| dc.description.abstract | After having completed relevant coursework in health
care in Britain and while researching late 19th century
health care in Port Arthur, I became fascinated by the
surprisingly advanced level of such services in Port Arthur
during the last two decades of the nineteenth century. One
would expect such an isolated community to have lagged far
behind southern Ontario and Britain in terms of progress in
health care services. Such, however, was not the case; Port
Arthur, despite its obvious handicaps of size and relative
isolation, managed to keep pace astonishingly veil.
Yet advances in Ontario health care services did emanate
from Britain. Therefore, it seemed logical to address first
the conditions which stimulated innovative changes in Britain
and the adaptation of these new ideas as they spread to
southern Ontario before examining their effects in a more
remote community.
To fully appreciate the rapid spread of ideas and
subsequent changes in services that occurred in Ontario —
and specifically, in a frontier community one must first
consider the stages in the development of the various fields
of health care. Health care in Britain and Ontario underwent
a dramatic change during the second half of the nineteent-h
century: what had been during the first half of the century
a rather primitive form of health care now developed into a
highly scientific and well-organized service. Major discoveries in the science of medicine; public health
awareness, with improved municipal cleanliness; clean water
supplies and sewage removal; understanding and control of
epidemics along with improved hospital facilities and nursing
care had combined to bring about this revolution.
To truly appreciate the impact of such advances and the
remarkable dissemination of knowledge from Britain, to
Ontario, and subsequently to Port Arthur, it is necessary to
establish a frame of reference: the examination of
conditions in existence during the first half of the
nineteenth century which served as a catalyst to dramatic
changes in health care. This thesis has consequently been
divided into two parts: Part 1, consisting of Chapters 1 and
11, deals with the development of the various fields of
health care in Britain and Upper Canada/Ontario during the
nineteenth century. Part 11, consisting of Chapters 111, IV
and V, examines the development of the Ontario Board of
Health, public health in Port Arthur and St. Joseph's
hospital.
Chapter 1 traces the crisis in health care in Britain
brought about by the Industrial revolution and its
demographic changes. The sanitary reform movement was a
direct response to the increase of disease in certain
segments of the urban population and to the need for reform.
The development of hospitals and nursing care is also
outlined in Chapter I, as well as the impact of the Crimean
War which served as a watershed in the improvement of medical services in Britain. Chapter 11 examines the conditions in
Upper Canada and the response of the colony to demographic
changes and the diseases brought by immigration. It also
surveys the construction of the first hospitals in Upper
Canada. Major discoveries in medical science, in the second
half of the century, are discussed in Chapter 11 to emphasize
the impact they had in the colony. In addition to these
changes in the medical profession, improvements in hospital
facilities and nursing care are also described. Finally,
Chapter 11 outlines the advances in public health in Ontario
brought about by legislation which enabled the province of
Ontario to keep pace with developments taking place in
Britain.
Part 11 of the thesis moves on to illustrate the context
in which change occurred. Chapter 111 deals with the
specific problems of the Ontario Board of Health: apathy of
the municipalities; why Ontario lagged behind Britain in the
enforcement of public health legislation; what was wrong with
this system, and what had to be done to improve public
health. There was discussion of legislation throughout the
1880's, and progress was made by the turn of the century
through public education. In Chapters IV andV,case studies
of Port Arthur and its Board of Health and St. Joseph's
Hospital and its Nursing School are presented to show how
even a small, remote community responded quickly to advances
made in southern Ontario and Britain.
Although Canadian public health reformers were in
contact with the American Public Health Association,
the stronger influence was with the British experience.
As Heather McDougall states in her essay Enlightening
the Public, "Such close ties indicated clearly the
extent to which the Canadians were emulating the
British approach." (p.439.) Indeed, on looking at the
American public health movement during the 1880*s it
also indicates an indebtedness to the British
experience. | |
