Tuberculosis pandemic had some North Dakota schools trying open air classrooms in the winter of 1922-23

FARGO — While millions of American children are staying healthy and safe this year through distance learning, their great- or great-great-grandparents did something a little different: They opened all the windows and wore sleeping bags to school.

In 1922, some schools opted to move classrooms outdoors to try to prevent and combat the spread of tuberculosis (TB), a deadly disease which usually affects the lungs. Known as “white plague” or “white death,” TB was the number one cause of death in the U.S. at the dawn of the 20th century.

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Open air classrooms took many forms but often consisted of a roof or canopy of some kind with no walls. It sounds reasonable enough in places like Arizona or California, but how exactly do you pull off outdoor school in Fargo — in January — when it’s 30 degrees below zero? It turns out, you do it very carefully and with a lot of help from PTA moms.

The concept of outdoor learning began in Germany in 1904. According to Smithsonian magazine, “In 1904, Germany recorded a staggering 193.8 tuberculosis deaths for every 100,000 people." For comparison’s sake, the United States is currently recording about 93 deaths for every 100,000 people during the Covid-19 pandemic.

About 20 years earlier, in the 1880s, German scientists discovered tuberculosis was caused by bacteria that was spread through even the smallest droplets of mucus from coughing, clearing your throat or even just speaking.

At the turn of the century, they theorized tuberculosis couldn’t be vanquished, but its spread could be contained if people were far enough apart from each other in well-ventilated, open areas. They thought the fresh air and sunshine would help those already stricken with TB breathe and feel better.

The first open air classroom, called Waldschule für kränkliche Kinder (or "forest school for sickly children"), opened in Charlottenburg just outside Berlin. True to its name, the school was located in the heart of a nearby forest. Most of the children were suffering from things like swollen glands and anemia and were considered to be in the stage of pre-tuberculosis.

The first open air classroom in the United States opened in Rhode Island in 1908. Within two years, 65 open air classrooms were operating in the United States. By 1918, 130 cities had outdoor classrooms.

The open air concept came to Fargo in 1922 when the Commonwealth Fund, a philanthropic health group, chose the city to be among four in the nation where maternal and child health services projects would be established. Out of the five-year project, a Fargo public health department was established to continue the project's work.

Steve Grineski, a retired education professor from Minnesota State University Moorhead, is studying how North Dakota cared for children with tuberculosis. At its peak in the early 20th century, he said, tuberculosis killed 450 Americans a day, most of them between 18 and 44 years of age.

Grineski said the lion’s share of those people lived in large cities, where many were undernourished and lived in substandard housing with poor circulation and not much sunlight.

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“Tuberculosis became a disease of the poor through no fault of their own,” he said.
So when the people from the Commonwealth Fund came to Fargo and partnered with Fargo Public Schools to try out the open air school concept, they picked what was Washington School located where the downtown YMCA is now. (Not the current Washington Elementary located in North Fargo.) Grineski said the neighborhood was home to many working class people and immigrants.

“It seems likely that maybe that school was picked because of the population it served because they were poor, because their houses flooded all the time. There probably was the high incidence of tuberculosis, because they made the whole school an open-windows school,” he said.

So for North Dakota, open air meant staying inside the four walls but opening every window in the large, two-story building — even on the coldest days.

“During the winter, the women who belonged to the PTA of all of the schools in Fargo made these big sleeping bag-type things,” Grineski said. “And somebody donated the money, and they would buy big boots and big mittens for the children.”

It appears North Dakota was "all-in" on the open air concept.

In 1922, Grineski said, proceeds from Christmas Seals were dedicated to establishing open air schools in Fargo, Grand Forks, Bismarck and Minot. He says in Bismarck they did a demonstration open air school with five students.

“It mentioned in a newspaper article that it got to be 20 to 36 below, and the kids were on a porch of a private residence. They had recess, they helped make lunch and they ate a lot, because a lot of the kids were poor and undernourished,” Grineski said.

He said the early proponents of open air learning struggled with the balance between how much rest and exercise to allow the students, but in the end, they believed the fresh air, sunshine and good food was highly beneficial for the children.

“I’ve even seen pictures of the kids in spring running around with little loin cloths on, playing games, because they believed the fresh air and sunshine were that important,” Grineski said.

Many reports from open air classrooms show the students doing relatively well despite the chilly temperatures. The reports claim children were stronger and appeared more resilient. But while the children appeared to be doing well physically, how about academically?

“At one point, they said the children were doing two years of schoolwork in six months and they felt like the academic performance was just fine, but they didn’t say how that was being measured,” Grineski said of the demonstration school in Bismarck.

What are the odds the children did all that work while they kept moving to stay warm? Even naptime with newspaper for cots and coats for blankets at Washington School looked less than restful. The funds provided also established a health food store there.

Following the school year of 1922-23, members of the Commonwealth Fund visited Fargo again, and according to a Fargo Forum story from Aug. 8, 1923, they were very pleased with how receptive Fargoans were regarding the initiatives with children's health.

"It tickled me to see how the people have taken hold in this work," declared Mr. Barry Smith, director of the fund. "I haven't seen anything like it elsewhere."

Even so, the open air classroom concept in Fargo schools appears to be short-lived, one Grineski says didn’t extend beyond that 1922-23 school year. By the mid-1940s, the open air school completely disappeared from America, as public health and sanitation conditions improved and effective antibiotic treatments were created to fight tuberculosis.

In 1909, the state created the North Dakota Tuberculosis Sanitarium, later known as the San Haven Sanatorium, in Dunseith, N.D.

• The Sanitorium was located on the south slope of the Turtle Mountains because the higher altitude, less snowfall and drier air was a favorable environment for TB patients.
• In later years, San Haven built a separate facility, called a preventorium, to provide preventative care and treatment for children.
• Children at the preventorium were either infected with TB but were asymptomatic or pre-tubercular, or they were undernourished, weak, frail and likely candidates to get infected.

In 1928, Camp Grassick was created in Dawson, N.D., to give the same population of children an outdoor camping experience.

• The camp was named after Dr. James Grassick, the founder of the North Dakota Anti-Tuberculosis Association.
• Camp Grassick is now Elks Camp Grassick and serves campers with special needs.

If you, a family member, or anybody you know spent time at Camp Grassick or any kind of summer camp, San Haven Sanitorium or Preventorium, or an open-air school due to tuberculosis, email Steve at grineski@mnstate.edu .

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