they didn’t like it back there anymore,” said native Richmond resident Marguerite Clausen in 1985 in an interview conducted with Judith Dunning for the Bancroft Library’s Regional Oral History Office. “They turned around and came back again. And they brought all their families with them.” *

Bernice Rarick, Portland shipyard worker, 1945, from "Bosn's Whistle" newsletter

Bernice Rarick, a Portland worker reflected that ambivalence when she told the “Bosn’s Whistle,” the northwest Kaiser shipyard newsletter, she was going right back to her ranch in Idaho yet wondered, “It doesn’t seem possible that everyone can go back to normal living again.”    

Transplants try to find their place    

The women were the first to go despite the fact that some 70 percent in a December 1944 Yard Two survey said they wanted to work. Black migrant workers also struggled to find new employment with the unemployment rate for black men in 1948 about 15 percent, three times the state average.    

“News came over that the contracts were cancelled, and that was it,” recalled Margaret Cathey who came from Iowa and worked as a welder. “You didn’t get two weeks notice or anything like that, no. You were just finished.” She was lucky because she found a job with the telephone company, anxious to hire women operators.    

A welder at the Kaiser shipyards, Willie Stokes earned $10 a day but, after the war, was only able to find unskilled labor at $6 and was unemployed by 1947. “One day you are an essential worker in a vital industry and the next you were a surplus unskilled laborer essential to no one,” he said in an article, “Willie Stokes at the Golden Gate,” by Cy W. Record published in “The Crisis Magazine,” June 1949.    

It took a while for many ex-shipyard workers to find their footing. In an article in “Salute Magazine” in June 1946, writer William Hogan called Richmond, “hangover town” because so many were still living there or had returned in hopes of finding work.    

Mostly from rural areas with ways that seemed backward, these workers and their families had been lifted out of poverty working for Henry Kaiser and were destined to prove themselves, especially to long-time Richmond residents.    

The Richmond Field Hospital continued to serve Permanente patients after the shipyards closed in 1946.

“I said, ‘Well, here these people are. They’re not going to leave here. This is Mecca,’ ” recalled Clifford Metz, a former Richmond school official who had insisted the notion that the migrants would go back was an illusion.    

“I think we went down maybe ten or fifteen thousand people in a short time. Most of them, well, they had learned that they liked it here. Some of them, with the money they had, they could invest. They were not unintelligent people.”    

Selena Foster, who came from Fort Worth, Texas, in early 1944, and her husband, Marvin, were among those with that precise idea.  “My husband said to me, ‘We have no home to go back to.’ We had a little money and we found property was fairly reasonable if you could find something to buy,” she said in 1992.    

The Fosters did make a trip back to East Texas in a shiny new car that made quite an impression on their family, but they returned to Richmond and within months had bought a home on Hoffman Boulevard and 29th Street, one of the first African-American families to do so after the war.    

The uncertainty of that holiday period 65 years ago was soon eased by a postwar economic boom in both the Bay Area and the Northwest. The upturn raised the fortunes of many who arrived back then with little but hope. Over the decades they have become woven inextricably into the cultural fabric of both regions.    

*Marguerite Clausen, “A World War II Journey: From Clarkesdale, Mississippi, to Richmond, California, 1942,” an oral history conducted in 1985 by Judith K. Dunning, Regional Oral History Office, The Bancroft Library, University of California, Berkeley, 1992.

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Promise of jobs attracts wartime workers to West Coast shipyards

posted on November 25, 2010

By Ginny McPartland

In the fall of 1942, thousands of New York area workers boarded Kaiser Shipyards recruiting trains in Hoboken, New Jersey, heading for Oregon.  Around the same time, thousands of job seekers were catching trains from the South and the Midwest bound for Richmond, California. Still others uttered a hopeful prayer as they started up their jalopies or farm trucks and headed west. Looking to change their lives for the better, the skilled and unskilled took a chance that the West Coast dream was not an illusion.

They were leaving their hometowns where recovery from the Great Depression was elusive. If they had jobs, the pay was low. Many were deep in debt and saw higher pay in the World War II shipyards as a way to heal their ailing finances. Some were young and saw no future or excitement in their native states.  

Chicago area welders wait for train to Richmond. National Archives photo by Jack Delano.

