The conference proceedings began on Day One with a traditional welcome to conference delegates at the Waipapa Marae within the grounds of the University of Auckland.
The conference covered a number of themes ranging from museums, to influenza, public health, medical research, women’s health, vaccination, biography, tropical disease, medicine and war, childbirth, non-western medicine, and others.
There were over 110 papers covering a range of challenging and stimulating topics that crossed the boundaries from clinical matters from the past to more general histories. Medical history attracts a cross-disciplinary cohort ranging from clinicians, practitioners, historians of various stripes, archivists, museum professionals and others. The discipline has a transnational following that was reflected in delegates from around the globe including Korea, UK, USA, Australia, Philippines, Canada, Russia, and the host New Zealand.
The keynote speakers represented the transnational nature of the conference and the cross-disciplinary following of the research area. From the University of Exeter there was Mark Jackson’s ‘Life begins at 40: the cultural and biological roots of the midlife crisis’ where he argued that this concept and experience is a product of the lifestyle of the 20th century. Nursing historian Christine Hallett’s ‘Between ivory tower and marketplace: the Nurses of Passchendaele project and the perils of public history’ argued that the desire of community engagement and university agendas has led to debates about the nature of public history. Yale University’s Naomi Rogers examined health activism in the USA in her paper ‘Between ivory tower and marketplace: the Nurses of Passchendaele project and the perils of public history’ and finally the University of Auckland’s Derek Dow reflected on evolution and revolution in the history of medicine since the 1960s in ‘Inert and blundering: one medical historian’s odyssey 1969-2019’.
I presented a paper called ‘A helping hand: Red Cross convalescent homes in New South Wales, 1914-1916. In this paper I argue that the military medical authorities and the patriotic funds were poorly prepared for the outbreak of war and failed to come to grips with the issue for months. The newly established Red Cross stepped into the breach and undertook groundbreaking work in the area of soldier convalescence, initially with homestays and then eventually establishing the first dedicated convalescent homes in New South Wales.
The power of the past in the present
The European past of New Zealand is front and centre within the grounds of the University of Auckland. There are a number of important heritage buildings linked to the period when Auckland was the nation’s capital. The outstanding example is the Old Government House at the bottom of the campus surrounded by pleasant gardens and lawns.
Walking around Auckland Harbour precinct I was struck by the vibrancy of the city. In part from the upcoming 2021 America’s Cup Challenge and the growth of Pacific rim cities like Sydney, Vancouver, San Francisco and Auckland. The city has a relaxed aesthetic with a dynamic youthfulness – just like a big country town. The huge cruise liners disgorge their passengers to spend up the high-end fashion outlets along Queen Street, all within sight of the longshore wharves and container terminal.
The city fathers have not lost sight of the past and have gone for adaptive re-use of old mercantile buildings in the Harbour precinct. There are some striking examples of heritage retention that could be models for town planners in Australian cities and towns.
Tourism can provide these benefits if handled with sensitivity and an understanding that the visitor is seeking evidence of authenticity and a genuine representation of the past. The city precinct demonstrates that heritage and history does not have to sacrificed in the search for economic prosperity and job creation.
Over 700 locals and visitors were present for the official opening of the Camden District Hospital nurses quarters or better known as the ‘nurses home’ by the NSW Minister of Health WF Sheehan in June 1962. Official proceedings at the opening were led hospital-chairman FJ Sedgewick who said that the board had been working towards the addition of the new building for many years. (Camden News 27 June 1962)
Construction on the building had begun in mid-1961, cost £92,000 and was located on farmland purchased by the hospital-board in 1949 opposite the hospital in Menangle Road on Windmill Hill. The three-story brick building had suspended concrete floors and was designed by architects Hobson and Boddington influenced by mid-20th century modernism and International Functionalism. Nurses accommodation was an improvement on wartime military barracks with 40 single rooms with separate bathrooms.
Lack of accommodation
Finally the hospital-board thought that a solution had been found to the lack of nurses accommodation at the hospital. Adequate accommodation for nurses had been an issue for hospital administrators from the hospital opening in 1902. Originally Camden nurses were provided with two bedrooms within the hospital building which had soon proved to be inadequate. (A Social History of Camden District Hospital, by Doreen Lyon and Liz Vincent, 1998, p. 17) Nurses were quartered within a hospital complex based on the presumption that this was necessary because of their 7-day 24-hour-shift roster that meant that they worked all hours. Added to this was the Nightingale philosophy that the respectability and morality of the nurses had to be protected at all costs. The all-male Camden hospital-board took their responsibility seriously and considered there was a moral imperative to protect the respectability of their young single female nurses.
