Canada Slim and the Humanitarian Adventure

Landschlacht, Switzerland, Tuesday 10 December 2019

There are things in Switzerland (and in our existence) that we simply take for granted:

And the thing about Swiss stereotypes is that some of them are true.

Diplomatic?

Yes.

Efficient?

Absolutely.

Boring?

Only at first glance.

Despite being one of the most visited countries in Europe, Switzerland remains one of the least understood.

It is more than simply the well-ordered land of cheese, chocolate, banks and watches.

It is more than a warm summer mountain holiday upon a cobalt blue lake, more than skiing down the slopes of some vertiginous Alp, more than postcard pristine beauty.

It is easy for the tourist to remain blissfully unaware of Swiss community spirit, that it speaks four official languages, that it possesses stark regional differences from canton to canton, that it has exubrant carnivals, culinary traditions and sophisticated urban centres.

 

 

With its beautiful lakeside setting, Geneva (Genève) is a cosmopolitan city whose modest size belies its wealth and importance on the world stage.

French-speaking and Calvinistic it is a dynamic centre of business with an outward-looking character tempered by a certain reserve.

Geneva’s major sights are split by the Rhône River that flows into Lake Geneva (Lac Léman) and through the city’s several distinct neighbourhoods.

On the south bank (rive gauche), mainstream shopping districts Rive and Eaux-Vives climb from the water’s edge to Plainpalais and Vieille Ville, while the north bank (rive droite) holds grungy bars and hot clubbing Pâquis, the train station area and some world organizations.

 

 

A little over 1 km north of the train station is the international area, home to dozens of international organizations that are based in Geneva –  everything from the World Council of Churches to Eurovision.

Trains and buses roll up to the Place des Nations.

Gates on the Place des Nations open to the Palais des Nations, now occupied by UNOG, the United Nations Office at Geneva, the European headquarters of the United Nations, accessible only to visitors who sign up for a tour.

The huge monolith just off the square to the west, that looks like a bent playing card on its edge, is WIPO (the World Intellectual Property Organization), the highrise to the south is ITU (the International Telecommunications Union), just to the east is UNHCR (the United Nations High Commission for Refugees), and so on, and so on, and so on, an infinite combination of letters of the alphabet in an infinite variety of abbreviations and acronyms.

The giant Broken Chair which looms over the square was installed in 1997 for the international conference in Ottawa (Canada’s capital) banning the use of land mines, a graphic symbol of the victims of such weapons.

 

 

Geneva is also the birthplace of the International Red Cross / Crescent / Crystal Movement.

And it was the latter, along with the International Museum of the Reformation, that compelled me to visit Geneva.

 

 

(For details about the Musée Internationale de la Réforme, please see Canada Slim and the Third Man in my other blog, The Chronicles of Canada Slim.)

 

Genevè, Suisse, mardi le 23 janvier 2018

Housed within the HQ of the International Committee of the Red Cross (ICRC), the Musée International de la Croix-Rouge et du Croissant Rouge chronicles the history of modern conflict and the role the Red Cross has played in providing aid to combatants and civilians caught up in war and natural disasters.

Enter through a trench in the hillside opposite the public entrance of UNOG and emerge into an enclosed glass courtyard beside a group of bound and blindfolded stone figures.

The stone gathering represents the continual worldwide violation of human rights.

 

 

Inside, above the ticket desk, is a quotation in French from Dostoevsky:

“Everyone is responsible to everyone else for everything.”

 

Above: Fyodor Dostoevsky (1821 – 1881)

 

A free audioguide takes you through the Museum.

 

Twenty-five years ago, Laurent Marti, a former ICRC delegate, had the idea of creating the International Red Cross and Red Crescent Museum.

 

Above: Laurent Marti

 

Marti won the wives of US President Ronald Reagan and Soviet Premier Gorbachev over to his cause in a bid to obtain the support of their respective countries, together with that of local and international societies and personages and of various multinational companies representing a full range of human activities.

 

Above: Nancy Reagan (née Davis) (1921 – 2016)

 

Above: Raisa Gorbacheva (née Titarenko) (1932 – 1999)

 

The goal of the Museum is to emanate a very powerful atmosphere where no one leaves without having been shaken and deeply moved by what they had seen.

Suffering, death, wounds and mutiliations can be followed by a time of healing, restoration, reunification and an opportunity to be happy again, a right that seemed to have been withdrawn.

Of course, the scars remain deep within the human soul, but the hope of restoration and of a return to normalcy is the message of the Museum.

 

 

The International Red Cross and Red Crescent Movement is dedicated to preventing and alleviating human suffering in warfare and in emergencies, such as earthquakes, epidemics and floods.

The Movement is composed of the International Committee of the Red Cross (ICRC), the International Federation of Red Cross and Red Crescent Societies, and the 188 individual national societies.

Each has its own legal identity and role, but they are all united by seven fundamental principles:

•  humanity
•  impartiality
•  neutrality
•  independence
•  voluntary service
•  unity
•  universality

The interactive chronology covers one and a half centuries of history, starting with the creation of the Red Cross.

For each year, the events listed include:

•  armed conflicts which caused the death of more than 10,000 people and/or affected more than one million people
•  epidemics and disasters that caused the deaths of more than 1,000 people and/or affected more than one million people
•  significant events in the history of the Movement
•  cultural and scientific milestones

 

 

In 1859 Henri Dunant was travelling on business through northern Italy.

 

Above: Henri Dunant (1828 – 1910)

 

He found himself close to the Solferino battlefield just after the fighting.

The battle of Solferino was a key episode in the Italian Wars.

 

 

With the support of France under Napoleon III, Victor Emmanuel II of Savoy, King of Piedmont, endeavoured to unite the different Italian states.

In spring 1859 the Piedmont forces clashed with the Austrian Empire, which had control over Lombardy and Venetia.

On 24 June 1859, the Franco-Piedmontese troops defeated the Austrians at Solferino, in a battle that left more than 40,000 dead and wounded.

Overwhelmed by the sight of thousands of wounded soldiers left without medical care, Dunant organized basic relief with the assistance of the local people.

 

 

“On that memorable 24th of June 1859, more than 300,000 men stood facing each other.

The fighting continued for more than 15 hours.

No quarter is given.

It is a sheer butchery, a struggle between savage beasts.

The poor wounded men that were picked up all day long were ghastly pale and exhausted.

Some, who had been the most badly hurt, had a stupified look.

How many brave soldiers, undettered by their first wounds, kept pressing on until a fresh shot brought them to earth.

Men of all nations lay side by side on the flagstone floors of the churches of Castiglione.

The shortage of assistants, orderlies and helpers was cruelly felt.

I sought to organize as best I could relief.

The women of Castiglione, seeing that I made no distinction between nationalities, followed my example.

“Siamo tutti fratelli” (we are all brothers), they repeated feelingly.

 

Above: Ossuary of Solferino

 

But why have I told of all these scenes of pain and distress?

Is it not a matter of urgency to press forward to prevent or at least alleviate the horrors of war?

Would it not be possible, in time of peace and quiet, to form relief societies given to the wounded in wartime?

Societies of this kind, once formed and their permanent existence assured, would be always organized and ready for the possibility of war.

Would it not be desirable to formulate some international principle, sanctioned by a Convention inviolate in character, which, once agreed upon and ratified, might constitute the basis for societies for the relief of the wounded?”

 

Above: Ossuary of Solferino

 

Back home in Geneva, Dunant wrote A Memory of Solferino.

The book was published in 1862 and was an immediate success.

 

 

In it, Dunant made two proposals:

• the formation of relief societies which would care for wounded soldiers
• the establishment of an international convention to guarantee their safety

Those ideas led, the following year, to the foundation of the Red Cross, and ten months later to the first Geneva Convention.

 

 

In 1863, in response to Dunant’s appeal, Gustave Moynier persuaded the Geneva Public Welfare Society to consider the possibility of training groups of volunteer nurses to provide relief for the wounded.

A committee was set up, the International Committee for Relief to the Wounded, the future ICRC, was born.

 

Above: Gustave Moynier (1826 – 1910)

 

The need to defend human dignity has been a constant concern throughout history.

From the Code of Hammurabi (1750 BC) to the Universal Declaration of Human Rights (1948), texts from all periods and cultures exist to testify to that.

Those texts were frequently written in response to incidents in which human dignity was shown no consideration – slavery, chemical weapons, civilian bombing, concentration camps, atomic bombing, sexual violence, landmines, child soldiers, prisoners with no legal status.

Throughout time mankind has determined:

• that the strong should not suppress the weak (Code of Hammurabi – Mwaopotamia 1750 BC)

Above: Stele of the Code of Hammurabi

 

• that peace is possible between warring nations (Treaty of Kadesh, the oldest peace treaty known to man and the first written international treaty –  Egypt 1279 BC)

Above: Treaty of Kadesh

 

• that we should be free to practice our own religions (Cyrus Cylinder – Persia 539 BC)

Above: Cyrus Cylinder

 

• that we should not do unto others what we don’t wish done to ourselves (The Analects of Confucius – China 480 BC)

Above: The Analects

• that we should live lives of non-violence with respect towards all (The Edicts of Ashoka – India 260 BC)

Above: The Edicts of Ashoka

 

• that power should not be used arbitrarily nor imprisonment without just cause (The Magna Carta – England 1215)

Above: Magna Carta

 

• that all persons are free and that no one is a slave to another (The Manden Charter – Mali 1222)

Above: The Manden Charter

 

• that women and children and the insane have dignity and rights that must be respected (The Viqayet – Muslim Spain 1280)

 

• that mankind has natural and inalienable rights (freedom, equality, justice, community) (Declaration of the Rights of Man and of the Citizen – France 1789)

 

• that the wounded need to be treated regardless of nationality, that all human beings are free and equal in dignity and in rights (Universal Declaration of Human Rights – United Nations 1948)

 

The original title of the initial Geneva Convention was the Convention for the Amelioration of the Condition of the Wounded in Armies in the Field.

It had only ten articles and one sole objective:

To limit the suffering caused by war.

Article 7 provided for the creation of the protective emblem of the red cross.

This document laid the foundations of international humanitarian law, marks the start of the humanitarian adventure.

By 2013, 194 nations are party to the Geneva Conventions of 12 August 1949.

(See http://www.icrc.org for the complete list.)

 

The Museum explains how the Geneva Conventions developed from one man’s battlefield encounter.

