Why is it important to conduct a consultation with the client before plaiting their hair?

To understand the client's hair type, texture, and desired style, as well as any sensitivities or allergies they may have.

Consultations are not necessary for hair plaiting

To share personal hairstyling preferences with the client

To convince the client to choose a specific plaiting style

What is the correct procedure for client preparation when plaiting hair?

Wash the client's hair and scalp with shampoo and conditioner, detangle the hair, and ensure the hair is completely dry before starting the plaiting process.

Use hair products to create a build-up on the hair before plaiting

Skip washing the hair and start plaiting immediately

Plait the hair while it is still wet

Why is it important to detangle the hair before starting the plaiting process?

Detangling the hair helps to prevent breakage and ensures a smoother plaiting experience.

Detangling the hair is not necessary for plaiting

Leaving tangles in the hair adds texture to the final result

Detangling the hair makes the plaiting process faster

What is an essential step to take before starting the plaiting process on a client with curly or textured hair?

Apply a leave-in conditioner or detangling product to help soften and moisturize the hair.

Skip conditioning and begin plaiting immediately

Apply a heavy styling gel to create definition in the plaits

Use a harsh clarifying shampoo to strip the hair of natural oils

What should be done to ensure the hair is completely dry before starting the plaiting process?

Use a blow dryer on low heat to dry the hair thoroughly.

Leave the hair to air dry naturally, even if it takes a long time

Start the plaiting process while the hair is still damp

Apply a leave-in conditioner to wet hair before plaiting

What type of shampoo should be used to wash the client's hair before plaiting?

A gentle, sulfate-free shampoo suitable for the client's hair type.

A shampoo specifically designed for color-treated hair

A clarifying shampoo to deeply cleanse the hair

Any shampoo with a strong fragrance

Why is it important to wash the client's hair before plaiting?

Washing the hair removes dirt, oils, and product build-up, creating a clean canvas for the plaiting process.

Hair products can be used to mask the need for washing

Plaiting can be done on dirty hair without affecting the outcome

Leaving the hair unwashed adds texture to the final result

What is the purpose of sectioning the hair before plaiting?

Sectioning the hair allows for better control and organization, ensuring neater and more uniform plaits.

Plaiting without sectioning results in a more natural look

Sectioning is not necessary when plaiting hair

Sectioning the hair makes the plaiting process longer and more complicated

What is the recommended way to protect the client's scalp while plaiting their hair?

Apply a small amount of scalp oil or moisturizer to prevent dryness and irritation.

Use a strong-hold styling gel directly on the scalp

Avoid applying any products to the scalp to keep it dry

Apply a thick layer of hair spray to protect the scalp

How should the hair be detangled before starting the plaiting process?

Use a wide-tooth comb or detangling brush to gently remove knots and tangles from the hair, starting from the ends and working your way up.