The Nightingale system hinged on the employment of women of unblemished characters as nurses…In the forty years since nursing has been made a respectable profession for women in Australia it had also acquired most of the dedicated overtones (and a great many of the rules, regulations, restrictions and inhibitions) of a religious order.
The blog Nurses For Nurses has a post with memories from one nurse about live-in-quarters at Lidcombe Hospital in 1971.
the large number of nurses who had to ‘live-in’ in the Nurses’ Quarters buildings (guarded by the bull-dog determination of the Home Sister, constantly on the look-out for those evil ‘boyfriends’ and male doctors!). These nurses were predominantly vulnerable, aged from 16 upwards, far, far from home in many cases. They needed friends, security, safety, comfort, respect, and a sense of ‘school pride’.
The cloisters of Camden District Hospital
The nurses at Camden District Hospital lived in a cloistered environment within the hospital grounds in 1902 , as they had done at Carrington Centennial Hospital for Convalescents and Incurable from 1890s, like a pseudo-religious order in their veils and capes. According to the NSW Health Minister Mr Sheehan,
‘The [new] building for the nurses I hope will be a home and comfort for them. It is consistent with the dignity of the service of the nurses in your community’. (Camden News 27 June 1962)
Duty and service were part of the ethos of nursing from the time of Florence Nightingale and Camden’s ministering angels met their workplace obligation.
There was comfort for the Camden community in the knowledge that the nurses’ quarters was on the road between the sacred heart of Camden at the St Johns Anglican Church and the Macarthur family’s pastoral empire at Camden Park Estate. The Macarthur family patriarchs had always been pre-occupied with the moral wellbeing of the town and the respectability of the nurses fitted this agenda. Mrs Elizabeth Macarthur Onslow was always mindful of the status of women and the moral dangers single nurses potentially faced in the town area. Mrs Onslow, her daughter Sibella and daughter-in-law Enid passed the hospital and the nurses quarters on their way to church and cast an observant eye over the complex to ensure all was well.
Lack of accommodation a constant problem from the beginning
Camden District Hospital was the major medical facility between Liverpool and Bowral and the Yerranderie silver field mines put pressure on the hospital. More patients meant a need for more staff. In 1907 a government grant allowed the hospital board to purchase a four-room cottage next to the hospital for £340 and converted it to nurses’ accommodation. (Camden News, 30 May 1907, 13 June 1907, 6 February 1908, 26 March 1908) Completed renovations in 1908 allowed the board to appoint a new probationary nurse, Miss Hattersley of Chatswood. (Camden News, 18 June 1908) The hospital’s status increased in 1915 when the Australasian Trained Nurses Association (ATNA) approved the hospital as a registered training school. (Camden News, 28 January 1915) Continuing pressure on the nurses accommodation stopped the hospital-board from appointing a new probationary nurse in 1916. (Camden News, 6 July 1916) While things were looking up in 1924 when electricity was connected to the hospital. (Camden Crier, 6 April 1983)
The hospital continued to grow as the new mines in the Burragorang coalfields opened up and adequate on-site nurses’ accommodation remained a constant headache for the hospital administration. In 1928 the hospital board approved the construction of a handsome two-storey brick nurses’ quarters at a cost of £2950 on the site of the existing timber cottage. (Camden News, 12 July 1928; SMH, 20 July 1928) The building design was influenced by the Interwar functionalist style and was a proud addition to the town’s growing stock of Interwar architecture with its outdoor verandahs, tiled roof and formal hedged garden.
