Monday, September 26, 2011

Wallace Kuralt's era of sterilization -- Now we have the pill and abortion. Which comes first, the scalpel or the egg?

Verne Strickland Blogmaster / September 26, 2011

Charlotte Observer tries to paint the program as racist and irrational. It was neither, and Kuralt is praised by many today, to the chagrin of liberals.

By Ann Doss Helms and Tommy Tomlinson
ahelms@charlotteobserver.com
Posted: Monday, Sep. 26, 2011
 
Compassionate. Visionary. A champion of women and the poor.

That's the reputation that Wallace Kuralt built as Mecklenburg County's welfare director from 1945 to 1972. Today, the building where Charlotte's poor come for help bears his name - a name made even more prominent when his newscaster son, Charles Kuralt, rose to fame.

But as architect of Mecklenburg's program of eugenic sterilization - state-ordered surgery to stop the poor and disabled from bearing children - Kuralt helped write one of the most shameful chapters of North Carolina history.

The Charlotte Observer has obtained records sealed by the state that tell the stories of 403 Mecklenburg residents ordered sterilized by the N.C. Eugenics Board at the behest of Kuralt's welfare department.
It's a number that dwarfs the total from any other county, in a state that ran one of the nation's most active efforts to sterilize the mentally ill, mentally retarded and epileptic.

The records crunch people's lives into a few terse paragraphs:

A chronic runaway who has hit puberty at 12: She should be protected as soon as possible from the consequences of actions over which she appears to have no control.
A woman, 24, pregnant with an out-of-wedlock child: This girl is sexually promiscuous and a pauper.
A woman, 35, deserted by her husband years before, who has just given birth to her ninth child: She is unable to provide the barest necessities for them or to give them minimum supervision and care.

Today, the term "eugenics" evokes shame and disbelief. Two governors and several state legislators have apologized for North Carolina's role.

People who knew Kuralt struggle to reconcile that label with the man they knew.

"He was a hero with women's reproductive rights. I would just be shocked if Wallace Kuralt were playing the game of 'improve the stock,' " says Dr. John Johnston, a retired pediatrician and public health leader.Kuralt retired almost 40 years ago and died in 1994. His key aides also have died, and memories have faded of the decisions that changed hundreds of lives. Some women came forward willingly. Some patients were little more than children who didn't understand what was to take place. Today, it is impossible to tease out the exact mix of good intentions and overzealous execution, prejudice and paternalism that let such a crusade run unchecked.
But Kuralt had no regrets. In writings and interviews throughout his life, he described sterilization and birth control as the key to saving tax money and rooting out poverty among the "low mentality-low income families which tend to produce the largest number of children."

"When we stop to reflect upon the thousands of physical, mental and social misfits in our midst," he wrote in The Charlotte News in 1964, "the thousands of families which are too large for the family to support, the one-tenth of our children born to an unmarried mother, the hoard of children rejected by parents, is there any doubt that health, welfare and education agencies need to redouble their efforts to prevent these conditions which are so costly to society?"

Records tell bleak stories
To date, no verified Mecklenburg survivors have spoken publicly, but typewritten case notes tell their tales.
The Observer obtained summaries of 548 county sterilization cases that have been sealed by the state. They include 430 brought by the Welfare Department - some that predate Kuralt - and 118 involving Mecklenburg residents in state mental hospitals and institutions for the retarded. They date from 1937 to 1966.

The names are blacked out, but the narratives unspool a litany of misery.

Women and couples living in dire poverty, with six children or more, came to the Welfare Department to stop having babies.

Adolescent boys and girls deemed promiscuous or delinquent were sterilized because their parents and guardians couldn't control them.

"The protection of sterilization" - a phrase repeated like a mantra in the records - was often ordered when families couldn't or wouldn't protect the disabled from rape, incest or other abuse.

There was a pregnant 16-year-old with the mind of a 7-year-old whose father raped her at 12. Her mother later gave a married male friend permission to have sex with her. The same father who assaulted her signed the consent to operate.

Another 16-year-old, severely retarded and partially deaf and blind, got her tubes tied on the consent of her unmarried mother. "It has been brought to the attention of the Welfare Department," the summary says, "that men of all ages have sex relationships with patient and as her mother works part time she is in the home alone and does not have anyone to protect her."

Johanna Schoen, a researcher and author, got the N.C. records before the state blocked their release. She provided the Mecklenburg reports to the Observer, minus the names.

After more than a decade of research, Schoen believes that some patients and families sought sterilization and benefited from it. She believes some involved in the program, including Kuralt, meant well.
But none of that blunts her conclusion: "It was a horrible program and it shouldn't have existed."

'No sentimentality'
Kuralt came to Charlotte in 1945, as the state's eugenics campaign blazed onto this city's front pages.
In March 1945, The Charlotte News, which eventually merged with the Observer, ran a three-part series highlighting the area's "alarming mental deficiency rate."

