providing medical assistance and maintaining people’s well-being
For the Gringai people, as for most isolated human populations suddenly brought into contact with new arrivals, the impact of introduced diseases on their health was devastating. Throughout the 1840s numerous deaths are reported, particularly among women and children, resulting from an epidemic far outweighing the diphtheria and other health problems of later generations. Those of the Gringai people who survived this period would have continued to have access to their traditional medicine, of which little is known, but did not it appears gain access to the medical support of the Europeans.1
For the European settlers’, the level of health care was a hit and miss affair at first, though for those of the Williams and nearby Patterson Valleys, at least, two medically trained people were available from the beginning. The first, and, for a while, only doctor was Dr Park at Paterson and by 1839, the ‘respectable settlers’ of Dungog on the Williams River were seeking their own medical man to avoid the need to send to Paterson.2 It is not known if it was because of any action on the part of these ‘respectable settlers’, but Dr McKinlay arrived in Dungog soon afterwards in 1840, having paid for his passage to the colony by supervising ‘60 Government Emigrants’.3
Slow transport meant that both doctors and patients often needed to travel long distances and wait for long periods before treatment could be obtained. When, for example, in 1834 John Flynn was speared, he walked some 20 miles before he was seen by Dr Park at Paterson, by which time his lungs appeared to have filled with blood and he died soon after.4 Dr McKinlay, on another occasion in 1840, was on his way to a patient when he was held up for a night by bushrangers.5 And a few years later, when Dr McKinlay wished to amputate the leg of a man who had been run over by a bullock dray, this man with a crushed leg had to wait two days while Dr McKinlay first sent to Stroud and then to Paterson for a second doctor. The leg was finally amputated but the patient died.6
Spearings and amputations might appear in newspapers, but little is known of the general health of most people, particularly convicts. One glimpse occurs when a prisoner complained enough to receive some attention from Magistrate Cook at Dungog. Cook wrote to Doctor Park at Paterson that he was sending Thomas Ford who had been sometime in the lock-up and wished to consult a medical practitioner for an ‘imaginary disease’. Cook sent him to the Paterson lock-up where Dr Park could advise him.7 A little later Cook seems to have modified his opinion, writing that Ford (who had been charged with cattle stealing), ‘seems to labor under some nervous affliction – arising I believe from confinement and anxiety of mind’. Cook suggested Ford ‘be either committed for trial or at once discharged’.8
If patients had to be flexible in their dealings with the few medical practitioners that were available, so too it seems were the doctors. Dr McKinlay, when first advertising his presence in the Williams River district, announced not only that he would pay ‘strict and unremitting attention to the cases entrusted to him’, but also that for ‘the convenience of settlers’ he would ‘always have on hand an assortment of Horse and Cattle Medicines’.9
Doctors, of course, could come and go from a district, such as when Dr McKinlay departed for a time to South Australia. The community would attempt to encourage other doctors to settle in their area or to keep those they had. A Dr Street was practicing in Dungog from at least 1844, but, by 1851, effort was required to ensure he remained. This was done in part by publicly requesting that ‘Dr F. Gale. S. Street’ remain, promising that efforts would be made to ensure his practice was remunerated, and assuring him that ‘no second Medical man was required in the district’. The names attached to this public notice were not those usually associated with public business in Dungog and may reflect a class division.10
On occasion, doctors were offered suitable housing in order to entice them to settle in an area and at least one house was built in Dungog with the requirements of a doctor in mind and provided for him, perhaps at a low cost, to purchase after settling in.11
As Dr McKinlay at Dungog aged and could no longer travel, the need for another medical man grew. In the 1880, Christopher Lean of Fosterton wrote: ‘What we want then, is not only a bridge for a medical man to cross but also a medical man to cross the bridge.’12 He also wrote: ‘Poor old Dr. McKinlay is talking of going home to Scotland, he says he is heartily sick of Dungog as no-one visits him now, which I think is not to be wondered at, he is so deaf that no one can converse with him.’13 As an aging person without relatives, Dr McKinlay’s situation points up the lack of services for the elderly not provided by one’s family. However, Dr McKinlay was not without financial means and was able to take up residence at a local boarding house and rely on his landlady to take care of him.14
The licensing of medical practice was not as strict as it is today and there is evidence of at least one unlicensed ‘medical man’, a Mr Higgs, setting bones, which in two cases resulted in death from ‘mortification’. The second death led to a coronial inquiry and some ‘some mild censure on Mr. Higgs’ as well as a trial at which he was acquitted of gross negligence.15
Health affairs were not entirely limited to these few medical men, qualified or not, and in 1845 an inspector of slaughter houses was appointed in an early effort at preventative medicine.16 While in the 1880s, the vaccination of children was also being performed to some extent.17 Towards the end of the 19th century, health care began to become more concerned with sanitation and the prevention of typhoid, cholera and other epidemics. This led, for example, to more regulation of piggeries near water supplies and the better disposal of human waste in towns.