Temporary nurses accommodation was added in December 1947 as each nurse was now entitled to a separate bedroom under the new Nurses Award. The hospital-board purchased a surplus hut from Camden Airfield as war-related activities wound down and facilities were sold off by the defence authorities. The hut was formerly a British RAF workshop hut, measured 71 by 18 feet, cost £175 and was relocated next to the hospital free of charge by Cleary Bros. RAF transport squadrons had been located at Camden Airfield from 1944 and local girls swooned over the presence of these ‘blue uniformed flyers’ and even married some of them. Hut renovations were carried out to create eight bedrooms, two store cupboards and bathroom accommodation at a cost of £370. Furnishings cost £375 with expenses met by the NSW Hospital Commission and the new building was opened by local politician Jeff Bate MHR. (Picton Post, 22 December 1947. Camden News, 1 January 1948)
As the Burragorang coalfields ramped up so did the demands on the hospital and the nurses’ accommodation crisis persisted. The issue restricted the ability of hospital authorities to employ additional nursing staff (Camden News, 21 September 1950) and the opening of the hospital’s new maternity wing in 1951 did not help. (Camden News, 4 March 1954)
Continuing accommodation crisis
The new 1962 nurses quarters did not solve the accommodation issue as the hospital grew from 74 beds in 1963 to 156 in 1983 (Macarthur Advertiser, 1 March 1983) and patient facilities improved with the opening of the 4-storey Hodge wing in 1971 on the site of the 1928 nurses’ quarters. (Camden News, 3 March 1971)
The finish of hospital-based trained nurses
The last intake of hospital-based training for nurses took place at Camden Hospital in July 1984 and nurse education was transferred from hospitals to the colleges of advanced education in 1985. (A Social History of Camden District Hospital, by Doreen Lyon and Liz Vincent, 1998, p.58)
By this time nursing staff were living off-site and the moral imperative of protecting the respectability and dignity of local nurses in a cloistered environment was challenged by feminism and the increased professionalism of the nursing profession.
In recent years the ghostly corridors of 1962 nurses’ quarters have remained eerily empty reflecting a lot of good intentions that were never quite fulfilled. The buildings stands as a silent citadel to the past and acts as a metaphor to the changing nature of the nursing profession, the downgrading of Camden Hospital, the imminent expansion of Campbelltown Hospital and the appearance of new medical facilities at Gregory Hills.
Fresh air was the order of the day for patients at the newly opened Carrington Centennial Hospital for Convalescents and Incurables at Camden in 1890. The hospital followed the latest methods in medical practice and building architecture from Victorian England based on the writings and approach advocated by Florence Nightingale.
Victorian England hospitals
By the late 19th century Victorian England had over 300 Convalescent hospital. They were one of a variety of specialist hospitals that appeared in Victorian England. They included consumptive hospitals, fever hospitals, ophthalmic hospitals, lying-in hospitals, venereal disease hospitals, orthopaedic hospitals, lunatic asylums, fistula infirmary, invalid asylums, as well as those catering for different groups of people for instance seamen’s hospitals, German hospital, children’s hospitals and others.
British historian Eli Anders states that in England convalescent homes were built as the seaside or in the countryside away from the dirty polluted cities. They were to be places of rest, nourishment and recuperation where there was plenty of fresh and healthy air. Medical practices dictated that fresh air and exercise were the order of the day.
Camden’s fresh country air
The location of Carrington fitted this model. It was located in the picturesque countryside with views over the Nepean River floodplain on a hill to catch lots of fresh country air. Camden was considered a healthy site away from the pollution and evils of industrial Sydney and the increased public health risks of the urban environment and issues with sanitation.
Carrington Hospital was the first major convalescent facility in New South Wales and followed design principles espoused by Florence Nightingale. Historian Eli Anders states that Nightingale wrote in her Notes on Nursing and Notes on Hospitals that she was an advocate for ventilation and proper site selection. She promoted the ‘healthfulness’ of convalescent hospitals in the countryside and on the edge of towns where they took advantage of fresh country air. Similar advantages could be achieved by a seaside location.
At the heart of this idea was miasma theory which stated that some diseases such as cholera, chlamydia or Black Death were cause by ‘bad air’. The theory stated that epidemics were due to a miasma started from rotting organic matter. The theory originated from the ancients in places like China, India and Europe and was only displaced by germ theory in the 1880s, which stated that germs caused diseases. Despite this popular culture retained a belief in ‘bad air’ and stated the urban areas had to clean up waste and get rid of bad odours. These ideas had encouraged Florence Nightingale’s activities in the Crimean War where she worked to make hospitals sanitary and fresh smelling. These ideas also had a major influence on Sydney and the outbreak of Black Death (bubonic plague) in 1900 after urban renewal process that followed in suburbs like The Rocks and Millers Point.
