Five Useful Online Databases for Health History Research

For today’s post, I will identify some of the most useful online databases for historical research on the history of healthcare and more general academic websites.

Throughout the course of my undergraduate and MA dissertations, I was introduced (by fellow students and academic staff) to online repositories that have provided useful to my own research. However, some of these resources can only be accessed my university students while others are also open to the public.

Lenus the Irish Health Repository

I first encountered Lenus as a third year history student undertaking my research seminar on Health and Politics in Independent Ireland at UCC. While Lenus holds newly published medical research, it contains various nineteenth and twentieth century Irish health archives. For example, the Hospital Commissions’ Reports, Reports of the Department of Health (1945-), and reports from Fever Hospitals. The full documents are be downloaded and accessed by researchers and the public.

U.K Parliamentary Papers

This database boasts a wide range of Bills, Acts and meetings of committees relating to Scotland, Wales, England and Ireland. I found the Parliamentary Papers useful to determine when certain medical provisions were first recommended and to trace amendments to significant acts on maternity and child welfare. Of course, the Irish Statute Book website records legislation passed in Ireland following 1922.

Irish Newspaper Archive

As far as I am aware to view the Irish Newspaper Archive you must set up an account, however, it Irish university students can usually access the archive through their library database section. Notably, the Irish Times have a separate online arrchive with a substantial collection of newspapers.

CSO.ie

The Central Statistics Office contain the annual registers for births, marriage and deaths in Ireland from the nineteenth century. In terms of my own research, they provided a detailed summary of the number and causes of infant and maternal deaths in Ireland between 1919 and 1979.

Cora, Cork Open Research Arachive

Lastly, most University’s such as University College Cork have an Open Research Archive which stores past PhD theses. Before I start my research, I need to ensure that the topic has not been already been carried out by another researcher because you want your findings to make a new and significant contribution to historiography. Websites like CORA, and TARA, Trinity’s Access to Research Archive, allow free access previous PhD research undertaken in your main research area.

Links:

Central Statistics Office https://cso.ie/en/index.html

CORA https://cora.ucc.ie/handle/10468/1

Irish Statute Book http://www.irishstatutebook.ie/

Lenus the Irish Health Repository https://www.lenus.ie/

TARA http://www.tara.tcd.ie/handle/2262/76240 2 Acc

Origins of Irish Industrial Schools, 1858-1922

For today’s post, I will analyse the origins of reformatory schools in Ireland during the nineteenth century.

According to Coolahan (Irish Education: Its History and Structure, p.191), until the mid-nineteenth century in Ireland, the only provision for orphaned and neglected children was in workhouses and some religious organisations cared for young offenders. In 1858, the Reformatory Schools Act 1858 was introduced. This Act allowed for the certification of “existing voluntary institutions as reformatory schools suitable for “youthful offenders” that were over the age of twelve and committed by the courts” (Ibid: 191). O’ Mahony (Criminal Justice in Ireland, p.200) states that the first Irish reformatory school was founded in Dublin in 1859, while the first industrial school was established in 1869. Industrial schools were designed to care for abandoned, neglected and orphaned children. By 1870, the number of reformatory schools declined and some were reclassified as industrial schools (Ibid). Moreover, industrial schools were financed by capitation grants from the government and managed by religious orders. They were often operated on the same premises as Magdalan asylums and other institutions ran by the same order.

The Commission to Inquire into Child Abuse (section, 2.09) maintains that in 1882, about 70% of the children entered industrial schools were under the category of begging. Ferriter (The Transformation of Ireland, 1900-2000, p.49) states that between 1869 and 1913, 48,664 children were admitted to industrial schools. Under the Act, these types of institutions would be inspected on an annual basis and local authorities had the power to remove children from their homes. Under the 1908 Children Act, the institutions were required to provide practical training to enable children to enter the workforce upon their release. Domestic service was the most common type of training girls received in industrial schools while boys were taught how to farm and tailor clothing (Commission to Inquire into Child Abuse, section 2.06).

Arnold and Laskey (Children of the Poor Clares: The Collusion between Church and state that Betrayed Thousands of Children in Ireland’s industrial schools, p.xx) argues that poverty and economic depressions were the main reasons for the detention of children in industrial schools at the start of the twentieth century. Due to the stigma associated with unmarried motherhood, many illegitimate children were sent to industrial schools as their mothers were deemed ‘unfit’ to care for them. O’ Sullivan et al (2012: 214) maintain that children committed to industrial homes included “children who have lost one or both parents”, parents that are unable” to care for them because of poverty, children of broken up families by “desertion or imprisonment of one parent” and children who have “no fixed abode”. The 1908 Act also ensured that children considered vulnerable to ‘bad’ influences, for example, children living with a thief of prostitute, were committed to industrial schools.

Separate industrial schools were operated for Catholic and non-Catholic children. After 1922, industrial schools and reformatory schools were managed by the State and religious orders. Charitable organisations such as St Vicenti de Paul and the National Society for the Prevention of Cruelty to Children investigated cases and distributed financial aid to poor families. Rafferty and O’Sullivan l (Suffer the Little Children: The inside Story of Ireland’s industrial schools, p.11) argue that the industrial school system was based on myths which justified its existence, for example, there was a belief that only religious run industrial schools would care for orphaned children as “no one else would”. However, they were funded and inspected by the State. The Irish Free State asserted further control over Irish children when the 1937 Constitution stated that if the parents fail to provide religious, intellectual and physical education to their children, the State could intervene (Madden, Medicine, Ethics and Law in Ireland, p.480).

The full authority of industrial, schools was gradually transferred to religious orders after 1922. There was a large degree of shame and stigma associated with them as they were not distinguished from reformatory schools by Irish society. From the 1990s, allegations of child abuse within these institutions began to emerge. Documentaries and books, such as Mary Rafferty’s States of Fear, were aired which marred the perception of these institutions as stigmatising and punitive. On the 11^th May 1999, the Taoiseach, Bertie Ahern, apologised ‘on behalf of the State and its citizens… to the victims of childhood abuse for our collective failure to intervene to detect, pain, to come to their rescue’. It was not until the introduction of 1991, that the 1908 legislation was replaced by the Child Care Act. Breathnach (Crime and Punishment in Twentieth Century Ireland: A Description of the Criminal Justice System, 1950-1980, p.142) states that ‘clerical culpability was never required by the clerically-run state’

Bibliography

Arnold, Mavis and, Heather, Laskey, Children of the Poor Clares: The Collusion between Church and state that Betrayed Thousands of Children in Ireland’s industrial schools, Trafford, Indiana, 2012.

Breathnach, Seamus, Crime and Punishment in Twentieth Century Ireland: A Description of the Criminal Justice System, 1950-1980, Universal Publishers, USA, 1981.

Children Act (1908), Available at www.legislation.gov.uk/ukpga//Edw7/8/67//contents/enacted

Commission to inquire into Child Abuse (2009), Report of the Commission to Inquire into Child Abuse, Volume 1-5. Available at www.childabusecommission.ie

Coolahan, John, Irish Education: Its History and Structure, Institute of Public Administration, Dublin, 1981.

