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CHAPTER1920 3 Depression andtheEndofExpansion Poliomyelitis ’s SchoolofHygieneandConnaughtLaboratories Lapses inOversight: and Typhoid Charitable Organizations Venereal Disease forIndigenous Communities Services Full-Time HealthUnits Public HealthNurses andChild Health Maternal and Growth Modernization This isPublic Health: ACanadianHistory

printable version ofthis chapter ...... – ...... 1929 ......

...... 3 .16 3 .15 3 .14 3 .11 3 .9 3 .8 3 .7 3 .5 3 .4 3 .2 3 .1 Profiles Glossary Table ofContents Contact CPHA Credits Endnotes CHAPTER1920 3 lesser .efforttodevelopfederallaboratoryresearchcapacity the .Departmentwasprimarilyfocusedoncollectinganddistributinginformation,withsome . was .createdtodeveloppoliciesandadvisethenewfederalDepartmentofHealthInitially, . In .Canada,thisneworderwassymbolizedbytheDominionCouncilofHealth(DCH),which . international .levelbythedevelopmentofHealthOrganization A .newpublichealthorderemergedintheaftermathofWorldWarI,representedat Ruthenian family, 1911 From Austria to Alberta, and Growth Modernization This isPublic Health: ACanadianHistory

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Miriam Elston, Provincial Archives of Alberta, A19485 populations .weregrowingrapidly .TheDepartmentofHealth . were .limited .ornon-existentand both .prairieandMaritime . an .economicdepression .in1921Ruralpublichealthresources of .immigrantsinsparsely .settledruralareas,especiallyafter In .the1920s,government .officialsworriedabouttheimpact the .countrycontinuedtoevolve the .roleofwomen—associalandeconomic .foundationsof from .aruraltoanurbansociety,andfundamental .changesin immigration, .industrialization,thebeginning .ofatransition had .notbeenpossiblebeforeMajorissuesincluded .increased tackled .avarietyofissuestogetheronnational .levelthat than .thefledglingdepartmentitservedCouncil .members important .tothedevelopmentofpublichealth .duringthe1920s In .someways,theDominionCouncilofHealthwasmore – 1929

League .ofNations . Profiles Glossary Table ofContents challenges . faced .withsignificantpublichealth of .provincialgovernmentswhen the .practicalandpoliticalisolation day .andwentalongwaytoovercoming the .majorpublichealthconcernsof compare .andco-ordinatestrategieson twice-yearly .forumtoopenlydiscuss, research .TheCouncilprovideda medicine, .publichealthandlaboratory academic .andscientificexpertisein universities, .thelatterrepresenting rural .women,labour,agricultureand and .representativesofurban the .chiefprovincialofficersofhealth Minister .ofHealthandmadeup was .chairedbythefederalDeputy The .DominionCouncilofHealth Dominion CouncilofHealth

Sanofi Pasteur Limited, Connaught Campus, Archives Contact CPHA Credits Endnotes of Health, 1919 Dominion Council

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3.1 CHAPTER1920 3 any, .accesstoobstetrical, .pre-orpost-natalmedicalcare widely .acrossthecountry .Ruralwomenhadverylittle,if in .bothinfantandmaternal .mortalityandtheratesvaried most .otherindustrializedcountries,Canada rated .poorly reported .byasmuch25%untilthe1930s Compared .to births .between1900and1920,buttheserates .wereunder- also .estimatedthatthematernalmortalityrate .averaged5per1,000live women .workinginindustrybeforeandafterchildbirththathadbeendevelopedatthe1919 . 1920, .theDominionCouncilofHealthendorsedaninternationalminimumstandardfor . forefront, .especiallysincetheinfluxofwomeninworkforceduringWorldWarIIn mothers .withsmallchildrenbroughtmaternalandchildhealthconcernstothe Concerns .abouttheeffectsoffactoryworkonpregnantwomenandhealth andChildHealth Maternal conditions .oraloathsomedisease”weretobedeportedassoonpossible they .leftforCanada“Undesirables…sufferingfrom developed .policiestoscreenimmigrantsfromcontinentalEuropefordiseasesbefore This isPublic Health: ACanadianHistory — shall makeitsafeforthebaby. If wemakeCanadasafeforthemother Division ofChildWelfare,1923 Dr. HelenMacMurchy,Chiefofthe – click toenlarge image 1929 6 .4deathsper1,000livebirthsMacMurchy . between .June1925and1926—arateof . maternal .mortalityandreported1,532deaths . country’s .firstcomprehensivesurveyof Dr. HelenMacMurchy International .LabourConference tuberculosis 2 , .defectivemental .conductedthe 1

