Daniel Lloyd reading The Mummy's Curse

Daniel Lloyd is a member of Cabra Library Creative Writer's Group. Here he reads from his short story "The Mummy's Curse".

The first scientific autopsy of a mummy revealed that a woman aged fifty who died in 600 BC had Tuberculosis. This terrible pestilence is not a new phenomenon although a new strain of the disease which is resistant to all available drugs is emerging.

Tuberculosis is infectious. It affects mostly the lungs but can affect other body organs. It is spread through the air by cough, sneeze or other body fluids. Known as consumption, symptoms are blood in sputum, fever, night sweats and weight loss. Diagnosis is by X-ray and microscopic examination of body fluids. Diagnosis of latent TB is by skin test. Prevention relies on screening programmes and vaccination.

As much as a quarter of the population may harbour the disease but few people actually develop TB. It can lie dormant in the body and only activated when the body weakens. This occurs mostly in developing countries where living conditions are crowded and widespread poverty exists. In Africa, Asia and some European countries the rate of infection is several hundred per 100,000 people. In the US it is ten times less.

TB was identified as a disease in 1882 by Robert Koch who won the Noble Prize for his discovery. Initially, he did not identify bovine TB with human TB, but later in his career he recognized infected milk as a source of infection. This was reduced by the pasteurisation of milk. He developed a remedy for TB but, unfortunately it was not successful. It fell to Calnette and Gueen to develop a successful immunization method called BCG in their honour. It was slow to be accepted, especially in the United States and only became popular after World War II.

In 1815 one in four deaths in the UK and one in six deaths in France were from consumption. Treatment was for patients to enter sanatoria situated in locations where there was plenty of fresh air and constant medical attention. By 1946, little advance had been made on this and the treatments of the day were: sanatoria, surgical intervention by collapsing an infected lung to rest it and allow TB lesions to heal.

However in 1946 the discovery of Streptomycin was the first effective cure for TB and mainly through its use mortality had fallen by ninety per cent by the year 1950. Unfortunately new Streptomycin-resistant forms of TB have developed and destroyed the prospect of actual elimination of TB. This is of major concern to the World Health Organization. In 2011, the first case of this new multidrug resistant strain TB was discovered in Bombay.  WHO reports that now four per cent of new infections are multidrug resistant.  Two million people in India develop TB annually mainly due to the terrible slum living conditions there.

Ireland, particularly Dublin did not escape the ravages of TB. We had the worst living conditions in Europe after the First World War with the city full of closely packed tenement housing with one whole family to the room in the most terrible hygienic conditions. Consumptives were treated as lepers. As soon as it was known that somebody in a family had developed the disease they were avoided for fear of contamination. The wealthy went to Switzerland where the clear mountain air was reputed to be a good treatment. This was good for the Swiss hotel industry but not an effective medical treatment. Garden sheds sprung up in Dublin suburbs with roofs and open sides to get the air but any improvement in a patient's condition was due to building up the body's immune system against the disease rather than any advantage of fresh air.

It was noticed that young trainee barmen coming from places like Tipperary to Dublin to learn their trade seemed to catch TB very easily. Investigation showed that coming from isolated country parts they had never encountered TB and had not built up an immunity to it. At that time most bars had sawdust strewn floors for customers to spit on. One of the duties of these young men was to clean those floors which left them wide open to infection. A campaign of anti-spitting was introduced but just as the recent anti-smoking campaign met fierce opposition from the licensed trade. However, in due course the sawdust on the floors went and 'no spitting' signs went up in buses and trams and buildings.

No account of TB in Ireland would be complete without mention of Dr Noel Browne. With a tragic family history from TB, he was by chance taken in hand by friends and through their unbelievable help, qualified as a doctor in Trinity College. He gained invaluable experience in a TB hospital in Britain though he eventually caught the disease himself, he did eventually recover. 

Just about this time Nye Bevan, a Welsh politician, was setting up a National Health Service in Britain. Just before the war the catch cry in England was to make Britain a home fit for heroes, and Bevan set about reforming the medical service. Up till then medical services in the UK were too expensive for the bulk of the population. People depended on old home remedies, over the counter medicines and quacks. One popular way of avoiding the expense of a doctor was for a person with a respiratory ailment to stand near a roadworks where asphalt was being laid to get relief. In the poorer areas doctors set up clubs where people paid in a few pennies a week and could avail of the doctor's services when absolutely necessary.

At first, the doctors said that they could not work for the salaries being offered by the National Health Service, but Bevan pointed out that he was offering more than the average doctor’s income as shown on their income tax returns. That clinched the deal, and the Brits being masters of compromise soon settled on a satisfactory rate of pay. It was a National Insurance System where everyone working paid a reasonable contribution every week and could avail of their doctor's services and free prescriptions as necessary. The system was a great success and Britain gained a medical service that was the envy of the world. That was until Margaret Thatcher began to ruin it many years later.

Having experienced this service Noel Browne felt he could do something similar in Ireland. Just about this time a new political party Clann na Poblachta was set up by two main leaders - Seán McBride an ex-bloodstained leader of the IRA and barrister and Noel Hartnett a very experienced political animal and barrister who had defected from Fianna Fáil. Noel was elected and on his first day in Dáil was made Minister for Health.

He wanted to introduce a National Health Service which was popularly called the Mother and Child Scheme. This was not to be funded by weekly subscriptions but by the taxpayer directly out of exchequer funds. He was not a member of the Knights of Columbanus, nor was he a Mason and to John Charles he was the devil incarnate. To replace their inefficient means tested workhouse like dispensary system where unbelievably arrogant old cutes handed out their bottles of coloured water by a modern system was beyond their vision.

Despite his inexperience in top administration he turned out to be brilliant. A small contribution from the Irish Hospital Sweepstakes went each year to the hospitals. As it was doled out annually there was not enough to make a serious impression on the anti-TB programme. He arranged a loan by promising the Sweepstakes annual contributions over a period of years and acquired enough capital to build a chain of purpose-built sanatoria. He launched a clean food campaign to educate the public in hygiene. He introduced a mass X-ray system where mobile X-ray vans were sent all over the country and people could just walk in for a test.  He also introduced a BCG inoculation service.  Although not directly connected with the war on TB he also discovered that Ireland did not have a national blood transfusion service and he set one up.

These measures combined with the availability of the wonder drug Streptomycin lead to a rapid decline in the number of people with the disease. In fact in a very few years TB has been forgotten about. Perhaps the memory is too horrible to contemplate. The newspapers carry the odd report about outbreaks in Ireland - there was recently a cluster of cases found in a school in Cork. With a large influx of people from TB prevalent countries we need a stringent medical examination of immigrants. This is in no way a racial slur on the people of Africa or Asia but a statement of fact. During the war years when tens of thousands of Irish were working in England the British felt that we were one of the causes of TB over there. Moving from TB free country parts with no immunity built up to bad digs in crowded cities it is quite possible we were. The US are very particular about medical examination and proof of good health of immigrants. Canada is particularly vigilant of pulmonary diseases. Smallpox has been practically eliminated as most countries would not allow travellers cross their borders without an International Certificate of vaccination.  A similar measure is needed to keep TB from reoccurring.

 

Recorded at Cabra Library Creative Writing Group, facilitated by Ora Ní hAonigh.

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