After Dunant’s publication of A Memory of Solferino in November 1862, Gustave Moynier (1826 – 1910), chairman of the Geneva Public Welfare Society, in response to Dunant’s appeal, persuaded Society members the following February to consider the possibility of training groups of volunteer nurses to provide relief for the war wounded.

An ad hoc committee was set up – the International Committee for Relief to the Wounded.

The future ICRC was born.

 

Above: ICRC Headquarters, Geneva

 

“Ambulances and military hospitals shall be recognized as neutral and as such protected and respected by the belligerants as long as they accommodate wounded and sick.” (Article 1)

“Inhabitants of the country who bring help to the wounded shall be respected and shall remain free.” (Article 5)

“Wounded or sick combatants, to whatever nation they may belong, shall be collected and cared for.” (Article 6)

“A distinctive and uniform flag shall be adopted for hospitals, ambulances and evacuation parties.” (Article 7)

A red cross on a white background was adopted in 1863, followed by a red crescent, a red lion and red sun (1929) and a red crystal (2005).

 

To protect the victims of conflict, the ICRC has at its disposal several instruments defined by international humanitarian law.

“At all times, parties to the conflict shall, without delay, take all possible measures to search for and collect the wounded and sick.”

“The civilian population as such, as well as individual civilians, shall not be the object of attack.”

“The parties to the conflict shall endeavour to conclude local agreements for the passage of medical personnel and medical equipment.”

“Civilian hospitals may in no circumstances be the object of attack.”

“It is prohibited to commit any acts of hostility directed against historic monuments, works of art or places of worship.”

“Works or installations containing dangerous forces, namely dams, dykes and nuclear stations shall not be made the object of attack.”

“It is prohibited to attack, destroy, remove or render useless objects indispensible to the survival of the civilian population.”

 

Above: The Red Cross in action, 1864

 

The Second World War (1939 – 1945) involved 61 countries in war and caused the death of around 60 million people, more than half of whom were civilians.

In 1945 more than 20 million people had been displaced.

In 1995 the ICRC publicly described its attitude to the Second World War Holocaust as a “moral failure“.

 

Above: Images of World War II (1939 – 1945)

 

The persecution of the Jews by the Nazis began shortly after Hitler came to power in 1933 and subsequently continued to intensify, culminating in systematic extermination from 1942 onwards.

 

Above: Auschwitz, Poland, May 1944

 

At the time, the ICRC had no legal instrument to protect civilians.

The 1929 Convention relative to the Treatment of Prisoners of War applied only to members of the armed forces.

The organization thus considered itself powerless in the face of the anti-Semitic fury of the Nazi dictatorship.

 

 

Thus in October 1942 the Committee refused, in particular, to launch a public appeal on behalf of civilians affected by the conflict.

Although the International Red Cross endeavoured to provide aid for Jewish civilians, it erred on the side of caution.

 

Above: Jewish women, occupied Paris, June 1942

 

It was not until the spring of 1944 that a change of strategy took shape.

As Germany’s war efforts collapsed, ICRC delegates belatedly managed to enter some concentration camps, becoming voluntary hostages in order to prevent the further massacre or forced evacution of the prisoners.

 

Above: Auschwitz, May 1944

 

The harsh lesson of the Second World War had been learned.

In 1949 the Fourth Geneva Convention was adopted:

It provides protection for civilians during armed conflict.

It was complemented in 1977 by additional protocols which reinforce the protection given to victims of armed conflicts, international or domestic.

In particular, the additional protocols established the distinction between civilians and combatants.

 

In an armed conflict, the ICRC’s mandate is to ensure respect for the Geneva Conventions.

When the ICRC observes serious violations of the Conventions, it points them out to the countries concerned in confidential reports.

However, on occasion, that information has been published in the press:

• Le Monde during the Algerian War

Above: Images of the Algerian War (1954 – 1962)

 

• The Wall Street Journal about Abu Ghraib Prison

Above: Lynndie England with “Gus“, Abu Ghraib Prison, Iraq

 

• The New York Review of Books / Wikileaks about Guantanamo Prison

Above: Guantanamo “Gitmo” Prison, Cuba

 

Such leaks put the ICRC in a difficult position as discretion is a necessary part of its work and its discussions with the authorities.

Its confidentialiy policy actually facilitates access to detainees, wounded people and groups of civilians.

When humanitarian diplomacy fails, the ICRC then resorts to a more open form of communication.

It then issues press releases publicly condemning serious violations of the Conventions.

In the 1980s the United Nations Security Council set up ad hoc tribunals to judge the crimes committed in former Yugoslavia and in Rwanda.

In 1998 the International Criminal Court (ICC) was established.

It was a permanent institution with the power to open investigations, to prosecute and to try people accused of committing war crimes, genocide or crimes against humanity.

The ICC began its work in 2005 by opening three investigations into crimes:

• in the Democratic Republic of the Congo
• in Uganda
• in the Sudan

The existence of a permanent international court gives the world the means of determining facts and of punishing those responsible for the crimes.

It gives victims an opportunity to have their voice heard.

 

Above: Logo of the International Criminal Court

 

Poverty, migration, urban violence….

All of them are present-day threats to human dignity.

All over the world, large sections of the population are living in extremely precarious hygenic conditions.

 

Economic changes are forcing more and more people to emigrate.

Those migrants, who frequently have no identity documents, are exploited and ostracized.

In some megacities, whole districts are at the mercy of armed groups which terrorize the inhabitants.

Each of those situations presents a challenge to which a response must be found.

 

Above: Syrian refugees, Ramtha, Jordan, August 2013

 

Since the First World War, the ICRC has had the right to visit prisoners of war and civilian detainees during an international armed conflict.

In other situations, the right to meet prisoners must be negotiated with the authorities.

Visiting prisons, talking to the detainees and making lists of their names are ways of preventing disappearances and ill treatment.

After each prison visit, ICRC delegates write a report.

They must have access to all places of detention and be allowed to repeat their visits as often as necessary.

The visits always follow the same procedure.

Following a meeting with those in charge of the prison, the delegates inspect the premises: cells, dormitories, toilets, the exercise yard, the kitchen and any workshops.

They draw up a list of prisoners and interview them in private without witnesses.

At the end of the visit, the delegates inform those in charge of the prison of their observations.

They then prepare a confidential report for the authorities.

 

 

The visitor sees many photographs of prison visits, including those to a German POW camp in Morocco, to French POWs in a German Stalag, political detainees in Chile, detainees in Djibouti….

But it is items from these visits given by prisoners to the ICRC delegates that tell far more emotional stories.

Some examples:

• a model village showing ICRC activities in Rwanda
• a doll figure of a female delegate made in an Argentinian prison
• a pearl snake made by Ottoman prisoners
• a necklace with a Red Cross pendant made by a lady prisoner in Lebanon
• a ciborium (a container for Catholic mass hosts – symbols of the body of Christ) made of bread by Polish prisoners of conscience
• a bar of soap carved into the shape of a detainee in a cell made by a Burmese artist imprisoned for suspected ties to the opposition party

 

An installation in the Museum that followed seemed somewhat incongruous….

Therein the visitor can change and produce large flows of different colours by touching a wall.

The idea is that the larger the number of visitors, the richer the flow of colours, so as to provide an interactive experience that appeals to people’s senses, emotions and feelings, thus all visitors become part of a colourful celebration of human dignity.

Honestly….

This felt more like a gimmick to capture children’s hyperactive attention than an exhibit that strengthens human unity, designed more to entertain than educate.

 

 

Human beings are social beings who are defined by their links with others.

When those links are broken, we lose part of our identity and our bearings.

Of the many activities the ICRC performs, the giving and receiving of news and finding one’s loved ones again are understood to be elements of stability that are critical during crisis situations.

 

 

This Museum has, like the Reformation Museum in this city, as other museums in other cities and countries I have visited, its own Chamber of Witnesses – video testimonials whose lifelike likenesses are meant to invoke within the voyeur a sense of how we are not unlike those speaking with us electronically.

We see Toshihiko Suzuki, a dentist and specialist in craniofacial anatomy, tell us how he identified victims of the 2011 tsunami.

We learn of the experience of Sami El Haj, an Al Jazeera journalist held in Guantanamo from 2002 to 2008.

We consider the life of Liliose Iraguha, a survivor of the Rwandan genocide.

We marvel at the resilience of human beings by listening to Boris Cyrulnik, a French neuropsychiatrist and ethologist.

 

 

During a conflict or a natural disaster, many people are cut off from their families – by capitivity, separation or disappearance.

Tracing one’s loved ones and passing on one’s news become basic needs.

 

 

Originally intended for victims of war, the ICRC tracing services subsequently expanded to include persecuted civilians.

More recently, tracing activities have been extended to families who have become separated as a result of natural disasters or migration.

The International Prisoners of War Agency (1914 – 1923) was established by the ICRC, shortly after the start of the First World War – which involved 44 states and their colonies and caused the death of more than 8 million people, 20 million wounded and in the immediate post-war period of epidemics, famine and destitution another 30 million deaths.

Organised in national sections, its archives contain six million index cards that document what happened to two million people: prisoners of war, civilian internees and missing civilians from occupied areas.

The cards contain information about individual detainees. when they were taken captive, where they were held and, if relevant, when they died.

People who were without news of a loved one could present a request to the Agency, which would then send them what information it had.

Today the Agency’s documents are still used to reply to requests from families as well as to enquiries from historians.

And, as far as I could tell, the Agency is now in the Museum.

It contains:

• 5,119 boxes with 6 million index cards
• 2,413 files containing information provided by the belligerents
• 600,000 pages filling 20 linear metres of general files

This location is fitting for it was in the Rath Museum in Geneva where the Agency once was.

In all, more than 3,000 volunteers, most of them women, worked there during the conflict.

During the War, the Agency dispatched 20 million messages between detainees and their families and forwarded nearly 2 million individual parcels as well as several tonnes of collective relief.

The Agency’s role was also to obtain the repatriation of prisoners who had been taken captive in breach of the Geneva Conventions: doctors, nurses, stretcher bearers and military chaplains.

It helped to ensure that the wounded were returned home or interned in neutral countries.

 

 

The pacifist writer Romain Rolland was one of the Agency’s first volunteers:

“Its peaceful work, its impartial knowledge of the actual facts in the belligerent countries, contribute to modify the hatred which wild stories have exasperated and to reveal what remains of humanity in the most envenomed enemy.”

 

Above: Romain Rolland (1866 – 1944)

 

It was not until the end of the Second World War that Europe realized the extent of the tragedy affecting civilians.

