Winneshiek County Public Health is celebrating its 75th anniversary from 11 a.m.-4 p.m. Friday, April 5, at its offices on the third floor of the Smith Building in Decorah. The Winneshiek County Public Health Nursing staff includes, from left, front row: Brett Mumford, Krista Vanden Brink and Nancy Sacquitne; middle row: Sally Herold, Penny Herold, Eunice Veeder and Karla O’Connell; and back row: Keri Sand, Lois Frana, Julie Goedken, Marian Henry and Nancy Olson-Folstad. Not pictured, Cheryl McConnell and Selina Quandahl.
Winneshiek County Public Health is celebrating its 75th anniversary from 11 a.m.-4 p.m. Friday, April 5, at its offices on the third floor of the Smith Building in Decorah. The Winneshiek County Public Health Nursing staff includes, from left, front row: Brett Mumford, Krista Vanden Brink and Nancy Sacquitne; middle row: Sally Herold, Penny Herold, Eunice Veeder and Karla O’Connell; and back row: Keri Sand, Lois Frana, Julie Goedken, Marian Henry and Nancy Olson-Folstad. Not pictured, Cheryl McConnell and Selina Quandahl.

Public health.

It touches every aspect of our lives. This week the agency that looks out for the wellbeing of all county residents celebrates its 75th anniversary.

"We take ownership for the health of all of them," said Krista Vanden Brink, Winneshiek County Public Health administrator since 2003.

Winneshiek County Public Health will host an open house at its offices from 11 a.m.-4 p.m. Friday, April 5, in conjunction with National Public Health Week (NPHW), a time set aside to recognize the contributions of public health and highlight issues that are important to improving the country.

The theme for NPHW is "Public Health is ROI (return on investment): Save Lives, Save Money."

"The 2013 NPHW theme was developed to highlight the value of prevention and the importance of well-supported public health systems in preventing disease, saving lives and curbing health-care spending," the NPHW website said.

"It's a time to showcase several different things and for the public to learn more about the programs we have for people that improve their health and keep people at home. There's a time and place for (nursing) facilities, but it's proven that it's more cost effective (to stay at home) than going into a facility," Vanden Brink said.

"People don't realize the services we have until they need them," she added.



TB

Winneshiek County Public Health was formed 75 years ago to deal with tuberculosis. At the time, Winneshiek County had the highest per capita rate of TB infection, but it still took two meetings with Winneshiek County supervisors to convince them a public health nurse was necessary.

"We're still dealing with it today. It hasn't gone away," Vanden Brink said of TB.

"It's gone full circle. A number of immigrants we're seeing are from other countries where TB is still a major health problem," said county Public Health Nurse Nancy Sacquitne.

In the early 1900s, Christmas Seals were sold by school children around the country to raise money for research and cure of "consumption" or TB, which was responsible for one in every seven deaths in the United States.

In Iowa, each county had a Christmas Seals chairperson who handled distributing the Seals to all the schools in the county and collecting the funds raised. After the fourth chairperson resigned in 1937, a county superintendent, along with a field representative of Iowa State Tuberculosis Association, contacted a group of concerned and influential citizens from all over the county to discuss the situation.

"The following people met at Dr. F.A. Hennessey's office on Nov. 17, 1937: Dr. Hennessey, Mrs. Helen Larson, Mrs. Ellen Anundsen, Dr. Carlie Evanson, Charles G. Stoen, Charles Altfillisch, Carrie Lee, Mrs. Helen Carlson, Mrs. Clarence Natvig, Miss Ernestine Klein, Mrs. George Bieber, Mrs. L. A. Sobolik, Mrs. Etta Baker, Joseph Norlie and Superintendent Perry. At this meeting, the Winneshiek County Tuberculosis and Health Association was organized," former Winneshiek County Public Health Secretary Judy Zweibohmer wrote in a history she compiled of the county's public health agency.

"A TB testing program, in cooperation with the Iowa State Tuberculosis Association, was discussed and proposed to be put into action. The County Medical Association approved this plan. The Winneshiek County TB and Health Association was the precursor of the current Winneshiek County Board of Health."

On Feb. 9 1938, an annual meeting of the Winneshiek County Tuberculosis and Health Association was held at the Hotel Winneshiek to discuss how to follow-up with the residents who tested positive for TB and the advisability of spending money for a county public health nurse.

The idea was discussed again at an executive meeting in July 1938 at Anundsen's home.

"At a Nov. 17, 1938 meeting, Mrs. Helen Larson announced the latest plan to fund a county nurse. The Association was willing to pay 80 percent of the nurse's salary and the county would pay 20 percent. The following year, the Association would pay 60 percent and the county would contribute 40 percent and continue shifting the percentage until at the end of the first five years, Winneshiek County would be responsible for the entire funding," Zweibohmer wrote.

"Dr. Hennesey and a committee of his choosing appeared before the Winneshiek County Board of Supervisors to explain this plan and arrange a workable agreement to hire the first county nurse, but it still didn't happen."

