Medical Care – Health Matters!

Aug 18, 2019 | Medical Care

The history of medical care began with early doctors who faced many challenges in serving the sick. Nurses played a vital role too. But perhaps the most important story for Canadian citizens is the Medicare saga which began in our province. We touch on determined individuals who played key roles in that history, the most famous being Tommy Douglas and Emmett Hall.

Indomitable early doctors

Forging a path in health care

Most Saskatchewan communities had pioneering doctors who are still revered for their fortitude and tenacity in reaching far-flung patients. Here are some stories of doctors who played adventurous roles in our past.

Dr. James Hector, medical doctor and naturalist, accompanied the Palliser Expedition in the fall of 1847 to figure out which lands in the Canadian interior could be used for agriculture. Then he stayed behind when Captain Palliser went east, and continued exploring the prairies on his own.

NWMP doctor Dr. Augustus Jukes was sent in 1882 to report on conditions in native camps in the Cypress Hills. He found children in rags, and thousands of destitute people starving, subsisting on dogs. With no buffalo hides for tepees, most were shivering in cotton tents. Despite his scathing criticism of government agents using starvation to force these families on to northerly reserves, they only meted out already-promised annuities.

Surgeon Major James Bell during the Northwest Resistance was commander of medical personnel at the field hospital in Saskatoon where five doctors, six “dressers,” and an orderly laboured to save lives of wounded soldiers.

Dr. Thomas Roddick was Deputy Surgeon General in 1885, tending wounded at the field hospital in Saskatoon. After hostilities ended and his patients were sent home, he stayed behind to minister to Metis wounded at Fish Creek and Batoche. He left them cash and medical supplies, and instructions to NWMP doctors for further care.

Dr. Robert G. Ferguson, superintendent of the Saskatchewan Anti-Tuberculosis League, achieved many firsts for the province, including free TB treatment, vaccination programs for “San” workers and indigenous people, and TB surveys.

Dr. Archibald Kitely of Nipawin was renowned in the 1920s for sewing a severed finger (plus two dangling fingers) back onto the hand of a three-year-old boy who had been playing with a hatchet. Dr. Kitely reportedly was pursued by wolves as he traversed the wilderness to reach patients at distant sites.

Dr. Elizabeth Matheson, “one of Canada’s first women doctors”, practised medicine from 1898 to 1918 at Onion Lake, where she and hubby John Matheson set up a mission and hospital for the Cree. At John’s urging, despite being pregnant and already a mother of two she returned East to finish the medical degree she had started earlier.

Dr. William John McKay, a feisty medical health officer in Saskatoon, was horrified by typhoid outbreaks caused by contaminated water every summer from 1907 to 1912. He argued that slop disposal methods were – well – sloppy, and the nuisance grounds were a public health hazard. He insisted they be moved further from the city, and railed against outdoor privies, shallow wells, and unsanitary restaurants. McKay drafted bylaws that set a lofty standard in public health, He was listed in the 1911 Who’s Who in Canada.

Dr. Alfred Shadd was probably Saskatchewan’s first African-Canadian physician. He had started medical studies in Ontario before coming to the Carrot River area as a teacher in 1896, After helping a severely injured man there, he returned east to finish his M.D. Graduating with honours, he returned and set up a practice in Kinistino. Following post-graduate studies in Europe in 1907, he moved his practice to Melfort, bought a pharmacy, a prosperous farm and a newspaper, and became an alderman.

A Dr. Walsh, aka Muski-kewe-yinew (medicine man) travelled by canoe in 1919 with a party of fourteen to the far north of Saskatchewan, distributing treaty funds to First Nations people. Accompanying Treaty Commissioner William McKay, Walsh set up his own tent to tend to the medical needs of the native people.

[Bell: Sessional Papers no. 6A,49 Vict., 1886, cited in Tolton, Prairie Warships, 133. Hector: Friesen, Where the River Runs, 219-227; Blaine Lake history, 7-8. Jukes: Letter, Jukes to White. 7 October 1882.  Kitely: assisted by Sharon Butala; Nipawin community history; Matheson: Buck: The Doctor Rode Side-Saddle. McKay: Western People 25 November 1999. Roddick: Ballantine, Saskatchewan History spring 1964. Shadd: Saskatchewan History vol 30 no. 2 (1977): 41-55.]

Milestones in Saskatchewan health care

Medicare owes its origins to the political and cultural will of Saskatchewan people who pioneered several innovations in health policy. Here we note some other health-related milestones that helped pave the way and distinguish the province as Canada’s conscience in healthcare. But, the journey was not an inevitable one. As of 1905, medical care in Saskatchewan was typically provided by individual doctors residing in smaller communities.

Paid doctors:  In 1916 Dr. Schmitt of Holdfast became the first doctor paid an annual salary, organized through the municipal doctor plan in the RM of Sarnia. Paying doctors a salary rather than a fee-for-service became one of the most contentious issues in the struggle for Medicare, ultimately erupting in the world’s longest doctors’ strike, when Saskatchewan doctors withdrew their services for twenty-three days on the eve of Medicare’s implementation in 1962.