The International Tracing Service (ITS) was then established.

The ITS has files on more than 17 million people: civilians persecuted by the Nazis, displaced persons, children under the age of 18 who had become separated from their families, forced labourers and people held in concentration camps or labour camps.

The ITS was set up in Bad Arolsen, Germany, and has helped millions of people to trace their loved ones.

 

Above: International Tracing Services, Bad Arolsen, Germany

 

Nowadays, the need to trace missing people also extends to the victims of natural disasters and to migrants, using not only index cards, but photo tracing (used to find nearly 20,000 children missing during the 1994 genocide in Rwanda), distributions of name lists (for example, the Angola Gazette – a list of people who went missing during the Angolan Civil War from 1975 to 2002) and the Internet (for example, http://www.familylinks.icrc.org).

 

Despite all tracing efforts, sometimes missing people do not get found, do not go home.

In that case, receiving confirmation of death puts an end to uncertainty and enables families to begin the process of mourning and to start to rebuild their lives.

The erection of memorials is one way of honouring the dead and of giving them a place of dignity in the collective memory.

 

 

For example, in 1995 the city of Srebrenica was attacked by forces under the command of General Radko Mladic.

 

 

Mladic had the women and children of this refuge of hounded Muslim civilians separated from the men and forced to leave Srebrenica.

The men were hunted down and killed.

More than 8,000 people went missing.

By 2010 only 4,500 victims had been identified and buried.

 

 

When faced with a collective tragedy and without a dead body, families are completely at a loss.

A memorial is sometimes their only means of paying tribute to the dead, of giving them a place in the collective consciousness and of recalling the events that led to those disappearances.

Examples include victims from:

• the 1945 atomic bombing of Hiroshima

Above: Hiroshima Peace Memorial (Genbuko Dome)

 

• the deportation of Jews from France

 

• the Khmer Rouge regime in Cambodia

 

• the Soviet gulags

 

• the nuclear disaster in Chernobyl, Ukraine

 

• the civil war in Peru

 

• the earthquake in Sichuan, China

 

• the 9/11 attack in New York City

 

Communication is often disrupted during a conflict or a natural disaster.

In circumstances like that, receiving news from one’s family is a source of joy and relief.

There are different ways of sending news:

• Red Cross messages (in use for more than a century)
• Radio messages
• Videoconferencing
• Satellite telephones

 

A Red Cross message is a short personal missive that was first used in the Franco-Prussian War (1870 – 1871).

It is still in use today.

Each year, thousands of messages are distributed in more than 65 countries with the help of the ICRC.

To make sure that they reach the addressees, messengers sometimes travel long distances to extremely remote areas.

The messages themselves are generally very simple.

The main thing is to enable people to pass brief news on to their loved ones – their state of health, their place of shelter or detention.

 

 

For example, the Museum shows messages:

• sent by a French POW to his godmother in Switzerland
• exchanged by a French POW in Morocco and Algeria and his family in France
• written by aircraft passengers taken hostage in Jordan in 1970
• illustrated by children during the Yugoslav conflict in 1994
• by a Sudanese detainee in Guantanamo
• from a Greek child refugee following the Cyprus conflict of 1974
• from a mother to her son in Liberia
• from a little girl writing to her parents in the Congo
• written by a woman to her brother in prison in Kirghizstan

 

In Columbia, the radio programme Las voces del secuestro broadcasts family messages to people held hostage in the jungle, enabling more than 18,000 people to send news to their loved ones.

 

 

In Bagram Prison in Afghanistan, no family visits are allowed, so in 2008 the ICRC and the American authorities developed a videoconferencing system to enable the detainees to communicate with their loved ones.

In the space of just a few months, 70% of the detainees were able to contact their families.

 

Above: Parwan Detention Facility, Bagram, Afghanistan

 

And finally the Restoring Family Links exhibition concludes with works by Congolese artist Chuck Ledy and Benin artist Romuald Hazouma.

 

 

Humanity has progressed by refusing to accept the inevitability of the phenomena that endanger it.

In the face of natural disasters and epidemics, communities take action to prevent the worst, to save lives and to preserve resources.

Another Chamber of Witnesses:

• Benter Aoko Odhiambo, the head of a Kenyan orphanage and the initiator of a market gardening programme
• Abul Hasnat, a Bangladeshi school teacher and a Red Crescent volunteer
• Madeleen Helmer, the Dutch head of the ICRC Climate Centre
• Jiaqi Kang, a Chinese student in Switzerland

 

After all, prevention concerns us all.

Blast Theory, a group of British artists, designed the game Hurricane to test the effectiveness of natural disaster preparedness activities.

Planting mangroves, constructing high-level shelters, building up reserve stocks of food and organizing evacuation exercises are all part of the game and involve actors such as ICRC delegates, village leaders, experts and volunteers.

As the hurricane strikes, the players have to evacuate the villagers.

At the end of the game tells us how many lives were saved.

 

 

Posters are key communication instruments in prevention initiatives.

The link between pictures and text makes the messages easy for everyone to understand.

The Museum’s collection of some 12,000 posters from more than 120 countries tells of the many different activities developed by the ICRC.

Nowadays, as the impact of global warming becomes clearer, the ICRC is increasingly involved in natural disaster preparedness.

 

 

The ICRC was very quick to perceive the role that the cinema could play in promoting its activities.

Some films focused on prevention – hygiene, epidemics and accidents.

Others on training volunteers in first aid or life saving.

While preventing illnesses and accidents is ancient history, the management of risks associated with natural disasters is a more recent development.

A workshop at the Haute école d’art et de design (Gèneve) was given a free hand to create new montages using more than 1,000 films from the Museum’s collection.

 

Above: Haute école d’art et de design, Genève

 

Prevention is first and foremost about saving lives.

A number of different measures can be taken to provide protection: building shelters, installing early warning systems, carrying out evacuation exercises and providing hygiene education.

All these activities mobilize the local communities and the humanitarian organizations.

They sometimes call for substantial investment.

It is easy to raise funds during disasters when emotions are running high.

It is more difficult to raise funds for longer-term work.

Nonetheless, one dollar invested in prevention is two to ten dollars saved in emergency relief and reconstruction work.

 

 

All of this is brought into sharp focus by the three “théâtres optiques” (Cyclone, Tsunami and Latrines), created for the Museum by the French artist Pierrick Sorin.

 

Above: Pierrick Sorin

 

Let’s take, for example, Bangladesh.

 

Above: Flag of Bangladesh

 

In 1970, Cyclone Bhola caused one of the worst natural disasters in history.

A 10-metre high wave and winds of 220 km/hour caused the death of 500,000 people here.

A cyclone preparedness programme was then launched, which included an early warning system, the construction of shelters and the training of evacuation volunteers.

 

 

In November 2007, Cyclone Sidr, one of the most powerful ever recorded, hit parts of Bengal and Bangladesh, affecting nearly 9 million people and causing vast economic damage.

1.5 million people were evacuated before the Cyclone struck.

Although 3,500 people died, this number of deaths was far below the 1970 disaster.

 

 

Or let’s consider Brazil.

 

Above: Flag of Brazil

 

Infectious diarrhoea can affect people throughout the world.

It is most frequently caused by water that has been contaminated by faeces.

Around 2 million people die from diarrhoea every year, most of them children in developing countries.

In 2008 more than 2 billion individuals were without suitable latrines.

Almost half of them defecated in the open air.

In 1997, the authorities in Salvador de Bahia in Brazil launched a water purification programme in the city.

A university team monitored 2,000 children under the age of 3, most of whome were living in impoverished urban districts.

The results showed that water purification had a direct impact on health:

The overall number of cases of diarrhoea fell by 22% in the city and by 43% in the poorest areas.

 

Above: Images of Salvador de Bahia, Brazil

 

The Museum was never designed with the intention of casting blame or lavishing praise upon particular countries or particular individuals, but rather it shows the situations, both general and particular, in which the ICRC functions and to further a better understanding of what they do.

The ICRC aids victims, not on account of their particular nationality or their particular cause, but purely and simply because they are human beings who are suffering and are in need of help.

It strives to assuage all human distress which has no hope of effective aid from other sources.

The ICRC desires to relieve above all that suffering which is brought about by man, brought about by man’s inhumanity to man, and is more painful on that account and more difficult to relieve.

 

The most terrible form of man’s inhumanity to man is war and that is why the idea of the Red Cross was born in the field of battle.

The Red Cross is a third front above and across two belligerent fronts, a third front directed against neither of them but for the benefit of both.

The combatants in this third front are interested only in the suffering of the defenceless human being, irrespective of his nationality, his convictions or his past.

The ICRC fights wherever they can against all inhumanity, against every degradation of the human personality, against all injustice directed against the defenceless.

These neutrals on this humanitarian front are free of the prejudice and hostility which is so natural to men engaged in warfare.

The dominant idea and the essence of the Geneva Convention is equality of treatment for all sick and wounded persons whether they are friends or enemies.

 

It is the fulfilment of the cry of Solferine:

Siamo tutti fratelli.

We are all brothers.

 

 

The Museum is a living embodiment of that humanitarian adventure.

It is an edifice of humanity working for humanity.

And it is good.

 

 

Sources: Wikipedia / Google / Lonely Planet Switzerland / Rough Guide to Switzerland / Red Cross Museum, The Humanitarian Adventure / The International Committee of the Red Cross, Basic Rules of the Geneva Conventions and their Additional Protocols / Dr. Marcel Junod, Warrior without Weapons

 

 

 

 

 

 

 

 

 

Canada Slim and the Body Snatchers

Landschlacht, Switzerland, 4 September 2018

I should be dead.

In fact, for at least a quarter of a century.

Back in Canada, I tried to chop a log.

The axe bounced off the log and sliced into my foot.

A mile in the bush limp, a drive home, a quick dash to the local hospital and an ambulance ride from there to the metropolis of Montréal, followed by surgery, hospitalization and convalescence….

And I am alive to tell the tale.

This injury, sadly, was the first of many unfortunate accidents I have had, transforming my body from a wonderland into a battlefield.

In earlier days, blood loss or infection might have ended my life, but I live, as many others live, longer and healthier.

We live in an age where the human anatomy has been mapped, where an abundance of drugs are available, where antiseptic conditions are par for the course in all medical institutions, where medical professionals are highly trained and qualified, where the deliverance of babies is no longer such a danger for infant or mother.

A time of liver and lung, uterus and penis, skull and scalp, arm and hand, face and heart, eye and hip replacements, appendectomies and mastectomies….

