Port Elizabeth of Yore: State of Medical Services in the 1800s

By the 1850s, there was heightened concern about the lack of a hospital in Port Elizabeth. Discussions amongst the town’s folk increasingly revolved around this requirement.  Whenever citizens congregated, it was a topic of discussion. Even though the population had risen by 1855 to about 3500 and disease and sickness was increasing, Port Elizabeth still did not have a hospital. Plans for a hospital were discussed over several years.

It was not until Act 5 of 1856 established the Port Elizabeth Provincial Hospital that planning for a hospital could commence. As an interim measure, a house in Rodney Street was hired to serve as a hospital. This was opened on the 10th September 1856 with Dunsterville and Rubidge serving as doctors.

Main picture: Entrance to the Richmond Hill provincial hospital in 1856

Technically the first hospital in Port Elizabeth was not the temporary hospital established in a rented house in Rodney Street during 1855, but rather a medical facility constructed prior to the creation of Port Elizabeth itself. This was the old military hospital below the Fort. Nothing is known about it; when it was erected, how long it operated for, what facilities it possessed and when it was demolished. Nonetheless, it must be acknowledged to represent the first medical facility in the town.

State of medical knowledge

Prior to the 19th century, the state of medical knowledge can be rated as rudimentary. Even the importance of cleanliness had not yet been appreciated. It would only be by the middle of the 19th century that the germ theory of disease transmission supplanted the “bad air” [miasma] theory. This was responsible for break throughs in the suppression of the spread of diseases such as cholera.


Laennecs stethoscope, c 1820

The development of the principal of vaccinations, commencing with smallpox, would gradually eliminate pandemics of infectious diseases. Even basic pieces of medical equipment such as the stethoscope were only invented during this century. All of these developments would ultimately trickle down to the four corners of the world but for the first 35 years of Port Elizabeth’s history, at best the provision of medical services could be classified as non-existent to rudimentary.

In an era prior to the discovery of anaesthetics such as nitric oxide and chloroform, one can imagine what conditions were like in Port Elizabeth when O’Brien and a one-legged seaman, Joe, had to restrain screaming patients while the surgeon’s knife was busy. One wonders what lack or discipline and decorum led to this quaint resolution being passed at one of the hospital’s Board Meetings which read as follows: “that in the event of any disorderly conduct’ in the Hospital, the matron  to  have  the   parties taken to the Tronk at once”.

Medical Services before the Hospital

Even though the population had risen by 1855 to about 3500 of whom 2000 were white, and disease and sickness was increasing, Port Elizabeth still did not have a hospital. What it did not lack was a leper hospital. In 1839 the Government rented Hougham Hudson’s “Mill Property” [future Mill Park], with the old mill and a small house, as the Baakens River Leper Institution. Dr R.L. Davies was the visiting surgeon and Richard Tee was Superintendent. By 1846 the Government had decided to move all lepers and paupers in the Colony to Robben Island. In 1846, the cutter “Isaac” took 16 lepers and 13 destitute people from Port Elizabeth to Robben Island.

At best during this era many surgeons had only served an apprenticeship and did not possess a degree. For the most part this implies that whatever medical they gleaned was by practical experience. As such, they possessed little understanding of diseases and their cause. So it was with Dr. James Chalmers who arrived in Port Elizabeth in March 1835 who had no degrees. Chalmers was Port Elizabeth’s first civilian doctor, Port Medical Officer and acting District Surgeon. He only occupied these positions until the end of 1839 when he relocated to Grahamstown.

Thereafter for many years, Drs. Davies, Dunsterville and Rubidge assisted by Dr. Houseley, were responsible for the health of the entire community, with B. G. Lennon, Leslie and Lacey as the apothecaries or chemists. Without proper medicines as are known today, they relied upon elixirs and potions and placed implicit faith in ‘Holloway’s Pills and Ointment  which were reckoned to cure everything and were advertised  in  almost  every issue of the newspaper from 1845 onwards.

Striving for a hospital

Ultimately the need to address the welfare of the town led to discussions on the need for a hospital. In the  forefront of this movement was John Anderson who championed the cause. The proponents established a committee of which Anderson was elected chairman. They drafted a scheme for the establishment of a charity and the Government was approached. The Governor of the Colony, Sir George Grey, promptly assigned them a grant of land for a site and endowment for the proposed Hospital adjoining the  Grey Institute  lands. The extent of this grant was over eleven morgen of ground covering what was now known as Bird  Street, Western Road and Pearson  Street.  It was promptly divided up into  lots and all but the actual site was sold to the public at prices ranging from £1 to £5 pounds per lot, the quitrents remaining good.