Ferriter, Diarmaid, The Transformation of Ireland 1900-2000, Profile Books, London, 2005.

Madden, Deirdre, Medicine, Ethics and Law in Ireland, Bloomsbury Professional, Dublin, 2011.

O’ Mahony, Paul, Criminal Justice In Ireland, Institute of Public Administration, Dublin, 2002.

O’ Sullivan, Eoin and, O’ Donnell, Ian, Coercive Confinement in Ireland: Patients, Prisoners and Penitents, Manchester University Press, Manchester, 2012.

Rafferty, Mary and, O’ Sullivan, Eoin, Suffer the Little Children: The inside Story of Ireland’s industrial schools, Continuum, London, 1999.

The Foundation of Deaf Institutions in Ireland and the Debate Between Oralism and Manualism, 1778-1900

For today’s post, I will analyse the establishment of deaf institutions Ireland and the debate between oralism (lip-reading) and manualism (sign language) as the best method to educate the deaf. There were three deaf institutions in Ireland: Claremont in Glasnevin, Dublin, St. Mary’s School for Deaf Girls in Cabra, Dublin and St. Joseph’s School for Deaf Boys in Cabra.

In the eighteenth century, deafness was viewed as an “a chastisement from above upon the parents” (Pritchard, Education and the Handicapped, 1760-1960, p.2). Mathews ‘Mainstreaming of Deaf Education In the Republic of Ireland: Language, Power, Resistance’, p.1) argues that deafness has many causes: including variation on a chromosome carried by both parents, “a mechanical obstruction in their middle ear”, an “auditory nerve may not function”, or trauma experienced at birth, exposure to medication harming aural faculties, or viral or bacterial infection impairing hearing. The first signing school was founded in France by Charles Michel Epee while Samuel Heinicke established the first oral school in Germany in 1778 (Crean, Breaking the Silence: The Education of the Deaf in Ireland, 1816-1996, p.12). These types of specialist institutions charged expensive fees, restricting them to the upper and middle classes. The provision of services in Ireland lagged behind international developments, but only slightly. Mathews (‘Mainstreaming Deaf Education’, p.122) notes that before the 1800s, the deaf were dealt with by industrial schools, asylums, and penitentiaries. However, in 1814, Dr Charles Orpen set up a school for the deaf in Smithfield penitentiary in Dublin (which moved to Claremont in 1816) (Susanne Mohr, Mouth Actions in Sign Language: An Empirical Study of Irish Sign Language, p.9).

According to Pollard (The Avenue: A History of the Claremont Institution p.78), a deaf child was educated for 4 to 5 years and pupils older than 12 were not admitted. Therefore, deaf adults and teenagers were excluded from this provision, remaining uneducated. However, as with all aspects of education, and most aspects of health, provision for the deaf was denominational, and the nineteenth century witnessed a growth of Catholic institutions. Father Thomas McNamara was concerned that there were no educational facilities for Irish Catholic deaf children (Terri Broderick and Regina Duggan, Origins and Developments of St. Mary’s School for Deaf, p.16). The Catholic Church supported separate education for boys and girls. Broderick and Duggan note that Fr McNamara and the Catholic archbishop of Dublin, Dr Daniel Murray approached the Dominican Convent of Cabra to undertake the education of deaf girls (Broderick and Duggan, St. Mary’s, p.15). A Committee, later known as the Catholic Institute of the Deaf, was set up in 1846 to fund raise for deaf schools (Ibid, p.166). Accordingly, St. Mary’s School for Deaf Girls was established in Cabra in 1846 and St Joseph’s School for Deaf Boys was established under the management of the Christian Brothers, in Cabra, in 1857 (Crean, Breaking the Silence, p.40). The Catholic Institutions introduced sign language while the Protestant institution embraced the oralist method.

In 1880, the Teacher’s Congress for the Deaf was held in Milan. It further divided deaf institutions in Ireland and abroad as it heralded oralism as the best method to educate the deaf. Mohr (Mouth Actions, p.11) states that as a result, “sign language was banned from all schools across Europe” and was replaced by the oral teaching method. In July 1885, the Conference of Headmasters called for State aid for the deaf and the Government appointed a Royal Commission in response (Pritchard, Education, p.95)^.In 1889, The Royal Commission on the Education of the Deaf and Dumb, Blind and Imbeciles also preferred the oral method. However, there were no deaf people on the commission and Archbishop Walsh, Chairman of the CID, complained that there were also no Irish or Catholic persons on the Commission (Crean, Breaking the Silence, p.35). The Catholic Church were opposed to government interference in traditionally controlled aspects of health and social provision and they also supported the manual method.

In 1893, the Elementary Education (Blind and Deaf Children) Act was introduced. It introduced the segregation of the sexes and of signers and those who spoke and lip-read in schools (Leeson and Lynch, ‘Three Leaps of Faith and Four Giant Steps: Developing Interpreter Training in Ireland’ in J. Napier (ed.), Signed Language Interpreter Education and Training: A World Survey, p.3). According to Pollard (The Avenue, p.66), after 1894, “almost all deaf children were sent to school”. Mathews acknowledges that government polices favoured the oralist approach in the early twentieth century (Mathews, ‘Mainstreaming of Deaf Education’, p.124).

Oralism was established in Protestant deaf schools in Ireland in 1918 (Mohr, Mouth Actions, 11). Crean (Breaking the Silence, p.35) argues that because of the political upheaval in Ireland after 1922, the education of the deaf in Ireland was a “combination of religious and political establishments”. Religious orders were repsonsible for the care for the sick and poor in Ireland from the nineteenth century. In 1922, when the Irish Free State was founded, the Catholic Church re-asserted their powerful position in Irish society. The culture of secrecy surrounding disability such as deafness, continued as children were hidden in large, isolated institutions or at home. The outbreak of the Second World War allowed for technological advances such including hearing aids which significantly changed the lives of deaf children and adults. The Catholic institutions maintained manualism as the preferred method until the 1950s. However, the failures of oralism were recognised during th1 1960s, allowing for the combination of the two methods as the best method to educate the deaf. The Irish government also introduced policies which allowed for the mainstreaming of deaf children into ‘ordinary’ Irish schools.

Bibliography

Broderick, Terri and Regina Duggan, Origins and Developments of St. Mary’s School for Deaf Girls, Cabra, St. Mary’s School for Deaf Girls, Dublin, 1996.

Crean, Edward J, Breaking the Silence: The Education of the Deaf in Ireland, 1816-1996, Irish Deaf Society Publications,Dublin, 1997.

Leeson, Lorraine and Theresa Lynch, ‘Three Leaps of Faith and Four Giant Steps: Developing Interpreter Training in Ireland’ in J. Napier (ed.), Signed Language Interpreter Education and Training: A World Survey, Gallaudet University Press, Washington D.C.,2009.

Mathews, Elizabeth S., ‘Mainstreaming of Deaf Education in the Republic of Ireland: Language, Power, Resistance’. PhD Thesis, NUI Maynooth, 2011.