A time of virtual and remote, robot-assisted and laser-aided, plastic and emergency surgery….

Days of disinfectant, inoculation, anesthesia, x-rays, MRIs and ultrasound….

 

I take my survival for granted, confident in the advances available to me in case of injury or illness.

 

Sometimes it is good to visit places that remind one of how and why mankind has been able to survive the rigours and ravages inflicted upon the body.

Such a place is in London at a venue of body snatchers and “the fastest knife in the West End“.

The tale begins last fall and travels back in time.

Welcome….

25 October 2017

We spend 80% of our adult lives working, but, on average, 80% of workers often confess that they dislike the work that they do.

My wife is among the happy minority of those who do what they love and love what they do.

My wife is a doctor.

When we travel together it is not uncommon to find us visiting, among many, tourist attractions that are medically themed.

During our week in London we would visit at least three attractions of this nature.

 

(For other London attractions not medically themed, please see: Canada Slim and….

• the Danger Zone
• the Paddington Arrival
• the Street Walked Too Often
• Underground
• the Outcast
• the Wonders on the Wall
• the Calculated Cathedral
• the Right Man
• the Queen’s Horsemen
• the Royal Peculiar
• the Uncertainty Principle
• the Museum of Many

For medically themed London attractions, please see Canada Slim and….

• the Lamp Ladies
• the Breviary of Bartholomew)

 

London has its fair share of quirkiness:

Near Wimbledon there is an authentic Buddhist temple that feels like it was discretely teleported directly from Thailand. (Buddhapadipa Temple)

One can climb a castle as if it were the rock face of Mount Everest or the Matterhorn. (Castle Climbing Centre)

Or visit a house lacking electricity and modern plumbing on a Monday night, Silent Night, candlelight tour. (Dennis Severs’ House)

Or tread softly in the necropolis that is Highgate Cemetery.

Come and watch people swing from the gallows. (London Dungeon)

Listen to Anne Boleyn plead her case just before her head is deftly separated from her soft narrow shoulders. (London Dungeon)

Walk by moonlight the Whitechapel backstreets as Jack the Ripper knew them. (London Dungeon)

 

We did none of these things, but this is not to suggest that our time was devoid of quirkiness….

 

Time is often not our friend when we travel, so we took the Tube to London Bridge Station instead of walking across the Thames River upon the London Bridge.

We would later sail underneath it but we denied ourselves the tactile experience of trodding upon it.

The River Thames is the longest river in England and the second longest in Britain (after the Severn) and is crossed by over 200 bridges, 27 tunnels, six public ferries, a cable car and a ford.

Prior to the commencement of my relationship with my wife, I followed on foot the Thames from its source near Cirencester to Oxford.

I would, on visits to London, also spend time by its banks.

 

There has been a London Bridge spanning the Thames since AD 50 and it could be argued that without a London Bridge there might never have been a London.

 

The first London Bridge was built by the Romans (“What have they ever done for us?“) as part of their road-building programme, to help consolidate their conquest.

This Bridge, and those London Bridge constructions that followed until 1209, was built of wood.

These timber crossings would fall into disrepair, be rebuilt and destroyed by both Saxons and Danes, be destroyed by the London tornado of 1091 and the fire of 1136.

The nursery rhyme “London Bridge is falling down” is connected to the Bridge’s historic collapses.

 

After the murder of friend/foe Thomas à Becket, the penitent King Henry II commissioned a new stone bridge with a chapel in the centre dedicated to Becket as martyr.

Begun in 1176, London Bridge was completed in 1209 during the reign of King John.

The Old London Bridge (1209 – 1831) was 26 feet / 8 metres wide, 900 feet / 270 metres long, supported by 19 irregularly spaced arches.

It had a drawbridge to allow for the passage of tall ships and defensive gatehouses on both ends.

By 1358 it was already crowded with 138 shops.

The buildings on London Bridge were a major fire hazard and the increased load on the arches required their reconstruction over the centuries.

In 1212, fire broke out on both sides of the Bridge simultaneously trapping many people in the middle.

Houses on the Bridge were destroyed during Wat Tyler’s Peasants’ Revolt (1381) and Jack Cade’s Rebellion (1450).

By the time of the Tudors there were over 200 buildings on the Bridge, some seven stories high, some overhanging the river by seven feet, others overhanging the road forming a dark tunnel through which traffic had to pass.

Yet this did not prevent the addition, in 1577, of the palatial Nonsuch House to the buildings that crowded the span.

The available roadway was just 12 feet / 4 metres wide , divided into two lanes, so that in each direction, carts, wagons, coaches and pedestrians shared a single file lane 6 feet / 2 metres wide.

 

The bridge’s southern gatehouse became the scene of one of London’s most gruesome sights – a display of the severed heads of traitors, impaled on pikes, dipped in tar and boiled to preserve them against the elements.

The head of William Wallace was the first to appear on the gate in 1305, starting a tradition that was to continue for another 355 years.

 

(Keep this morbid tradition in mind while remembering that before the Anatomy Act of 1832, the only legal supply of corpses for anatomical purposes in the UK were those condemned to death and dissection by the courts.)

 

Other famous heads on London Bridge pikes included Jack Cade (1450), Thomas More (1535), Bishop John Fisher (1535) and Thomas Cromwell (1540).

In 1598, a German visitor to London, Paul Hentzner, counted over 30 heads on the Bridge.

John Evelyn’s Diary noted that the practice stopped in 1660, following the Restoration of King Charles II, but heads were reported at the site as late as 1772.

By 1722 congestion was becoming so serious that the Lord Mayor decreed that “all carts, coaches and other carriages coming out of Southwark into this City do keep all along the west side of the Bridge, and all carts and coaches going out of the City do keep along the east side of the Bridge.”

This has been suggested as one possible origin for the practice of traffic in Britain driving on the left.

By 1762, all houses and shops on the Bridge had been demolished through an Act of Parliament.

Even so, the Bridge was narrow, decrepit and long past its useful life.

 

The New London Bridge (1831 – 1967) was completed in 1831, and was 928 feet / 283 metres long and 49 feet / 15 metres wide.

By 1896 the Bridge was the busiest point in London and one of its most congested: 8,000 pedestrians and 900 vehicles crossed every hour.

This Bridge is a prominent landmark in T.S. Eliot’s “The Wasteland“, wherein he compares the shuffling commuters across London Bridge to the hellbound souls of Limbo, the first circle of Hell, in Dante’s Inferno.

Subsequent surveys showed that the Bridge was sinking an inch / 2.5 cm every eight years.

By 1924 the east side of the Bridge had sunk 4 inches / 9 cm lower than the west side.

The Bridge would have to be removed and replaced.

In 1967 the City of London placed the Bridge on the market.

 

On 18 April 1868, the Bridge was purchased by Missouri oil entrepreneur Robert McCullough for US $2,460,000.

As the Bridge was dismantled, each piece was meticulously numbered, then shipped via the Panama Canal to California and then trucked from Long Beach to Lake Havasu City in Arizona.

This Bridge was rebuilt across the Bridgewater Channel canal and opened on 10 October 1971.

Gary Nunn’s song “London Homesick Blues” includes the lyrics:

“Even London Bridge has fallen down and moved to Arizona.

Now I know why.”

The modern, current London Bridge was opened on 17 March 1973, with a length of 928 feet / 283 metres.

 

Emerging from the London Bridge Tube Station I recall John Davidson’s poem “London Bridge” and think to myself that clearly Heathrow Airport hadn’t been built when he wrote it:

“Inside the Station, everything’s so old,

So inconvenient, of such manifold

Perplexity, and, as a mole might see

So strictly what a Station shouldn’t be,

That no idea minifies the crude

And yet elaborate ineptitude.”

The main line station is the oldest railway station in London fare zone 1 and one of the oldest in the world having opened on 14 December 1836.

It is one of two main line termini in London to the south of the River Thames (the other being Waterloo) and is the fourth-busiest station in London, handling over 50 million customers a year.

 

In Tudor and Stuart London, the chief reason for crossing the Thames, to what is now Southwark, was to visit the disreputable Bankside for its pubs, brothels and bear-baiting pits around the south end of London Bridge.

Four hundred years later, Londoners have rediscovered the habit of heading to Southwark, thanks to the traffic-free riverside path and a wealth of top attractions, with the charge led by the mighty Tate Modern.

Of these attractions, the most educational and strangest is the Old Operating Theatre Museum and Herb Garret, at 9a St. Thomas Street.

The operating theatre and garret (1822 – 1862) were originally part of St. Thomas Hospital, itself part of the Augustinian Priory of St. Mary Overie, founded in 1106.

The Priory, which stood on the present site of Southwark Cathedral, provided care for the poor and gave board and lodgings to pilgrims.

The “spital” of St. Mary Overie was named St. Thomas in 1173 in tribute to Thomas à Becket, the Christian martyr murdered in Canterbury Cathedral in 1170.

When the Priory and the Hospital were destroyed by fire in 1212, the Bishop of Winchester, Pierre des Roches, paid for them to be rebuilt.

The new Hospital, independent of the Priory, was opened in 1215.

It continued to be staffed by monks and nuns, but surgical work was carried out by barbers since the Council of Tours (1163) had ordained that the shedding of blood was incompatible with holy office.

St. Thomas still provided hospitality for pilgrims.

 

Funds for the Hospital were largely provided by donations from individuals who believed giving to the poor would speed their spiritual journey to heaven.

One donation came from Alice de Bregerake who gifted her property in return for a yearly rent of one single rose.

 

(“There’s a lady who knows all that glitters is gold and she’s buying a stairway to heaven.“)

 

During the early 1500s, Southwark was a thriving community and St. Thomas was at its heart.

Within St. Thomas was the Southwark School of Glaziers, where the stained glass windows for King’s College Chapel in Cambridge were made.

In 1537, the first complete edition of the Holy Bible in English was completed here.

In January 1540 the Priory was dissolved by King Henry VIII, as part of his reforms of the church in England, and the Hospital closed.

In 1551 the Hospital was purchased and repaired by the City of London and two years later Henry’s son Edward VI awarded it a Royal Charter alongside four other London hospitals.

In 1681 fire led to the loss of 24 Hospital buildings.

By 1702 the main Hospital consisted of three grand classical courtyards.

 

In 1703, Dr. Richard Mead (1673 – 1754), one of London’s most famous physicians, was appointed to the Hospital staff.