 Individuals were desperately needed to build ships to help win the war. So it didn’t matter whether you were black or white or Asian or Hispanic – or if you had skills and experience. You could learn on the job, and if you did well, you could improve your position and pay. You didn’t even have to be healthy and strong – and many weren’t. You could seek medical care at the shipyards, and you could purchase the Kaiser Foundation Health Plan, affordable comprehensive, prepaid health care for yourself and your family.  

The shipyard life wasn’t all hearts and flowers. Worker housing was inadequate, and communities were overwhelmed with newcomers.  But for many workers, migration to the West Coast opened up a new, optimistic world.  

Mississippi mother of 11 becomes shipyard welder  

Lucille Preston, reared in Clarkesdale, Mississippi (near Memphis, Tennessee), is a case in point. She first went to work on a plantation at age 12 or 13 babysitting for the wealthy owner’s children. Eventually, she cooked for the family every day and served at their elaborate parties. The generous family hosted her wedding when she married a man whose parents worked for the same prominent family.  

When the couple’s six child was on the way, Preston’s husband, Willie, caught the California bug. “My husband just came home one evening and said that there was work in Richmond, California. ‘They’re opening up the Kaiser Shipyard, and I would like to go.’ So I said: ‘Why sure,’ ” Preston told Judith K. Dunning, oral history interviewer for a Bancroft Library project in 1985.*  

Unidentified family awaiting a train in Chicago. National Archives photo by Jack Delano.

Willie sent for Lucille when he got an apartment in the war housing. She set out for Richmond on a train, eight months pregnant, carrying her one-year-old with the other four clinging to her skirt. On the platform, a kind conductor shepherded Lucille and her brood through the crushing crowd onto a car bound for California. From El Paso, Texas, to Richmond, Lucille stood holding the baby while the other children settled at the feet of nearby passengers.  

At Richmond, the Prestons settled in their new home, Lucille gave birth and a month later she was working graveyard at the shipyards and learning how to weld. Willie worked swing shift so the two took turns at parenting.  The couple had five more children over the next decade. After the war, Lucille operated a dress-uniform press at Treasure Island where she worked for 20 years.   

Lucille told Dunning her only regret was that the expense of raising eight sons and three daughters kept her from building her dream house. However, most of her children went to college – one daughter has two master’s degrees –and they all have successful careers.    

Government helps young men launch shipyard careers  

Getting to California from other parts of the country seemed a pipe dream for many would-be welders. Kaiser Shipyard recruiters fronted train fare for many who came across the country with nothing. Workers could pay back the loan when they got their paychecks. For young men 16 to 24, the federal National Youth Administration (NYA), established by Eleanor Roosevelt in 1935, collaborated with the Richmond Kaiser Shipyards to make the impossible dream possible.  

The NYA paid for transportation to California. Once in Richmond, the young men were welcomed at the Richmond War Work Residence Center where they lived in dormitories and received two to four weeks of welder training. The pay for a month was $33.30, minus $22.50 for meals, dental and medical care, work clothes and equipment. After the initial period of “confusion, bewilderment and expense,” the men were placed in shipyard jobs, according to the Richmond Shipyard newsletter “Fore ‘N Aft.” By April 1943, the project had placed 1,500 welders in Richmond yards.  

Diversity reigns in the shipyards  

Throughout the war years, the West Coast shipyards attracted all kinds of people from all over the globe.  There were actors, writers, lawyers, cowboys, farmers, housewives, shopkeepers, and doctors. Some were experienced at building ships and others had never seen one.  

Here’s how the “Fore ‘N Aft” described the work force in April 1944: “We are all kinds of people, as you can tell by listening to us – Texas twang and Brooklyn brogue, down east Yankee and Carolina drawl, along with almost every language on earth from Polish to Swedish, from Syrian to Italian. It takes all kinds of people to build ships, just as it took all kinds to build America. Shoulder to shoulder, we’ll come through together.”  

*Lucille Preston, “A World War II Journey: From Clarkesdale, Mississippi, to Richmond, California, 1942,” an oral history conducted in 1985 by Judith K. Dunning, Regional Oral History Office, The Bancroft Library, University of California, Berkeley, 1992.  

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Wartime shipyard child care centers set standards for future

posted on September 29, 2010

Naptime for Kaiser kids

By Ginny McPartland
Child care at the workplace was a brand new phenomenon in World War II. The government-subsidized Kaiser West Coast Shipyards nursery schools, which enrolled more than 7,000 offspring of women war workers, offered the perfect opportunity to test theories of the then-fledgling field of child development.