Apply a heavy styling cream to smooth out the tangles

Avoid detangling the hair as it adds texture to the final look

Yank and pull at the tangles aggressively to quickly detangle the hair

State the procedure for client preparation when plaiting hair

When Europeans met American Indians in the late 15th century, the people of two continents exchanged many beneficial customs and goods. Europeans received New World crops such as potatoes and corn. American Indians acquired cloth and horses. However, besides the beneficial exchanges, Europeans and American Indians often traded deadly germs–bacteria and viruses–for which they had no immunity. Smallpox and Indians Image 1: Smallpox epidemics helped Europeans conquer the Aztec and Incan Empires of Mexico and South America. North American Indians quickly concluded that contact with Europeans often resulted in devastating diseases that caused widespread death. This drawing, made in the 1500s in Mexico, shows how the disease was passed from a European to an American Indian through simple contact. Many of the diseases that were common in Europe were entirely new to the peoples of North America. Diseases such as tuberculosis and measles could be fatal, but Europeans had developed resistance to the disease, so many people survived. However, when European diseases infected American Indians with no previous exposure, the people suffered terribly. The most devastating of these diseases was smallpox which is caused by a virus (Variola major). Smallpox, like many other diseases, had a latent period of about one week between the time the person was exposed to the disease and the time when signs of the disease became apparent. During this time, the sick person might begin a journey and carry the germs along with him. Anyone the person met would be exposed to smallpox. Anything the victim touched including clothing, bedding, or unwashed dishes carried living germs of smallpox. Cotton Mather Image 2: Cotton Mather was a Boston minister. When smallpox threatened Boston, he remembered reading about how the Turks inoculated people with dried material from smallpox blisters. The inoculation usually gave the person a mild case of the disease and future immunity. The procedure was highly controversial, but it helped save the lives of 274 people who were inoculated during the Boston smallpox epidemic of 1721. Symptoms of the disease began with fever, chills, and aches. The fever might raise a person’s temperature from the normal 98.6o to a dangerous 106o. After four days of misery, the victim entered the second stage when large pustules (fluid-filled bumps) appeared on the body. The rash made the person feel as if their skin were on fire. After suffering with the rash for nine days, the victim entered a new stage-if he or she had survived this long. The pustules opened and dried up. Each pustule formed a scab that turned into a scar that marked the person’s face for the rest of his or her life. Complications of smallpox for those who survived might include loss of vision or damage to the lungs, heart, or liver. Waterhouse Image 3: Dr. Benjamin Waterhouse of Harvard University brought Jenner’s smallpox preventative to the United States. It was called vaccination and used cowpox as the infective material. This much milder form of pox gave immunity to smallpox with fewer complications. Dr. Waterhouse encouraged President-elect Thomas Jefferson to promote vaccination. Jefferson responded, “Every friend of humanity must look with pleasure on this discovery, by which one evil more is withdrawn from the condition of man.” (T. Jefferson 12/25/1800 to Benjamin Waterhouse, December 25, 1800) Historians have found evidence of smallpox as far back as 1157 B.C. when the Egyptian pharaoh Ramses V apparently died of smallpox. From Egypt, where scientists believe smallpox began, the disease spread to Asia. Europeans began to experience periodic epidemics of smallpox in the14th century when Crusaders returning from the Middle East brought smallpox to Europe. People who survived the disease were immune and could not get smallpox again. This fact explains why epidemics struck periodically and the disease was not a constant threat to European societies. Smallpox Vaccination 1803 Image 4: Dr. Edward Jenner’s new smallpox vaccination (from cowpox) was widely accepted. This medical image was published by a Spanish physician to teach colonial doctors how to apply the vaccine to native Mexicans. The scratches were supposed to go through several stages of development as evidence that the vaccine had given the patient immunity. Vaccination was very effective in preventing smallpox epidemics among those who received the vaccine. In 1520, while Cortés was trying to conquer the Aztecs, smallpox broke out among the Spaniards and was transferred to the Aztecs. By 1527, the disease had migrated through Central America to Peru where it helped Pizarro conquer the Incas. (See Image 1.) In 1633, smallpox infected American Indians living near the English colony of Plymouth, Massachusetts. The disease traveled very quickly to tribes living far inland from the English colonies. In 1721, a smallpox epidemic threatened the English colonists of Boston. (See Image 2.) Cotton Mather, a Boston minister, wanted to inoculate people against the disease. He knew that Turkish healers took material from a dried smallpox scab and injected it into the body of a healthy person by scratching the surface of the skin. The patients developed a mild form of the disease from which they recovered. The procedure was highly controversial in Boston where about 280 Bostonians accepted inoculation. The epidemic infected more than half of the people living in Boston at the time. About 15% of those who got sick died of the disease. Among those who were inoculated, only six (2%) died of smallpox. The practice of inoculation spread to other English colonies, but not to the American Indian tribes living near the colonies. Late in the 18th century, British doctor Edward Jenner recognized that people who milked cows never came down with smallpox. They had already been infected with cowpox, a similar, but much milder disease that gave them immunity to smallpox. In 1796, Jenner inoculated a young man with cowpox virus he had collected from a milkmaid. The young man had a mild infection for less than 24 hours and recovered. Jenner’s efforts resulted in a widespread acceptance of vaccination (vaccine comes from Latin words meaning “taken from a cow”). By 1800, many Americans were receiving smallpox vaccinations. (See Image 3.) President Thomas Jefferson supported and encouraged the vaccination program in major American cities. (See Image 4.) By the middle of the 19th century, smallpox was under control, but broke out from time to time among unvaccinated people. Bismarck, Dakota Territory, experienced a small outbreak of smallpox in 1882. American Indians, however, were still subject to the disease in its most dangerous form.