In addition to doctors, chemists also played an important role as health providers, with some operating for many years, such as one that operated until the year 2000 from the same location in Brighton Terrace on Dowling Street, Dungog for over 100 years.18 Gresford also had a number of chemist shops – the last closing in 1985 – after which doctors, when they were available, were licensed to dispense drugs also.19 Clarence Town does not appear to have ever had a chemist.20
Children, in particular, were vulnerable to many dangers to their health, mainly endemic diseases such as diphtheria and whooping cough; but also such hazards as playing with matches, the wax kind being poisonous, as a two year old in the Redman family found to her cost.21 There were also many instances when people were left to home remedies, such as in 1904 when Granny Ann Rumbel was suffering from gangrene in one leg. Her treatment involved boiling water and it was said her screams could be heard three miles away.22
Dr McKinlay himself got to the point of declaring:
Despite Dr McKinlay’s misgivings, the general community continued to press for more medical services and, at the end of the 19th century, a major change in the district’s health services occurred with the building of Dungog’s first hospital.
THE DUNGOG COTTAGE HOSPITAL. A movement has been started at Dungog for the establishment of a Cottage Hospital, and we rejoice to know that the project has been taken up warmly by the people of the district. A provisional committee has been appointed, and canvassers chosen to raise subscriptions toward the building fund. Already about £200 are in hand, we understand, towards which Mr. J. K. Mackay, of Cangon, Dungog, has contributed £50, with a promise of £10 per year. Further donations, however, are needed, and the committee appeals for support towards so laudable an object.24
The Dungog cottage hospital was built in 1892 by Boots Bros for £849 with community funds at a time when the population of the town was 836 people. The hospital was intended to assist those who could not afford medical help and opened with a matron plus a visiting doctor, a men’s ward of six beds and a women’s of four beds. The then Governor of NSW, the Earl of Jersey, laid the foundation stone and community support provided the hospital with linen and food, and local doctors (to whom a direct phone line was installed in 1898), the medical requirements. Patients who could afford it were charged £1 a week and doctors received £1.11.6. In 1916, the doctors agreed to receive a reduction to £1 a week. At one point only married women were allowed to use the hospital for ‘lying in’.25
The original 1892 building has been much extended, including verandahs in 1914, a new operating theatre in 1915, and even a tennis court for nurses in 1953. In 1917, electricity replaced ‘expensive’ acetylene lighting and, by 1935, one ward was air conditioned. Polio in the 1950s saw an ‘iron lung’ bought, again with community funds, and in 1958 a maternity ward replaced the private hospitals. A ladies’ auxiliary generally raised funds, but, in 1910, a Girls Patriotic Fund helped furnish the nurses’ quarters, and, in 1911, a bazaar provided a cot (though government grants, such as £900 for instruments, were also useful). In later years, the opening of the new picture theatre and wood chopping competitions also raised funds for this community facility.