Regardless of their initial success, at a meeting during June 1855, they struck while the iron was hot. They drafted a long report and submitted it to the Government.

” In the first place,  it  being  probable  that  the  Government are about to give up  the establishment  for Lunatics on Robben Island, and as considerable  expense and trouble have, from time to time, been incurred by the Government in forwarding  unfortunates  of  this  class  from  various  parts of the Eastern Province to the Cape, the Committee would suggest that the design of the projected Hospital should be extended so as to include the treatment of lunatic patients belonging  to this  part  of  the  country ,  and  that  the  Institution be styled : ‘THE EASTERN PROVINCE HOSPITAL AND LUNATIC ASYLUM ‘. “

Included in this letter was the proviso that “if the Government approved of  the inclusion of an Asylum in their projected scheme, then they respectfully  requested  an extra annual grant towards defraying the expense of medical attention for the Lunatic Asylum, plus a further grant of endowment land, plusa special grant for the site of the Institution which  it  is desirable should be separated  from  other  buildings,  anhave a considerable open space round it as the immediate vicinity of  a  Lunatic Asylum mightend  to  materially  depreciate the value of buildings in the neighbourhood . . . the  most eligible situation  for  the  Institution  having  been  voted  at the North End of the town .”

The proposal regarding the accommodation in the Hospital, excluding the Asylum for the time being, was to consist of  two wards to contain ten beds each, and two wards to contain one bed each “for cases requiring quiet and seclusion“. Besides the usual administrative accommodation, there were to be “one wash house, two water closets, and one dead house “.

Requests for plans were called for. Those of a Mr. Penketh was considered the most suitable but required certain modifications. They provided accommodation “for nine male and eight female patients in the public wards, and two private wards of one bed  each “, plus the necessary administrative  quarters . The total cost of “building  and  furnishing”  the  place  was  estimated  at  £ 2000. Finally, among other things, they recommended “that the management of the Institution be entrusted to a Committee consisting partly of  Municipal  Commissioners and partly of such gentlemen of influence and high standing in our community as may feel disposed to assist in  carrying out this benevolent and important object “.

After the acceptance of the Report by the Government, this Committee  was  disbanded and a new Committee entitled “The Provisional Committee of Management”  was established with its members being Messrs. J. Anderson, J. Williams, Capt.  J.M.  Hill,  W. Fleming, J. Simpson, H. S. von Ronn, A. Ebden, A. Wares, F. D. Deare, J. W. Kemp, and J. Perkins. The resolutions of this short-lived Provisional Committee were drafted in “An Act of Incorporation for Regulating the Provincial Hospital at Port Elizabeth“, passed by the  Government on the 4th day of June 1856. The Act then mandated that a Board of Managers be appointed.

Battle of the sites

The first decision to be taken related to the all-important question of choosing the correct site for the proposed new Hospital. Even though the Governor, Sir George Grey, had in 1855 granted them sufficient land both to use as the site of the hospital as well as to sell in order to generate  cash to fund the construction of the buildings, insufficient land was available for the buildings after the sales of plots had been finalised. Management incompetence was clearly evident in the allocation of plots for sale.

There were still plenty of open spaces in town and after due investigation, the Building Sub-Committee reported: “After  carefully  inspecting  the  separate  pieces  of   unappropriated lands such as the Parade Ground, Cooper’s Bridge above Kay’s house, Outspan Spring, Baaken’s River, etc., they are of opinion that the open space in the neighbourhood of the Outspan Spring, situate at the north entrance to the town, possesses all points considered, and more natural advantages for the purpose contemplated than any they have been able to discover elsewhere . .

But the question of site was not to be so easily settled as all that, and from November 1855, until January 1857, there raged a fierce debate what may be termed “the battle of the sites“!  On many occasions. the question was “definitely settled”, yet on so many occasions reopened. Sites at the top and bottom of Cooper’s Kloof [later Albany Road] at South End near the River, on to the site of the present Drill Hall and even the one originally proposed between Bird Street and Pearson, all found supporters; but finally, the site “situate upon the Hill near the Gunpowder Magazine”  to the North End of the town was selected.  Land  to  the  extent of just over one morgen was granted to them there by the Government, and later. a further fourteen morgen surrounding· it which, when divided up into lots, sold so rapidly  that  the  unwise Managers were reduced to the sole plot upon which  the  hospital was to be erected, leaving no place for expansion. They were reduced at  a later date to re-purchase some of the plots at a loss. Yet again, the allocation of land was unwisely handled.