Certainly, let's expand on each section in detail so you can learn more from the provided text: # Summary This text aims to explain various aspects related to technology, particularly focusing on a concept known as "Tech Disruption." It explores how technology affects different sectors, outlines the conditions for tech disruption, discusses the industrial revolutions, introduces the laws of disruption, and mentions factors influencing technology choices. ## Concept of Technology **Technology** encompasses a range of elements within organizations. It includes **expertise, equipment, and procedures** used to convert inputs, such as resources or raw materials, into outputs, which can be products or services. This involves various aspects, such as **product design, production techniques, quality assurance measures, human resource development, and management systems**. In essence, technology represents the tools and knowledge used to create and deliver goods or services effectively. ## What is Tech Disruption **Tech Disruption** refers to a phenomenon where smaller companies with limited resources successfully challenge well-established incumbent businesses. This disruption is primarily driven by **technology**, which acts as the catalyst, enabler, or even the sole reason behind the change. The significance of this concept lies in the fact that entrepreneurs must make careful and thoughtful decisions when it comes to adopting and investing in technology. **Why it's Important?** These decisions are crucial because they involve significant investments and will have a substantial impact on a company's ability to create, innovate, and operate its services in a sustainable and cost-effective manner. ## Four Main Impact **Tech Disruption** has four main impacts on businesses and industries: 1. **Shifting Customer Expectations**: As technology evolves, customer expectations change. Companies must adapt to meet these evolving demands to remain competitive. 2. **Enhanced Products Through Data**: Data-driven insights improve the productivity and efficiency of assets, leading to better products and services. 3. **New Partnerships and Collaboration**: Tech disruption encourages companies to form new partnerships and collaborations, recognizing the importance of working together to stay relevant. 4. **Transformation of Operating Models**: Traditional operating models are being transformed into digital models, where technology plays a central role in how businesses operate and deliver value. ## The 11 Macro Sources of Distribution The **11 Macro Sources of Distribution** represent various factors that influence the distribution of resources and opportunities in society. These factors include: 1. **Wealth Distribution**: How wealth is distributed among individuals and entities. 2. **Education**: The availability and quality of education opportunities. 3. **Infrastructure**: The state of infrastructure, such as transportation and communication networks. 4. **Government**: Government policies and regulations that impact resource distribution. 5. **Geopolitics**: Geopolitical factors, such as international relations and conflicts. 6. **Economy**: Economic conditions and trends, including markets and financial systems. 7. **Public Health**: The state of healthcare and public health systems. 8. **Demographics**: Characteristics of the population, such as age and gender. 9. **Environment**: Environmental factors and sustainability concerns. 10. **Media and Telecommunications**: The role of media and communication technologies. 11. **Technology**: Technological advancements and their impact on society. ## When Does Tech Disruption Happen? **Tech Disruption** occurs when specific conditions are met: ### Technology Is Mature Enough - **Technology Accessibility**: Technology must be accessible to a wide range of people and organizations. - **Critical Mass**: It should have reached a critical mass where it can create significant impact. - **Affordability**: Technology must be affordable for businesses to adopt. ### Sector Is Ready For Change - **Tech Infrastructure**: The sector should have the necessary technological infrastructure in place. - **Policy Framework**: A conducive policy framework is essential to support and regulate the use of technology. - **Lack of Disruption**: If the sector is stagnant or facing issues, it becomes ripe for tech disruption. ### Sector + Technology + Timing + Product - **Mature Technology with an Unready Sector**: If technology is mature but the sector is not ready, it can lead to building the wrong product based on incorrect assumptions. - **Unmatured Technology with a Ready Sector**: Conversely, if technology is not matured but the sector is ready, it may take longer to develop the product. ## Ready for Industri 5.0? This section briefly outlines the five industrial revolutions: 1. **Industri 1.0 (1784)**: Marked by mass production assembly lines using electrical power. 2. **Industri 2.0 (1870)**: Introduced mechanization, steam, and water power. 3. **Industri 3.0 (1969)**: Characterized by automated production, computers, IT systems, and robotics. 4. **Industri 4.0 (Present)**: Involves smart factories, autonomous systems, IoT (Internet of Things), and machine learning. 5. **Industri 5.0 (Future)**: Envisions mass customization and cyber-physical cognitive systems. ## Three Laws of Disruption These laws explain the nature of disruption: 1. **Disruption Comes to All**: Disruption is a universal phenomenon; it affects all industries and businesses sooner or later. 2. **Product-Market Fit**: Disruption occurs due to changes in Product-Market Fit, which means aligning a product with its target market effectively. 3. **Methods to Change Product-Market Fit**: To address disruption, a company can change the product, the target market, or influence people's preferences regarding the product. ## The 40% Rule This rule provides a framework for evaluating the fit between a product and its market: - **Value Proposition**: The product should solve customers' problems effectively. - **Channels**: The product should be able to reach customers cost-effectively. - **Monetization**: Customers should be willing to pay for the product. ## PMF Framework: 5 Steps to Product/Market Fit The **PMF (Product/Market Fit) Framework** consists of five steps: 1. **Business Modeling**: Developing a business model that aligns with the market. 2. **Market Validation**: Confirming that there is demand for the product in the market. 3. **Customer Interviews**: Gaining insights from potential customers. 4. **Product Development and Customer Acquisition**: Creating the product and acquiring customers. 5. **Product Analytics**: Using data to determine if the product has achieved Product/Market Fit. ## Factors Determining the Choice of Technology Several factors influence the choice of technology: 1. **Government Policy**: Government regulations and policies can encourage or restrict the adoption of specific technologies. 2. **Available Resources**: The resources, both financial and human, impact the adoption of technology. 3. **Technological Capability**: The organization's technological capabilities influence the choice of technology. 4. **Existing Technological Level**: The current technological state of the industry or organization plays a role. 5. **Institutional Arrangement**: Organizational structures and arrangements affect technology choices. ## Conclusion In conclusion, the text emphasizes the critical role of technology in driving change and disruption in various industries. It highlights the need for informed decision-making when it comes to technology investments, as well as the conditions necessary for tech disruption to occur. Understanding the historical context of industrial revolutions, the laws of disruption, and the factors influencing technology choices is essential in today's fast-paced and tech-driven business environment. Embracing technology disruption is crucial for transforming business models and adapting to evolving market dynamics.