Provincial Archives of Alberta, 1924, A11807 (left), A11808 (right) Profiles Glossary Table ofContents — . determined of the Service the divisions Pagé Services Immigration of creation at Chief, Medical joining medicine from 1861 . . . Vol .25,1934 Canadian PublicHealth Journal the prospective Health . . physical Overseas . . . and was Laval . . port of . . the was . . . . Superintendent, to of in Dr Services Medical andQuarantine First ChiefofImmigration J.D. Pagé . the . . . . graduated appointed for in Due ...... of the this St federal . University . . . . established, . prior Contact CPHA Credits Endnotes 1919 and J . Immigration . . . some Immigration Medical . . . . D . Casimir, immigrants largely federal . department, . . mental . Pagé . and to . . Government years . . . in embarking Chief . . . . . the and . . to With . Department . was medicine . . He Quebec . . . . status . enabling . his . before . . and . transfer . . . Hospital . . of Quarantine . . . practised . Medical . to born . . . the . . initiative . . Dr these . . . be . later . . . . . in . as . . of . , . 3.2 CHAPTER1920 3 a also for to women Public interest the “undertake provided 1920, sum of made Ontario maternal .health first .majoractivitywasthepublicationofpamphletsandbrochuresonchild Department .ofHealthalsoestablishedachildwelfaredivisionatthistimeandits to .workwithpublichealthdepartmentsatalllevelsofgovernmentThefederal Child .WelfareSectionasthenationalfocusofvoluntarychildwelfareprograms mortality .throughoutCanada” energetic .movement,alongeducationallineslookingtothereductionofinfant Canadian .PublicHealthAssociation,enablingit“toinitiateimmediately,amost In .1920,theCanadianRedCrossSocietyfundedanewchildwelfaresectionof . This isPublic Health: ACanadianHistory general . . Health “readily . . supervision supervision . . be that . . the possible . health . . provided . . and in had . . . . . exceeded by nurse Province . . The the cover . maternal . . . children the progressive . nurses . . . necessity by amount . . . and . for of Ontario . . her on . significantly . the . . . the hired explaining . . expert occasion . . . district . were and and . district . . allocations allocated . . for . . Red maternal . eight . Ontario’s child . given . advice . pre-natal . in . . Cross, to . . nurse . . and . higher public . order welfare . 3 . the primary . . .TheDominionCouncilofHealthendorsedCPHA’s rose . . . ” . of and demonstrating 5 . . . district . . district and An ” . . all . . to . . . care health Every budget from . . child . . work . inexpensive persuade . the organized . – responsibility . and . . . . nurses $50,000 nurse, . other . . effort . health nurses . as appropriations . allied . well 1929 . . individual . provinces . . . was scientific supplemented . were . local , and . . . travelling . . as supplemented in problems . . to . . general . 1910 . for . welfare provided community . be . the . . . . methods . of made mothers . to for . . . exhibit . . . Canada health ” public $530,000 . programs . 4 the . . by with . to . by . . . Provincial a . health . . “arouse . . . of . and . health in . pediatrician . another a put . . the . “motor a . . . . in welfare at truck . together . . centres necessity . . . . 1920—a . this . under . general . . . eight . Board . . . car” . would . . time, . . of . . . and . to . . In . Eunice Henrietta DykeEunice Henrietta — . welfare .andsocialservices . public .healthandassociated .community credited .withestablishinglinksbetween world-wide .acclaimMsDykewasalso the .firstofitskindandwhichreceived on .adistrictbasis—asystemthatwas of .thefamilyasaunitanddecentralized organized . and .theDepartment’snursingstaffwas the .Department’schildhealthcentres welfare .servicesbecamethenucleusof On .MsDyke’srecommendation,child energetic .andpioneeringindividuals susceptible .totheeffortsofenthusiastic, time .whenpublichealthwasextremely Health .oftheCityTorontoin1911ata started .attheDepartmentofPublic Baltimore, .Marylandin1905She Johns .HopkinsSchoolforNursesin in .Toronto1883andentered Eunice .HenriettaDykewasborn Family HealthandWelfareServices Comprehensive SystemofChildand Vol .51,July1960 Canadian JournalofPublic Health Profiles Glossary Table ofContents to . provide . service . Contact CPHA Credits Endnotes on . the . basis . , . 3.3 CHAPTER1920 3 program of University February Dalhousie municipalities .andconductinghomenursing .classes 1919 .Thewesternprovincesfocusedonchild .healthstationsinthemajorcitiesandrural its .firstpublichealthnursein1917,followed .byAlbertain1918andSaskatchewan in .1916andby1922,had53workingaround .theprovinceBritishColumbiaappointed Manitoba .establishedthefirstprovincialpublic .healthnursingservicewithfivenurses increased .demandfornursesbeganinWorld .WarIandcontinuedwellintothe1920s the .factthatthereisadeplorablescarcityof nurses .ineveryprovinceofCanada” In .1920,theDominionCouncilofHealthexpresseddismayabout“therevelation Public HealthNurses undertaken .bycitiesandtownsduringthisdecade from .theconstructionofmoreefficientandsafewatersewagemanagementsystems . modern .septictanksandindoorplumbingManyruralcommunitiesalsowereexcluded outdoor . inspection .andhome provision .ofpublichealthserviceswasachallengeRuralschoolsreceivedlimitedmedical . million .in1920to101929)wasspreadsparselyacrosslargeruralareasandthe . themselves .todeathAbouthalfofCanada’smodestbutgrowingpopulation(from84 DCH .Inadditiontoalackofsafeandavailablefood,farmwomenwereseenbeworking . The .conditionofchildrenandwomenlivinginruralareaswereaparticularconcerntothe . This isPublic Health: ACanadianHistory . Alberta . privies . it 1920, . . . University . of Public had . Western . . established followed .threatenedgroundwatersupplies,mostfarmerscouldnotaffordtoinstall . health . in . sanitation Ontario, . Halifax . . nursing shortly . in . 1919, . the . . offered thereafter . .andplumbingwereusuallypoorornon-existentWhile at . . . University UBC the . . first the . was – . by . . first such . a . . the of . supplement . substantive . . British 1929 . nursing University 7 . Columbia . degree . to . . public of . the . Toronto, . program . baccalaureate . (UBC), . health . McGill . . . nursing and in . the . the . . University, . in British . . . University . course nursing . 6 .An . Empire . in . . the . . Profiles Glossary Table ofContents —Dominion CouncilofHealth,1931 Canada. six percentofthebirthsthatoccurin provides nursingcareforapproximately cent ofthetotalnumber.TheOrderthus obstetrical cases,orwellovertwentyper the Order.Ofthisnumber,14,218were some 64,356patientswerecaredforby of maternityservice.Intheyear1929, the VictorianOrderofNurses,isthat which comesmorethananyotherto The particularphaseofbed-sidenursing, Contact CPHA Credits Endnotes 3.4 CHAPTER1920 3 never .materialized . by .theRockefeller .Foundationwere .critical,asfederalfunding .forMcCullough’s .campaign “hammering .awayatit .forthelast10years”Substantialfinancial commitments .provided as .oftenhecould,to .thepointofapologizingtoDominionCouncil .ofHealthfor level, .whichhesawas “the .greatestpublichealthneedinCanada” and .pressedtheissue 1924, .hefocusedonpromotingtheconceptof .full-timehealthunitsatthedistrictorcounty departments .withanefficientorganizationoverseen .byafull-timeofficerofhealthIn campaign .toadvancepubichealth,startingwith .theestablishmentofcompetenthealth In .1923,Ontario’schiefprovincialofficerof health, . support .afull-timepublichealthorganization . enough .fundingavailablefromthelocaltaxbase .inruralareasandsmallercommunitiesto professional .qualificationstobeeffectivepublic .officersofhealthbuttheresimplywasnot officer .ofhealthwasusuallyabusyprivatephysicianManylackedthetime,interestand . on .part-timeofficersofhealthandlimitedinfrastructuresinthe1920srural qualified, .full-timemedicalofficersofhealthSmalltownsandruralareasstilldepended . in .1921,althoughmanyurbanareashadfull-timehealthdepartmentsstaffedbywell- Canada’s .firstfull-timecountyhealthunitwascreatedinSaanich,BritishColumbia, Full-Time HealthUnits graduates .ofrecognizedschoolsnursing of .MedicineandtheOntarioRedCross,whichoffered10one-yearscholarshipsto in .PublicHealthNursingattheUniversityofTorontoconnectionwithFaculty Red .CrossprovidedfullfundingfortheestablishmentofaDepartmentInstruction and .toattractsupportstudentsIn1920,theOntarioDivisionofCanadian The .universitiesrequiredfinancialassistancetodeveloppublichealthnursingcourses This isPublic Health: ACanadianHistory 10 – 8 9 1929 John McCullough , .initiateda Profiles Glossary Table ofContents — . Health Professor of appointment Ontario, Public Director Harvard Laboratory as in public his The New Hygiene, Sanitation for Nurses, was epidemiologists in bacteriologist . . . Vol .26,1935 Canadian Public HealthJournal . the Boston Canada Director . keen, . the . . Vancouver . health Health . in . author . . . . of London, Medical . critical . . the of . from and . . . the of and . Bacteriology . . . . of . methods University . the to in . . . was . newly in was Dr Bacteriology Authorship andTeachingin Pioneering Work, Hibbert Winslow Hill of . . 1898 . taught Director . . . in serve the evaluation ...... General School 1871 Boston . New Public Health, and . . . the Contact CPHA Credits Endnotes Hibbert . all one born . University . . to established . . . . . in of . in . United and . bacteriology . During of 1905, ...... of which 1925, in . a of . Board In . . and Hospital the . . . full-time . . . was British . Winslow Saint Laboratories . . of 1912 . . . . he . pioneer . Nursing States . existing . . accepted . . . his expressed . the of . of . . served . . . John, he Institute . . Western . . . Columbia health . . . residency . first . and . . . . capacity . at . , . . . became . Hill . He . and . . and . . NB . . the . . 3.5 of . . CHAPTER1920 3 great of On the job safety, 1924 Secrétariat .delaProvince both .andthetwoessentiallyranaprovincialministryofhealthunderauspices . and .adivisionofprovincialhygienein1922Henamed provincial .secretaryandregistrarin1919createdadivisionofpublicassistance1921 . and .directedcentrallybytheprovincialgovernmentAthanaseDavidwasappointed From .thatpointon,publichealthservicesweredeliveredbythecountiesandadministered . municipalities .by1891,theydidnotbegintoprovidepublichealthservicesuntilthe1920s . in .1887butinvestedverylittlethisbodyandalthoughtheprovincealreadyhad876 health .units,with23establishedbytheendof1930Quebechadcreatedahygienecouncil . populated .anddevelopedcountystructuresfacilitatedtheefficientestablishmentof . Quebec .wasthesecondprovincetocreateafull-timecountyhealthunitin1926andmore . This isPublic Health: ACanadianHistory . the