Temporary hospital

The sale of the plots resulted in the hospital funds being cash flush. As a  stop-gap measure, the Board of Managers decided to hire a building for use as a temporary hospital. To this end they called for tenders for the hire of a building containing not less than six rooms as well as a kitchen. The winning tender was a house in Rodney Street, “just off Main Street and opposite the sand hills.” For me it is unimaginable that “sand hills” would still be in existence so close to Market Square 35 years after the 1820 Settlers landed. This is indicative of how small the town was still at that stage.

The building which had previously been occupied by Mrs Bruton, was  secured at a rental of £48 per annum. With slight alterations, it would later form part of the business premises of Messrs. A. E.  Marks & Co. Auctioneers. Most of the building was constructed from timber removed from the broken wrecks that were strewn over the beaches. At a later stage, many of the original houses in the village of Schoenmakerskop would be constructed of packing cases. Mr. and Mrs. J. O’Brien were appointed as Master and Matron. As  part  of  the  equipment, it was decided to  purchase  the  cooking stove of the Sarah Lydia, a vessel that had gone ashore during a gale.

Temporary Provincial Hospital in Rodney Street, 1856

Construction commences

Prior to the selection of the site, a new Building Subcommittee  was  appointed,  consisting of  Messrs. Ebden, Murphy, Harsant, Wares, and Slater. Having decided on a plan prepared by Mr. Archibald, they accepted a tender of £3425 for the erection of the building with Mr. Williams being  the contractor. Work began in February 1857 and was practically completed by July 1858.

Final occupation delayed

In the words of Redgrave, “It seems ironical that the first inmates of the  new  Hospital should have been a batch of strong and  healthy  people, but such was the case. Just as the building was habitable, the Indian Queen dropped anchor in the roadstead, having on  board  a  number of  homeless immigrants. At  the  request  of  the  Government, the Managers allowed them to be housed in  the  buildings  where they stayed until about October. Smallpox then broke out in the town in 1858 and spread panic among the citizens. The temporary Hospital in Rodney Street  became overcrowded and from October 1858 to August 1859, some two hundred sufferers were treated by Dr. Dunsterville and Dr. Rubidge. Hence the Board were compelled to give notice of their intention to take possession of the new building at once.”

Old Provincial Hospital on Hospital Hill

At long last, the pioneering tiny Hospital in Rodney Street could be vacated and was taken over by James Somers Kirkwood, who converted it into an Auction Market.

Additional wards required

The increasing demand on the services provided by the hospital reflected the steady growth in the population of Port Elizabeth. By 1860, the need for another ward resulted in the construction of the Victoria and Albert ward, which was opened in 1862. Another of the quaint Board Resolutions
was passed in 1864 “that the notices to the visitors  for  the week, and
the clergy, he sent per penny post”.

Nursing home of the old Provincial Hospital

Having served the town faithfully from before the establishment of the hospital, Dr. Rubidge passed away in August 1869. As a mark of respect, one of the wards was named after him. The Hospital did benefit from his will as he bequeathed it certain property which was sold and the proceeds placed in the Endowment Fund.

Richmond Hill Hospital layout in 1905

During April 1871 two senior employees since 1863 resigned; chemist James Richardson, and his wife,  Superintendent and Matron of the Provincial Hospital respectively. The Board appointed Dr George Askew Hull to be the first Resident House Surgeon and Dispenser and he was succeeded in August 1872 by Dr Robert Lamb.

ln 1873, a dining-room and extra rooms for the Staff were added, together with a store room and sundry offices. Up till now, the Hospital had been quite open and only a light fence surrounded it, but in 1875 the entire grounds were enclosed with a solid brick wall. During this year, Dr. Dunsterville retired after nineteen years of faithful service, and two years later, he passed peacefully  away,  highly  esteemed, and deeply mourned by all who knew him. The ward then used for female patients, was named “Dunsterville Ward” in memoriam. His successor was Dr. F. Ensor.

With the number of patients still increasing, in 1877 it was deemed necessary to add the ” Chronic ” and the ‘Pearson’ Wards, the latter being
named after Mr. H. W Pearson who had taken a most  active  and  practical
interest in the work of the Institution.  

Up to 1878 the internal administration of the Hospital  had been entrusted alternately to lay and medical superintendents who acted also as dispensers, but, by the appointment of Dr. Chute. the position of House Surgeon was inaugurated, and his status as regards the treatment of, and responsibility for cases was defined, together with that of the Visiting Surgeons .