Community clinics: In 1962, socialist-minded physicians, who supported the government and opposed the doctors who went on strike, formed a working group to create an alternative to fee-for-service, hospital-based medical care.  Combining the need for prevention with family practice, community clinics remain a critical primary care service and are a reminder of the importance of prevention and education as key elements of our healthcare system. 

Tuberculosis: Indigenous deaths from TB were ten times higher than non-indigenous rates in the first half of the 20th century.  Dr. Robert G. Ferguson, working at the TB Sanatorium at Fort Qu’appelle, introduced the first controlled trial of a TB vaccine (BCG), which relied on experiments on Indigenous children.  The trial proved successful, if controversial.

Mental health: In 1921 Saskatchewan allegedly built the last Victorian asylum in the western world: the Saskatchewan Mental Hospital, Weyburn.  Forty years later ours was the first province in Canada to aggressively reject the long-term confinement of people with mental illnesses or intellectual disabilities, and provincial reformers took a leading role in developing a new system of care: care in the community.

Cancer: In 1931 Saskatchewan introduced the first cancer registry in the nation; this systematized accounting helped to improve early detection and bolstered research that led to major technological innovations, including the cobalt-60, the betatron, and much later, the synchrotron, all of which made Saskatchewan a leader in radiation physics and cancer care services.

Medical education: In 1952 the University of Saskatchewan introduced a full program of medical education, allowing local students the opportunity to complete their training in the province.  This move coincided with the opening of the University Hospital, fulfilling international recommendations that academic medical education occur in tandem with laboratory research and bedside observation.

Spiritual care: In 1954 Plains Cree people established the first (and only) Canadian branch of the Native American Church.  This organization provided spiritual guidance and post-colonial healing through prayer, worship, and the use of peyote (mescaline).

Hospitalization: Drafting the blueprints for a publicly funded healthcare system, Saskatchewan communities pooled their resources to retain physicians, maintain local hospitals, and invest in medical and nursing education programs.  The results of investing in communities paid off:  in 1947 the province passed the Hospitalization Act – the first of its kind, covering the costs of in-hospital care for all provincial residents. 

Medicare: A decade later the Medical Care Services Act (1957) expanded the coverage to services outside of hospitals, excluding pharmacare.  In 1984 the Canada Health Act recognized the culmination of these policies at the national level; all other provinces and territories had followed suit and established their own publicly funded systems of healthcare.

Dental care: Building on its health care promises, in 1978 Saskatchewan introduced the children’s dental service in, what later amounted to a short-term attempt, to bring more health services under the public umbrella.  Recognizing that preventing illness is much less costly than restoring health, dental care became an important area for expanding healthcare services in the community. 

[Erika Dyck, U of S professor & health historian; Canada Research Chair, History of Medicine]

Medicare super-heroes

Leaders in the fight for Medicare

What we know as “Medicare” was made possible by a succession of individuals and groups determined to institute a system of publicly-funded medical care in Saskatchewan. They weathered heated conflict between doctors and government, and a tumultuous doctors’ strike.

Dr. Maurice Seymour served in the 1885 Resistance, practised in the Qu’Appelle Valley, then headed the provincial department in charge of public health. He pushed for public funding of hospitals and physicians, made important contributions to public health, hired Dr. R.G. Ferguson for the tuberculosis program, and dealt with outbreaks of the Spanish flu and other serious infectious diseases.

Norwegian immigrant Mathew (Mathias) S. Anderson could be called the grandfather of Medicare. Starting in 1927, he pushed repeatedly at rural municipality conventions for publicly-funded medical care and hospital insurance. The Matt Anderson Plan, passed as an Order-in-Council in 1939, allowed municipalities to impose taxes for health services. Several did. It cost individuals $5 a year.

Rural Saskatoon resident Diana Wright, after hearing renowned Swiss medical historian Dr. Henry E. Sigerist lecture at Queen’s University on the topic of tax-funded health services for the poor, arranged for him to meet CCF leader T.C. Douglas and CCF MPs from Saskatchewan in 1943.

Dr. Henry Sigerist was a towering figure in the march toward Medicare. He agreed to come to our province if the CCF won the next election, and they did. Sigerist came to Regina for three months, then prepared a report containing advice that would later be implemented in the provincial Medicare scheme.

Thomas C. (Tommy) Douglas, a former Baptist minister, was horrified by the expense of health care in the harrowing 1930s, care not available to the poor. He pioneered Saskatchewan’s 1947 hospitalization plan, our country’s first, emulated across Canada by 1958, and became a seminal figure in the genesis of Medicare. He oversaw the adoption of the Saskatchewan Medical Care Insurance Act on November 17, 1961, before resigning to lead the new federal NDP party.  

W.G (Bill) Davies, Saskatchewan’s Minister of Health at the time, countered a resulting doctor’s strike by bringing in pro-Medicare doctors from Britain.

Succeeding Premier W.S. Lloyd saw Medicare put into effect on July 1, 1962. it was the first government-funded, comprehensive and universal medical insurance plan in North America.  It was born in a maelstrom of controversy and a doctors’ strike, but within ten years all Canadians benefited from Medicare.  