At the time one of the most common ailments of St. Thomas in-patients, who were treated in the foul wards at the rear of the Hospital, was venereal disease.

Above: Richard Mead

 

(Remember the aforementioned brothels?)

 

Mead’s recommended cure, aqua limacum (snail water), was included in the Pharmacopoeia Pauperum (a directory of medical treatments to be used in London hospitals) in 1718:

“Take garden snails, cleansed and bruised, 6 gallons; earthworms, washed and bruised, 3 gallons; common wormwood, ground ivy and carduus, each one pound and half penny royal; juniper berries, fennel seeds, aniseeds, each half a pound; cloves and cubebs bruised, each 3 ounces; spirit of wine and spring water, of each 8 gallons.

Digest them together for the space of 24 hours and then draw it off in a common alembick.

This is admirably well contrived both for cheapness and efficacy.

It is as good a snail water as can be made….

Mostly given in consumption contracted for viscous practices and venereal contagions, this is the constant drink of those who are under the weakness and decays….”

Improvements to the facilities continued throughout the following 150 years.

 

St. Thomas’ Grand Committee Minutes of 21 October 1821 record that the women’s operating theatre be moved from the west end of one of the women’s wards and that “the herb garret over the church be fitted up and in future used as a theatre for such operations instead of the present theatre.”

The new operating theatre opened in 1822.

 

John Flint South (1797 – 1882), the son of a Southwark druggist, began his medical training at St. Thomas in 1814.

He was appointed Conservator of the Hospital’s anatomy Museum in 1820 and was made Joint Lecturer in Anatomy in 1823.

In 1841 he was appointed surgeon at St. Thomas, a post he held until 1863.

He was also appointed surgeon to the Female Orphan Asylum in 1843.

South’s Career at St. Thomas spans the entire period of the Old Operating Theatre’s history and as such his memoir, John Flint South Memorials, published 20 years after his death, provides a remarkable insight into how the operating theatre functioned.

Above: John Flint South

 

The Murder Act of 1752 decreed that only executed murderers could be used for dissection, but this did not provide enough subjects for the medical and anatomical schools.

By the 19th century only about 56 people were being sentenced to capital punishment each year, but with the expansion of medical schools as many as 500 cadavers were needed annually.

Body snatching – the secret removal of corpses from burial sites to sell them to medical schools – became so prevalent that it was not unusual for relatives and friends of someone who had just died to watch over the body until burial and then keep watch after burial to stop it being violated.

Interfering with a grave was a misdemeanour, not a felony, and therefore only punishable with a fine and imprisonment rather than exile or execution.

The body snatching trade was a sufficiently lucrative business to run the risk of detection, particularly as the authorities ignored what they considered a necessary evil.

In Edinburgh, during 1827 and 1828, William Burke and William Hare brought a new dimension to the trade of selling corpses “to the doctors” by murdering rather than grave robbing and supplying their victims’ fresh corpses for medical dissection.

The murders raised public awareness of the need for bodies for medical research and contributed to the passing of the Anatomy Act of 1832, which allowed unclaimed bodies and those donated by relatives to be used for the study of anatomy and required the licensing of anatomy teachers, effectively ending the body snatching trade.

 

When pioneering health reformer, Florence Nightingale, returned to London from the Crimean War in 1856 she set up a fund “to establish and control an institute for the training, sustenance and protection of nurses paid and unpaid.”

The specialist training of nurses was not universally supported and many doctors viewed it as a threat to their authority.

The work left for nurses, it was believed, required little more than “on-the-job” training.

There were prejudices too against “delicate“, educated women undertaking manual work or having contact with the coarse realities of the hospital wards.

However, Nightingale was an influential and convincing advocate for reform.

The Nightingale Fund raised almost 50,000 pounds.

She chose to establish her School of Nursing at St. Thomas.

The two main deciding factors were Nightingale’s admiration for Sarah Wardroper, St. Thomas Matron and Superintendent of Nurses, and the fact that the Hospital would soon move to a new site where the School could be built to the latest, Nightingale-inspired plan.

The School of Nursing opened at the St. Thomas Southwark site on 24 June 1860 with 15 students.

Above: Florence Nightingale (1820 – 1910)

 

In June 1862, the Hospital moved to make way for a railway line to Charing Cross.

 

With the move, the operating theatre, situated in the attic of St. Thomas Church, was sealed up and lay in darkness for nearly a century.

After the Hospital closed the only access to the roof space of the Church was through an opening, 20 metres above floor level, in the north wall of the first floor chamber of the bell tower.

 

In 1956, Raymond Russell (1922 – 1964), while researching the history of St. Thomas decided to investigate the attic.

He found the garret in darkness, the skylight above the operating theatre had been replaced by slates and the other windows were black with a century of dirt.

Russell’s find was extraordinary:

No other early 19th century operating theatre in Europe has survived.

It is likely that the use of the garret of St. Thomas as a Hospital apothecary dates back to the present Church’s construction in 1703.

Hooks, ropes and nail holes in the roof and dried opium poppy heads discovered under the floorboards in the 1970s are all evidence of the garret’s former use.

Herbs have been used as medicine since ancient times and before the development of the chemical industry, medicinal compounds were made from natural materials, mostly plants.

Even today, the majority of medicines originate from plant sources.

At St. Thomas, quantities of herbs were purchased from a visiting “herb woman” and the Hospital had its own botanical garden and apothecary’s shop within its grounds.

The apothecary was the chief resident medical officer of the Hospital and was responsible for prescriptions for surgical cases and, in the absence of the physician, for dispensing medicine to all the Hospital’s patients.

In 1822 part of the Herb Garret was converted into a purpose-built operating theatre.

The patients were mainly poor people who were expected to contribute to their care if they could afford it.

Rich patients were treated and operated on at home, probably on the kitchen table, rather than in hospital.

The patients at the Old Operating Theatre were all women.

 

A description of the students packing the theatre to witness an operation has been left by Dr. South:

“The operating theatre was of utterly inadequate size for the numbers of pupils who congregated….

The general arrangement of all the theatres was the same: a semicircular floor and rows of semicircular standings, rising above one another to the large skylight which lit the theatre.

On the floor the surgeon operating, with his dressers, other surgeons and apprentices and the visitors stood about the table, upon which the patient lay, so placed that the best possible view of what was going on was given to all present.

The floor was separated by a partition from the rising stand-places, the first two rows were occupied by the other dressers.

Behind a second partition stood the pupils, packed like herrings in a Barrel, but not so quiet, as those behind them were continually pressing on those before and were continually struggling to relieve themselves of it, and had not infrequently to be got out exhausted.

There was also a continual calling out of “Heads, Heads” to those about the table whose heads interfered with the sightseers.

The confusion and crushing was indeed at all times very great, especially when any operation of importance was to be performed.

I have often known even the floor so crowded that the surgeon could not operate till it had been partially cleared.”

 

Patients put up with the audience in their distress because they received medical treatment from some of the best surgeons in the land, which they otherwise they could not afford.

The majority of cases were for amputations or superficial complaints as, without antiseptic conditions, it was too dangerous to do internal operations.

The risk of death at the hands of a surgeon was likely, as there was a lack of understanding of the causes of infection.

Beneath the table was a sawdust box for collecting blood.

The death rate was further heightened by the shock of the operation and because operations took place as a last resort, patients tended to have few reserves of strength.

Until 1847, surgeons had no recourse to anaesthetics and depended on swift technique, the mental preparation of the patient, and alcohol or opiates to dull the patient’s senses.

 

(Dr. Robert Liston (1794 – 1847) was described as “the fastest knife in the West End. 

He could amputate a leg in 2 1/2 minutes.”

Indeed he is reputed to have been able to complete operations in a matter of seconds, at a time when speed was essential to reduce pain and improve the odds of survival of a patient.)

Above: Robert Liston

 

After 1847, ether or choloroform was used.

 

The small room at the side of the Theatre was used to spare the patient the sudden alarm of being brought straight into the Theatre full of students, with the operating table and instruments on view.

“Soon after….another female was brought in blindfolded and placed on to the table for the purpose of undergoing an operation for the removal of the leg below the knee.”

(The Lancet, October 1829)

 

These were the days before antisepsis (eliminating possible infection in the wound after the operation) or asepsis (avoiding any contamination from the start).

Unsterilized clothes were blood and pus stained while undisinfected hands used undisinfected instruments and sponges from previous operations.

In those days, “surgeons operated in blood-stiffened frock coats – the stiffer the coat, the prouder the busy surgeon“. (Dr. Oliver Wendell Holmes)

Above: American Dr. Oliver Wendell Holmes Sr. (1809 – 1894)

 

“There was no object in being clean.

Indeed cleanliness was out of place.

It was considered to be finicky and affected.

An executioner might as well manicure his nails before chopping off a head.” (Sir Frederick Treves)

Above: Frederick Treves (1853 – 1923)

 

No one wore a face mask or rubber gloves.

There were no blood transfusions nor vaccines.

Neurosurgery, cataract surgery, cardiac surgery, transplant surgery, Caesarian sections and hip replacements were either unknown or too dangerous to attempt.

 

Charles Bell (1774 – 1842), in his Illustrations of the Great Operations of Surgery (1821), describes the five most complex operations undertaken during the time of the Old Operating Theatre.

Below is a description of what the visitor would expect to see:

“To one side a table with instruments, covered with a cloth to preserve the edges of the cutting instruments.

On it we expect to see:

1. A large cushion with tenacula (sharp hooks), needles, pins and forceps.
2. Ligatures (binding materials) of every variety, well arranged.
3. Adhesive straps, well made and not requiring heating, but if they should, let chafing dishes be at hand.
4. Lint, compresses, flannel and calico bandages, double and single headed rollers, tow, cereate spread on lint.  Let there be no want of sponges, so that when the surgeon calls for a sponge, you have not to seek it among the patient’s clothes.  When a sponge falls among the sand, let it be not necessary to touch the wound with it.
5. Wine and water and hartshorn (ammonia solution used as smelling salts).
6. A kettle of hot water, a stoup (flagon) of cold water, basins, bucket, plenty of towels, apron and sleeves.”

Above: Scottish Dr. Charles Bell (1774 – 1842)

 

On the wall are two inscriptions:

 

Miseratione non Mercede (Latin for “For compassion, not for gain“)

 

The other sets out the Regulations for the Theatre as approved by the Hospital’s surgeons:

“Apprentices and the dressers of the surgeon who operates are to stand around the table.

The dressers of the other surgeons are to occupy the three front rows.