click toenlarge image . many . DCH, . of . “the . the . province . people Quebec’s .publicassistancedivisionwasresponsibleforadministering provincial .grantsforhospitalsandothercharitableestablishments,

Provincial Archives of Alberta, A11813including .thecareofindigentTheService .provinciald’hygiène replaced .theConseild’hygièneanddivision .quadrupledpublic health .spendingbetween1922–23and1935–36, .focusingon and .childhooddiseasesAshealthunitsspread .acrosstheprovince, . Minister approach Saskatchewan, administered .atthecountylevel,province .alsobeganbuilding TB .sanatoriumsin1924,aninitiativethathad .untilthenbeenleftto to the .privatesector . of . obtain . Saskatchewan . of . . the by . Health . providing . necessary . with – . . covers Maurice Seymour 11 . almost . free . 1929 medical . a . . . very consultative fully . . . large assistance, Dr. AlphonseLessard rural . . area, conditions, . told . health . and . . and the . . clinics . it . June it . . is . took is . very . very . 1928 . . As a . . difficult . different . difficult . .tolead Deputy . . meeting . VD . for . for , . TB . a . . a . . Profiles Glossary Table ofContents — . for .hisinterestandsupport . Hygiene .alloweadebtof .gratitudetohim Canadian .NationalCommittee .forMental Council, .theHealthLeagueofCanada, Order .ofNurses,theCanadianWelfare in .CanadaItissaidthattheVictorian the .firstpublichealthnursingservice Canada .atSaanichin1921anddirected organized .thefirstcountyhealthunitin of .schoolmedicalinspectionDrYoung was .thefirstprovincetoprovideasystem interest .ineducation,BritishColumbia of . Board .ofHealthandRegistrarGeneral 1916 .hewasappointedSecretaryofthe claimed .theinterestofDrYoungandin developing .ProvincialBoardofHealth Provincial .SecretaryTherapidly appointed .MinisterofEducationand of .BritishColumbiain1906andwas Dr .HEYoungenteredtheLegislature As .DeanofCanadianofficershealth, BC, CanadaandtheUnitedStates Effective LeadershipinPublicHealth H.E. Young Vol .29,1938 Canadian PublicHealth Journal Vital .Statistics .Becauseofhiskeen Contact CPHA Credits Endnotes , . 3.6 CHAPTER1920 3 hospitals .to .servetheverysparse and .nomadicnorthern .Indigenouspopulation .Instead,he in .thesame .area,muchtoLivingston’s .annoyanceHealso .objectedtothebuilding .of Anglican .missionaries .operatedsmallnorthernhospitals,oftenduplicating .theirefforts Northwest .Territories and .YukonBranchoftheDepartment .InteriorCatholicand North .beganin1922with .theappointmentofDrLDLivingstonas .MedicalOfficerforthe The .firstsubstantivefederalefforttoprovide .healthservicestoIndigenouspeopleinthe Columbia Tuberculosis Indigenous ended to Children at residential school, 1924–25 work Alberta great This isPublic Health: ACanadianHistory . provide

