Medicine, health and Irish experiences of conflict, 1914–45

David Durnin, Ian Miller

• Publisher: Manchester University Press
• Year: 2016
• ISBN:
  9781526108234
• Edition: 1
• Topic: History
• Subtopic: Irish History
• Index: History

This book explores Irish experiences of medicine and health during the First and Second World Wars, the War of Independence and the Civil War. It examines the physical, mental and emotional impact of conflict on Irish political and social life, as well as medical, scientific and official interventions in Irish health matters. The contributors put forward the case that warfare and political unrest profoundly shaped Irish experiences of medicine and health, and that Irish political, social and economic contexts added unique contours to those experiences not evident in other countries. In pursuing these themes, the book offers an original and focused intervention into a central, but so far unexplored, area of Irish medical history.

Part I:
Health and disease on the domestic front

1
‘Every human life is a national importance’: the impact of the First World War on attitudes to maternal and infant health

Fionnuala Walsh

‘We must avoid a continued slaughter of the infants as every human life is of national importance.’ So stated prominent barrister Samuel Shannon Millin in 1915, referring to the need to address the appallingly high infant mortality rate in Ireland, at a time when many Irish lives were being lost on the battlefield.¹ In early twentieth-century Ireland, infant mortality (the death of a child aged less than 12 months) was a serious problem. The issue received heightened attention during the First World War in both Great Britain and Ireland. The number of recruits deemed physically unfit for military service led to a greater recognition of the devastating impact of poverty on health, while the unprecedented loss of life on the battlefields simultaneously raised concern about the vitality of the nation.² In Ireland, infant and maternal health captured the attention of various politically disparate groups. This chapter examines this wartime apprehension and investigates the impact of the war on infant and maternal mortality as it arose in Ireland. It builds upon previous work by scholars such as Janet Dunwoody, Lindsey Earner-Byrne and Ian Miller to offer a comprehensive examination of the wartime infant welfare movement, and a quantitative analysis of wartime trends in infant and maternal mortality in Ireland.³ By considering the wider United Kingdom context, the particularity of the Irish situation will be established. Overall, this chapter argues that the turbulent political situation in Ireland strongly affected attempts to combat infant mortality, leading to significant differences in public attitudes towards the welfare movements in Great Britain and Ireland.

The pre-war infant welfare movement

Ireland had the lowest infant mortality rate in Europe during the last quarter of the nineteenth century. Although this rose during the 1890s, it remained significantly below the levels witnessed elsewhere in the United Kingdom.⁴ However, the difference between urban and rural Ireland was very evident. For instance, Dublin had a particularly high infant mortality rate.⁵ Social class was a key determinant of infant mortality rates. The babies of labourers were seventeen times more likely to die in their first year than the children of professional households.⁶ High unemployment levels, poor sanitation and overcrowded housing in Ireland's urban areas combined to create potentially lethal conditions for infants. Increasing attention was paid to the problem in the years immediately preceding the First World War.

Various voluntary organisations attempted to address the issue, most notably the Women's National Health Association (WNHA). The WNHA was established in 1907 under the guidance of the Countess of Aberdeen Ishbel Gordon, wife of the Lord Lieutenant of Ireland. Although primarily concerned with eradicating tuberculosis, its initial objectives included promoting the rearing of a ‘healthy and vigorous race’.⁷ By 1911 the WNHA had 155 branches and almost 18,000 members across Ireland.⁸ Their work was heavily influenced by neo-hygienist doctrines that highlighted maternal ignorance as a leading cause of high infant mortality rates. Accordingly, their activities were primarily educational in focus.⁹ From 1908, they operated mother-and-baby clubs in Belfast and Dublin. At the clubs, babies were weighed and doctors were available to provide medical advice. Home visits by nurses to investigate feeding and hygiene regimes also took place.¹⁰

Similar initiatives were taking place in Great Britain at the same time. Carol Dyhouse's work on infant mortality in pre-war London reveals the extent of the problem in Britain's cities, and the various attempts made to combat the issue. She claims that between 1900 and 1914 the subject had become ‘defined by contemporaries as one of the major social problems of the time’.¹¹ A wide range of organisations and initiatives developed in Britain to promote infant welfare. These included baby shows, which offered prizes for breast-fed babies, as well as nursing mothers' restaurants, milk depots and ‘schools for mothers’. This ‘rapid mushrooming’ of infant welfare centres resulted from both voluntary and municipal efforts.¹² The increased interest in the area was affected by societal concern with racial degeneration following the high rejection rates at recruiting stations during the Boer War (1889–1902).¹³ Although Miller has noted the influence of long-standing non-military social issues such as diet and health on concerns about national decline, Francesca Moore also points to the crisis of the Boer War as having encouraged infant mortality to be increasingly seen as a target for state intervention.¹⁴

In both Britain and Ireland, emphasis was placed on educating the mothers to take better care of their children rather than improving the adverse conditions in which many working-class people lived. Influential contemporary commentators dismissed the impact of poverty and the poor housing and sanitation conditions in overcrowded urban areas as of little relevance to infant mortality rates. Arthur Newsholme, chief medical officer of the Local Government Board for England and Wales from 1908 to 1919, claimed that any attempt to reduce infant mortality by addressing poverty would be ‘unscientific’.¹⁵ The pre-war infant welfare movements were very similar in Ireland and Great Britain, sharing a common focus on maternal education and promoting domestic hygiene. However, the Boer War had less impact in Ireland where the discussion continued to concentrate on problems arising from post-Famine dietary customs.¹⁶ Across the United Kingdom scientific advancements in the understanding of the role of bacteria in causing infection led to a new optimism that infant mortality rates could be radically reduced with appropriate education.¹⁷ Another war provided further incentive for attempts to improve infant survival rates.

Infant welfare and the First World War

The outbreak of the First World War brought renewed attention to the topic in both Britain and Ireland. The high numbers of men rejected as physically unfit for military service (41 per cent of all recruits examined in Great Britain during 1917 and 1918) caused great concern to the government.¹⁸ However, it was the unprecedented losses suffe...

Table of contents

• Cover
• Title page
• Copyright page
• Contents
• Figures and tables
• Contributors
• Acknowledgements
• Introduction
• Part I: Health and disease on the domestic front
• Part II: Health and political unrest
• Part III: Institutions and medical personnel
• Index