The surgeon’s pupils are to take their places in the rows above.

Visitors are admitted by permission of the surgeon who operates.”

 

The blackboard is a reminder of the Theatre’s use for lectures as a report in The Lancet of November 1923 records:

“25 November 1923:  At half past one this day, the following clinical remarks were delivered by Mr. Travers, in the female operating theatre, in reference more particularly to the case of compound fracture….”

 

The operating table is made of Scots pine, has four stout legs, and at 60 cm high is low by modern standards.

It has an inclined headboard and a long wooden slide extension at the foot end.

The table stands with the foot end towards the audience.

Beneath the table is the aforementioned wooden box of sawdust.

Distinguished visitors (generally foreign professors) were given seats on chairs, stools or a bench at the foot of the table.

The two small side tables held instruments and equipment.

The cupboard contained the instruments, dressing materials and lotions.

There is a wash stand, also of Scots pine, holding a small basin and ewer of blue and white china.

Above this is a tiny looking glass and a row of pegs from which hang the purple frock coats with grocer’s bib and apron.

A low sturdy wooden chair is used by the surgeon chiefly for cases of piles (hemorrhoids) and leg amputations.

 

The Museum also contains a collection of artefacts revealing the horrors of medicine before the age of science, including instruments for cupping (skin sunction), bloodletting, trepanning (drilling a circular hole in the skull) and childbirth.

There are also displays on monastic health care, the history of St. Thomas’s, Florence Nightingale and nursing, medical and herbal medicine.

 

Once upon a time body snatchers stole corpses so doctors could practice their skills and students learn anatomy.

Once upon a time doctors created more corpses and snatched lives from bodies than surviving patients.

Now doctors snatch many bodies from the jaws of death and generally make them whole.

 

Without Egyptian, Chinese, Indian, ancient Greek and Islamic medicine….

Without the trials and errors of dissection and pathological examinations….

Without the development of cell and neuron and molecular theory….

We would not have evolved to the discoveries and understanding of the body that we as a civilization now possess.

Without an understanding of blood circulation, the evolution of dealing with mental illness, the discovery of germs and the dangers of insects, the founding of the talking cures of psychoanalysis and psychotherapy, the study of hormones and immunology, the genetic revelation of genes and genomes, could we have a fighting chance in understanding health and disease in the manner that we do.

Without the stethoscope, the microscope, the hypodermic syringe, the thermometer, x-rays and radiotherapy, the sphygmomanometer (blood pressure measurement), the defibrillator, lasers, the endoscope, ultrasound and CT (computerized tomographic) scanning, MRI (magnetic resonance Imaging) and PET (positron emission tomography), the incubator and medical robots, we would lack the tools that doctors need to heal us and prolong our lives.

Mankind has survived the plague, typhus, cholera, puerperal fever, tuberculosis, influenza, smallpox, polio, cancer and AIDS, and thanks to great discoveries in medicine, though the battle against these scourges remains inconclusive, we still have a greater opportunity to overcome than prior generations had.

Opium provides pleasure and pain relief, quinine treats malaria, digitalis is a tonic for the heart, penicillin cures syphilis and gangrene, the birth control pill offers a woman freedom, drugs for the mind ease mental suffering, ventolin helps us breathe easier, Insulin aids the diabetic, dialysis cleans the kidney, statins lower our cholesterol and vitamins compensate for whatever our diets may lack.

Wounds are properly dressed, anaesthesia makes surgery painless, operations are clean, blood is transfused, exploration of the brain is possible, eyesight can be restored, mothers are less likely to die giving birth, hearts can be healed, organs transplanted, hips replaced and scars reduced by less invasive keyhole methods.

 

Truly, compared to the past, we live in an age of miracles.

 

Sometimes we take modern medicine for granted.

Stand in the middle of the Old Operating Theatre and be reminded how lucky we are to live in this day and age and how far we have travelled to get here.

Above: The Rod of Asclepius, the Greek god of healing and Medicine

Sources: Wikipedia / William and Helen Bynum, Great Discoveries in Medicine / The Old Operating Theatre Museum and Herb Garret Museum Guide / The Rough Guide to London / Rachel Howard and Bill Nash, Secret London: An Unusual Guide / http://www.thegarret.org.uk

 

 

 

 

Canada Slim and the Lamp Ladies

Landschlacht, Switzerland, 30 December 2017

In this season of goodwill and gratitude for all the blessings we enjoy, those who are healthy should especially be thankful, for we live in an age when life expectancy is higher because mankind has developed medicines and methods to extend life and restore health.

Granted there is still much significant progress needed, for far too many people still fall victim to the scourges of cancer and strokes.

There is still much we do not understand about diseases like Parkinson´s, AIDS and far too many others to comprehensively list here.

Even the common cold with its endless variety of mutations remains unsolvable and must simply be accepted as one of the countless burdens we must endure in life.

What is significant about today when compared with yesteryear is that common injuries are less likely to be fatal.

As well through the contributions of thoughtful compassionate innovators, our attitudes towards the care of the injured and ailing have improved.

Here in Switzerland and back in my homeland of Canada I have been hospitalized due to injuries caused by accidents: a fall from a tree (shattered shoulder), an axe slip (shattered foot), and a fall on a staircase (shattered wrist).

And though I also have medical conditions of anemia and celiac, neither these conditions nor the accidents I have had led to risks of fatality.

For prompt and compassionate medical attention provided to me ensured that I still live a functional, mostly painless, and happy healthy existence.

For the Christian West, Christmas is the season to show thanksgiving to God for sending His Son Jesus Christ to save our immortal souls, we also should not forget the human instruments of change that have assisted mankind to save our mortal flesh.

I married a doctor, and, even though she is a children´s physician, knowing her has given me an appreciation of just how difficult a profession medicine really is at all levels of medical treatment.

From the surgeon whose precision must be matched with efficiency, to the specialist doctor whose diagnosis must be accurately matched with the most likely cause of the patient´s symptoms, to the technicians who operate machinery that can reveal the interior of a patient´s body, to the family doctor who must know when to send a patient to a specialist and when to trust his/her own treatment, to the pharmacist that must know what medicines do and how to administer them, to the administrator who must balance the needs of patients with the cost of maintaining those needs, to the cleaning staff who ensure that the health care environment is as sterile as humanly possible, to the therapist who teaches the patient how to heal him/herself, to the nurse who monitors and comforts the bedbound sick person unable to fend for him/herself…..

The world of health care is a complex and complicated system demanding dedicated people and a neverending desire to improve itself.

A visit to a London museum two months ago has made me consider how grateful I am that an Englishwoman had the courage to be compassionate, Christian, and transformed the world for the better.

London, England, 24 October 2017

As mentioned in great detail in my blogpost Canada Slim and the Royal Peculiar my wife and I visited Westminster Abbey, that necrophiliac fetish house for the Establishment.

And folks whether or not they were avowed antiestablishment found themselves commemorated here.

The poet Shelley, despite wishing to be known as an anarchist artist and was buried in Rome, is memorialised here in Poets´ Corner, across from Viscount Castlereagh, a man Shelley loathed.

Above: Percy Bysshe Shelley (1792 – 1822)

“I met Murder on the way.

Above: Robert Stewart, Viscount Castlereagh (1769 – 1822)

He had a face like Castlereagh.”

Before leaving the Abbey, we briefly visited the Undercroft Museum with its death-worshipping collection of royal funeral effigies.

Until the Middle Ages, British monarchs were traditionally embalmed and left to lie in state for a set period of time.

Eventually, the corpse was substituted for a wooden figure of the deceased, fully dressed with clothes from the Great Wardrobe and displayed on top of the funeral carriage for the final journey.

As the clothes were expected to fit the effegy perfectly, the likenesses found in the Undercroft are probably fairly accurate.

Edward III´s face has a strange leer, a recreation of the stroke he suffered in his final years.

Above: Westminster Abbey effigy of Edward III (1312 – 1377)

His eyebrows came from a plucked dog.

Several soldiers are known as the Ragged Regiment due to their decrepit decay.

Frances, the Duchess of Richmond and Lennox, holds what may be the world´s oldest stuffed bird, an African Grey parrot that died in 1702.

Above: Frances Teresa Stewart (1647 – 1702)

Samuel Pepys wrote in his diary that Frances was the greatest beauty he had ever seen.

Sadly she was disfigured by smallpox in 1668.

Sadly her final fate no different than that of her parrot.

Leaving the Abbey we see the Methodist Central Hall, an inadequate and unnecessary replacement to the building that once stood here.

On this site once stood the Royal Aquarium and Winter Garden, opened in 1876, a grand Victorian entertainment venue.

It housed palm trees, restaurants, an art gallery, an orchestra, a skating rink, the Imperial Theatre, smoking and reading rooms.

A variety of sea creatures were displayed here, but the Aquarium was often plagued by frequent plumbing problems, so the place became better known for the exciting performances staged here than for the fish.

Come one, come all.

See William Leonard Hunt, aka the Great Farini, the world renowned Canadian showman and tightrope walker!

Above: William Hunt, aka the Great Farini (1838 – 1929)

Gasp in awe at 14-year-old Rossa Matilda Richter, aka Zazel, the first ever human cannonball, as she (barely 5 feet tall and 64 lbs heavy) is launched through the air flying 30 feet or more!

Above: Rossa Richter, aka Zazel (1863 – 1929)

Protests were launched over the danger Zazel faced and for a while the venue was in danger of losing its license but crowds kept coming to see the performances.

By the 1890s the Aquarium´s reputation became disreputable and it became known as a place where ladies of poor character went in search of male companions.

The Great Farini and Zazel were one thing, but an Aquarium of ill repute was too much for Victorian propriety to accept.

The Aquarium closed in 1899 and was demolished four years later.

In 1905 construction began on the Hall for Methodists, Christianity´s least entertaining sect.

We headed towards the Thames and followed Millbank Road to a place which suffered the opposite fate of the Aquarium.

While the Aquarium lost its aura of entertainment and was replaced by a stodgy religious institute, opposite the Tate Britain Museum is an almost invisible plaque upon an unremarkable bollard that tells the reader that where the entertaining Tate stands once stood Millbank Prison.

Above: Tate Britain

Millbank was built to serve as the National Petientiary and was used as a holding facility for convicts due for transportation to Australia.

“Near this site stood Millbank Prison which was opened in 1816 and closed in 1890.

This buttress stood at the head of the river steps from which, until 1867, prisoners sentenced to transportation embarked on their journey to Australia.”

