Public health in different Canadian regions in 1930s-1950s

Introduction

The area of study of the articles selected for this assignment is the history of public health in different Canadian regions in the period between 1930s and 1950s. The authors provide extensive expositions regarding the challenges faced by governments in combating various diseases and public health concerns. On that account several themes are evident throughout the articles. The three major historiographical themes in the texts include poor public health, reforms and medical breakthroughs.

Article Overview

Peter Neary’s Article

The article was authored by Peter Neary, a Professor of History at the University of Western Ontario in Canada.

He was also a prolific publisher of other popular texts focusing on social, economic and political developments in Newfoundland, a Canadian island off the East Coast of the North American mainland, in the 20th Century . In the abovementioned article published in 1998, Neary offers a detailed analysis of the public’s perceptions and government’s responses in curbing venereal disease in Newfoundland in the period between 1930 and 1940.

In the 1930s, the prevalence of venereal diseases was highlighted as one of the main public health issues affecting the Newfoundland population. The culture of Newfoundland at this time was heavily influenced by practices in Britain, Ireland and North America. Further, women were viewed as the carriers of these infectious diseases, especially venereal disease, which had caused a crisis in the health sector of the island province. The crisis emanated from the high transimission rates and high number of deaths arising from venereal diseases. The efforts of Newfoundland’s authorities to implement a lasting solution to contain venereal disease were curtailed by its limited financial resources.

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However, in the early years of the 1940s, the arrival of Canadian and American military forces in Newfoundland was accompanied by an interventionist approach and a better flow of public revenue that contributed significantly to combatting the scourge of venereal disease. The game changer that helped the Newfoundland administration fight venereal disease however, was the discovery of the antibiotic penicillin. This was complemented by systematic reform in the health sector to alleviate the threat of venereal disease to public health. In particular, the enactment of the Health and Public Welfare Act of 1931, had led to the creation of a progressive legal framework to guide the fight against venereal disease . However, the Act was not implemented until in the early 1940s due to lack of funds to operationalize its proposals. Subsequently, nursing responsibilities were transferred to the Newfoundland Outport Nursing and Industrial Association to enhance the effectiveness of managing the disease.

The other significant reform introduced by the administration of Newfoundland to contain venereal disease was the creation of headquarter facilities in cottage hospitals to accommodate district nurses. This ensured that the practitioners could treat the illnesses promptly and efficiently. This reform further enabled the nurses to offer training to the local communities, especially women, on how to conduct home nursing to assist victims of venereal disease. A directive was issued by the administration that all persons diagnosed with a venereal disease should report immediately to the Director of Venereal Diseases. This enhanced regulation and enabled government and the nursing fraternity of Newfoundland to treat the disease and thereby reduce its prevalence.

Christopher Rutty’s Article

This article was authored by Christopher Rutty in 1996, a professor and health heritage consultant from Toronto. The primary objective of the research was to give an historical reflection of the extent and effects of paralytic poliomyelitis in Canada between 1936 and 1937, a much dreaded disease . The author’s fundamental contention is that polio in Canada, especially in Ontario, was an ailment of middle class citizens. Before the discovery and distribution of Salk and Sabin vaccines in the second half of the 20th century, polio was among the most feared diseases in North America. The author believes that polio was perceived to be more menacing and sinister than death itself. The climate of perpetual fear of contracting polio in Canada was reinforced by the frequent occurrences of the ailment at the beginning of the century. Although the Canadian medical profession achieved great success in combating numerous infectious diseases, it expressed an inability to prevent or cure polio . Christopher reinforces this position by relying on the comments published in the Manitoba Medical Association Review in 1936 . In this article, the authors claimed that there is no other disease in Canada evoking such fear among citizens and creating such a feeling of powerlessness among the medical practitioners, as polio.

In Canada, polio was generally dealt with by voluntary medical services from individuals and organizations, combined national and local public health traditions, as well as collaboration between government and other participants from the medical profession. The initial government response in Canada towards combatting the spread if polio started in 1927. The administration sponsored the development of provincial polio strategies to accommodate more patients. Further, it initiated a series of prevention, treatment and hospitalization methods that were free of charge. During this period, no other disease in Canada had prompted such an expansive and multi-sectorial approach involving government agencies as well as provincial administration. The general feeling among government and health officials, was that the lack of recognized medication or vaccination for polio could be supplanted by efforts geared towards reducing the frustration and pressure associated with polio.