7.03 Patients with Infectious Disease The center adheres to infection control policies to ensure the safety of patients, physicians, and staff members. Patients who are currently being treated for an infectious disease or condition that is transmitted via the contact route may not be treated at the center. Patients with disease spread via droplet (e.g. influenza) or airborne (e.g. tuberculosis, measles) routes will reschedule their procedures in consultation with their physicians. The infection control nurse, in consultation with the infection control consultant, will determine whether the patient requires isolation or other additional precautions. If a patient with current Clostridium difficile-associated diarrhea is treated at the center, all rooms where the patient was housed, even briefly, should be cleaned by housekeeping under supervision of the staff at the center. Physicians must document relevant information in their pre-admission documentation. Standard Precautions will be followed in the care of all patients. Cigarroa Interventional Institute establishes policies to ensure compliance with infection control policies for the care of patients with drug-resistant organisms. The physician will screen patients through the medical history review prior to scheduling a patient at the center. During the pre-operative (pre-op) phone call or interview, a pre-op screening of the patient will be conducted. Strict isolation policies are required to treat patients with active MRSA, VRSA, or tuberculosis. Since this facility has no provisions for strict isolation, those patients with active infections will be referred elsewhere for treatment. Patients who are undergoing or completed a course of antibiotic therapy, are colonized and/or are not actively infected may be treated at the center. Patients with active infections requiring transmission-based precautions are not appropriate candidates for this facility and will be referred to another facility or rescheduled. Procedures cannot be scheduled for patients currently undergoing an infection with transmission based precautions. The patient must finish the course, and they will be rescheduled. Definitions and Standards: The following definitions and standards are provided for informational purposes only: Airborne Transmission and Precautions: This mode of transmission occurs by the spreading of either airborne droplet nuclei (small particle residue of 5 microns or smaller), of evaporated droplets which contain microorganisms that remain suspended in the air for long periods of time) or dust particles containing microorganisms. Patients must be isolated in private rooms with special air handling and ventilation, and the door must remain closed. Patient transport should be restricted to essential transport only. Respiratory precautions must be taken when in the presence of patients with active tuberculosis, including respiratory masks. Droplet Transmission and Precautions: Droplets are transmitted from the host source by coughing, sneezing, talking, or during procedures such as suctioning or bronchoscopy. Patients must be isolated, and a distance of 3 feet maintained between the infected patient and others. Caregivers within 3 feet of the patient should wear a mask. Patient transport should be minimized. Contact Transmission and Precautions: Direct contact transmission involves direct body surface to body surface contact with physical transfer of microorganisms between a susceptible host and an infected person. Indirect contact transmission involves contact with an intermediate object (usually inanimate) and a susceptible host. Patients should be isolated as much as possible. Gloves and hand washing are essential for all contact with the patient and contact with objects, which come in contact with the patient. Gloves should be changed after each contact. Reportable Condition If the patient is determined to have a reportable condition at any time during pre-admission, the Director of Operations/Nurse Manager will be notified. The procedural physician will be contacted and the case will be canceled. The Department of Health will also be notified the same day following state regulations regarding Reportable Communicable Diseases. To report a disease or condition, contact: The City of Laredo Epidemiology 24/7 Reporting Line: (956) 763-2915, if unable to report locally, call The Texas Departmrent of Health Services epidemiology program: 24/7Number for Immediately Reportable – 1-800-705-8868