Mohr, Susanne, Mouth Actions in Sign Language: An Empirical Study of Irish Sign Language, Ishara Press, Preston UK, 2014.

Pollard, Rachel, The Avenue: A History of the Claremont Institution, Denzille Press, Dublin, 2006.

Pritchard, D. G., Education and the Handicapped, 1760-1960, Routledge and Keegan Paul, London, 1963. nt 3;\l

My First Experience of Presenting at a Conference: The Irish History Student’s Association 69th Annual Conference

For today’s post, I will discuss my experience of presenting a paper at a conference for the first time at the Irish History Student’s Association Annual Conference at Mary Immaculate College, Limerick.

During the 1950s, the IHSA conference was established in the 1950s by representatives from Irish universities. I was delighted when my abstract on ‘Public health nurses and the expansion of maternal and infant provision, 1922-1960’ was accepted by the organisers of the IHSA. They consistently sent out emails regarding the programme, direction to the campus and other important information leading up to the conference. The conference was held on the 1^st – 3^rd March 2019 at Mary Immaculate College, Limerick. I was chosen to present on the 14^th panel on ‘20^th Century health and body histories’ at 3:30pm on 2^nd March alongside two other speakers.

I felt enthusiastic and a tad nervous to present a paper for the first time at a history conference. My only experience with public speaking had included classroom presentations in front of fellow students and friends as well as a year’s experience of debating during my time at secondary school. However, I constantly reminded myself that I was overly familiar with my research and that I had rehearsed my presentation at least five times at home. I was also looking forward to meeting other researchers with similar interests in maternal and child welfare in Ireland. I was especially excited to meet the chair of my panel, Dr Sarah-Anne Buckley, whom had undertaken research on the NSPCC and child welfare in the Irish Free State during the twentieth century.

However, due to the fact that I was travelling from Cork to Limerick I was unable to attend the Keynote address by Professor Jane Ohlmeyer (UCD) on Friday, 1^st March. The organisers of the conference were very welcoming and kind as were all the other speakers I met on the day. They offered me advice on public speaking and gave me directions to the room I was presenting in. I felt relaxed and at ease while I presented my paper and was asked numerous questions at the end of my panel. I also had the opportunity to meet Dr Sarah-Anne Buckley whom was very friendly and interested in all the speakers’ papers.

Overall, it was an incredibly positive experience as I made new friends and researchers with similar interests to myself. The IHSA’s conference offers a great opportunity in a supportive and friendly environment for anyone interested in presenting for the first time. ffffff

The Expansion of TB Sanatoria in Ireland, 1900-1922.

For today’s post, I will examine the expansion of TB sanatoria between 1900 until 1922. In 1882, Robert Koch discovered that tuberculosis was spread by air droplets when the infected person coughed. It was a highly contagious disease and there were two main types of tuberculosis in Ireland. Pulmonary tuberculosis was caused by bacteria in the lungs and its symptoms included a cough and sputum with blood. Moreover, non-pulmonary TB could affect any part of the body including bones and joints and lymph nodes. According to the Thirty-Sixth Detailed Annual Report of the Registrar-General for Ireland in 1899 (p.8), 12,813 people died from TB and it accounted for the second highest cause of death in Ireland.

The lack of TB health services contributed to the development of anti-TB campaigns by The National Association for the Prevention of Tuberculosis and Consumption and The Women’s National Health Association. The NAPT was founded in 1899 and the WHNA was set up by Lady Aberdeen, the viceroy’s wife in 1907. They advocated for improved sanitary conditions in the home and workplace as well as a healthy diet as the best form of prevention against TB (Forty-Seventh Detailed Annual Report of the Registrar-General for Ireland 1910, p.xxvii).

There was limited provision available in Ireland for TB patients. The government had to find suitable accommodation to treat and isolate TB cases. Greta Jones (‘Captain of all these men of death’: The History of Tuberculosis in Nineteenth and Twentieth Century Ireland, p.105) maintains that the ‘general hospitals were reluctant to admit tuberculosis cases and hostile to the possibility that they might be used for segregation of the consumptive’ and the workhouses could not effectively implement the isolation of TB cases. Moreover, the TB sanatoria also refused to treat advanced cases (Ruth Barrington, Health, Medicine & Politics in Ireland, 1900-1970, p.72). Many TB cases were treated by the dispensary doctor in their homes.

The 1909 Tuberculosis (Ireland) Act made county councils responsible for providing of TB sanatoria and dispensaries. TB sanatoria would be financed by local rates. It made the notification of TB cases compulsory but only in the case where the infected person was in close contact with another person. In 1909, the Allan Ryan House was founded by Aberdeen and Heatherside was set up in Cork in 1911 (Jones, ‘Captain of all these men of death’, p.110). In most sanatoria, treatment included ‘fresh air, bed rest and nutritious food’ and early detection of the disease gave the tuberculous a greater chance of recovery (Ibid, p.160).

Under the 1911 National Insurance Act, a sick allowance would be given to TB patients in sanatoria. The government gave a grant of £145,623 for the construction of sanatoria. In 1913, the Tuberculosis Prevention (Ireland) Act made county councils responsible for the construction of sanatoria from board of guardians and the hospital boards. Sanatoria and dispensaries were financed by local rates and the county councils. However, the acts were weakened from the beginning. The county councils ‘found purchasing beds in voluntary sanatoria such as Newcastle and Peamont, a cheaper alternative to the costs of constructing their own TB hospitals’ (Greta Jones, ‘The Campaign against Tuberculosis in Ireland, 1899-1914’, p. 167). Therefore, patients were not effectively isolated.

TB mortality rates significantly rose during the First World War in Ireland, 1914 and 1918. It peaked in 1917 with 9,680 deaths (Fifty-Fifth Detailed Annual Report of the Registrar-General for Ireland 1918, p.xiv). Jones argues that there was no specific reason for the increase in TB deaths as ‘Ireland’s agricultural economy benefitted from the increase in food prices and the shipbuilding, engineering and textile industries’ (Jones, ‘Captain of all these men of death’, p.129). However, it postponed the building of sanatoria (Ibid, p.72). Moreover, Alan Carthy’s The Treatment of Tuberculosis in Ireland from the 1890s to the 1970s: a case study of medical care in Leinster (p.231) argues that the Irish War of Independence affected the operation of sanatoria as a number of sanatoria run by the Dublin Corporation were temporality closed including the Crooksling sanatoria.

County health services remained unco-ordinated during the 1920s and 1930s in Ireland. There were a number of weaknesses in the TB health services including a strong reliance on the TB dispensary, a low rate of reporting of TB cases and when most cases were diagnosed they were in the advanced stages of TB (Jones, ‘Captain of all these men of death’, p.138-9). During the 1930s, Dr Dorothy Stopford Price introduced tuberculin testing and the BCG vaccine to Ireland. However, TB mortality rates remained high until the 1950s. The Minister for Health, Noel Browne, constructed regional TB sanatoria and introduced a national immunisation scheme and a free X-Ray service during this period.

Bibliography

Thirty-Sixth Detailed Annual Report of the Registrar-General for Ireland containing A General Abstract Of The Numbers of Marriages, Births and Deaths Registered in Ireland During The Year 1899.