In 1943, Henry J. Kaiser invited key figures in child development studies to his shipyards to set up ideal facilities and programs so workers could build ships without worrying about the safety and health of their children. These model child care centers at the Kaiser shipyards in Richmond, California, and Portland, Oregon, yielded valuable research results that helped fuel the study of early childhood education for decades after the war.

Catherine Landreth, PhD, of the University of California, Berkeley, set up the Richmond schools program. Lois Meek Stolz, PhD, a child development researcher and author from Columbia University and UC Berkeley, set up the Portland centers. James L. Hymes, Jr., a student of Stolz at Columbia, served as manager of the Portland centers.

Stolz and Landreth continued to exert influence on the child development world until the end of their lives. But it was Hymes, just 30 at war’s end, who would become a prodigious contributor to the child development literature for the next five decades. His work is often quoted today. One such quote reflects lessons from the home front: “Every day-care center, whether it knows it or not, is a school. The choice is never between custodial care and education. The choice is between unplanned and planned education, between conscious and unconscious education, between bad education and good education.”

Early Hymes work discovered this summer

Recently, my colleagues and I unearthed the final report of the two Portland Kaiser wartime child development centers, along with a series of seven pamphlets written for postwar child care providers. We found these documents, mainly written by Hymes, in the Institute of Governmental Studies Library in the basement of UCB’s Moses Hall. They were originally filed in 1946 in the Library for Economic Research at Berkeley.

The series of pamphlets includes: 1) A Social Philosophy from Nursery School Teaching; 2) Must Nursery Teachers Plan? 3) Who Will Need a Post-War Nursery School? 4) Meeting Needs: The War Nursery Approach; 5) The Role of the Nutritionist; 6) Large Groups in Nursery School; 7) Should Children Under Two Be in the Nursery School? Two unnumbered pamphlets titled “Toys to Make” and “Recipes for Foods for Children” were also mentioned in the report but copies are not available in the library. Teachers bought a total of 2,582 pamphlets at 15 cents each, according to the report dated December 1945.

Pamphlets offer nuggets

The pamphlet titled “Should Children Under Two Be in Nursery School?” addressed an issue the child care centers were forced to face head-on during the war. Generally, nursery schools did not take children under 2 because experiments had shown the younger children did not thrive in group settings. But the demand for care for infants was too high in the shipyards to ignore. They agreed to accept children as young as 18 months, and in Oregon alone the centers enrolled 904 children 18 to 24 months of age.

“We therefore set out to plan a program which would include among other things: Provision for close and continuous relation of each child with one adult who would be responsible for him especially during eating, toileting and sleeping and during any time of emotional stress when he needed ‘mothering,’ ” wrote Stolz and Hymes.

Good food for good health

Another key wartime lesson: “Food influences behavior. Small children…have pounded into us in unforgettable ways that hungry people are irritable; that they fight more; that they cry easily; that they become destructive…Some children we have seen, hungrier still, have told us that hunger can make people placid, inactive, lethargic,” Hymes wrote. In pamphlet 5, Miriam Lowenberg, chief nutritionist, discussed the crucial link between food and good health: “The (nursery school) nutritionist (helps) teachers … bring the child who needs medical care to the attention of a visiting nurse or doctor.”

The final report discussed other crucial issues such as: the need for child care services after the war for low-income women, costs of the child care operation including nourishing meals, methods of recruiting and retaining qualified teachers, nurses and counselors, providing weekly onsite professional development, and offering opportunities for staff to participate in policy decisions. Attempts to maintain a 10:1 child-to-teacher ratio for the children over 2 and a 5:1 ratio for the infants 18 to 24 months were mostly successful, the authors reported.

Kaiser experts shine on after war

After the war ended, Hymes gained national recognition as an author. Among his earliest best-selling booklets was “A Pound of Prevention” in 1947, which advised first-grade teachers on how to handle difficult “war babies.” He wrote that the “crybabies, whiners and bullies” were still suffering from the disruption of war. Hymes also wrote “How to Tell Your Child About Sex” (1949), “Behavior and Misbehavior: A Teacher’s Guide to Discipline” (1957), “Teaching the Child Under Six” (1968), and “Twenty Years in Review: A Look at Early Childhood Education 1971-1990.”