click toenlarge image . . together many . his . amended . . . career on health . . to communities . . Association behalf . . pay to . . request in . . care provincial . for . the . of . that . . and the . federal . provincial . . undertook became . . . assistance Department services . health . public . more . . . legislation for funding . . a after . service . . two-year First . . of publicly Glenbow Museum, PD-341122b – . . Indian outspoken Medical when Health few and government public Indigenous forIndigenous Communities Services they . . to Nations . . . . Remarkably . enabling services support . protection have . . . study Dr . known 1929 . health . Affairs Service . Superintendent . . E . obtained and . critic . . . of communities . . . . L were a was municipal . . services in . . . . . unit coast 13 . . his Stone did for . . . the . high of responsible . . provided . persistent . . . Canada’s . 12 not the it . . mid-1920s, and . . . succeeded ” . rates . . . As Saskatchewan, begin federal . councils . . interior General . . also it . . of . at is . . Aboriginal . . advocacy to . for . . tuberculosis . this . today, had government’s . . . develop . when . . Dr. Peter Bryce within bands health . . Bryce . time very . the . . the . Manitoba effectively ...... a in limited . . peoples, promotion . . The . until had . federal . county . . Canadian . British . . in . . . . Indian . been failure . . 1927, . . . . to . and . but . . . as . an . Profiles Glossary Table ofContents — . health .inCanada much .inthedevelopmentofpublic provided .byqualifiedpersonnelmeant the .valueoffull-timehealthservices .Thisdemonstrationof death .ratesfrom disease .clinics,andgreatlyreduced an .effectiveprogramofvenereal enlarged .sanatoriumaccommodation, tuberculosis .diagnosticclinics, through .theprovisionoftravelling saw .thefruitionofmuchhisefforts On .hisretirementin1937,DrLessard to .improvinghealthadministration 1922, .hegaveearnestconsideration of .theProvincialBureauHealthin in .QuebecOnassumingthedirection the .full-timehealthunitmovement associated .withthedevelopmentof Dr .AlphonseLessardwasintimately of Full-Time Health Units in Quebec Developed and Demonstrated the Value Alphonse Lessard Vol .29,1938 Canadian PublicHealth Journal Contact CPHA Credits Endnotes .fever .and , . 3.7 CHAPTER1920 3 sponsored .by .localCouncilbranches .andfeaturedpublic .healthofficialsandcelebrity . implementing .theVD campaign .inmostprovincesandmajorcities .Speakingtourswere Social .HygieneCouncil .in1922)wasavoluntaryorganizationlargely .responsiblefor The .CanadianNational .CouncilforCombatingVenerealDiseases(renamed .theCanadian reporting .regulationstendedtolimitthisin practice . were .requiredtoreportconfirmedcasesbut carelessness .orignoranceoftheprovincial province .exceptPrinceEdwardIsland,providing .free,compulsorytreatmentPhysicians $200,000 .annuallyandby1922,52venereal .diseaseclinicswereestablishedinevery was .thefirstsharedfederal-provincialhealth .programThefederalgovernmentprovided sexual .relations,whichwereconsideredthe root .ofvenerealdiseasesCanada’sVDcampaign the .needfor“normal”maritalsexualactivity .asopposedtothe“abnormal”extra-marital VD .preventionandcontrolweredrivenbythe .conceptof anyone but in people First Stopping Venereal Disease services . base .forthemedicalofficersunderhisdirectionandout-patientlimitedin-patient . hospital .thereAsecondwasestablishedinChesterfieldInlet1930asanadministrative . established .a“medicalheadquarters”inPangnirtung1928,incorporatingsmallAnglican . This isPublic Health: ACanadianHistory . the . Deputy . World . Arctic . contributed . up 14 . the . there, . . Health War . . spread Syphilis . . except The . . Minister to . of . . . had deadly a . venereal . post-war . those . spread . Amyot . impact . who . diseases . . effort from . . are stressed . of . . . . free contact Spanish to – . (VD) . keep . from . that . . became . with VD . 1929 influenza . . Venereal “the . from . early . 16 protection . a . . spreading national . . European and . social .hygiene Disease . tuberculosis . has . preoccupation . . ” to . 15 explorers . got . Indigenous . , .whichemphasized to . . be among . . not in . . after the . . populations . to . Indigenous . . . North, . allow . . the . Profiles Glossary Table ofContents

Provincial Archives of Alberta, A11819 Provincial Archives of Alberta, A11821 Contact CPHA Credits Endnotes  enlarge image click to  enlarge image click to  enlarge image click to 3.8