Convalescent homes were often built by philanthropists and charitable organisations. Carrington Hospital was built by Sydney philanthropist and businessman WH Paling (1825-1895), who immigrated with his family to Sydney in 1853. Paling ran a music business importing pianofortes and sheet music, and was an entertainment promotor and composer during the heyday of the gold rushes. His business success allowed him to pursue his political and philanthropic interests. Paling was an alderman on Petersham Municipal Council and mayor, a member of the Royal Society and a director the Mercantile Mutual Insurance Company. The Australian Dictionary of Biography states
His far-sighted preoccupation with questions of sanitation, health and hospital accommodation culminated in his presentation to the colony on 23 April 1888 of his 450-acre (182 ha) model farm Grasmere at Camden, valued at £20,000, to be used as a hospital for convalescents and incurables; he also donated £10,000 for the erection of suitable buildings. A public committee led by Sir Henry Parkes raised a further £15,000 for equipment and development at the Carrington Convalescent Hospital on the site.
The hospital site was purchased in 1881 from Camden Park by a syndicate of WH Paling, AH McCullock, Benjamin James Jnr and W Stimson containing 5100 acres. It was part of the North Cawdor Farms sale which also included a number of Camden Town blocks. The sale had a number of conditions and was not finalised until 1888. In the meantime Paling developed his Grasmere Estate farms. He established a Deed of Gift in 1888 with Lord Carrington was president of the hospital and chair of the general committees and himself as vice president.
The hospital was named after Lord Carrington, Governor of New South Wales (1885-1890), who served from on the centenary of the foundation of the colony.
Late Victorian Queen Anne Revival
The 89 bed hospital (49 male, 40 female) was designed by Sydney architect HC Kent and constructed by building contractor P Graham. The NSW State Heritage Inventory states:
It is representative of a late Victorian institutional building and is also representative of hospital building techniques (including setting) of the time. Main building of late Victorian eclectic style is brick on concrete foundations with cement dressings in the super structure and tower.
The main building is considered to be an excellent example of a Late Victorian Queen Anne Revival style. There were also additional buildings which included gardeners cottage, Masonic cottage, morgue, and Grassmere Cottage. There were extensive landscape gardens in a general Victorian layout with a carriage loop and flower bed.
In England convalescent facilities were very good and were better than home life conditions for many poor people. The idea with convalescent hospital were that the patients spent weeks recovering away from their home. Rich people who hired their own doctors to treat them during illness or convalescence. They paid to recuperate in a seaside health resort or travel to a spa centre. Convalescent homes were seen as superior to hospitals because they were different from dreary wards. Supporters advocated their calming and home-like qualities with libraries, games rooms and sitting rooms.
Ventilation and fresh air
The Illustrated Sydney News stated that the Carrington Hospital is located on a hill overlooking Camden to take advantage of ‘fresh air’ with ‘ventilation in the sleeping and living rooms’. The ventilation in the buildings was planned by Sir Alfred Roberts and based on Prince Alfred Hospital. The convalescence patients will be able to ‘sit outside and enjoy the lovely view and balmy health giving air’. The garden had ‘comfortable shady seats, where patients can wander about and rest at will, is of great importance, as also the verandahs where they can obtain exercise in wet weather, and the large sitting or day rooms’. There is the pleasant ‘park-like appearance’ of the countryside around Camden which ‘is very English in its character’. Patients will be able to recuperate for ‘two or three weeks’ rest and proper food that would mean so very much to them just at this stage…They are free to revel in the country scenes and sounds and rest awhile from the bustle of life’.
The Sydney press stated that the aims of the hospital
are, that persons recovering from acute illness may benefit by a short residence in the healthful climate of Camden, and a plentiful use of the farm products from the estate ; and further, that persons suffering from incurable diseases may have their lives prolonged and their sufferings alleviated by the above-named advantages. (Illust Syd News)
Lord Carrington lays foundation stone
The Governor of New South Wales Lord Carrington laid a foundation stone in February 1889 in front of a crowd of over 2000 people. A special train came from Redfern and was met at Camden Railway Station by well over 1000 people. The Maitland Mercury and Hunter River Gazette reported that Camden Station was ‘gaily decorated’ with a string of flags. Lord Carrington arrived by train from Moss Vale and he was met at the home by Sydney dignatories who were members of the management committee and trustees. The report noted that hot and cold running water would be laid on throughout the building.