Hymes served in the Lyndon Johnson administration on the National Planning Committee for Head Start. He and Catherine Landreth both were instrumental in the development of the educational program for low-income children. Landreth was also known for her groundbreaking research in social perception. One of her studies found that children learn racial prejudice from their parents as early as three years old. She wrote three books that were influential in shaping early childhood education: “Education of the Young Child” (with Katherine H. Read), 1942; “The Psychology of Early Childhood,” 1958; and “Preschool Learning and Teaching,” 1972.

After the war, Stolz published “Father Relations of War-Born Children,” a study of how father-child relationships were affected by a father’s absence for war duty (1954); “Our changing understanding of young children’s fears, 1920-1960” (1964), among other related works.

To learn more about the legacy of child care in the World War II Kaiser Shipyards, visit the Home Front festival Saturday, Oct.2, at the Craneway Pavilion on the Richmond waterfront. Kaiser Permanente Heritage Resources is collaborating with Rosie the Riveter/World War II Home Front National Historical Park to tell the story of the wartime child care centers.

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Mending Lives in the WWII Kaiser Richmond Shipyards

posted on August 28, 2010

by Jacqueline Brown

Jacqueline Brown, Communications Associate in Kaiser Permanente’s Brand Strategy Communications and Public Relations, is a 2010 graduate in Rhetoric and Media Studies from Willamette University, Salem, Oregon.

People from all over the country flocked to Richmond, California, in 1941 to work at the Kaiser Shipyards. Having endured the hardscrabble years of the Great Depression, migrant workers flooded Richmond by the thousands seeking employment in the suddenly booming World War II Home Front economy.

For most of these workers the yards provided a much needed stable income. More than a few arrived in frail health, without family network support, and challenged by economic necessity.  They found a helping hand in the community benefit programs of Kaiser Industries.

Helen Amy Mason in “Welfare Services for Members of the Permanente Plan of Prepaid Medical Care,” a graduate thesis submitted in 1946 to the School of Social Welfare at the University of California, Berkeley, offers a view into the circumstances that challenged many of these workers.

Henry Kaiser visits a shipyard worker at the Oakland Permanente Hospital

Mason describes the hardships and the liberal assistance Henry Kaiser offered through the Department of Employee Welfare of the Richmond Shipyards and the Hospital and Medical Care Program of the Permanente Foundation.

The Department of Employee Welfare provided personal and financial services to those who fell ill or who were injured on the job, especially those without the support of family. The staff made bed-side hospital calls and offered essential meal and child care arrangements, banking, shopping, and transportation services throughout convalescence to recovery.

The Department also administered the “Help a Buddy Fund,” a voluntary community service chest funded through a worker payroll deduction (about 25 cents per week) and distributed according to need for groceries, rent, child care, etc., with no restrictions attached.

The Hospital and Medical Care Program of the Permanente Foundation provided emergency financial assistance to workers who could not meet medical expenses, either because they had elected not to enroll in the health plan, or because they were confronted with circumstances not covered by the plan, long-term hospitalization (the plan provided 111 days) for mental illness or tuberculosis, for example.  The ill or injured breadwinner was often the beneficiary, or his children, the comprehensive “family” plan coverage debuting late in the war effort.

One example is that of a woman who was admitted to the hospital with a heart condition that caused frequent attacks that required numerous and extended hospitalizations for two to four weeks at a time. She was the mother of two children and the sole source of income for her family.  The Foundation covered the cost of her frequent and extended hospitalizations.

The Department of Employee Welfare and The Permanente Health Plan in the Kaiser Shipyards – today’s Kaiser Foundation Health Plan – mended more than broken bones in the Richmond shipyard community. As Dr. Clifford Kuh, a Permanente physician in the Richmond yards, put it: “The distinguishing characteristic of the Permanente Health Plan, besides prepayment, is it’s focus on the community.”

The tradition continues to the present day. Last year, for example, Kaiser Permanente gave a $5.2 million gift to the UCLA School of Public Health to endow the UCLA Kaiser Permanente Center for Health Equity—a center dedicated to improving the health of underserved populations through research, community collaboration and leadership development.

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KP’s ‘Baby in the Drawer’ Helped Turn the Tide Back to Breastfeeding Babies after World War II

posted on August 23, 2010

By Tom Debley
Director of Heritage Resources

Since this is National Breastfeeding Awareness Month, you may have read that Kaiser Permanente believes that one of the most important ways a mother can promote the health of her baby is to choose to breastfeed exclusively.

That’s a position that is based on more than a half-century of tradition that began in the 1950s with Kaiser Permanente as one of the leaders in reversing early 20th century trends that led American women to more commonly bottle-fed their babies.

