The Development of Some Health Care Services in Barbados from 1945 to Independence by Sylvan Spooner

COLONIAL DEVELOPMENT WELFARE POLICY AND RECOMMENDATIONS

Stemming from the damning indictment that was the Moyne Commission (and other) reports, various recommendations were made by colonial authorities in order to improve the health and wellness of the poor and lower classes on the island. The following article documents some of those   health care initiatives.

In 1945, on the heels of the release of the Moyne Commission Report, Mr. Henry Douglas Weatherhead introduced a memorandum titled “Medical Services of Barbados and Proposals for Reorganization.”[1][2] In this he concluded that there was a dire need for new legislation governing health care on the island and further recommended that the islands’ entire health care sector be reorganized. That same year, the Colonial Welfare Department, guided by the recently passed Colonial Welfare Act, allocated £800,000 to the island; funds meant to facilitate this reorganization over the ten year period from 1946 to 1956.[3]

These, in part, made possible the implementation of a number of health care building projects and initiatives. One such initiative was the construction of the Verona Maternity hospital which was completed in 1947 and opened in 1948; [4] a dental clinic was opened at the same location three years later in 1951. These were followed by the construction of numerous other health care facilities over the following decade.[5]

BARBADOS FAMILY PLANNING ASSOCIATION

The Barbados Family Planning Association was another organization which arose in the decade post- Moyne. Founded in May 1954 out of the necessity to control and reduce the island’s high infant and maternal mortality rate, the figures from the decade which followed its founding indicate that it was a successful addition to the islands’ health network. In 1954, the national birthrate was 33.2 per 1000; this decreased to 20.9 in 1969 and was further reduced to 17.6 in 1977.[6] This pattern of decline continued and by 2004 it stood at 12.7 per 1000.[7] Undoubtedly, the introduction of female contraceptives and planned parenthood education contributed to the success of this programme.

HEALTH CENTRES

The Moyne Report was an unflattering indictment on the disregard for the health of the working class among whom malnutrition, venereal disease and high infant mortality were endemic. Out of these unfortunate set of circumstances came the Five year plan of development and taxation for 1952-53 to 1956-57. As a result, the Governor appointed a committee under the chairmanship of Dr. Hugh Gordon Cummins which was tasked to advise government and to implement a programme of hospital expansion. The 1953 Public Health Act presented the framework for which a community clinic initiative was to be introduced.

SPEIGHTSTOWN HEALTH CENTER

The Speightstown Health Center was officially opened on 1^st July 1953 by Colonial Governor Sir Robert Arundell making it the first parochial approach to organized public health on the island.[8] One month before its official opening, Dr. Maurice Byer was appointed its first Medical Health Officer with Sister Aurora Waters, who had recently completed her public health training in Jamaica and Trinidad, acting as Public Health Nurse. Nurses M. Mayers and B. Payne were added to the staff in September as junior Public Health Nurses while Mr. E. Baird acted as sanitary officer from 15th February 1954. Such was the need for the service it provided that within nine months of its commencing operations 9,090 injections of Penicillin were administered, 584 cases of Syphilis treated along with 237 cases of Gonorrhea.[9] In addition, two years later, in 1956, a family planning clinic was opened at the clinic.[10]

This clinic serviced the northern parishes of St. Lucy, St. Peter, St. James, St. Andrew, St. Thomas and St. Joseph with the majority of its patrons coming from St. James parish during its first 9 months of operation. By 1959, several outpost clinics had been established, one at Belleplaine another at Chimborazo and one other established at Mt. Hillaby in 1960. A mental health clinic, one of the first of its kind on the island, was started at Speightstown Health center in 1960.