 Children’s Ward

The necessity of a ward specifically for children had long been acknowledged and fund-raising for this purpose had been in progress for a
decade with concerts, bazaars and donations. 

Mother Cecile of St Peter’s Mission in Grahamstown (The Community of the Resurrection, an Anglican Order) offered to provide nursing staff free of charge for three years if a children’s ward were built. The official opening of a children’s ward at the Provincial Hospital was performed by the Mayoress, Mrs. Pearson on the 17th January 1888. The Sisters managed the ward until 1898 when it was decided that the Hospital Board should control it. Sister Fanny, a trained nurse, was placed in charge. The Sisters also nursed in the main hospital until 1898.

Further accommodation was provided in 1882 by the erection of the “Rubidge Ward”,  followed  later  by the “Salamon and Bramson Wards”. The  latter  were  the  gift  of  Mr. Salamon and Mr. Bramson, two worthy citizens of the Bay, who also endowed them with a sum of £600  each. In accordance with the racial sensitivities of that era, this enabled the European and Black females to be separated, who had up till then, been accommodated in the same ward. From this are we able to infer that black males were similarly treated at this hospital?  

Layout and cramped conditions

Redgrave described the final demise of this hospital as follows: “But the hospital “situate on the Hill near the Gunpowder Magazine” could now no longer cope with the ever-increasing population, and it had been so added on to that there was no longer space for an addition of any sort . With the rapid advance of medical science, the buildings themselves were already antiquated. The buildings were all scattered, rendering efficient and hygienic service quite impossible. For instance, the  food had to be taken through the open air  from  the kitchen to the wards, and patients had to be  conveyed  in  the  same  way  to and from the Operating Theatre, as there were no covered ways. The Operating Theatre, formerly the kitchen, was in a very dilapidated condition. The idea of another storey to be added on to the present building was put  forward, and  plans embodying the idea were prepared by Mr. ‘White-Cooper and sent to Cape Town in 1898 where they remained until 1901, when the Government suggested an entirely new hospital ” to be erected on the same site “. The plans were drawn up and were shelved for months in Cape Town.”

New site requested

The Hospital Board then approached the Council for the grant of a new site. After much  discussion, five morgen of ground were allotted just off the Cape Road, in Buckingham Road near the tram terminus. The site was considered ideal  and  it also allowed for any future expansion.

The foundation stone of the new Provincial Hospital was laid on the 5th June 1912 by the first Administrator of the Cape, Sir Frederic de Waal. Designed in Cape Town, the much larger hospital was keenly awaited, and was finally opened on 4th June 1915.

Opening the new provincial hospital in 1915

Future use of the old hospital

The old hospital was disinfected and then taken over by the School Board. A Hebrew School was opened in part of the old hospital premises in 1918. This was later moved to the Old Foresters’ Hall on the western corner of Edward and Campbell Streets.

 In 1926 The Port Elizabeth Secondary School opened in the old hospital buildings, with L.V. Deary as Principal, and going up to standard 8. It was the first school here to offer Afrikaans on the higher grade, thus catering for children from the Afrikaans-medium primary schools as well as for those from English-medium, schools.

The section for infectious diseases (Isolation Ward) of the old hospital can still be seen to the west of the new buildings on the property.

After the hospital’s relocation

Origin of Nelson Square

Delving into the history  of  the original Provincial Hospital it can be discovered  that in 1855 a committee set up for the purpose of establishing a hospital applied to the  governor (Sir George Grey) for a grant of land. An area adjoining the Grey Institute lands was allocated to the municipality for this purpose. The exact limits of this area have not been ascertained but according to the account it included parts of the Bird Street,­ Western Road and the Pearson Street area. The land was never  used  for building a hospital and it was later sold off in lots between 1859 and 1888, after the rights had been transferred to the Board of Managers of the Hospital in 1857. A further grant of land was obtained on Richmond Hill and the hospital was subsequently erected there. A map of 1874 still shows the Nelson Square area as “hospital quit-rent land” but on a map of 1905 the square is shown as “Nelson Square”. It is not certain when it acquired this name, but it may possibly have been in 1905 as in that year the city
celebrated the 100th anniversary of the Battle of Trafalgar in a large-scale festival

Nelson Square between Western Road and Pearson Street
The hospital is prominent on the crest of the hill

Sources

Port Elizabeth: A Social Chronicle to the end of 1945 by Margaret Harradine (2004, Historical Society of Port Elizabeth, Port Elizabeth)

Port Elizabeth in Bygone Days by J.J. Redgrave (1947, Rustica Press)

Nelson Square  by Khitab (December 1973, Looking Back, Vol X111, No 4)

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