The story also is one of the most popular in Kaiser Permanente lore: The Baby in the Drawer.

The "Baby in the Drawer" hospital room from 1953 was featured a half century later as a replica in a 2004 Oakland Museum of California special exhibit on the life and impact of Henry J. Kaiser, in this case in co-founding of Kaiser Permanente with Dr. Sidney R. Garfield.

The story begins one evening in the early 1950s when several doctors and their families were socializing at the home of Dr. John G. Smillie, an early Permanente Medical Group pediatrician. Smillie told founding Kaiser Permanente physician Sidney R. Garfield he had read an interesting article about the now famous Yale University School of Medicine research experiments with rooming-in for mothers and babies.

Well, this was a prime example of the kind of innovation Garfield fostered, always scanning the environment for new ideas or research findings and quickly applying them to the care of  his growing Kaiser Permanente patient population.  Garfield was in the process of designing three brand new hospitals for San Francisco, Los Angeles and Walnut Creek. He locked on to the rooming-in idea, adding the Baby in the Drawer.

Garfield did arranged each mother’s maternity room in a circle around an adjacent nursery. A bassinet for the infant was set in an ordinary metal file drawer built into the wall separating the mother’s room and the nursery.

“When the mother wanted to take care of the baby,” Garfield explained, “she’d pull the drawer out and there was the baby. (If) she wanted to put it back in the nursery,  she could put it back in. That was a great hit.”

This allowed a newborn to be adjacent to its mother while also being under the direct supervision of the medical staff. A simple light signal would tell the nurse whether a baby was in the nursery or in its mother’s room.

Because Garfield believed strongly in research and innovation, the Baby in the Drawer proved to be one of the best illustrations of his further belief that these principles could keep care cost-effective, bring better patient outcomes and make Kaiser Permanente a better place to work. The reasons: the Baby in the Drawer reduced an estimated seven out of 10 steps for the maternity nurses, large numbers of mothers chose to breastfeed as a result of the system, and it improved bonding between baby and mother.

That it was, as Dr. Garfield put it, “a great hit” has been borne out by history.

When Ora Huth, an oral historian in the Regional Oral History Office at the University of California at Berkeley, interviewed Dr. Smillie in 1985 as part of a series with Kaiser Permanente pioneers, he told her the Baby in the Drawer story.  Huth interrupted him to announce she had used the Baby in the Drawer system in San Francisco.

“I thought it was such a great idea,” Huth says in the published oral history.
“Now you know where the idea came from,” the late Dr. Smillie responded.
In 2004, when the Oakland Museum of California did a special exhibition on the life of Henry J. Kaiser, co-founder of Kaiser Permanente with Dr. Garfield, it included a life-size replica of the Baby in the Drawer hospital room.

Today, whenever I give a talk about this concept I’m almost always guaranteed that someone in the audience will come up to me afterward to announce, “I was a Baby in the Drawer.” It’s equally likely that the person was breastfed as an infant because Dr. Garfield was helping to turn the tide away from bottle feeding after World War II.
I’m sure Dr. Garfield would be smiling if he could see the Kaiser Permanente News Center website item: Kaiser Permanente’s Care Delivery and Research Support Breastfeeding to Promote Healthy Families.

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Children’s art scholar finds wartime treasure on newsprint

posted on August 10, 2010

By Ginny McPartland

Joe Fischer is no stranger to art. He’s no stranger to children’s art. A Berkeley resident and former UC Berkeley professor, Joe Fischer has written five books on Indonesian art and culture. He spent 25 years visiting and studying Indonesia, and he has been curator of many exhibits on Indonesian traditional art and children’s art.

Joe Fischer with furniture from World War II Richmond shipyard children's art program

Joe Fischer is also no stranger to war. He served in the U.S. Navy in the Pacific Theater during World War II and visited the Japanese cities of Hiroshima and Nagasaki within two weeks after their destruction by Allied atomic bombs.

So when Joe heard about the rich collection of children’s art from the Richmond Kaiser Shipyards child care centers, needless to say, he was intrigued. The more he explored the boxes full of children’s paintings and cut-and-paste artwork preserved at the Richmond Museum of History, the more fascinated he became.

Joe quickly understood the significance of the children’s uninhibited observations of life on the home front. Given the creation in 2000 of the Rosie the Riveter/World War II Home Front national park in Richmond, Joe’s passion for bringing the art to light seemed to hit the right note. Sharing his enthusiasm with the staff of the new park, they agreed the museum had indeed captured a national treasure-trove.