The final installment offered the solution: sterilization.
"Certainly it is simpler, less expensive, more far reaching, more certain, than segregation" of the mentally handicapped, according to the article by Evangeline Davis, a freelance writer and wife of an associate editor.

"It is here that sentimentality must not enter in," she continued. "No matter what our feelings concerning the mentally deficient, it is senseless and cruel, in the end, to permit them to procreate and bring into the world more of their kind."

It is unclear whether Kuralt immediately heeded such arguments.

During the Great Depression, he had struggled to find a job. A Massachusetts native, he came to UNC Chapel Hill for an education, hoping for a career in advertising. He worked for a grocery chain, put creosote on telephone poles and created a short-lived tour agency before landing a job with the Emergency Relief Agency.

It sparked his passion for social work, which led him to Charlotte.

A compact man with a dapper moustache, his ever-present cigar or pipe became a trademark. His enthusiastic and forceful personality made a mark with his young, female workforce. Social workers called him "Papa K" and viewed him with awe.

"We were all scared to death of him. He was extremely strict," says Margaret Setzer, 64, who became a social worker in 1969 and worked for the department for 35 years. "He was very, very, very smart. He was a forward-thinking person for that time, particularly in the welfare business."

Kuralt drew little public attention during his first decade on the job. Mecklenburg's eugenic sterilization program remained low-key as well. Records show the department brought only a handful of cases a year to the Eugenics Board from 1937 to 1954 - some years none at all.

The majority of people sterilized in those years, like the majority of Mecklenburg residents, were white. In 1955, things changed.

The roots of poverty
Kuralt was starting to articulate strong views about poverty - and clashing publicly with county commissioners who questioned how he spent money and served clients.

Despite Charlotte's postwar prosperity, many remained mired in the direst poverty. Sterilization records tell of 10 people living in a three-room shack, kids sleeping on piles of cotton and corn husks, homes lacking food and running water.

Kuralt believed many of these people lacked the skills and intellect to support the children they were having, and that "generation after generation of children born mentally deficient" would face a bleak future.

Kuralt's daughter, Catherine Kuralt Harris, now 69, remembers only that her father would talk about women who wanted to stop getting pregnant.

"Women requested it because they had no control over their husbands," said Harris, who lives in Washington state. "He was certainly concerned about the underprivileged."

In 1955, as sterilizations were starting to taper off statewide, the Mecklenburg Welfare Department got 19 sterilizations of "feebleminded" clients approved. By 1957 there were 57. The department averaged at least one a week for the next two years.

Many of the women sterilized in the late 1950s came to the public maternity clinic, where they were seen by the Health Department's Dr. Elizabeth Corkey. An obstetrician who came to Charlotte in 1955, she emerged as a leader in improving race relations and women's reproductive rights.

Becky McNair, a caseworker from 1961 to 1964, remembers Corkey as "a hands-on, caring person" who was central to the sterilization push.

"We'd say after the 10th child, 'We're going to send you to Dr. Corkey,' " said McNair, 73.

Little restraint
Kuralt and Corkey sent dozens of sterilization cases to the Eugenics Board for approval. Often the IQ tests that labeled those clients feebleminded were done by Ethel Abernethy, the founder of the psychology department at Queens College. After her retirement in 1954, she went to work with the Welfare Department.
IQ testing conferred "scientific legitimacy and authority" on the label of feeblemindedness, which eugenicists assumed to be hereditary, Schoen writes in "Choice & Coercion," a book on reproductive history that focuses on North Carolina. The accuracy of such labels has since been discredited, especially for diagnosing genetic defects in people who were often suffering from poverty, poor education and emotional stress.

An IQ of 70 or lower made a person fit for sterilization in North Carolina. While some case reports indicate patients with severe mental disabilities, many of the Mecklenburg women sterilized had ratings just below the threshold.

The five-member Eugenics Board, made up of state health, welfare and legal officials, made the final call on whether sterilization was justified. But after hearing brief synopses of local cases, they almost always endorsed the plans brought before them.

Only six of 430 Mecklenburg welfare department cases in the records provided by Schoen were clearly rejected, with four more unclear about the resolution.

The records show the state board initially declined the department's request to sterilize a 15-year-old girl described as physically attractive, sexually developed and lacking modesty. The girl, who had an IQ of 52, went to Girl Scouts, church and piano lessons, and her parents feared she would become pregnant because of her "provocative" behavior.

The welfare department brought the request back three times, noting that the girl was talking about her desire to have a baby. Finally, when she was 16, the board gave the go-ahead.

Question of consent
Records show patients signed consent for 317 of the 430 sterilizations brought by the Welfare Department.
Those without consent were often the youngest patients. All told, the department got sterilization orders for 54 children 16 and younger. The youngest was a 10-year-old girl with a mental age of 4 who had begun menstruating the year before.

The parents, who signed the consent for surgery, "appear to give her good supervision but she frequently eludes her parents and wanders away," the summary says.