At the inception of 1930, the government then initiated several reforms to provide a broader approach in containing the disease and to improve the chances of discovering a polio vaccine. It implemented this by strengthening institutional and individual connections between medical research, federal health departments and medical practitioners. Provincial polio programs were expanded throughout all provinces to improve efficiency in tackling the disease . New polio therapies were discovered and rolled out to the public, regardless of the controversy they created. Likewise, striking treatment combinations were implemented between 1927 and 1959 in six different phases, with each category involving a unique polio treatment ranging from convalescent serum to prophylactic nasal sprays . Other discoveries during this period were the unorthodox physical therapy and gamma globulin. Long-term success in preventing polio in Canada was only realized after the discovery of the Salk and Sabin vaccines in the 1950s and 1960s.

Nancy Bouchier Ken Cruikshank’s Article

The article is a product of joint authorship of Nancy Bouchier and Ken Cruikshank in 2011. Bouchier is a professor at McMaster University in Ontario, Canada. Ken Cruikshank is a professor at the faculty of humanities in the McMaster University in Ontario. The article gives a reflective analysis of the development of swimming pools to provide clean and healthy recreational services in Hamilton, Ontario from the 1930s to the 1950s. Municipal swimming pools in the city were cited as a technological fix that would address the issue of water pollution in Hamilton’s bay area. Notably, before the advent of these swimming pools, the level of pollution in the natural swimming pools had skyrocketed, since many companies had directed their industrial waste into these water bodies. To prevent the situation from become a public health hazard, the leaders and medical bodies in Hamilton proposed the development of artificial swimming pools that would supplement the few remaining natural pools . The administration did not however aim to eliminate natural swimming pools completely. Its aim was mainly to ensure that the contaminated natural in Hamilton bay were replaced by safer swimming pools that did not endanger public health.

The title “Abandoning Nature” is used by the authors to demonstrate that there was departure from the use of natural waters at Hamilton’s bay through the creation of artificial pools that did not endanger public health. After the World War II however, pollution increased at an alarming rate and there are consequently no available lakeshores to accommodate the population of Ontario. The authors describe the paradigm shift in swimming pool facilities as the “constructive power of the profit motive”.

By 1953, Hamilton’s bay was viewed as one of the dirtiest industrial ports in Canada, thus necessitating the need for alternative swimming pool facilities. In fact, one local observer described the unhealthy condition of the Hamilton’s bay as the largest beautiful septic tank in the world. The main sewage disposal conduits of the city as well as major factories were situated at the waterfront of Hamilton bay. Due to the high rate of pollution, summertime swimming for most of the city dwellers subsequently became impossible. Because of these developments, the government initiated several regulatory measures to protect the public from the dangers posed by the polluted natural swimming pools along Hamilton’s bay. Principally, it passed a regulation that trespassing at the harbor shoreline was an offence punishable by law.

Mary Anne Poutanen’s Article

The author explores how the high prevalence of tuberculosis was a health catastrophe at Montreal schools. Poutanen starts by recognizing the failed health system of Montreal by describing it as the unhealthiest city in Canada in 1900. During this time, residences of the working class in the city were not only overcrowded, but also polluted by smoky factories, dusty streets and poor sanitation. In addition, the inner-city’s industrial employees lived in poorly maintained houses located in areas without any adequate green space . These conditions augmented the spread of tuberculosis in the city. Notably, school children were adversely affected. The wards of the working population of Montreal were situated below Mount Royal, which was known for its high infant mortality rates due to unpasteurized milk consumption.

The infant deaths caused by tuberculosis were increased rapidly because of the poverty and poor living conditions of the inner city dwellers . Frederick Lear was one of the school-going children who suffered from Tuberculosis. However, his condition was detected timely and suitable medication was prescribed. The author depicts Frederick as one of the more fortunate learners who recovered from the disease. The health system of Montreal could not help schools to fight the “white plague” – tuberculosis. Apart from poverty, poor living conditions and inadequate public health facilities, the author claims that tuberculosis became a health menace due to the city’s overreliance on private charities to cater for the health needs of residents and learners. From a school perspective, Poutanen claims that the Montreal Protestant School Board played a bigger role in containing and preventing tuberculosis in schools than the public health authorities of the city. In particular, the School Board spearheaded early detection initiatives for pupils and educated the public on how to prevent tuberculosis.