By 1939, Winneshiek County had more cases of tuberculosis than any other county in the state of Iowa. The state average was 19 persons per 100,000 capita, but Winneshiek County had a rate of 51 cases per 100,000 capita.

Those who contracted the disease were called "lungers," according to Zweibohmer's history, and were sent away to sanatoriums - "prison-like institutions" to separate TB patients from the general population" for six months to a year.

"It cost the county $300 per month for each county resident that resided at the Oakdale State Tuberculosis Sanatorium. The need for a county nurse was urgent," Zweibohmer wrote.

Hennessey's committee gained support from Parent Teacher Associations, clubs and citizens from around the county before approaching the Board of Supervisors again, finally gaining the Board's support.

"The Board hired Miss Esther Good as the first Winneshiek County public health nurse and allotted $2,700 for funding this position. She began her employment on Feb. 15, 1940."

By 1942, 80 Iowa counties had organized a tuberculosis association, and the death rate had decreased by 75 percent since 1915.

"By teaching good health habits, testing for TB and arranging for the care of those infected, Public Health Nurse Esther Good, with the support and aid of the County Tuberculosis and Health Association, had turned the tide on this deadly disease. The original Association Board members all served for at least 18 years, dedicated to improving the lives of Winneshiek County residents. Winneshiek County was one of the first of the 99 (Iowa) counties to form an association and establish a public health nurse office. TB is a disease that is still tested for and treated 75 years later, one of many services provided by Winneshiek County Public Health Nursing Service," Zweibohmer wrote.



A long way

Winneshiek County Public Health has come a long way since its beginnings in the 1930s, Sacquitne said.

"We don't send people (with TB) away any more."

Today, families are no longer separated if one family member is infected. If someone has TB, precautions are available so the family can stay together. There is no vaccine for TB, which is a communicable, respiratory disease.

Medicines are available now that weren't available during the peak of TB, Sacquitne explained.

The Iowa Department of Public Health has a program that provides the medication at no cost.

"Our role is to disperse that medicine to those (infected) people. We're the point of contact to get those medicines when there is an active case," Sacquitne said.

That protocol was followed when a Luther College student was diagnosed with a case of TB in February. Public Health nurses were required to watch the student take the prescribed medication daily and follow-up with people who would have been in close contact with the student to determine whether they needed treatment.

Fortunately no other people were infected, Sacquitne said.





Other diseases

Public Health has been at the forefront in dealing with other communicable diseases, Vanden Brink said, such as polio, measles, swine flu and H1N1.

The agency also works closely with the county sanitarian on issues such as water quality and proper sewer systems.

Because the agency can't bill for services, other than home health care, it relies on grants and taxpayer support to do the work it does, Vanden Brink said. Iowa Code mandates counties provide the services, Sacquitne added.

As a Medicaid certified agency, Winneshiek County Public Health does receive reimbursements for home health care through Medicaid and Medicare, in addition to private insurance and private pay.



Changes

As the responsibilities of public health have grown over the years, so has the staff. The agency has eight public health nurses, three home care aides and three support staff members. Offices were moved from the ground floor of the courthouse into the third floor of the Smith Building, the old county hospital, in the early 1990s.

Prevention is the focus of many programs offered.

"We can treat chronic diseases, but isn't it easier to prevent them?" Vanden Brink asked.

There are more regulations associated with the work of public health than in the past, she said.

"Government accountability and transparency are all good. It means more paperwork on our part, but if we can demonstrate a need and what we're able to accomplish, I'm all for it," she said,

The terrorist attacks of Sept. 11, 2001, have had a "huge" impact on public health, Sacquitne said,

"Emergency preparedness wasn't a program before, now that's one of our top programs. We're looking at now setting up collaborations to serve the whole community," she said.

"Over the years, we've become more involved in policy development from the legislative standpoint, because we've had to be," Vanden Brink said.

As it deals with the challenges of the future, Winneshiek County Public Health is building on the foundation established by the county's first Public Health nurses and those nurses and administrators who followed.

"They did have a vision. They truly cared for Winneshiek County and the residents. They tried to make the best decisions for the county, and we as an agency continue to try to make the best decisions for the county residents," Vanden Brink said,

"Public health has an interesting history, and as years go by, it's going to continue to be interesting," she added.

Sacquitne said its rewarding to be able to make a difference in someone's life.

When she's making a home health care visit, Sacquitne reminds herself she's a guest in that person's home.

"It has to be what they want, not what I want. I have to abide by their wishes. I want to help make their life better. That's what we're all about," she said.

Former staff members are being invited to Friday's open house and photos from throughout the agency's history will be on display. The Smith Building is handicap accessible and has an elevator.

The public is invited to come and go as they please throughout the open house, Vanden Brink said.

"We want as many people as possible to stop up and see the services available and talk with the staff," Vanden Brink said.