"The family lives on a nursery farm where there are many men employees in the different areas, and the parents are greatly concerned for fear that she might be taken advantage of by one of these employees. While sterilization will not change the basic situation, it will give (her) protection and her parents peace of mind on this score."

Some patients who signed consent were eager to stop having kids, reports say. At least 50 cases include descriptions such as "she is quite fearful of childbirth and greatly desires permanent protection" or "she brought her husband to the welfare department after the birth of her eighth child."

And more than 100 describe parents who were neglecting or abusing the children they had.

"I don't recall trying to limit that population for any purpose other than for them to manage their life to be better - to be able to feed their kids, to be able to clothe their kids," said Setzer, the former social worker.

But records indicate some mentally retarded patients who signed consent didn't understand the operation.
All of the former welfare staff interviewed by the Observer or Schoen said that sterilization was not done rashly. But some acknowledged it may have been pushed too hard.

In 1997, Schoen interviewed Kuralt's assistant, Ed Chapin, who died in 2007.

"I think there was some concern that we were doing sterilizations for women and perhaps some subtle arm-twisting," Chapin told Schoen. "I remember one of my coworkers whose office was next to mine and I am embarrassed to tell you that I think he sterilized his entire case load (60 people) over a period of a year or two years. I think that was perhaps a little excessive."

The race issue
In 1960, just under 25 percent of Mecklenburg residents were African-American.
But blacks made up more than 80 percent of the people ordered sterilized at the request of the Welfare Department between 1955 and 1966. In 1957, the peak year for Mecklenburg, the state approved sterilizations of 52 blacks and five whites.

Dozens of black women were sent to surgeons at Good Samaritan Hospital, Charlotte's segregated black facility.

Thereasea Elder, a retired public health nurse who is African-American, recalls a stream of hysterectomies and tubal ligations when she worked there in surgery.

"I never knew the reason why they did so many hysterectomies," said Elder, 84. "We thought they were diseased. We were never told the reason for the sterilizations."

The Eugenics Board records reflect the racial attitudes of the times. A 17-year-old white boy with an IQ of 47 was ordered sterilized in 1963. The report notes that he lived in a low-income, racially mixed neighborhood, and "his interest in Negro girls" is one reason cited to stop him from having children.
In some cases, welfare workers noted neighborhood conditions as evidence that Africans-Americans needed protection from childbearing.

"She has never worked and is always present at her mother's social gatherings, which includes music from a juke box which requires coins and there is evidence of eating and drinking, including alcoholic beverages all over the house," says the report for one black woman. "The apartment itself is located in a section of the city which has a poor reputation."

Schoen attributes the preponderance of black women in N.C. sterilizations to their lack of access to other birth control and their growing presence on public welfare rolls.

Mecklenburg social workers from that time recall fierce battles with county commissioners, some of whom were hostile toward the people getting welfare. Kuralt pushed back with arguments that preventing births would save money.

In his 1964 piece in The Charlotte News, Kuralt noted that one in three Negro children was born to an unmarried mother.

"These children came into the world with all the odds against them," he wrote, "and their mothers face a blighted life of hopeless struggle just to survive."

A changing world
When birth control pills became available in 1960, Kuralt and Corkey leapt at the chance to provide it to their clients. The family planning clinic created as a joint project of the welfare and health departments that year was among the nation's first.

"Here, at last, was a method of preventing unwanted pregnancies by an acceptable, practical, and inexpensive method," Kuralt wrote in the March 1967 journal of the N.C. Board of Public Welfare. "The poor readily adopted the new techniques for birth control."

As use of "the pill" grew, Eugenics Board sterilizations tapered. By the time the board was abolished in 1974, it was virtually obsolete - in part because the N.C. legislature passed voluntary-sterilization legislation in 1963. That meant welfare and health departments could pay for clients who wanted the surgery without having to prove they were mentally defective.

In the 1967 journal article, Kuralt estimated that his department was paying for about 30 sterilizations a month for "very low income families."

While Kuralt always pushed for family planning, by the mid-1960s he talked more about providing child care, job training and medical care for the poor.

Despite his political battles, Kuralt was widely admired by the time he retired in 1972, after 27 years in the job. More than 200 turned out for a testimonial dinner.

"He's a combination of Yankee efficiency and Southern charm," said County Commission Chairman Charles Lowe. "This community has a mutual love affair going with Wallace Kuralt."

By the 1970s and '80s, lawsuits had been filed alleging abuse of the eugenic sterilization program in other parts of North Carolina. The program had become an embarrassment to many.

But Kuralt always took pride in what his department had done.

Writer Mary Snead Boger interviewed him for her 1972 book "Charlotte 23," a collection of profiles of the city's most important residents. He told her planned parenthood for the poor was his most significant accomplishment.

"I suppose," he said, "no comparable population in the world has ever received more eugenic sterilizations."

Researchers Marion Paynter and Maria David contributed.

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