Policy for Bloodborne Pathogen Exposure Incident as per OSHA regulation (29 CFR 1910.1030) Purpose: To ensure that ASC staff members are protected against potential exposure to bloodborne pathogens per OSHA regulations (29 CFR 1910.1030). Scope: This policy applies to all ASC staff members who may be exposed to blood or other potentially infectious materials during their duties. Policy: An exposure incident is defined as a specific eye, mouth, other mucous membranes, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee's duties. Any spill or accident that results in an exposure incident must be immediately reported to the Infection Control Nurse, first-line leader, or another responsible person. The employer shall make available the hepatitis B vaccine and vaccination series to all employees who have occupational exposure and post-exposure evaluation and follow-up to all employees who have had an exposure incident. The employer shall provide a confidential medical evaluation and follow-up for the exposed employee, which shall include at least the following elements: • Documentation of the route(s) of exposure and the circumstances under which the exposure incident occurred. • Identification and documentation of the source individual, unless the employer can establish that identification is infeasible or prohibited by state or local law. The source individual's blood shall be tested as soon as feasible and after consent is obtained to determine HBV and HIV infectivity. • Collection and testing of blood for HBV and HIV serological status. • If the employee consents to baseline blood collection but does not consent to HIV serologic testing, the sample shall be preserved for at least 90 days. If, within 90 days of the exposure incident, the employee elects to have the baseline sample tested, such testing shall be done as soon as feasible • Post-exposure prophylaxis, when medically indicated, as recommended by the U.S. Public Health Service. • Counseling. • Evaluation of reported illnesses. The employer shall ensure that the healthcare professional evaluating an employee after an exposure incident is provided with the following: A copy of OSHA regulation 1910.1030 A description of the exposed employee's duties as they relate to the exposure incident Documentation of the route(s) of exposure and circumstances under which exposure occurred Results of the source individual's blood testing, if available. All medical records are relevant to the appropriate treatment of the employee, including vaccination status, which is the employer's responsibility to maintain. The employer shall obtain and provide the employee with a copy of the evaluating healthcare professional's written opinion within 15 days of the completion of the evaluation. The healthcare professional's written opinion for Hepatitis B vaccination shall include the following: Whether it is indicated for the employee If the employee has received such a vaccination The healthcare professional's written opinion for post-exposure evaluation and follow-up shall include the following: That the employee has been informed of the results of the evaluation That the employee has been told about any medical conditions resulting from exposure to blood or other potentially infectious materials which require further evaluation or treatment All other findings or diagnoses shall remain confidential and not be included in the written report. An employer must establish and maintain accurate medical records for each employee with occupational exposure. Records should include the employee's Name, hepatitis B vaccination status and dates, results of medical testing and follow-up procedures, healthcare professional's written opinion, and information provided to the healthcare professional. Records must be kept confidential and not disclosed without the employee's written consent, except as required by law. Records must be kept for at least the duration of the employee's employment plus 30 years. Form 7.041 Employee Consent Form for Testing for HBV and HIV Serological Status Following Accidental Exposure I, __________________________, understand that I have been involved in an accidental exposure incident and may be at risk for contracting Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) under 29 CFR 1910.1030. Therefore, following OSHA standards, I am being offered the opportunity to be tested for these viruses. I understand that the testing will involve a blood sample and that the results will be kept confidential and will only be shared with authorized personnel. I also understand that testing is voluntary and that I have the right to refuse to test. By signing this form, I consent to be tested for HBV and HIV following the accidental exposure incident. Signed: __________________________ Patient's Name: __________________________ Form 7.042 Patient Consent Form for Testing for HBV and HIV Serological Status Following Accidental Exposure I, __________________________, understand that a staff member involved in an accidental exposure incident may be at risk for contracting Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) following 29 CFR 1910.1030. Therefore, by OSHA standards, the staff member may be offered the opportunity to be tested for these viruses. I also understand that testing of my blood is necessary to determine if I am infected with HBV and HIV. The results will be kept confidential and only shared with authorized personnel. I understand that testing is voluntary and that I have the right to refuse to test. By signing this form, I consent to the staff member being tested for HBV and HIV and to my blood testing following the accidental exposure incident. Signed: __________________________ Form7.043 Refusal of Testing Patient/Employee (Circle One) I,_____________________________________, understand that I have the right to refuse testing for Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) following an accidental exposure incident per 29 CFR 1910.1030. I understand that if I refuse to test, it may impact my ability to receive appropriate medical treatment and the healthcare facility's power to respond to the exposure incident. Following 29 CFR 1910.1030, The source individual's blood shall be tested as soon as feasible and after consent is obtained to determine HBV and HIV infectivity. The employer shall establish that legally required consent cannot be obtained if permission is not obtained. When the source individual's consent is not required by law, the source individual's blood, if available, shall be tested, and the results documented. Signed: __________________________