ENMORE HEALTH CENTER

One of the Governor’s requests, as part of the five year development plan, was for the establishment of a health center for Bridgetown. This was placed at the Enmore site. As a result, the Enmore Health Clinic was opened in February 1955. Later, in October of that year Dr. Edgar Cochrane was appointed as Medical Health Officer with Dr. D.O.D Payne as part-time Tuberculosis Officer. Enmore was equipped with a modern X-ray unit with a 5”x 4” camera detachment.[11] In January 1956, a national BCG campaign commenced and this was head-quartered at Enmore.[12]

In addition, a V.D clinic was introduced in September 1955, followed by a chest clinic which was frequented by persons wishing to travel to the United Kingdom. A total of 71,952 persons attended Enmore in 1956 followed by 64,371 in 1957. These figures alone indicate that this clinic was greatly appreciated by residents of Bridgetown and surrounded areas. In 1960, dental and ophthalmic services were introduced at Enmore[13] followed by a mental hygiene clinic in October 1961.[14]

SIX ROADS HEALTH CENTER

With health centers located in Bridgetown and in the north of the island, on March 15^th 1957, the Six Roads Health Centre was officially opened with Dr. Cochrane visiting weekly from Enmore as consultant.[15] On the 27^th of April 1958, Dr. Kenneth Standard was appointed Medical Officer of Health and assumed duties on May 5^th with Nurse Millington as his Staff Nurse and Dr. C. Hutson as V.D Officer. Numerous satellite clinics were established from Six Roads including school- medical and diabetic clinics, home visiting, and clinics for midwifery and health education for schools. This clinic served the southern parishes of St. Phillip, and Christ Church, parts of St. John and St. George.  Other clinics were located at Kendal in St. John (from 1^st Oct 1959) and at Charles Rowe Bridge From Oct 2^nd 1959 which was later called the Glebe Clinic from 1960.[16] Other much utilized clinics were located at Gall Hill in St. John, and at St. Augustine in St. George.

DISTRICT HOSPITALS

In December 1960, the first District Hospital was opened. Its area of operation was the highly populated Oistins district and at the time provided 20 beds for persons seeking care.

Other District Hospitals

St. Thomas District Hospital,

St. Andrew District Hospital,

St. Phillip District Hospital (Ruby),

St. Michael District Hospital,

St. Lucy District Hospital,

Gordon Cumming District Hospital (Rock hall)

POLYCLINICS AND YEAR ESTABLISHED

Sir Winston Scott – 1984

St. Phillip and St. John Outpatient’s Clinic – 1957

Maurice Byer (Horse Hill Out patients Clinic) – 1978

Randall Phillips - 1984

Black Rock Polyclinic – 1994

Warrens (St. Thomas and St. Andrew Out-Patients)

Edgar Cochrane – 1984

Glebe Polyclinic – 1987

  QUEEN ELIZABETH HOSPITAL

Opened in 1964 14^th November 1964 at a cost of $8,683,653, it replaced the old General Hospital as the premier primary care facility on the island.[17] This 520 bed facility was fully equipped with surgical and medical theaters and was considered state of the art at its completion.

 ST.JOSEPH HOSPITAL

The St. Joseph Hospital  at Villa Maria , Ashton Hall St. Peter was opened on  Thursday January 6, 1966 by Premier of Barbados Mr. Errol Walton Barrow. As premier, Mr. Barrow was given the honor of delivering the opening address for the spanking new 135 bed facility, owned and operated by the sisters of sorrowful mothers incorporated Inc.  In the presence of a crowd of 500, the dedication of the facility was performed by Grenadian Roman Catholic Bishop Justin Field whose diocese included Barbados. Taking two years to complete, at a cost of 2.5 million US dollars, the St. Joseph Hospital was built by the contractors R. P Farnsworth and Company Inc and was the first to be built in the West Indies by this catholic sect.