Megan Sproule-Jones’ Article

This article examines the contribution of Dr. Peter Bryce in championing the establishment of good public health systems in Canada in the first few decades of the 20th century. After Bryce successfully advocated for reforms in the native education system in Canada, he turned his attention to the collapsed public health system and facilities. He was specifically interested in pushing the government to initiate measures to combat diseases like tuberculosis that were the cause of high mortality rates among school children. Bryce was appointed as the Chief Medical Officer for Interior and Indian Affairs in 1904 . After uncovering the mess in public health systems, Bryce became a strong critic and advocate for proper health and education amenities for the native communities of Canada.

From the statistics he obtained over a period of 17 years, Bryce found that native Canadians had been marginalized and discriminated against in terms of health services and facilities. For instance, he found that people from native communities in Canada were 20 times more likely to contract and die from TB than the non-natives. To this end, his efforts became even bolder in advocating for the health rights of native Canadian learners attending residential schools. The author claims that his advocacy for the health needs of indigenous Canadians were largely successful and prompted countless reforms in the Canadian health system.

Poor Public Health

The theme of poor public health in Canada has been accurately depicted throughout the above articles. Peter Neary in his article, “Venereal Disease and Public Health Administration in Newfoundland in the 1930s and 1940s”, demonstrates how sexually transmitted diseases had become a health crisis in Newfoundland due to a poor public health system. In his view, the primary indicator of inadequate public health in Newfoundland, was the absence of a legislative framework that established clear modalities for managing serious health issues since the 1931 Act had not been implemeted . As such, the government was acting impulsively without any clear guidelines on how to control venereal diseases. Another indicator cited by Neary to vindicate his claims that the public health system in Newfoundland was defective, is the absence of resources to implement the Health and Public Welfare Act that was enacted in 1931. There were few health facilities and most of the medical practitioners in the region lacked sufficient knowledge of mitigate the spread of venereal disease.

Christopher Rutty, in his article “The Middle Class Plague: Epidemic Polio and the Canadian State, 1936-37”, blamed the polio pandemic on poor public health in Ontario and other parts of Canada. He, in particular, expressed grave concern that the federal and provincial health facilities in the region lacked sufficient capacity to manage the numerous and growing cases of polio. Christopher also claims that poor public health was the product of poor government planning and resource allocation in fighting polio. Low government investment in medical research and science is another factor that Christopher uses to illustrate the causes of poor public health in Ontario in the first half of the 20th century. In his view, the fact that a government can admit that it is helpless in fighting a particular disease is an irrefutable indicator of a failed public health system . In addition, the limitations experienced by provincial polio programs in terms of providing polio treatment and therapy as well as educating the public on polio, justifies Christopher’s claim that Ontario’s healthcare system was poor and could not contain the polio epidemic.

Bibliography

1. Bouchier, Nancy B. and Ken Cruikshank. “Abandoning Nature: Swimming Pools and Clean, Healthy Recreation in Hamilton, Ontario, 1930s–1950s,” Canadian Bulletin of Medical History 28, no. 2 (Fall 2011): 315-337.
2. Neary, Peter. “Venereal Disease and Public Health Administration in Newfoundland in the 1930s and 1940s.” Canadian Bulletin of Medical History 15, no. 1, (Spring 1998): 129-151.
3. Rutty, Christopher J. “The Middle Class Plague: Epidemic Polio and the Canadian State, 1936-37,” Canadian Bulletin of Medical History 13, no. 2 (Fall 1996): 277-314.
4. Poutanen, Mary Anne. ‘Containing and Preventing Contagious Disease: Montreal’s Protestant School Board and Tuberculosis, 1900–1947.’ Canadian Bulletin of Medical History 23, no. 2 (2006): 409
5. Sproule-Jones, Megan. ‘Crusading for the forgotten: Dr. Peter Bryce, public health, and prairie native residential schools.’ Canadian Bulletin of Medical History 13, no. 2 (1996): 200-218