Forty-Seventh Detailed Annual Report of the Registrar-General for Ireland containing A General Abstract Of The Numbers of Marriages, Births and Deaths Registered in Ireland During The Year 1910.

Fifty-Fifth Detailed Annual Report of the Registrar-General for Ireland containing A General Abstract Of The Numbers of Marriages, Births and Deaths Registered in Ireland During The Year 1918

Barrington, Ruth, Health, Medicine and Politics in Ireland 1900-1970, Institute of Public Administration, Dublin, 1987.

Carthy, Alan Francis, ‘The Treatment of Tuberculosis in Ireland from the 1890s to the 1970s: a case study of medical care in Leinster’. PhD thesis, National university of Ireland Maynooth, 2015.

Jones, Greta, ‘The Campaign against Tuberculosis in Ireland, 1899-1914’ in E. Malcolm and G. Jones (eds.) Medicine, Disease and the State in Ireland, 1650-1940 (Cork University Press, Cork, 1999), pp.158-176.

Jones, Greta, “Captain of all these men of death”: the history of tuberculosis in nineteenth and twentieth century Ireland, Rodophi, New York, 2001.

Review: CIT Investigates Public Talk on ‘Mother & Baby Homes and Adoption Practices in Ireland’.

For today’s post I will review a public talk organised by CIT School of Humanities and CIT Arts Office on ‘Mother & Baby Homes and Adoption Practices in Ireland’.

I was drawn to this event as I have a personal interest in the history of children’s and women’s institution in Ireland. I was greatly impressed and familiar with some of the guest speakers that were on the panel discussion, namely, Professor Eoin O’Sullivan, author of Suffer the Little Children: The inside Story of Ireland’s Industrial Schools and Coercive Confinement in Ireland: Patients, prisoners and penitents and Mike Milotte, author of Banished Babies: the secret history of Ireland’s baby export business which highlighted the illegal adoption system during the twentieth century in Ireland. Other members of the discussion panel consisted of Conail O’ Fatharta, a Senior News Reporter from the Irish Examiner and Liam O’ Mahony, a Psychotherapist and Addiction Counsellor whom was born in Bessborough Mother And Baby Home, Mary Slattery whom ‘lost her first born to a forces, secretive and closed adoption system through St Anne’s Adoption Society Cork’ in 1973 and Terri Harrison whom was abducted by the Catholic Aid and Rescue Society from Britain and brought to Bessborough Mother and Baby Home and later St Patrick’s Mother and Baby Home on the Navan Road, Dublin as she was a single expectant mother.

Prof. O’Sullivan, Professor of Social Policy at Trinity College Dublin, argued that by the 1950s, 1% of the Irish population were institutionalised such as psychiatric hospitals and county homes and although these institutions existed across Europe, they lasted longer in Ireland due to a tendency to care for the ‘dispossessed’ and ‘unwanted’ by society. Moreover, he maintained that some of these institutions were inherited from the pre-independence period while others such as the Mother and Baby Homes emerged during the 1920s to suit the needs of Irish society. Mother and Baby Homes and the Magdalan laundries were designed to separate first-time unmarried expectant mothers and women who had ‘fallen’ more than once and O’Sullivan argues that the cost of caring for ‘recidivist’ women and their children led to the development of adoption in Ireland. However, children from county homes or industrial schools were fostered while babies born in the Mother and Baby Homes were illegally adopted as they were perceive to possess a lesser ‘recidivist gene’ than those born with mothers with a number of ‘illegitimate ‘children in these other institutions. O’Sullivan states that the State paid a capitation fee for each child attending industrial schools which encouraged these intuitions to extend the stay of children for a long period of time.

Mike Milotte states that about 2,000 children were officially adopted from Ireland in 1950 and that it was organised by a religious infrastructure including nuns, the Archbishop of Dublin, Charles McQuaid, and the Department of External Affairs (whom were responsible for allocating passports). He argues that an illegal adoption system existed in Ireland and it is possible that thousands of children were exported to America during the twentieth century. According to Milotte. American business travelled to Ireland to adopt and left Ireland two weeks later with the children. He noted that this practise emerged during the Second World War as American airmen brought children back from Europe to their wives however, in 1948, the illegal exportation of children was prohibited in Europe except in Ireland. Milotte highlighted that there was no inspection of the family before the child was placed in their care as the Catholic Charities. The Catholic Charities, an adoption organisation based in America would investigate the family however, these inspections often did not take place. The only prerequisite required for the family’s approval by the religious order was that they were a Catholic family. The media collaborated with the Catholic Church’s hierarchy to conceal the scandal and therefore, stories of illegal adoptions went unreported. Therefore, unregulated adoption system in Ireland and children possibly sent to unsuitable homes. The children were referred to as ‘orphans’ but many had one parent alive in Ireland.

O’Fatharta spoke about Mother and Baby Homes in relation to the media and he stated that when the Tuam Mother and Baby Home Scandal emerged in 2014, the Minister for Children, was aware of the story since 2012. Moreover, he noted that the death rates in the Mother and Baby homes were underreported by the nuns and the homes were not inspected by the government. O’Fatharta maintained that the public need to view Mother and Baby Homes and other related institutions as a network operated by the Catholic Church in Ireland. Mary Slattery ‘lost’ her daughter to St. Anne’s Adoption Society in 1979 and explained how the Catholic ethos from her social environment influenced her decision to have her daughter adopted. Importantly, her family were supportive of her pregnancy but the Catholic Church and government acts such as the 1931 Illegitimacy Act stigmatised unmarried pregnant women and their vulnerable children. St’ Anne’s Adoption society organised through an organisation known as Ally for Mary to travel to Dublin to give birth. However, she later discovered that some of the information provided to her before the adoption was deliberately misleading in an attempt to encourage her to choose adoption. Mary Slattery states that she was told that her daughter was going to family in their thirties however, she later discovered they were in their forties.

Terri Harrison explained that she was accepted as a single expect mother in England.. However, the Catholic Aid and Rescue Society ‘abducted’ her and forced her onto an airplane back to Ireland. When she arrived at Bessborough Mother and Baby Home in 1973 she was assigned a house name and a house number. She escaped from Bessborough but was found in Dublin and sent to St. Patrick’s Home on the Navan Road. She highlighted the sexual double standard that existed for men and women in Ireland as she maintained there were no special homes for unmarried fathers. Terri described how she felt ‘de-humanised’ by the lack of medical attention and counselling after she gave birth to her son, Niall. She states that ‘[her] first encounter with motherhood was destroyed’. Due to a genetic medical condition she and her son urgently needed to go to hospital following the birth however, the nuns’ ambulance passed ‘seven hospitals’ on their way to St. Kevin’s Hospital. Liam O’Mahony, member of the Irish Association for Counselling and Psychotherapy and Addiction Counsellors of Ireland described how early development trauma impacted his life after he was born on Bessborough Mother and Baby Home. He cited his inability to form meaningful relationships with other people, his negative self-image as he felt ‘unwanted’ and his perception of others as potentially ‘threatening’.