Provincial Archives of Alberta, A11823 CHAPTER1920 3 and helped In Charitable Organizations did .wassetupclinicsandaffordfreetreatment .” to .betreatedasadiseaseiscrime… .TheBritishpeopledidnotgosofarAllthey article, .TorontoAssistantCrownAttorneyJ W .McFaddenwrotethat,“whatwasintended “tremendous .power”giventomedicalofficers .ofhealthIna1922 that .somefeltwasnotyetpossibleThelegal .communitybecameconcernedaboutthe compulsory .treatmentandthedeprivationof .individuallibertyrequiredalevelofprecision The .diagnosisofvenerealdiseaseswasachallenge .forpublichealthlaboratoriesand publications on and venereal male dance clubs, In for .womenonlywaslaterheldinalessconspicuouslocationdowntownOttawa painted .byartiststorepresentcutaneouslesionsofsyphilisandgonorrhea”Asimilarexhibit . in .1923,withlife-sizewaxmodelsprocuredfromFrance,“copiedlifeand speakers .Apopularmen-onlyVDexhibitwasshownatOttawa’sCentralCanadaExhibition . This isPublic Health: ACanadianHistory . . . addition the readers . . facilitated nation . sexuality, . . . the halls 1920s, . fund . disease . control . . . “to . ” to and . . . the pollute VD . the . . the . help the . recognizing . . other training . . Council . resulting . . Council VD . of creation . in . . alcohol, the . . . campaign, public a . . crusade . atmosphere . of president . called . from . . of public . “that . . custodial places . full-time . . . prostitution . for against voluntary . sex . health . . . and sex Stopping . . of indulgence . . care . . county . our and Public Health Journal . the . – nurses, . health . . . . for newsstands moral literary . was . . the health . the . . . strengthened 1929 is a . . organizations spread . 19 . . education . “feeble-minded” great not . scavengers . units . essential . and . menace . of . . The . VD the . for .

university editor . . . . and . required Canadian and . . minds . to children, to . . good . . the . and scandal Public HealthJournal international . Gordon Bates . . of individual, . . the . . health, a . infrastructures . . our . Red . social new . . supervision mongers . young . Cross . attitude . . and and . charities . . community . . . . . people that . was athletic . . 17 . called . whose . . . towards . of . . of . . . ” 18 Profiles Glossary Table ofContents —John .Last only .nowbeginningtolose . communities .withlongmemories .itis handed .authoritarianism .thatinsome health .acquiredanimage .ofheavy- and .typhoidfeverInthatway,public contagious .diseasessuchasdiphtheria were, .orwerethoughttobe,contactsof private .homesandseizechildrenwho (like .policesearchwarrants)toenter public .healthofficialshadwarrants serious .abuseofpowerForinstance, We .wouldnowadaysregarditasa image .ofpublichealthquiteseriously widely .usedinawaythattarnishedthe local .publichealthserviceswerevery early .20 fringe .civillibertariansButinthe the .HIVpositiveindividualandafew Nobody .seriouslyobjectstothisexcept arrested, .chargedandimprisoned knowingly .transmitsHIVdisease,is when .asexuallypromiscuousperson this .nowadaysonlyrarely,forinstance exercise .of“policepowers”Wesee practice .stillhappensoccasionally: An .unfortunatemistakeofpublichealth Police Powers th .centurythepolicepowersof Contact CPHA Credits Endnotes 3.9 CHAPTER1920 3 with .findinganationalfocus,ascompetingvoluntaryorganizationsspecificpublic The .CanadianPublicHealthAssociation,meanwhile,struggledwithitsfinancesand education initiatives Metropolitan public department, coast particular This isPublic Health: ACanadianHistory contributed . volunteer .servicesand$80 . World .WarII,theCanadian .RedCross areas .ofCanadaafterthe .warDuring set .upoutposthospitals in .isolated $35 .millionforoverseas .reliefand War .I,theCanadianRedCrossraised volunteer .aidinCanadaDuringWorld the .Societyresponsibleforproviding Cross SocietyAct government .passedthe Cross .Societyin1896Thefederal branch .(Toronto)oftheBritishRed Ryerson, .whoorganizedaCanadian was .foundedbyGeorgeSterling The .RedCrossmovementinCanada Canadian RedCross million .ingoods .andmoney . . In health . Prince . . . importance and in . . the Canada . . services, Life . studies, . Edward . Canadian . and .in1909,making . and . . . . in other with while . Canadian Red Island, . . providing around . Red . most . . life a the . Cross . . where insurance . . Rockefeller . of the . . public the . . world assumed . there . work – . . health companies . . . was . Foundation Institutes . the .Daughters .oftheEmpire,and .Women’s of .Tuberculosis,theIndependent .Orderof the .CanadianAssociation .forthePrevention Diseases, .theCanadian .SocialHygieneCouncil, Canadian .NationalCouncil .CombatingVenereal the .CanadianMedicalAssociation, Red .Cross,theVictorianOrderofNurses, including .representativesoftheCanadian voluntary .organizationswasformed, Council .forbetterco-operationwithother find .organizationalefficienciesAnAdvisory . support .CPHA,whilestressingtheneedto public .health’sfieldabilitytosufficiently W .FRoberts,downplayeddoubtsaboutthe and .NewBrunswickMinisterofHealth, health .interestsdevelopedCPHAPresident conducted . responsibility . . no 1929 training . provincial . sponsored . by . supported . and . public . for . services . health . . delivering a . health . range . public . board . on . . nurses of . the . health . . . all . local . . or . . east . . Profiles Glossary Table ofContents — . and .Lachine establishment .inMontreal,QuebecCity had .excellentreferencesfromthemedical with .StJohn’sAmbulancefor24yearsand Testing .andPlumbingHewasanAssociate and .obtainedofficialqualificationsinMilk 1914 .withtheLachineHygieneDepartment 1886, .hebeganhispublichealthcareerin Certificate .#1inOctober,1935Born Inspection .(Canada)Hereceived of .PublicHealthInspectors Tim .Roark,Historian,CanadianInstitute to .receivetheCertificateinSanitary Quebec .becamethefirstperson Mr .ArthurDicaireofLachine, Arthur Dicaire Arthur and Hygiene Pioneer inSanitaryInspection Contact CPHA Credits Endnotes 3.10 CHAPTER1920 3 the .journalwasre-named editing .it,withnewprofessionalfocusonscientificcontentandaccuracyInJanuary1929, . Committee .responsibleforbusinessmanagementandRobertDDefries public .healthstudiesCPHAassumedfullownershipofthejournal,withitsExecutive continue .CPHAand“developitintoaneffectiveprofessionalsociety”conductvarious . but .atthe1928annualmeetinginWinnipeg,membershipreneweditscommitmentto . CPHA’s .leadershipconsideredbecomingapartoftheAmericanPublicHealthAssociation . “alternate .proposalsforthefutureofAssociation”and At .the1925CPHAannualmeetinginMontreal,arenewedinitiativewaslaunchedtodevelop . Association .couldnotaffordtoimplementthisorevenholdanannualmeetingin1924 . Advisory .Councilandestablishaffiliateprovincialordistrictpublichealthassociations,the . Despite .aresolutionforCPHAtohirefull-timeExecutiveSecretaryadministerthe Anti- sentiments This isPublic Health: ACanadianHistory