A report of 1909 stated there had been 90 cases at the hospital, with 72 cured, 3 relieved, 2 unrelieved and 8 deaths. While in the 1930s, a diphtheria epidemic resulted in 60 cases at one time, with even tents used on the grounds, but only one death. In 1929, the hospital came under the authority of the Hospitals Commission and in 1986 its Local Board was replaced with an Area Board. From a peak of 35 beds the hospital has been reduced to 15 beds.26
While the hospital dealt with those already ill, measures were also taken to reduce the causes of such diseases as typhoid. In 1900, a health inspection recommended that the keeping of pigs be banned from Dungog town and that the collection of night soil be increased to once a week. Typhoid was common at the time and often affected children. The following year a reduction in fevers was reported, but so also were increases in complaints about the cost of the more frequent night soil collection.27
By the 1920s, the use of hospitals for most procedures was more common, particularly for maternity cases – who would have previously relied on midwives (about whom very little is known). This led to the establishment of private hospitals, which were usually owned and operated by a nurse in connection with a specific doctor who would attend and perform operations. A number of these existed, such as Keba and Oomabah in Dungog, and Kalala and Clevedon in Gresford which operated from the 1920s into the 1950s, by which time government reports were condemning private maternity hospitals and recommending the concentration of resources in public hospitals.28 There is no evidence that the Williams Valley or nearby district’s private hospitals were not satisfactory, but this did not stop their closing.
While both Paterson and Dungog appear to have been able to attract medical practitioners from their earliest days, there is little mention of medical services at Clarence Town. In the 1850s, there was a Dr Wigan, who seems to have remained only three years before moving onto Maitland. At his farewell dinner no mention was made of getting a replacement for him.29 In 1885 a Dr Canny is mentioned as about to transfer from Stroud to Clarence Town.30 The relative ease of Clarence Town’s connection with Newcastle and its health care, particularly its hospital, may have limited any community demand for such services in the town itself. Though in the 1940s Clarence Town was reported as having trouble obtaining a doctor when a Dr C Gordon Harper arrived, having reportedly refused a Paris based UN position to do so.31
This pattern of doctors for short periods of time with gaps in-between of no local medical care continued in the post-war period. The doctors who did settle in Clarence Town were a diverse lot and included the ‘elderly lady’, Dr Charleston, followed by the Hungarian Dr Andre for four to five years, then an Irish ship’s doctor named Mitchell who was reputed to have helped the Emir of Dubai’s wife and been given a pearl (flawed) for his trouble. Later two London doctors were shared between Dungog and Clarence Town, as was Dr Holley until recently. At the present time Clarence Town is visited by Dungog based doctors.32
Ambulance services became important in the 1930s, and annual carnivals and regular fundraising, along with locally trained volunteers, supported this service more many years until a gradual professionalisation led to this role being taken over by medical bureaucracies. Today, community fundraising efforts focus on the provision of a helicopter rescue service for fast evacuation to health services that are now largely located at a distance.33
Other health services were the establishment of Baby Health Centres, often by the local Country Women’s Association (CWA), again with extensive community fundraising.34 Baby Heath Centres had begun being established in Sydney and Newcastle before the First World War, but it was not until the 1920s that they became more common in rural areas. The first in the three valleys was that at Gresford when a Baby Health Centre was established by the Gresford CWA in the old Post Office in 1939, moving to new premises in 1954 before being taken over by the Community Health Centre in 1984. In 1946, it was reported that the Dungog BHC, which was established in 1940, saw 95 babies under 12 months of age, as well as another 42 older children, while the sister had visited 12 new-borns.35
Trained nurses were used to supplement a lack of doctors and to provide additional health care. Bush Nurses had been established from the early 1900s to provide basic medical support to remote settlements and homes.36 The details as to how many and where these nurses operated within he three valleys are sketchy. One such nurse who in the Allynbrook area after 1910 was Laura Eason, who worked with sick families, delivered babies and set broken bones. After she married in 1914 she continued her work, only now without charging a fee.37
These bush nurses evolved into district nurses, then into community nurses in the 1980s, and finally into the specialist aged care services and other services current today. As with many of these services, community support and fundraising provided for many years, such things as cars, until the gradual extension of government funding took over and standardised all such aspects of these services.
Specialisation and cost of new technology has meant local health services have become limited, as resources are concentrated for efficiency and maximised use. This development has reduced the scope of local input and a sense of intimacy within health services. In contrast to this, aged health services have increased at the community level, with efforts to ensure that an aging population remains in its community for as long as possible.38 Often beginning as community run, these services too have becomes standardised and regulated through medical bureaucracies, though often with a measure of community involvement. In 1973, for example, a public meeting was held in Gresford to discuss Meals-on-Wheels, which ran as a voluntary service until 1994, when it was taken over by Dungog District Neighbourhood Care.39
Private Hospitals (Keba, Oomabah)
Medical equipment at museums