Significantly, the majority of the guest speakers cited the economic benefit for the religious orders as the reason for the long-term retention of women and children in mother and baby homes and industrial schools in Ireland. The Mother and Baby Homes Commission of Investigation report was granted an extension of one year in February 2019. The adoption system was illegal and unregulated in Ireland until the introduction of the Adoption Act in 1952. The Catholic Church’s hierarchy and the Department of External Affairs facilitated a large number of adoptions in Ireland, many which are unaccounted for. Single and expectant mothers and their babies were stigmatised by Irish society, the State and the Catholic Church and institutionalised in a Mother and Baby Home exempt from State inspections.

Bibliography

Mother & Baby Homes and Adoption Practices in Ireland: A Panel Discussion and Q & A with Conail O’ Fatharta, Prof. Eoin O’ Sullivan, Mike Milotte, Liam O’ Mahony, Mary Slattery, and Terri Harrison, Cork Institute of Technology, 13 February 2019.

Developments in District Nurse Training, 1890-1919

For today’s post, I will briefly analyse the developments in nurse training from the late nineteenth century to the introduction of the 1919 Nurses Registration (Ireland) Act.

Under the 1851 Medical Charities Act dispensary midwives were appointed to work in a local dispensary district. Ciara Breathnach ‘Handywomen and Birthing in Rural Ireland, 1851-1955’ (41) argues that although, the dispensary midwife was employed in the local dispensary, ‘distances from dispensaries and union hospitals coupled with a reticence to engage with medical care under the poor law served as deterrents for pregnant women’. Many women continued to avail of the handywomen’s service rather than the district voluntary nurses due to a difficulty in the community to raise funds to support a nursing association (Ibid, 40). ‘Handywomen’ were untrained midwives and facilitated the spread of disease amongst new mothers. However, most women did not give birth in hospitals and there was no ante-natal provision available during late nineteenth century in Ireland. Joe Robins’ Nursing and Midwifery in Ireland in the twentieth century: fifty years of an Bord Altranais (the Nursing Board) 1950-2000 (14) highlights that ‘the family home was accepted as the proper place for birth’. Many women died from puerperal sepsis and other conditions related to birth.

Most nurses were untrained during the nineteenth century, with a bad reputation for drunkenness and their lack of education (Gerard Fealy, A History of Apprenticeship Nursing in Ireland, 18). However, Florence Nightingale influenced the new value of morality becoming a requirement for nursing during the second half of the nineteenth century (Ibid, 11). Apprenticeship nurse training then developed during the 1890s and nurse training schools were attached to ‘voluntary hospitals and in the large hospitals operated by religious orders’ (Robins, Nursing and Midwifery, 11). Nurse training was denominational and there were separate training schools for Protestant and Catholic nurses. Maria Luddy’s ‘‘Angels of Mercy’: Nuns as Workhouse Nurses, 1861-1998’ (106) states that religious orders, drawing recruits from educated middle classes, played a significant role in the establishment of nurse training and thereby helped to raise nursing standards including the Sisters of Mercy. To train as a nurse, women were required to have a good moral character, ‘a positive reference and an ability to pay a general fee to the training school’ (Ann-Marie Ryan, ‘General Nursing’, 79).Various nursing trainings schools were set up including The Dublin Metropolitan Technical School for Nursing during the 1890s (Robins, Nursing and Midwifery, 14).

By 1900 attempts were made to provide official training for district nurses and various organisations such as Lady Dudley’s Nursing scheme (1903) and Queen Victoria’s Jubilee Institute (1897) organised voluntary nursing services throughout rural and poor parts of Ireland. The nurses treated a range of illnesses including tuberculosis and they often arrived to treat patients following a ‘referrals from general practitioners, the Jubilee Committee and pharmacists’ (Armstrong, ‘Public Health Nursing, 127). According to Armstrong (Public Health Nursing’, 127), the district nurses were trusted by the community as they had the power to convince patients to receive vaccinations. However, they worked long hours as they held a dual role of midwife in many districts (Ibid). The voluntary nursing services were limited in Ireland as Breathnach ‘Lady Dudley’s District Nursing Scheme and the Congested Districts Board, 1903-1923’ (151) states that there were only a small number of Lady Dudley nurses: only 21 for 24 congested districts. It was a free service and the nurses travelled from areas on bicycle (Robins, Nursing and Midwifery, 12).

In 1919, the Nurses Registration (Ireland) Act was introduced, establishing the General Nursing Council, and a register for separate nursing divisions including general nurses and mental nurses and the Council would supervise nurse training, inspections and examinations. Nurses had to be enrolled in a training hospital in order to join the register. Moreover, a Central Midwives Board was founded and midwifery training would take place in maternity hospital for six months (Robins, Nursing and Midwifery, 17). Armstrong ‘Public Health Nursing’ (127) maintains that ‘the district nurses was also the appointed midwife for the area’ and they worked all day as they may be called to treat an injury or an illness. After the Irish Free State was established in 1922, the new Department of Local Government and Public Health funded Maternity and Child Welfare schemes and half the costs of local authority and voluntary nursing association nurses (Annual Report of the Department of Local Government and Public Health, -1925, 34). However, nurses were given insufficient wages by by the government and local rates (Commission on the Relief of the Sick and Destitute Poor Including the Insane Poor appointed on the 19^th March 1925, 65-66). However, by 1927, general nurses in many counties only had midwifery skills (Ibid, 66).

Voluntary scheme provided an essential service to the sick poor by travelling to patients in rural parts of Ireland. By the twentieth century, most nurses were moral and middle class women trained in a voluntary hospital or training school based in Dublin. District nurses employed by local authorities or voluntary nursing associations carried out a wide range of duties such as the maternity and child welfare schemes and preventive health services. However, district nurses continued to be over-worked and underpaid by the DLGPH and local rates in the Free State.

Bibliography

Primary sources

Annual Report of the Department of Local Government and Public Health, 1925-28, (Stationary Office, Dublin, 1928).

Commission on the Relief of the Sick and Destitute Poor Including the Insane Poor appointed on the 19^th March 1925 (Stationary Office, 1927).

Nurses Registration (Ireland). A bill to provide for the registration of nurses in Ireland.

Secondary Sources

Armstrong, Sheila, ‘Public Health Nursing’ in J. Robins (ed.) Nursing and Midwifery in Ireland in the twentieth century: fifty years of an Bord Altranais (the Nursing Board) 1950-2000 (An Bord Altranais, Dublin, 2000), pp.125-139.

Breathnach, Ciara, ‘Lady Dudley’s District Nursing Scheme and the Congested Districts Board, 1903-1923’ in in M. H. Preston and M. O’ hOgartaigh (eds.) Gender and Medicine in Ireland, 1700-1950 (Syracuse University Press, New York, 2012), pp. 138-153.

Breathnach, Ciara, ‘Handywomen and Birthing in Rural Ireland, 1851-1955’, Gender and History, Vol. 28, No. 1 (April 2016), pp.34-56.

Fealy, Gerard M, A History of Apprenticeship Nurse Training in Ireland, Routledge, London, 2006.