Novelist Henry James called Millbank “a worse act of violence than any it was erected to punish”.

Above: Henry James (1843 – 1916)

The phrase “down under” is said to be derived from a nearby tunnel through which the convicts were walked in chains down to the river.

A section of the tunnel survives in the cellars of the nearby Morpeth Arms, a pub built to seve the prison warden and said to be haunted by the ghost of a former inmate.

Depending on their crime, prisoners could be given the choice of receiving a five-to-ten-year jail sentence instead of exile.

Among the many to be sent to Australia – and perhaps the unluckiest of them all – was Isaac Solomon, a convicted pickpocket and the inspiration for the character Fagin in Charles Dickens´ Oliver Twist.

Above: Isaac “Ikey” Solomon (1727 – 1850)

In 1827 Solomon managed to escape while being taken to Newgate Prison.

He fled England to New York, but then travelled on to Tasmania when he discovered his wife had been transported there for crimes of her own.

Upon arrival in Tasmania, Solomon was rearrested, shipped home to London, retried, reconvicted and sentenced to exiled imprisonment for 14 years….back to Tasmania.

We made our weaving way to Pimlico Tube Station, a unique station in that it doesn´t  have an interchange with another Underground or National Rail Line.

We rode the rails until Waterloo, the last station to provide steam-powered services and the busiest railway station in London / the 91st busiest in the world / the busiest transport hub in Europe.

I had once taken the Eurostar from Waterloo Station to Paris as one of the 81,891,738 travellers during the 13 years (1994 – 2007) Eurostar operated from here, before it began service from St. Pancras.

The clock at Waterloo has been cited as one of the most romantic spots for a couple to meet, and has appeared in TV (Only Fools and Horses) and in the film Man Up.

Waterloo Station has appeared in literature (Three Men in a Boat, The Wrong Box, The War of the Worlds), films (Terminus, Rush Hour, Sliding Doors), theatre (The Railway Children), music (the Kinks song “Waterloo Sunset”) and paintings.

Our destination – typical of travelling with a doctor – a hospital, St. Thomas Hospital, noteworthy for a male serial killer and a lady humanitarian.

Dr. Thomas Neill Cream, also known as the Lambeth Poisoner, was a Scottish Canadian serial killer who claimed victims from the United States, England, Canada and Scotland.

Above: Dr. Thomas Neill Cream (1850 – 1892)

Born in Glasgow, Cream was raised outside Quebec City.

He attended Montreal´s McGill University and then did his post-graduate training at St. Thomas.

In 1878 Cream obtained qualifications in Edinburgh.

He then returned to Canada to practice in London, Ontario.

In August 1879, Kate Gardener, a woman with whom he was having an affair, was found dead in an alleyway behind Cream´s office, pregnant and poisoned.

Cream claimed that she had been made pregnant by a prominent local businessman, but after being accused of both murder and blackmail, Cream fled to the United States.

Cream established a medical practice not far from the red light district of Chicago, offering illegal abortions to prostitutes.

In December 1880 another patient died after treatment by Cream, followed by another in April 1881.

On 14 July 1881, Danial Stott died of poisoning, after Cream supplied him a remedy for epilepsy.

Cream was arrested, along with Stott´s wife.

Cream was sentenced to life imprisonment in Joliet prison.

Cream was released in 1891, after Governor Joseph Fifer commuted his sentence.

Using money inherited from his father, Cream sailed for England.

He returned to London and took lodgings at 103 Lambeth Palace Road.

At that time, Lambeth was ridden with poverty, petty crime and prostitution.

On 13 October 1891, Nellie Donworth, a 19-year-old prostitute accepted a drink from Cream.

She died three days later.

On 20 October, Cream met 27-year-old prostitute Matilda Clover.

She died the next morning.

On 2 April 1892, after a vacation in Canada, Cream was back in London where he attempted to poison Louise Harvey.

Above: Louise Harvey

On 11 April, Cream met two prostitutes, Alice Marsh, 21, and Emma Shrivell. 18, and talked his way into their flat.

Cream put styrchine in their bottles of Guinness.

Both women died in agony.

On 3 June 1892, Cream was arrested and was later sentenced to death.

On 15 November, Cream was hanged on the gallows at Newgate Prison and his body buried in an unmarked grave within the prison walls.

Cream´s name does not appear in later McGill graduate directories.

No mention of those who mourned Cream´s victims is made either.

Ladies of the night lost in the shadows of Lambeth lamplight, fallen and forgotten.

Another medical professional is equally remembered at a site as inconspicuous as a prison burial ground: a parking lot.

On the south side of Westminster Bridge, a series of red brick Victorian blocks and modern white additions make up St. Thomas´s Hospital, founded in the 12th century.

At the Hospital´s northeastern corner, off Lambeth Palace Road, is a car park.

A hospital car park isn´t the most obvious location for a museum, but that where one finds the homage to Florence Nightingale, the genteel rebel who invented the nursing profession.

Born on 12 May 1820 at the Villa Colombaia, three decades before Cream, Florence Nightingale was named after the city of her birth, Florence, Italy.

Above: Florence Nightingale (1820 – 1910)

“There is nothing like the tyranny of a good English family.”

Florence was born into a rich, well-connected family though quite liberal in their attitudes.

Their circle of friends and acquaintances included the author Elizabeth Gaskell, the scientist Charles Darwin and the reform politician the Earl of Shaftesbury.

(For the story of the Earl of Shaftesbury, please see Canada Slim and the Outcast of this blog.)

Her maternal grandfather William Smith campaigned to abolish slavery and Florence´s father William Nightingale educated both her and her sister Frances Parthenope (after her birthplace of Parthenope, Naples) in French, Latin, German, mathematics, philosophy and science, then considered strictly male pursuits,

The Nightingales loved to travel – her parents´ honeymoon lasted so long that they produced two daughters before they returned home.

Growing up Florence visited many European cities.

She travelled to France, Switzerland, Germany and Italy.

She enjoyed visiting museums, dancing at balls, and going to concerts, confessing at one point that she was “music mad”.

In 1838, her father took the family on a tour of Europe where they were introduced to the English-born Parisian heiress Mary Clarke, with whom Florence bonded.

Above: Mary Clarke (1793 – 1883)

Clarke was a stimulating hostess who did not care for her appearance, and while her ideas did not always agree with those of her guests, “she was incapable of boring anyone”.

Clarke´s behaviour was said to be exasperating and eccentric and she had no respect for upper class British women, whom she regarded generally as inconsequential.

She said that if given the choice between being a woman or a galley slave, she would choose the galleys.

Clarke generally rejected female company and spent her time with male intellectuals.

However Clarke made an exception in the case of Florence.

They were to remain close friends for 40 years despite their 27-year age difference.

Clarke demonstrated that women could be equals to men, an idea that Florence did not obtain from her mother Fanny Smith.

Florence underwent the first of several experiences that she believed were calls from God in February 1837 while at her family home of Embley Park, prompting a strong desire to devote her life to the service of others.

Above: Embley Park

Devout and scholarly, Florence was not expected to do anything much apart from marry and procreate.

As a young woman, Florence was attractive, slender and graceful.

She had rich brown hair, a delicate complexion and a prominent, almost Roman, nose.

She was slim until middle age and tall for a Victorian woman, about 5´8″ or 172 cm in height.

While her demeanour was often severe, she was very charming and possessed a radiant smile.

Florence received several marriage proposals.

She was certainly not supposed to work, but Florence´s ambition was to become a nurse.

Her parents were aghast.

In the Victorian Age, nurses were known for being devious, dishonest and drunken.

Hospitals were filthy, dangerous places exclusively for the poor.

The rich were treated in the privacy of their own homes.

In her youth Florence was respectful of her family´s opposition to her working as a nurse, but nonetheless she announced her decision to enter the field in 1844.

Despite the intense anger and distress of her mother and sister, Florence rebelled against the expected role for a woman of her status to become a wife and mother.

“I craved for something worth doing instead of frittering time away on useless trifles.”

Florence came closest to accepting the marriage proposal of politician and poet Richard Monckton Milnes, but after a nine-year courtship she rejected him in 1849, convinced that marriage would interfere with her ability to follow her calling to nursing.

Above: Richard Monckton Milnes (1809 – 1885)

Whether Milnes´ devotion to the writing of Marquis de Sade and his extensive collection of erotica had something to do with Florence´s decision remains unstated.

She knew that marriage would mean swapping one cage for another and felt that God meant her to remain single.

“Marriage had never tempted me. 

I hated the idea of being tied forever to a life of Society, and such a marriage could I have.” 

In the essay Cassandra, Florence wrote about the limited choices facing women like her and raged against the way women were unable to put their energy and intelligence to better use.

Florence´s parents allowed her to visit Rome in 1847 with family friends, Charles and Selina Bracebridge, hopefully to take her mind off nursing.

In Rome, Florence met the young politician, former Secretary of War, Sidney Herbert on his honeymoon with his wife Elizabeth.

Above: Sidney Herbert (1810 – 1861)

Together Florence and Elizabeth visited convents and hospitals run by Catholic nuns.

Sidney and Florence became lifelong close friends and the Herberts would later be insturmental in facilitating Florence´s future nursing work.

Florence continued her travels with the Bracebridges as far as Greece and Egypt.

Her writings on Egypt in particular are testimony to her learning, literaray skill and philosophy of life.

Sailing up the Nile as far as Abu Simbel in January 1850, Florence wrote of the temples there:

Above: The temples of Abu Simbel: the Great Temple of Ramses II (left), the Temple of Nefertari (right)

“Sublime in the highest style of intellectual beauty, intellect without effort, without suffering …. not a feature is correct – but the whole effect is more expressive of spiritual grandeur than anything I could have imagined.

It makes the impression upon one that thousands of voices do, uniting in one unanimous simultaneous feeling of enthusiasm or emotion, which is said to overcome the strongest man.”

At Thebes, Florence wrote of being “called to God”.

A week later near Cairo she wrote in her diary:

“God called me in the morning and asked me would I do good for Him alone without reputation.”

During a visit to the Parthenon in Athens, Florence rescued an owl, which she called Athena.

Above: The Parthenon

Athena always perched on Florence´s shoulder or in her pocket, with a specially designed pouch to to catch her droppings.

Above: Athena (1850 – 1855)

Athena was a demanding creature who had to be bathed with sand daily.

When the badtempered owl died, Florence wrote:

“Poor little beastie, it was odd how much I loved you.”