click toenlarge image Lapses inOversight: Smallpox and Typhoid Persistent .outbreaksoftyphoidand in .publichealthoversightandhighlighteda longstanding .neglectbysomelocal Canadian PublicHealthJournal

Ontario History (December 1983) required .proofofrecent .smallpoxvaccinationinorder compulsory . .Asaresult,theUnitedStates 33 .deathsin1920,city .authoritieshesitatedtocarryout outbreak .occurredintheTorontoareaandresulted .in stored .oradministered were .oftenreinforcedwhenphysiciansimproperly . some .membersofthepublicandmedical .profession governments . Manitoba .and .Quebec were .imposed .onanyonefromToronto .entering to .crosstheborder,and .similarquarantinerestrictions – smallpox 1929

Anti-vaccination .sentimentsamong .demonstratedunacceptablelapses vaccines Journal ofPublicHealth . 20 .Whenasmallpox . Profiles Glossary Table ofContents — . Commissioner by was to and school and inaugurated of and aid the the Health program behind where then Siberia, she Wilson After Pioneer inPEI Health Dedicated Nurseand Wilson Mona Gordon . . Vol .51,July .1960 Canadian JournalofPublic Health . handicapped receive the . . . . for Junior Chief . . . . volunteered arranged smallpox evolved given . . set Mona . . . . Canadian she . health . the . was the took . . Montenegro off . . Red . . When . training . a . became . development Red . . development . . for formed leave . Gordon . . . a her clinics . . . . . program, for vaccination, Cross project . . . Canada’s in Cross . . . . children . PEI’s for nurse’s Red . . . the when Newfoundland Contact CPHA Credits Endnotes . . the . . In . in for . duty Nurse . . . . and first . Cross . . as . for 1940, . 1922, Department . moving immunization . . . she . health . . . training, . an . . . of . smallest . of in the . Albania Ms dental . . . developed . . better . . . in-school . its She to WWI . was . Ms Ms . . treatment . . Wilson . . serve . . public education, spirit . . . . . organized . requested . . Wilson Wilson . hygienists ...... health . in province . She . . of . . . as France, . . . health . the . . its . , . . was . 3.11 .

Prince Edward Island Books and Publications, Charlottetown, PE CHAPTER1920 3 hiring hobbled attempts epidemic, pasteurization City reinforced a 533 was nurses, Provincial in Cochrane, Montreal A been health had vaccinated rate severe The a Despite . . . This isPublic Health: ACanadianHistory debate situation . major more ...... dead ever epidemic caused among officials . proven . . . and officials smallpox . . as . . pressure, . . than . typhoid by . with been . . to . four . . . paid Public . . well . . Board typhoid-contaminated retaining persistent . over could . . . insufficient by the combat . . were as . . . 800 anti-vaccinationists, . in . . . vaccinated . . . years contaminated by-law . . concluded, as high never . unvaccinated . . the . outbreak Toronto . . . epidemic health possibly . . of . . $20,000 Ontario’s the cases . . . . previous the Health . . tribute qualified later . . . . concerns before main New . . power . . epidemic, authorities and . . . eased . . died illustrated in . develop . “the in ...... to provided to target chief York . . . . Windsor, 50 ” . . . 12 . Cochrane, milk . of 21 . . public help . the vested in . . . about . value . after . deaths years 71% . . . officer Windsor City’s . . . . work noting . . of sewage . . and in trusting the . were . . . . . of blame, . . . . 200,000 health other . . of engineers, a in that contracted . . . Ontario . . . . town modern . left the among . Health . . of vaccination . the of Ontario . . – that struck . . . . entered . Montreal’s . city’s . . health, . lapses reported more . When . the . civic workers . for The . . Dr. . . voluntary . . a Commissioner, in . public’s . failing . civilized . . . ability . with general . . population . health than in . 1929 the . . .