A state of the art facility, built on six acres of land, it included a built-in chapel, an emergency power plant, and a 30,000 gallon water  storage reservoir and a 50,000 gallon sewage treatment plant as well and an emergency backup power system in case of  power failure.[18] Its maternity and operating theaters, the laboratory as well as the Doctors lounge were fully air-conditioned. Of its 135 beds, 25 were dedicated to pediatric care and 20 were designated free to members of the public.[19]

In his opening address, Barrow lauded its thoughtful planning and excellent architecture.  Responsibility for construction fell under the guidance of Robertson Ward and Associates, Mechanical consultants were Harry Goldstein and Associates David Key and Partners were the structural engineers and its Electrical consultants were Mario Zervigon and Associates.[20] Telephone communication at the facility consisted of 50 lines with four main lines while the building was built with specially designed floor tiling designed to prevent electrical interference. A state of the art kitchen with specially design food carts ensured that meals arrived at the bed sides of patients at the required temperature. At its opening this hospital was state of the art in style as well as substance.

Its first Director/Matron was Sister Mary Bartholomea and it was she who was responsible for the interior design of the new facility. A nurse early in her career, in 1946 she decided to study architecture and the St. Joseph facility was her first overseas design. In her remarks during the opening ceremony she expressed the wish that the island would “…take full advantage of the activities…offered” at the new facility. Other than Mr. Barrow, other dignitaries in attendance were Senator Odessa Gittens, Barbados Minister of Health Edwy Talma, and Father Hilary Carpenter of the Dominican Mission who came from Rome for the occasion. Officially opened to patients on February 15^th, Its Chief of medical staff was Dr. H.C. Rogers, its Vice President was Dr. P.D. Wardle and its Secretary Treasurer Dr. T. J Gilmore.

 

BIBLIOGRAPHY

Annual Reports of the Director of Medical Services. 1957-1967.

Barbados Advocate, Jan 6, 1966.

Barbados Advocate, February12th, 1955

Barbados Family Planning Association. http://bfpa.net/cms/default.asp?V_DOC_ID=1182. Retrieved.

March 31^st 2015.

Byer, Maurice.” Development of Public Health Services in Barbados” in Four Decades of Advances in

Health in the Commonwealth Caribbean. Paho, 1979.

Colonial Reports: Barbados, 1947, 1950 and 1951.

Gilkes, Al. “A Special Gift” Barbados Advocate, January 8, 1966.

Ramsey, Frank. Protein Energy Malnutrition in Barbados. Josiah R. Macy Foundation, 1979.

Standard, Kenneth. L. Four Decades of Advances in Health in the Commonwealth Caribbean.

Bridgetown, 1977.

---

[1] Kenneth. L Standard. Four Decades of Advances in Health in the Commonwealth Caribbean Bridgetown, 1977, p46.

[2] Also in Frank Ramsey. Protein Energy Malnutrition in Barbados, p23.

[3] Colonial Report, Barbados 1947, p4.

[4] Ibid.

[5] Colonial Report, Barbados, 1950 and 1951. p40.

[6] Frank Ramsey. Protein Energy Malnutrition in Barbados, New York, 1977 p, 25.

[7] Barbados Family Planning Association. http://bfpa.net/cms/default.asp?V_DOC_ID=1182. Retrieved. March 31^st 2015

[8] Annual Reports of the Director of Medical Services 1953-54. p, 7.

[9] Ibid 8

[10] Annual Report of the Director of Medical Services 1956-57, p4.

[11] Ibid, p6.

[12] Maurice Byer.” Development of Public Health Services in Barbados” in Four Decades of Advances in Health in the Commonwealth Caribbean. Paho, 1979, p77.

[13] Annual Report of the Director of Medical Services, 1960, p34.

[14] Annual Report of the Director of Medical Services, 1961, p32.

[15] Annual Report of the Director of Medical Services, 1956-58, p11.

[16] Annual Report of the Medical Services, 1959-60, p47.

[17] Frank Ramsey. Protein- Energy Nutrition in Barbados, 1979, p27.

[18] Barbados Advocate , Jan 6, 1966 , p1

[19] Annual Report of the Chief Medical Officer, 1967. p14.

[20] Al Gilkes. “A Special Gift” Barbados Advocate January 8, 1966 p8.