Carrington Convalescent Hospital opened on 20 August 1890 and the first matron was Miss McGahey who resigned in 1891 to take a position as matron at Prince Alfred Hospital in Sydney. She was followed by Matron Kerr, then Matron Blanche Bricknell in 1897 who served until 1907.
The 1898 7th annual report in the Camden News stated that the hospital had treated 1153 in the previous 12 months with the annual cost of each bed being £35/8/9d. The meeting discussed the reluctance of patients to contribute the cost of their stay. During the year Sister Elenita Williams had been succeeded by Sister Edith Carpendale. Nurses Bertha Davidson and Eva Thomson had been succeeded by Nurses Lily BanfieId and Theresa Richardson. Mr JR Fairfax and Major JW Macarthur Onslow were elected the management committee by subscribers.
The 1900 annual report in the Camden News stated that the hospital had treated 1040 patients in the previous year with the average number of patients 75. The average patient stay was 28 days at a cost of £2/10/11d. The hospital shut its emergency section when the Camden Cottage Hospital opened during the year and Camden medical officers acted in an honorary capacity.
First major convalescent hospital
Carrington Hospital was the first major convalescent hospital in New South Wales and its surrounding buildings and gardens are list on the Camden Local Environment Plan Heritage Inventory (Item 118). Carrington Hospital is significance in that it is, along with Thomas Walker Convalescent Hospital, one of only two remaining functional purpose built late 19th century convalescent hospitals in New South Wales.
Out at Concord, located in Sydney’s inner west, is the magnificent building of the former Thomas Walker Memorial Hospital for Convalescents, that is now the school Rivendell. It was recently open for inspection by the City of Canada Bay Heritage Society.
The heritage society organises regular open days to continually raise public awareness of this heritage icon.
The Thomas Walker Convalescent Hospital is situated in the Municipality of Concord on the Parramatta River bounded by Brays Bay and Yaralla Bay. It is a large complex on a large park-like riverside estate, with extensive and prominent landscape plantings, making it a landmark along the river.
Opened in 1893 patients were taken from Circular Quay to the Watergate at the front of the complex on the Parramatta River. The landing stage was a pontoon that went up and down with the tide. A bridge connected the pontoon to the Watergate.
The convalescent hospital was constructed from a bequest of 100,000 pounds from the will of businessman and politician Thomas Walker who died in 1886. Walker was a philanthropist, member of the legislative council and director of the Bank of New South Wales.
The executors of Walker’s will announced a design competition in 1888 for a convalescent hospital. Architect John Kirkpatrick won the design competition although criticized for being overly expensive.
In 1889 architectural commission was given to Sydney architects Sulman and Power. The building cost 150,000 pounds with additional funds coming from other family members and supporters.
Between 1943 and 1946 the hospital was managed by the Red Cross with control then passing to Perpetual Trustees.
The hospital complex
The main hospital building is Queen Anne Federation style with a four-storey clock tower at the centre. There is classical ornamentation. On either side of the main building are two wings containing cloisters.
The hospital complex is based on a pavilion basis, with each pavilion to retain its functional integrity with the central block for administration and service blocks either side. There are 8 buildings in the complex.
The main building is two storey with a three storey tower over the main entrance, an impressive vestibule, and an entertainment hall for 300 people. There is sandstone detail throughout inside and out.
The Sulman buildings have elaborately shaped exposed rafter ends, Marseilles pattern terracotta roof tiles and crafted brickwork.
The building’s symmetrical design originally divided it into male and female sides. It includes two enclosed courtyards, a concert hall and a recreation hall which is supposed to be highly decorated. It is of the first known buildings to make use of “cavity walls” for insulation and protection against Sydney’s hot climate.
The hospital is important because it reflects Florence Nightingale’s influence on 19th century convalescent hospital design principles and their adoption into Australian architecture.
The Estate is a rare surviving late 19th century major institution of a private architect’s design in Australia and is John Sulman’s finest work in this country.
The grounds of the hospital are of national heritage signficance as an intact example of Victorian/Edwardian institutional gardens which have maintained an institution throughout their whole existence.
Look out for the next visitor open day in mid 2018 (July) run by the Canada Bay Heritage Society as well as the associated house of Yaralla at Concord in April and October.