1923–24 Montreal . in the Seraphim Boucher . Dr the . . March . . . as cases public . disease . . . The . “amazement emergency officer . . . John . 5,000 water to . a . to . ability officials . . . . means and . city,” vaccinations . enforce . severity, . protect . . . No 1923 resulted . . health . McCullough, typhoid . . . of . . supply, of and stricken public . . . . . one “to and . in 3,400 . health, . of . and and . . . . . a no was . assessing . public . judge . . prevention oversight . . . scale who how milk . that . . . in . health . . . . epidemic . one insufficient resulting . another . . . . over, and . . were The . . a in . . . . was . had . . . such . it . . fairly mortality . and . health who . . . his . refused . . . local . given, . the . . been . . economic . In . . . in . has . in . 22 . . the salaries . . to while . . enter matter . — . international Montreal of of Montreal’s his to rate to health efficient When inadequate, Department When Advanced andDevelopedMontrealPublicHealth Seraphim Boucher impact . . a . . . Canadian PublicHealth Journal . . for . Quebec the 84 10 . . . more . achievements into . . when . . . ” . 2 . on . . College . he Dr . per Montreal’s . . Department his . . . retired in . . Seraphim he . . He 1,000, Société . . . . and retirement 1901 Profiles Glossary Table ofContents of . . assumed . commissions . of established . Health, . . . Physicians the as . . and . from . Dr . general . Médicale Director . . activities Boucher . . . with served Boucher . . office . . the 21 Such . . . . activities 5 . the death . budget . . and . . in . in . and was on . . . first . results limited . first . . 1913 1938, was . . numerous Surgeons . . . rate later 215 Contact CPHA Credits Endnotes . . entered . was infant . . , .Vol29,1938 . one in The . . . . stand the . per had largely . . served . every small, . of . . . infant City . 1,000 . health . . dropped . of the . Montreal’s . . Canadian as . . . field the . . . to . as had . the records founders . . . mortality . . and sanitation . . Registrar . Province . clinic . . . staff . of a . . in . . highly . down . public . . . and . . 1936 . . of . in . . of . 3.12 . CHAPTER1920 3 restrict .the right .ofpersonalchoice .” based .upon .theinherentdislikeof .theAnglo-Saxontoall .measureswhichare .designedto selfish .motives,someare .misinformed,but,inthemain,thisopposition .wouldappeartobe Health Journal vaccination, .compulsory .schoolattendanceandchildlabourlaws As .a Public .healthleadersput .rawmilkadvocatesinthesamecategory as .opponentsof the .debatesbetweenadvocatesofrawmilkand .thosecallingforcompulsorypasteurization milk . Outbreaks .oftyphoidandotherentericdiseases .exposedweaknessesinsanitarycontrolsof importance,” .whilecautioningthat“agreatdeal .remainstobedone” Journal a .bacteriologist,hadbeenmadebeforethesurvey .wasdoneA delay .Somereforms,suchashiringmore unanimously .endorsedbyMontreal’sCityCouncilandmostimplementedwithminimal and .betterco-operationwithvoluntaryhealthorganizationsTherecommendationswere . and .communicablediseasecontrolservices,strictenforcementoffoodmilkby-laws . of .Health,abudgetupto91¢percapitaproperlysupportschoolhealth,laboratory the .lowestofUScitiesat50¢ThereportcalledforareorganizationDepartment . health .expenditurewas39¢,comparedtoPittsburgh,thehighestat$118,andPhiladelphia, . expenditures .withthoseof12AmericancitiesandMontrealclearlyrankedlastItspercapita . within .itssocialcontextThesurveycomparedMontreal’smortalityandmunicipalhealth . and .earlyunderstandingoftheimportanceusingstatisticsplacingpublichealth The .ground-breaking1929MontrealHealthSurveyReportreflectedasophisticated and League of This isPublic Health: ACanadianHistory . the . professional . supplies . 1927 . to .editorialdescribedthecity’sstrongendorsement .ofthesurveyreportas“anevent . invite . typhoid These .outbreaks . .editorialnoted,“Some .ofthesepeopleareundoubtedlyaffectedby .purely an . men . . “unprejudiced in . . to Montreal . undertake . prompted and . . group . a . the .persistentthreat thorough 25 . – of . Montreal’s . public sanitary . investigation 1929 . health .inspectors,publichealthnursesand . Anti-Tuberculosis . experts” of . . of milk-borne . . Montreal’s Canadian PublicHealth . and . unaffiliated 24 . and Canadian Public tuberculosis .enflamed . health . General . needs . business . . Health . . 23 Profiles Glossary Table ofContents — . congress .onBCGin1950 . represent .Canadaataninternational . diphtheria, .thatledtohis .invitationto for .thepreventionoftuberculosisand methods .ofimmunization,particularly centres .forexperimentalresearchin direction, .Montrealestablishedseveral of .MontrealUnderDrBaudouin’s the .SchoolofHygieneUniversity nurses, .whichwaslaterintegratedwith a .trainingschoolforpublichealth local .parishgroupsHealsofounded relating .publichealthservicewith infant .mortalityrateinQuebecby Montreal .andworkedtolowerthe President .ofLaSociétéMédicale of .Lachinein1909In1927hebecame Medical .OfficerofHealththeTown Dr .JosephAlbertBaudouinbecame Vol .50,1959 Canadian PublicHealth Journal Research Centres Established Vaccine Health inMontrealand Advanced Public Baudouin Joseph Albert Contact CPHA Credits Endnotes , . 3.13 CHAPTER1920 3 modern .immunization .program Connaught .andthe testing . scientist . telegram .fromParisto .TorontoandtaskedConnaught provoking .animmune .responseFitzGeraldsenta formalin .torenderthe .toxinharmlesswhilestill how .hetreateddiphtheriatoxinwithheatand . Ramon .atthePasteurInstituteinParisand learned . In .1924,Connaught’sJGFitzGeraldmetDr .Gaston programs .inpublichealth Canadian .universitiesalsobeganofferinggraduate . workforce .Bytheendoferaanumber .other meet .thegrowingdemandforaqualifiedpublic .health School .ofHygieneplayedamajorroleinhelpingto medical .publicserviceWithfinancialassistancefromtheRockefellerFoundation, University .ofToronto’sSchoolHygienein1927,dedicatedtoresearch,teachingand beginning .withtheestablishmentofBantingResearchFoundationin1924and .hadabigimpactonCanada’spublichealthandmedicalresearchinfrastructure, and .Bestthelaboratory’sassistancewithexpandingproductionmethodsclinicaltrials . Toronto . world .inJanuary1922anddrewunprecedentedattentiontoCanadatheUniversityof . patients .whosuccessfullyreceivedthenewpancreaticextractspreadrapidlyaround University .ofTorontoin1921hasbeenwelldocumentedThenewsthefirstdiabetic The .dramaticstoryofinsulin’sdiscoverybyFrederickBantingandCharlesBestatthe Toronto’s SchoolofHygieneandConnaughtLaboratories This isPublic Health: ACanadianHistory diphtheria Dr. Peter J. Moloney John FitzGerald . , .sparkingthe .birthofa , .DirectorofConnaughtAntitoxinLaboratories,offeredBanting .withdevelopingand – 1929 — . mortality .attractinginternational .attention trends .ofmortalityinCanada .fromimportantcauses,withhisfindingson .cancer in .theConnaughtLaboratories .Hemademanysurveysandstudiesincluding .the Epidemiology .andBiometrics .andHeadoftheDepartmentResearch .Member toxoid .inpreventingdiphtheriaIn1944,hewas .appointedasProfessorof children .inTorontoandestablishedunequivocally .theeffectivenessofdiphtheria diphtheria .toxoid,usingprimarilytherecordsof .theimmunizationof36,000 Laboratories .WithDrMaryRoss,heundertook .studiesoftheefficacy of .EpidemiologyandBiometricsasresearch .associateintheConnaught Dr .NeilEMcKinnonwasappointedin1925tothe .staffoftheDepartment Established theEffectivenessofDiphtheria Neil E. McKinnon Canadian Journal ofPublicHealth , .Vol53,June .1962 Profiles Glossary Table ofContents Toxoid Contact CPHA Credits Endnotes Antitoxin Laboratories, The facilities of Connaught