Between 1775 and 1782 (the years of the American Revolution) a smallpox epidemic spread across North America. By 1782, the disease had reached the villages of the Mandans and Hidatsas. The death rate was very high. The Dakotas attacked the weakened Mandan villages including On-a-slant village (today the villiage is in Fort Lincoln State Park) and Double Ditch village. By 1790, the survivors (of both disease and war) left the Heart River area and moved north to establish villages near Painted Woods Creek and at the mouth of the Knife River. The Mandans who had once occupied six large villages now lived in two small villages. There were only two remaining Hidatsa villages and another village where both Mandans and Hidatsas lived. The populations of the two tribes had been reduced by 75 percent. The Mandans and Hidatsas also suffered cultural losses because of the smallpox outbreaks. The Mandan villages had always shared some common cultural traits, but each village had a slightly different language. As the survivors were forced to move together for security, the differences disappeared. There were similar cultural losses for the Hidatsas. The Arikaras who lived farther south along the Missouri River also experienced the smallpox epidemic. By 1790, the Arikaras had been reduced from a large population living in 32 villages to a group that occupied two villages. Only 500 men of military age remained of the 4,000 Arikara warriors who had protected their villages in previous decades. In 1801, smallpox struck the people of the northern Great Plains again. This time, the epidemic killed fewer people. It is possible that the survivors of the 1782 epidemic were still immune to the virus this time. In 1830, the Army identified smallpox as a dangerous disease at Indian agencies on the lower Missouri River (in modern-day Missouri, Kansas, and Nebraska). The Secretary of War, L. G. Randolph, authorized Indian agents to hire doctors to vaccinate American Indians living at the agencies. However, these agents were not ordered to vaccinate Indians. Many mothers feared the vaccine. They had seen many babies become sick because doctors did not use sterile procedures (which were unknown at the time). Sometimes vaccine was not effective and the children became sick anyway. For a variety of reasons, the Army’s vaccination campaign did little to stop smallpox epidemics among the Indians of the frontier. Indian agents on the frontier were concerned about smallpox. Non-Indian settlers were approaching the lands where the tribes lived. Disease was spreading and the agents begged the Office of Indian Affairs (part of the War Department) to provide vaccine for Indians. Finally, in 1832, Congress passed the Indian Vaccination Act. The bill appropriated $12,000 to purchase vaccine and hire doctors to vaccinate Indians. Exactly which tribes would be vaccinated was not specified in the bill. Secretary of War Lewis Cass, who administered the program, decided that the vaccination program would be extended to tribes that were friendly to the United States, those with important economic roles, and those tribes (Cherokee, Choctaw, Chickasaw, Creek, and Seminole) that were being forced out of southern states to relocation sites in the West. Cass specifically excluded the Mandans, Hidatsas, and Arikaras (along with other tribes living farther up the river) from the vaccination program. Cass believed the fur trade on the Upper Missouri River was no longer economically important. He also stated that the treaties that all three tribes signed in 1825 identified them as hostile towards the U. S. and its citizens. (See Document 1.) Other tribes, including the Teton Sioux (Lakotas) did not have such statements in their treaties. Cass excluded the Upper Missouri tribes from vaccination because he considered them to be far removed (both geographically and socially) from “civilized man.”

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