Luddy, Maria, ‘‘Angels of Mercy’: Nuns as Workhouse Nurses, 1861-1998’ in G. Jones and E. Malcolm (eds.) Medicine, Disease and the State in Ireland, 1650-1940, (Cork University Press, Cork, 1999), pp.102-117.

Robins, Joe, Nursing and Midwifery in Ireland in the twentieth century: fifty years of an Bord Altranais (the Nursing Board) 1950-2000, An Bord Altranais, Dublin, 2000.

Ryan, Anne-Marie, ‘General Nursing’ in in J. Robins (ed.) Nursing and Midwifery in Ireland in the twentieth century: fifty years of an Bord Altranais (the Nursing Board) 1950-2000 (An Bord Altranais, Dublin, 2000), pp.77-99.

The Evolution of Magdalan Asylums in Ireland and Common Routes of Entry, 1829-1960

For today’s post, I will examine the evolution of Magdalan asylums in Ireland and the most common routes of entry into Magdalan asylums including self-committals, committals by clergymen and through the judicial system.

According to Maria Luddy’s Women and Philanthropy in Nineteenth Century Ireland (p.99), Irish cities had high rates of prostitution which created a need for Magdalan refuges. The Moral Rescue Movement in Britain aimed to prevent unmarried mothers from turning to prostitution (Maria Luddy, Prostitution and Irish Society, 1800-1940, p.115). Protestant asylums were founded during the eighteenth century. In 1767, Lady Arabella Deeny established the first protestant refuge (Ibid, p.77). By the end of the eighteenth century, there was a significant number of lay refuges established. However, they were reluctant to accept women who had been involved in prostitution for a long period of time (Ibid, p.84).

Magdalan asylums were founded during the nineteenth century and they offered refuge and redemption for ‘fallen women’. In 1832, the first Magdalan refuge was founded by the Irish Sisters of Charity in Townsend Street, Dublin (James M. Smith, Ireland’s Magdalan Laundries and the Nation’s Architecture of Containment, p.28). The asylums were denominational. They were based on the religious icon of Mary Magdalene, a prostitute who repented for her sins and was forgiven by Jesus Christ. Magdalen asylums were often referred to as Magdalen laundries as they had a commercial business attached. They were not financially supported by the State and therefore, they were dependent on donations and bequests (Jacinta Prunty, Monasteries, Magdalan laundries and reformatory schools of Our Lady of Charity in Ireland, 1853-1973, p.147).

There were 10 Catholic Magdalen asylums manged by four religious congregations in Ireland including the Sisters of Mercy, the Religious Sisters of Charity, the Sisters of Our Lady of Charity and the Sisters of the Good Shephard. Most of these asylums were established by laywomen and/or a member of the Catholic clergy in the early nineteenth century such as the refuge Drumcondra, Dublin in 1829 (Ibid, p.93). The laywomen or a bishop often invited a religious order from France to assume the responsibility of the refuge. Frances Finnegan’s Perish or Penance: a study of Magdalen laundries in Ireland (p.35) argues that some of the refuges were reluctant to allow the women to re-enter society however, they were not required to stay for the rest of their lives. They hoped to inculcate religious values.

Most women who entered the refuge were in their twenties during the nineteenth century. In the Good Shepherd’s asylum in Cork, 51 percent were in their twenties on entry between 1872 and 1890 (Ibid, p.235). However, the McAleese Report (p.173) states that most girls entered the refuges at 17 or 18 years of age in the twentieth century. In 1922, the Irish Free State was established and the Catholic Church exerted a powerful influence over the Nation State, especially on issues related to morality and thus stigmatised those in society that did not adhere to social norms and values, especially unmarried mothers and their illegitimate children. Diarmaid Ferriter (Occasions of Sin: Sex and Society in Modern Ireland, p.17) maintains that there was a sexual double standard in Ireland as ‘little attention focused on the men who impregnated the unmarried women: there were no ‘fallen men’ in Ireland’. The majority of women left after less than one year in the asylum in the twentieth century (Inter-Departmental Committee to establish the facts of State involvement with the Magdalen laundries, p.168). However, during the nineteenth century, 62.7 percent of known cases remained in the refuges for more than ten years while others never left (Ibid, p.195).

In the nineteenth century, self-committal accounted for 10 percent of committals (Smith, Ireland’s Magdalan laundries, p.30). Women entered for a number of reasons including ‘alcohol addiction, misfortune, expulsion from home, seduction, violent abuse by a partner of relative, illness, mental or physical disability and entrapment into prostitution’ (Prunty, Our Lady of Charity, p.304). Importantly, many women re-entered asylums during the nineteenth century which indicates that Magdalan asylums may not have been regarded as a punitive institution but rather a sanctuary from danger and immorality. According to Luddy’s Prostitution and Society (p.97), 29 percent of women re-entered the Good Shepherd’s asylum in Belfast between 1851 and 1899. However, self-committals only accounted for 16.4 percent of entries in the twentieth century (Inter-Departmental Committee to establish the facts of State involvement with the Magdalen laundries, p.888).

Many women were referred to Magdalan asylums through a priest during the nineteenth century as 37.49 per cent of entries into the Sisters of Charity’s asylum in Donnybrook was through the priest (Luddy, Philanthropy, p.128). It was the third most common route of entry during the twentieth century at 8.8 per cent (Inter-Departmental Committee to establish the facts of State involvement with the Magdalen laundries, p.854). Moreover, nuns also had the authority to transfer women from Magdalan asylums from another which accounted for a significantly higher percentage of admissions after 1922 at 14.8 percent (Ibid, p.162).

During the nineteenth century, prostitutes entered the Magdalan asylums from Lock Hospitals. During the 1860s, the Contagious Diseases Acts permitted police officers to arrest women suspected of being a prostitute at army and naval bases in Britain. However, many were committed to Magdalan asylums after they were medically treated, for example, 18 prostitutes entered the Good Shepherd’s asylum in Waterford between 1842 and 1900 (Finnegan, Perish or Penance, p.107). The Legion of Mary also committed prostitutes into the asylums after 1919 (Inter-Departmental Committee to establish the facts of State involvement with the Magdalen laundries, p.232).

After 1922, Mother and Baby Homes were established in Ireland for first time unmarried mothers as Magdalan asylums did not accept pregnant women. After 1922, 3.9 percent of entries were from mother and baby homes (Ibid, p.437). Illegitimate birth rates were extremely high during the 1920s in Ireland and the church strongly disapproved of unmarried mothers and their illegitimate children. Moreover, there were 107 from ‘psychiatric hospitals and institutions for the intellectually disabled’ after 1922. The NSPCC and County Councils also referred women to Magdalan asylums in Ireland (Ibid, p.163, 479).