Her sister Frances wrote a short story, The Life and Death of Athena, ensuring the little owl´s posthumous fame.

Rather than forget nursing as her parents hoped, Florence´s determination grew even stronger.

Later in 1850, Florence visited the Lutheran religious community at Kaiserswerth-am-Rhein, near Dusseldorf, in Germany, where she observed Pastor Theodor Fliedner and the deaconesses working for the poor and the sick in a hospital, orphanage and college.

Above: Kaiserswerth Clinic

She regarded the Kaiserswerth experience as a turning point in her life, where she received months of medical training which would form the basis for her later care.

Florence learned about medicines, how to dress wounds, observed amputations and cared for the sick and dying.

She had never felt happier.

“Now I know what it is to love life.”

On 22 August 1853, Florence took the post of Superintendant at the Institute for the Care of Sick Gentlewomen in Upper Harley Street in London, a position she held until October 1854.

When an epidemic of cholera broke out in London, Florence rushed to nurse victims in the nearby Middlesex Hospital.

Florence read about the disaster facing the British army in the autumn of 1854.

Hundreds of soldiers were sent to fight with the French and the Ottoman Turks against the Tsar´s Russian army in the Crimea were dying of disease.

The Crimean War was the first time the public could read in the newspapers about how the troops were suffering.

Above: Map of the Crimean War (Russian version)

When the news broke of the disaster in the Army, polticians were criticised.

More soldiers were dying from disease, and from cold during the winter, than from enemy action.

“In most cases the flesh and clothes were frozen together.

As for feet, the boots had to be cut off bit by bit, the flesh coming off with them.”

The wounded arrived by the boatloads at the British Army´s base hospitals at Scutari in Constantinople (today´s Istanbul).

Reporting from the front lines in the Crimea, William Howard Russell, Times journalist, blamed disorganization and a lack of supplies.

Fellow Times journalist in Constantinople, Thomas Chenery, reported that the French allowed women to nurse, unlike the British.

After the initial battles in the Crimea, the conflict centred on the besieged port of Sebastopol, where Russian and Ukranian women nursed heroically.

Above: The Siege of Sebastopol (September 1854 – September 1855), by Franz Roubaud (1902)

Conditions in the vast hospitals were horrific.

“Must men die in agony unheeded?”, demanded the Times.

The scandal provoked a public outcry.

Sidney Herbert, once again Secretary of War, wrote to Florence asking her to lead a group of women nurses – a new and risky idea.

Florence and her team of 38 brave women volunteer nurses that she trained and 15 Catholic nuns set sail for Scutari.

Florence arrived early November 1854 at Selimiye Barracks in Scutari and found that poor care for wounded soldiers was being delivered by overworked medical staff in the face of official indifference.

Medicines were in short supply, hygiene was being neglected and mass infections were common, many of them fatal.

There was no equipment to process food for the patients.

There was a lack of food, a lack of blankets, a lack of beds.

Casualities arrived, after a long journey, dirty and starving.

“It is of appalling horror!

These poor fellows suffer with unshrinking heroism, and die or are cut up without complaint.

We are steeped up to our necks in blood.”

At Scutari the nurses had to contend with rats, lice, cockroaches and an absence of sanitation and had to cope with long hours and hard physical work.

After Florence sent a plea to the Times for a government solution to the poor condition of the facilities, the British Government commissioned engineer Isambard Kingdom Brunel to design a prefabricated hospital that could be built in England and shipped to the Dardanelles.

Above: Isambard Kingdom Brunel (1806 – 1859)

The result was Renkioi Hospital, a civilian facility that had a death rate less than one tenth that of Scutari.

Florence reduced the death rate from 42% to 2% by making improvements in hygiene.

She implemented handwashing and other hygiene practices in the war hospital.

She organized the nurses and soldiers´ wives to clean shirts and sheets and the men to empty the toilets.

She bombarded Herbert with letters asking for supplies and used her own money and funds sent by the public via the Times, to buy scrubbing brushes and buckets, blankets, bedpans and operating tables.

“This morning I foraged in the purveyor´s store – a cruise I make almost daily, as the only way of getting things.  I am really cook, housekeeper, scavenger, washerwoman, general dealer and storekeeper.”

Every night she walked miles of hospital corridors where thousands of casualities lay, holding a Turkish lantern (fanoos) on her nightly rounds of the wards.

Florence would always dismiss the idea that she alone improved the Hospital.

It was a team effort.

In Britain, penny papers popularised the image of “the Lady with the Lamp” patrolling the wards.

Her work went beyond nursing care.

Florence treated the soldiers equally, whatever their rank, and also thought of their families´ welfare.

She wrote letters of condolence to relatives, sent money to widows, and answered inquiries about the missing or ill.

When the initial crisis was over, Florence also organized reading rooms.

As an alternative to alcohol, the Inkerman Café was opened, serving non-alcoholic drinks.

She set up a banking system so ordinary soldiers could send their pay home, rather than drink or gamble it away.

Stories of Florence´s devotion to the men flooded home to Britain.

One soldier wrote home of the love and gratitude for Florence felt by “hundreds of great rough soldiers”.

The men worshipped her.

During her first winter at Scutari, 4,077 soldiers died.

Ten times more soldiers died from diseases such as typhoid, typhus, cholera and dysentary than from battle wounds.

Scutari had been built on top of a huge cesspool.

With overcrowding eased, defective sewers flushed out and ventilation improved, death rates were sharply reduced.

Florence still believed that the death rates were due to poor nutrition, lack of supplies, stale air and overworking of the soldiers.

She came to believe that most of the soldiers at the hospital were killed by poor living conditions.

Florence believed that she needed to maintain military style discipline over her nurses.

“If a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed-sore, it is generally the fault not of the disease but of the nursing.”

She wanted her nurses to be treated with respect by the men and doctors.

This meant no flirting with doctors or soldiers, no disobedience or drunkenness.

The first image showing Florence as “the Lady with the Lamp” appeared in the Illustrated London News early in 1855.

As the war dragged on, Florence´s work made her internationally famous.

“She is a ministering angel without any exaggeration in these hospitals, and as her slender form glides quietly along each corridor, every poor fellow´s face softens with gratitude at the sight of her.

When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds.”

Florence hated what she called the “buzz fuzz” of celebrity, but she knew how to use public opinion.

Fame gave her power and influence to make changes, but she knew it obscured the achievements of others and the human cost of the war.

Florence´s image appeared as pottery figurines, souvenirs and even on paper bags.

Songs and poems were written about her.

When the US poet Henry Wadsworth Longfellow published “Santa Philomena” in 1857, it fixed Florence´s image forever as the Lady with the Lamp.

Above: Henry Wadsworth Longfellow (1807 – 1882)

“Lo! in that house of misery

A lady with a lamp I see

Pass through the glimmering gloom

And flit from room to room.”

After contracting “Crimean fever” from infected goat´s milk, Florence suffered ill health.

After the Crimean War, Florence returned to Britain in August 1856, travelling under the name “Miss Smith” to avoid publicity.

Thin, exhausted and ill, she felt a sense of failure and grieved over the soldiers who did not return.

“My poor men lying in your Crimean graves, I stand at the altar of murdered men.

Florence devoted the rest of her life to ensure that they did not die in vain.

While Florence shrank from public appearances, she skillfully used her reputation and the authority of her name to convincethose in power of the need for health reform, starting with Queen Victoria, whom she impressed greatly when they met in Balmoral.

Above: Queen Victoria (1819 – 1901)

For the rest of her days she would continue to suffer reoccuring bouts of fever, exhaustion, depression, loss of appetite, insomnia and severe back pain.

Unable to continue nursing, she devoted herself to health reform, founded the first training school for nurses at St. Thomas, campaigned to improve hospital conditions and championed the cause of midwives.

Often irritable, highly critical of herself and others, Florence worked on, writing hundreds of letters, gathering and analysing statistics, commenting on reports, briefing politicians and medical experts.

Prompted by the Indian mutiny of 1857, Florence began a lifelong campaign to improve the health of all Indians, not just British soldiers.

She studied the design of hospitals in Britain and across Europe.

Florence wrote Notes on Nursing to help ordinary women care for their families.

She stressed the importance of cleanliness, warmth, fresh air, light and proper diet.

Florence wrote some 200 books, pamphlets and articles, and over 14,000 letters.

As well as nursing she wrote about religion and philosophy, sanitation and army hygiene, hospitals, statistics and India.

She wrote about her travels and the frustrations of life for educated women.

Florence changed society´s ideas about nursing.

She believed in looking after a person´s mental as well as physical wellbeing.

She stressed the importance of being sensitive to a patient´s needs and their environment to aid recovery.

She helped make nursing a respectable profession for women.

Her work proved an inspiration to many, including the founder of the Red Cross movement, Henri Dunant.

Above: Henri Dunant (1828 – 1910)

Florence championed causes that are as just important today as they were in her day, from hospital hygiene and management, to the nursing of soldiers during war and afterwards, and healthcare for all around the world.

In recognition of her pioneering work in nursing, the Nightingale Pledge is taken by new nurses.

The Florence Nightingale Medal is the highest international distinction a nurse can achieve and the annual International Nurses Day is celebrated around the world on her birthday.

The Florence Nightingale Museum doesn´t just celebrate Florence as a devout woman who single-mindedly revolutionized the healthcare industry but as well it hits the right note by putting the two years she spent tending to the wounded of the Crimean War in the context of a lifetime of tireless social campaigning, and also mentions others involved in that same health care crisis.

Dimly lit and curiously curated with circular display cases covered in fake grass or wrapped in bandages, this small museum is packed with fascinating exhibits, from Florence´s hand-written ledgers and primitive medical instruments to pamplets with titles like How People May Live and Not Die in India.

The Museum and the neighbourhood of Lambeth are worth exploring, especially in a world too full of Dr. Creams and too few Florence Nightingales.

Perhaps if our politicians visited more museums like the Red Cross Museum in Geneva or the Florence Nightingale Museum there might less incentive to cause war ourselves or to ignore wars far removed from us, such as Yemen – “a pointless conflict (that) has caused the world´s worst humanitarian crisis”.

Perhaps if we followed role models such as Florence we might one day truly find peace on Earth and good will towards man.

Sources: Wikipedia / The Rough Guide to London / Rachel Howard and Bill Nash, Secret London: An Unusual Guide / Simon Leyland, A Curious Guide to London / Florence Nightingale Museum / http://www.florence-nightingale.co.uk