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Sanofi Pasteur Limited, Connaught Campus, Archives CHAPTER1920 3 little paralytic collected The could article paralysis,” Manitoba “”) In Poliomyelitis December, campaigns immunization Deputy especially campaigns Diphtheria declined .dramaticallyinCanadaandelsewhere disease .Thetoxoidprovedtobesafeandeffective,subsequentlydiphtheriaincidence . the .firststatisticaldemonstrationofvalueanon-livingvaccineinpreventingspecific . became .thegloballeaderinproductionandtestingofdiphtheriatoxoidprovided . in .OntarioandSaskatchewanfrom1925through1927Insurprisinglyshortorder,Canada . provincial .governmentsbeganconductingfieldtrialsusingthetoxoidonschoolchildren . This isPublic Health: ACanadianHistory . contrast . only . effort . predict . entitled, . . Minister increased . . . weapon effects, from . . in compared . . . . . to . although . against and and immunization with . 1928, . . use which . . polio rates . . . popular “Death against . . . although the . . of the against . . dramatically . Ontario . diphtheria . Health . . . . victims with successful case . . the serum with . . Walks typhoid . . reaction new . . . polio would well-coordinated . . . its opposition was . . Maurice . . in in . The . effect and . . . . 1929, . . in 1927, in at . undertaken control . . . in in prove . . . . . serum Summer,” . this September to strange . . . incidence, January was . . . . diphtheria and Seymour recognizing . . time to . mild, . . of . unclear . was . smallpox – Quebec . . diphtheria, disease . was . . . across and . . and . urged freely . “or and . . first launched . . . a immunization . . . concentrated . Alberta’s . February which . that 1929 human . in . October, . . . . did . vaccination supplied in the parents . 1930 . . British “the . . . not poliomyelitis country . will . . an “convalescent” . . . . Department . public, Polio strike . 26 . . . against to . initiative cripple in . Columbia . . “suspect . . education . most . was along . In . was infants . in . May . . . smallpox generally hopelessly . . . . provinces spite (often still . . to with . . of . . every . 1926, . and . boost serum . only . . widely . and Public of . . elaborate shortened . . the Alberta . .thing” . . . in . very immunization . . Saskatchewan . . A diphtheria . . to . ” made . . . . . November 27 Department’s . Health magazine . called . prevent . positive, . . since . . in . publicity . with . to . . . “infantile . 1927, . . made . . . polio’s . no . blood . . and . . one . Profiles Glossary Table ofContents

Provincial Archives of Alberta, A11764 Contact CPHA Credits Endnotes exercises, 1928 Muscle training

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3.15 CHAPTER1920 3 the .nextdecade,aswould .theexpansionofpublichealthservicesand .infrastructure would .deepeninthe1930s .Theindustrializationandmodernization .wouldalsobeslowedin services .inthenextdecadeandurban-rural .disparityinthelevelofservicesprovided The .stockmarketcrashof1929wouldhinder .theprovisionofpublichealthandacutecare Depression andtheEndofExpansion financial .assistanceavailableincasesofneces . specialists .Itprovidedspecializedtreatment .givenatcostforallprovin built .neartheUniversityofAlbertaHospital .inEdmonton1928,staffedbyorthopedic following .asurveyof131patientsA60-bedSpecialHospitalforInfantileParalysiswas impact .ofpoliowithspecializedhospital-basedtreatmentandaftercareforaffectedchildren, . The .Albertagovernmentwasthefirsttoaddresslonger-termphysicalandeconomic an not public were reflect Manitoba quarantine usually extensive This isPublic Health: ACanadianHistory . approach . minimized, . “of . .ing panic . called . doubtful . . educational . a responded . . and better . . from similar . the . . restrictions but . . physi . . efficacy awareness developing . no . to . . with efforts, . . .cian scare Manitoba’s . . ” public . . 29 on only . . . stories . Manitoba did of . . public “Nothing . . current after . . not education . as . or . . realize . gatherings . paralysis polio . exaggerat . . engaged . research – was . . . continued the emphasizing . held . sity . had . significance . . 1929 and .ed newspapers . indicating . back; . . appeared statements . travel . its . the . . west the . for . . . seri of that . . . and early Alberta . . . children the to . were .ous . . isolation . east . radio early . use .ness . printed . . instituted spread . . of . . 28 . in symptoms,” of . cial .cases,with convalescent . . . and an the . . . ” effort . 30 . situation school . . school Ontario . to . and . . . closings . prevent . . . closings, . serum, . . . was . took . Profiles Glossary Table ofContents Contact CPHA Credits Endnotes 3.16