The 2020 COVID pandemic turned Belfast into a desolate city. Shops, schools, pubs, restaurants, churches all closed. The city’s usually bustling streets took on an eerie atmosphere. The lack of cars, planes and taxis created an ominous silence. Part of COVID’s defining experience was how unique it felt to us. We hadn’t experienced a pandemic for an entire century since the 1918-19 influenza pandemic killed 50,000,000 people worldwide. However, historically, disease outbreaks were a day-to-day occurrence and part of life. In the past, Belfast’s citizens had no option but to go about their business. In an era of deep poverty with little welfare support (other than the dreaded workhouse) until the NHS was introduced in the 1940s, social distancing, working from home or closing businesses for months were not feasible options.
In 2021, a team from Ulster University’s School of History decided to find out more about Belfast’s historical experiences with disease, sickness and illness since it emerged as a major industrial centre in the mid-nineteenth century. Medical history is often thought about as a heroic battle against sickness/illness, one in which medical scientists are gradually winning a battle against germs and viruses. In such narratives, discoveries, breakthroughs and great doctors take centre-stage. These include the smallpox vaccine (introduced in 1796 by Edward Jenner), development of anaesthesia in the 1840s, John Snow’s 1854 experiments at the Broad Street pump which decisively proved cholera to be water-borne and, moving into the twentieth century, the developments of anti-biotics which helped free us from the constant threat of disease.
However, we uncovered a more complex, and often harrowing, account of the city’s medical past, one full of complexities and intricacies. We also adopted a more inclusive approach that moved beyond examining the white, middle-class men often foregrounded in popular accounts of medical history. Instead, we encompassed working-class voices, women, children, the mentally ill, disabled communities, prison doctors, key workers employed in hospitals during the Troubles and LGBTQ+ communities. Given the presence of community tensions, a protracted 30-year conflict and the country’s pronounced religious ethos, medicine and health acquired considerable complexity in Belfast, although this aspect of the city’s story has so far remained largely untold.
The Industrial Revolution brought with it over-crowding, pollution, poor public health conditions and deadly outbreaks of diseases including tuberculosis, smallpox and cholera. As Rebecca Watterson found out, in the mills, female workers often died from a young age from lung-related issues or developed toe or foot-rot due to working in wet conditions. Eugenie Scott discovered that in the nineteenth century, parts of Ulster had the highest cancer mortality rates in the UK and Ireland, which was blamed partly on industrialisation. Meanwhile, Ian Miller explored the poor diets endured by Belfast’s working-class families. Women, in particular, too often lived on little more than tea and white bread. Psychiatrists believed that over-reliance on strong tea was causing an epidemic of mental health conditions including hysteria and epilepsy, a belief reflected in rising asylum admissions across late-nineteenth-century Ireland. Evidently, life in Victorian Belfast could be grim, to say the least.
At the time, hospitals and doctors were widely distrusted. Many working-class communities viewed hospitals as ‘gateways to death’ (and not without good reason). Infuriated by the imposition of compulsory smallpox vaccination in the mid-nineteenth century, an anti-vaccination movement emerged which had a strong presence in Belfast. Bleak conditions in Ulster’s asylums encouraged those patients who could afford it to travel to Scotland instead to seek psychiatric care. Around the 1890s, the Belfast Corporation found the money to build an extravagant new city hall and many of Belfast’s most grandiose city-centre buildings. However, they proved less willing to fully finance public health at a time when most other cities were doing so. Between 1905 and 1907, a deadly meningitis epidemic swept through the city, drawing attention to this lack of financing and causing the Lord Lieutenant to establish a Belfast Health Commission to find out what was going so wrong in Belfast.
There were, however, some positive developments. Working-class communities benefited from the construction of public baths across the city. As Tom Thorpe discovered, wealthier schools such as Campbell College established state-of-the-art medical facilities, although poorer schools lagged behind. Although the First World War saw widespread cases of shell shock and influenza, the twentieth century was a period of improvement in health matters. A therapeutic revolution occurred around the 1910s and 1950s. The majority of contagious diseases became treatable simply by ingesting an antibiotic drug.
However, the twentieth century was not without its problems. A polio epidemic in the 1950s, combined with the widespread use of the harmful thalidomide drug, left a legacy of children forced to grow up enduring severe physical disabilities. Asylum doctors, disheartened by a persistent inability to cure, out of desperation turned to procedures such as electroconvulsive therapy and lobotomies – the psychosurgical removal of part of the brain. The Troubles placed pressure on hospitals and prison medical services. Political prisoners claimed that their prison doctors were far from ‘neutral’ and were failing to adhere to standard medical ethics at a time of conflict and crisis. After the Second World War, psychologists and psychiatrists developed emotionally harmful procedures to ‘cure’ homosexuality as part of an attempt to turn gay people straight. As if things weren’t bad enough for LGBTQ+ communities, the AIDS crisis disproportionately affected them from the 1980s.
The team’s findings and interviews will be documented in a new podcast series entitled Epidemic Belfast. (For more information, see www.epidemic-belfast.com). As part of the ESRC Festival, the Epidemic Belfast team will be hosting an evening event at Sunflower, Belfast, 5 November 2021 where they will discuss their most intriguing, harrowing and sometimes gruesome findings. Following this, a small group will be led on a medical history walking tour around Belfast. The tour is free, book here. Follow us on Twitter at @epidemicbelfast.
Written by Ian Miller (Ulster University), Rebecca Watterson (Ulster University), Eugenie Scott (Ulster University)
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