Significantly, society was complicit in the incarceration of ‘fallen women’ as more than 10 percent of admissions were through a family member or relative during the nineteenth and twentieth centuries (Ibid, p.194, 858). These women were placed in a Magdalan asylum due to promiscuity, poor health or a disability (Ibid, p.860). Importantly, the McAleese Report (xiv) highlights that after 1922, an increased percentage of girls (7.8 percent of admissions) were committed to the Magdalan refuges from reformatory and industrial schools. Reformatory schools were established during the second half of the nineteenth century and detained children convicted of minor offences while industrial schools were set up to organise provision for abandoned and neglected children. Some girls were refused entry into industrial and reformatory schools and they were placed in a Magdalen asylum including victims of sexual abuse as the nuns feared that they would exert a bad influence over the other children (Smith, Ireland’s Magdalan laundries, p.20).

Another route of entry into the Magdalen asylum was upon release prison or the criminal court. Prunty (Our Lady of Charity, p.146) argues that 46 women were transferred from Grangegorman Jail to High Park between 1859 and 1895. Women continued to be committed through the courts into the asylums after 1922 as 24.8 percent of state admissions into Magdalen asylums were from the court system (Inter-Departmental Committee to establish the facts of State involvement with the Magdalen laundries, p.165). Some received a suspended sentence and in other cases it was used as an alternative to jail (women convicted of infanticide were sent to Magdalan asylums) (Ibid, p.229). During the twentieth century, women were committed to Magdalan asylums on probation by their probation officer for a period between 6 months and 3 years and these committals accounted for 31.4 percent of state admissions (Ibid, p.165, 228). Additionally, girls on remand were sent to Magdalan refuges as the State did not want to place them with hardened adult criminals in jail (Smith, Ireland’s Magdalan Laundries, p.67). Under the 1960 Criminal Justice Act, the Lower Sean McDermott Street asylum accommodated girls on remand (Inter-Departmental Committee to establish the facts of State involvement with the Magdalen laundries, p.221). However, some Magdalen refuges accepted girls on remand before the 1960s including the Good Shepherd’s in Limerick (Ibid, p.226). Prunty (Our Lady of Charity, p.491) maintains that girls awaiting sentencing in the Magdalen refuge were there ‘from an overnight stay to seven days’.

Magdalan asylums were originally established to rehabilitate ‘fallen women’ including the unmarried mother and prostitute. However, after the establishment of the Irish Free State, The Church used these institutions to punish women that did not obey the Catholic Church’s moral doctrine such as promiscuous women and women deemed vulnerable to seduction. The number of self-committals remained high from the nineteenth to the twentieth century and the incarcerations by clergymen, nuns from reformatory and industrial schools and mother and baby homes reflected low levels of social tolerance towards those that society considered deviant. Moreover, the State increasingly relied upon these asylums to place young women on remand and women convicted of infanticide.

Bibliography

Report of the Inter-Departmental Committee to establish the facts of State involvement with the Magdalen laundries. Available at http://www.justice.ie/en/JELR/Pages/MagdalenRpt2013 (accessed 10May 2018).

Ferriter, Dairmaid, Occasions of Sin: Sex and Society in Modern Ireland, Profile Books, London, 2009.

Finnegan, Frances, Do Penance or Perish: a study of Magdalen Asylums in Ireland, Cosgrave Press, Kilkenny, 2001.

Luddy, Maria, Women ad Philanthropy in Nineteenth-Century Ireland, Cambridge University Press, Cambridge, 1995.

Luddy, Maria, Prostitution and Irish Society, 1800-1940, Cambridge University Press, Cambridge 2007.

Prunty, Jacinta, The monasteries, magdalen asylums and reformatory schools of Our Lady of Charity in Ireland, 1853-1973, The Columba Press, Dublin, 2017.

Smith, James M., Ireland’s Magdalen Laundries and the Nation’s Architecture of Containment, University of Notre Dame Press, Indiana, 2007.

The School Medical Service in Ireland, 1904-1925

For today’s post, I will analyse the factors that contributed to the introduction of the Irish School Medical Service in 1919.

High rates of childhood mortality plagued early twentieth century Ireland and diseases such as TB, bronchitis, diphtheria, diarrhoeal diseases and heart disease were rampant (Forty-Second Detailed Annual Report of the Registrar General for Ireland containing A General Abstract Of The Numbers of Marriages, Births and Deaths Registered in Ireland During the Year 1905). Treatment was limited for contagious diseases which spread easily amongst children in schools and at home due to unsanitary conditions. According to the Report of the Registrar-General in 1905, 84% of deaths from measles were children under five while about 42% of scarlet fever deaths were of children. Children were vulnerable to diseases due to a lack of proper nourishment. Clarkson and Crawford’s Feast and Famine: A History of Food and Nutrition in Ireland 1500-1920 argues that the national diet in Ireland mainly consisted of food with little nutritional value such as Indian meal and tea. Additionally, independent imitative such as the Ladies School Dinner Committee, founded in 1910, aimed to improve children’s health and nutrition (Earner-Byrne, Mother and Child: Maternity and Child Welfare in Dublin, 1922-60).

In 1906, the Education (Provision of meals) act empowered local education authorities to provide meals for children in national schools that ‘are unable by reason of lack of food to take full advantage of the education provided for them’. However, it was not a compulsory provision. According to Earner-Byrne, in 1914, urban district councils became in charge of the distribution of children’s food in Irish national schools. Under the 1906 Act, the school medical officer or ‘a medical official’ would determine whether the schools meals scheme should be introduced into a national school. However, the scheme only applied to large urban areas. Fionnuala Walsh in Durnin and Miller’s Medicine, Health and Irish Experiences of Conflict, 1914-45 argues that ‘the outbreak…renewed attention to the topic

[of infant welfare]

in both Britain and Ireland’ as a high number of infants died in childbirth although, there was a slow decline in infant mortality rates during the war years.

In 1918, the first Dail established two commissions to inquire into the conditions of primary and secondary schools in Ireland. In 1919, the Killanin report and the Molony report found that the general conditions in Irish schools to be a very poor standard and Killanin recommended that local school committees be responsible for organising school medical services, the maintenance of school building and school equipment in primary schools (Brian Titley, Church, State and the Control of Schooling in Ireland, 1900-1944). Under the 1919 McPherson Bill, local education committees would manage the school medical service and deliver the school meals scheme ‘in each county and county borough’ (John Coolahan, Irish Education: Its History and Structure). However, the school meals scheme was not compulsory as it only applied to state-recognised national schools.

The 1919 the Public Health (Medical Treatment of Children) (Ireland) Act, introduced medical examinations on entry to school or ‘as soon as possible on their admission’. However, like the school meals scheme, it was not compulsory for all children to be examined in national schools. The act made county boroughs and councils responsible for organising school medical inspections. A school medical officer and assistant, dentist and district nurse carried out the service and they could refer children to hospital or dispensary for treatment (First Report of Department of Health 1945-1949). Health authorities relied on district nurses to carry out the school medical inspections in many areas. This service and the school meals scheme was financed by local rates and were only established in urban areas.