The little noticed collection of 5,000-plus pieces brims with creativity,individuality, emotion and small-child confidence. Joe’s diligent study and interpretation of the art –and the enthusiastic support of the museum board of directors – culminated this summer in the publication of “Children’s Art & Children’s Words.” The book includes 185 color plates of the artwork, as well as direct quotes from the 2- to 12-year-olds about their masterpieces as told to their teachers.

The Richmond Museum of History is hosting a book signing 5 p.m. August 28, at the museum, 400 Nevin Ave., Richmond. www.richmondmuseumofhistory.org.

Focus on individual artists

“The focus (of this book) is on the paintings of individual children, comments by them and their teachers, and the environment in which this took place,” Joe says in the introduction. “The child care program in all its various aspects was an extraordinary educational model. It provided care, nurture, materials, and creative outlets for thousands of children. Such a comprehensive child care program had probably never existed in the United States before the war nor has one been developed since, he adds.

The children’s art collection, which includes pieces from 1943 through 1966, only exists due to the foresight of the late Monica Haley, longtime art director of the child care centers. She retained the children’s work and their comments conscientiously, realizing their historical value. Subsequent to her retirement in 1966, Haley donated the entire collection to the Richmond Museum of History. Richmond’s child care centers’ art created after that date has been lost to history. Joe devotes a whole chapter of the book to Haley.

Veronica Rodriguez, Isabel Jenkins Ziegler, and Pavlos Salamasidis of the Rosie the Riveter/World War II Home Front National Historical Park with child's art easel from World War II Kaiser Shipyards child care center

Kaiser child care breaks new ground

The Richmond child care program began in 1943 through the collaboration of Henry J. Kaiser, the U.S. Maritime Commission and the Richmond school district. Kaiser, who ran the shipyards, saw the critical need for high quality, around-the-clock care for the children of mothers working on ships. Although society had frowned on mothers working outside the home, the war urgency put that attitude on hold.

Kaiser worked through the Maritime Commission to obtain funds to build and subsidize the centers, and the school district received federal funds. The Lanham Act set up wartime funding to help war production communities, like Richmond, accommodate ballooning populations. The federal money earmarked initially for fire stations, roads, schools, and other local services, was also approved for construction and operation of child care centers.

The Richmond child care program had 14 sites during the war years. Set up by the best child care experts of the time, including Catherine Landreth, PhD, of the UC Berkeley Institute of Child Welfare, the program was groundbreaking. The buildings were thoughtfully designed to make the environment comfortable and healthy for children.

The routine included a health check, nutritious meals planned by a dietitian, plenty of rest, outside play, and lessons in art and music. There were sleeping rooms for naps and overnight stays, child-sized sinks and toilets, lockers, and a sick room to isolate ailing students. The school district took care in making the experience educational and stimulating. For all this, the parents paid 50 cents a day, 60 cents if they had breakfast.

Bubble bursts when war ends

After the war, the shipyards closed and the federal funding for child care centers dried up. But there were still many women in Richmond and many other places who wanted or needed to continue working. So the Richmond community lobbied the federal and state government to continue the funding. They were successful, and California became one of only few states that continued child care after the war.

Maritime Child Development Center, 10th and Florida in Richmond, to be restored for use as school and museum

At the same time, the Kaiser Shipyards child care programs in Portland, Oregon, and Vancouver, Washington, shut down completely. The Northwest child care centers, also influenced by UC Berkeley child development experts, did not have the community support needed to keep them open. However, experience in these child care centers contributed invaluably to the study of child development, and the legacy informs current practice.

The Richmond schools continued to operate preschools on essentially the same wartime principles until around 1967.   A variety of federal, state and local funding sources, including Head Start, have continued a semblance of the program to the present.

One of the original Kaiser-built centers, the Maritime Child Development Center at 10th and Florida streets in Richmond, has been designated a national historical landmark. Renovation of the center is under way, and Rosie the Riveter/World War II National Historical Park museum curators are collecting and interpreting historical artifacts, such as furniture from the original wartime program. The center, to house classrooms and a National Park Service museum, is scheduled to open in 2011.

The Richmond Museum of History also operates the restored SS Red Oak Victory, a World War II ship built in Richmond and docked at the Rosie the Riveter national park. To find out more: ssredoakvictory.org.

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