Significantly, it was not until the second half of the 1920s that many county boroughs and county councils began to introduce the school medical service. The Annual Report of the Department of Local Government and Public Health 1925-28 complained they were not implemented as ‘the main administrative defects have arisen from apathy on the part of Local Authorities and consequent laxity on the part of their inspecting officers’. It was not compulsory for county councils and county boroughs to establish a school medical service unless they deemed it fit for the area. However, during the 1920s, the concept of preventive healthcare was promoted and the Department of Local Government and Public Heath sought to prevent children from developing health conditions and illnesses through vaccination programmes, education of the mother by the health visitor and Maternity and Child Welfare Centres. Therefore, public health nurses played an essential role in providing health services to the community. Only a small number of counties and county boroughs had established a school medical service in the first half of the 1920s including Cork, Dublin and Clonmel county boroughs. In 1924, Cork and Clonmel County Boroughs established a school medical service (The child health services: report of the study group appointed for the Minister for Health to inquire into the child welfare service and school examination service).

Importantly, the school medical officers and the district nurses found that many children were malnourished and suffered from tonsil and adenoid, eye and nose defects. Schoolchildren had poor dental hygiene as approximately 70% of the children examined had dental defects and 22.5% had defective eyesight (DLGPH 1925—28). Moreover, 11.8% were unclean and 8% were classified as malnourished. This was due to the schools meals scheme inadequate funding by local rates. In Cork County Borough, the school medical officer and the nurse referred children with defective conditions to special treatment facilities (DLGPH 1925—28). As a result of the high number of dental defects, school medical services often included a dental-surgeon. The Annual Report of the DLGPH 1925-28 stated that the Clonmel Corporation provided a school medical service which included a part time nurse and medical officer, dentist and eye specialist.

At the school medical inspections, the nurse educated the parents on nutrition, cleanliness and illnesses and identified children’s medical conditions such as dental defects. The School Medical Service provided preventive health services including vaccination schemes, particularly diphtheria immunisations during the late 1920s and 1930s. Schoolchildren were also referred for specialist services free of charge.

Health Visitation and Maternity and Child Welfare Centres: the Expansion of Maternal and Infant Provision, 1915-1930

In 1900, maternal mortality rates were high in Ireland due to numerous factors. The only provision available to mothers was through the dispensary midwife from the local dispensary and voluntary nursing associations such as Lady Dudley’s nurses. Moreover, most women did not give birth in hospital and relied on a handywoman, an untrained midwife, to assist with childbirth. This practise often resulted in the spread of infection to the new mother. According to the 37th Annual Report of the Registrar General, 6.4 per 1,000 women died in birth from puerperal fever or other diseases linked to parturition in 1900.

At the start of the twentieth century infant mortality rates were extremely high due to the spread of infectious diseases such as diphtheria, pneumonia, gastro-enteritis and tuberculosis. In 1900, the Registrar General’s report stated that 38 per 1,000 children under five years of age died. According to Joe Robin’s Nursing and Midwifery in Ireland in the twentieth century: fifty years of an Bord Altranais (the Nursing Board) 1950-2000, the high infant mortality rate was influenced by various socio-economic factors including a lack of nutrition and an unclean living environment. Poor mothers were not educated on sanitation, nutrition, breastfeeding and infant illnesses. However, independent initiatives were established by middle class women such as the Women’s National Health Association in 1907 to reduce the high infant and maternal mortality rates in Ireland and to educate mothers on breastfeeding and cleanliness.

In 1907, the Notification of Births Act was passed, however, it did not make the notification of births compulsory. Under the 1915 Notification of Births (Extension) Act, health visitation was introduced for new and nursing mothers and children under the age of five. The Local Government Board was made responsible for the establishment of Maternity and child welfare centres and for the distribution of food to mothers and young children. However, the act only applied to urban areas.

In 1918, the Maternity and Child Welfare Act was passed, requiring local authorities to ensure provision for nursing and expectant mothers and children under five including health visitation, maternity and child welfare centres and free food and milk to poor mothers and young children. Nurses from voluntary nursing associations were mainly employed by local health authorities to undertake the health visitation service. It sought to educate mothers on nutrition and breastfeeding, thus helping to eradicate the ignorance of mothers about childbirth and babies. Significantly, in 1918, the Central Midwives Board was set up and a register of trained midwives was introduced to ensure that the practise of handywoman was discontinued. A register for general nurses was also introduced under the 1919 Nurses Registration Act.

During the 1920s, health services such as hospitals were co-ordinated. In 1923, a County Medical Officer was appointed to manage county health schemes including maternal and infant health services. Health visitors were appointed to work in the maternity and child welfare centres in county boroughs with high infant mortality rates including Dublin and Cork. They educated the expectant or nursing mother on childbirth and dangers of handywomen. The DLGPH’s Report 1922-1925 stated that ‘the ultimately the remedy lies in the gradual enlightenment of expectant mothers with regard to risks involved’. The Irish Nurse’s Union Gazette advised that the public health nurse to teach mothers through physical instruction rather than an explanation, for example, ‘by boiling the water we are going to use we can demonstrate the principle of sterilisation’. However, health visitation continued to be the only provision available to women in rural areas.

The high infant mortality rates encouraged the growth of the schemes in other counties and county boroughs. According to Report of the Commission on the Relief of the Sick and Destitute Poor Including the Insane Poor appointed 19^th March 1925, by 1925, there were 93 Maternity and Child Welfare schemes in operation throughout the country. The maternity and child welfare centres were funded by the Irish government. They funded half the costs of the voluntary nurses working under the Maternity and Child welfare schemes while the remainder was paid by local rates. It was mainly voluntary nurses that operated the maternity and child welfare schemes. Ruth Barrington’s Health, Medicine & Politics in Ireland, 1900-1970 maintained that in 1927, the first child welfare centre was set up in Lord Edward Street, Dublin, providing health education to mothers and public health nurses could refer patients for specialist treatment. Specialist treatment included treatment for medical conditions including rickets.

By 1930, the notification of births began in urban districts in countiessuch as Donegal. The voluntary nurses managed more maternity and child welfarecentres than district nurses employed by local authorities. According to the DLGPH’s Report 1930-31, health visits were carried out to 18,379 mothers and 33,930 children and 37,914 mothers in their homes. The Maternity and Child Welfare Schemes also provided free milk to poor mothers and infants. The DLGPH’s report 1930-1931stated that a Maternity and Child Welfare Centre opened at Tukey Street, Cork in 1931. Lindsey Earner-Byrne’s Mother and Child: Maternity and Child Welfare in Dublin, 1922-60 argues that Maternity and Child Welfare Schemes in urban areas including Dublin, Limerick and Cork were co-ordinated with the maternity hospitals, facilitating the development of ante-natal services.

Significantly, the 1915 Notification of Births (Extension) Act was the first attempt by the British government to establish provision for mothers and infants in Ireland. Importantly, the Nurses Registration Act 1919 and the Midwives (Ireland) Act 1918 marked the beginning of the decline of untrained handywomen and nurses. Maternal and infant provision was reinforced by the County Medical Officer whom oversaw their gradual introduction into county boroughs. By 1930,numerous maternity and child welfare centres were established and the number of health visits undertaken by nurses increased. They offered an ante-natal service to expectant mothers and the provision of food and milk for poor mothers and children under 5 helped to reduce medical conditions linked to malnourishment.