Dr.  Sam Wolfe was a mover and shaker in setting up Saskatoon’s community clinic. He co-authored the definitive 1967 book, Doctor’s Strike: Medical Care and Conflict in Saskatchewan.

Dr. Orville K. Hjertaas was a key figure in setting up a community clinic in Prince Albert.

Ed Mahood was the first chair of the Saskatoon Community Clinic board, which started the first “interdisciplinary community medicine” in Saskatchewan.

Saskatoon’s Citizens in Defense of Medicare called for citizens to demonstrate their support for Medicare.

Stan Rands, executive secretary of the Community Health Services Association (CHSA), wrote Privilege and Policy: A History of Community Clinics in Saskatchewan.

Dr. Frank Coburn, a professor of psychiatric medicine, played a strong role in the fight for Medicare, and helped set up community clinics.

Bill Harding, founding president of CHSA, chaired the Regina clinic board from 1962-65. With Rands, he helped establish thirty-five clinics in Saskatchewan.

Roy Atkinson was a CHSA founder and its second president.

Citizens for a Free Press, led by Ben and Adele Smillie, challenged the Saskatoon daily newspaper to stop refusing pro-Medicare letters to the editor.

Notably, in 1961, Prime Minister Diefenbaker appointed Justice Emmett Hall – who had experienced poverty and hardship as a young man in the dirty thirties in Saskatchewan — chair of a Royal Commission on Health Services, charged with exploring ways of publicly financing medical services country wide. The resulting Hall Report (1964) pushed for the implementation of a national Medicare scheme, modelled on ours.

[Seymour: Houston, Steps on the Road to Medicare chapter 2. Wright: Diana Wright fonds, Sask Archives. Anderson: Marilyn Deck, in Canadian Encyclopedia. Sigerist: Houston, Steps on the Road to Medicare; Diana Wright fonds, SAB. Other information: Canadian Encyclopedia; Houston; Canadian Dimension, vol. 46 no. 4, 2012; Jim Harding’s blog]  

Medical honourees

Some people honoured by the Canadian Medical Hall of Fame (CMHF), the government, or a university

Dr. Marc Baltzan, Saskatoon, (OC, SOM), pioneer in kidney research who helped perform the second kidney transplant in Canada at Saskatoon, was president of the Canadian Medical Association.

Dr. Richard Baltzan, Saskatoon (OC, QJM, SOM, LLD) was instrumental in hemodialysis treatment of kidney disease. He chaired the Deptartment of Medicine at U of S, and president of the Royal College of Physicians and Surgeons of Canada.

Dr. John Conly, a graduate of the U of S Medical College, was recognized by his alma mater for his work as an infectious disease specialist and expert in microbial resistance at the University of Calgary.

The Honourable Dr. Sylvia Fedoruk (OC, SOM) a medical physicist, was born in Canora. She helped develop the world’s first calibrated cobalt-60 unit used for cancer treatment at the U of S.  She was also lieutenant-governor, and a champion curler.

Dr. William Feindel lived for a time in this province, and founded the neurosurgical department at Royal University Hospital in Saskatoon. He is honoured in the CMHF.

Dr. Robert George Ferguson led in the battle against tuberculosis and received a lifetime membership in the Canadian Medical Association.

Justice Emmett Hall attained an LLB from U of S, and is known by many as one of the Fathers of Medicare. He is in the CMHF.

Dr. Louis Horlick of Saskatoon (OC, SOM, QJM) was a specialist in internal medicine and cardiology, and taught medicine at the U of S.

Dr. C. Stuart Houston of Saskatoon (OC, SOM, QJM) is former head of radiology at the U of S, and author of books on topics ranging from natural history to Medicare.

Dr. Harold Johns, best known for his work in using a calibrated Cobalt-60 unit for treatment of cancer while a member of the U of S. faculty, is in the CMHF.

Dr. Sam Landa of Saskatoon (OC, CM), popular physician catering to athletes, was inducted into the Saskatchewan Sports Hall of Fame.

Dr. Roberta McKay of Regina, is a physician specializing in dermatology. she received a YWCA Lifetime Achievement award for her philanthropy.

Dr. James Till from Lloydminister, earned a BSc and MSc in physics at U of S. His most stunning contribution to medical science was the discovery, with a colleague, of stem cells while at the University of Toronto. He is in the CMHF.

Dr. Calvin Stiller, who grew up in Naicam and graduated from the U of S College of Medicine, was one of the first to use ciclosporin to prevent rejection of transplanted tissues. He is also in the CMH.

[Wikipedia, Saskatchewan government; email 13 Feb 2018 from CMHOF]

They also served

Other health heroes

Indomitable nurses and others worked in developing countries or countries under siege, and multitudes of other heroes saved folks here in times of crisis.

Ella May Matthews of Maple Creek was a nurse in Europe during the Great War. She nursed in France with the Queen Alexandra Imperial Military Nursing Service (QAIMNS) in 1917, and at the Somme and Paaschendaele battles. 

Nursing sister Harriet Graham went with the first Canadian contingent to France in World War I, where she served as matron at No. 1 Casualty clearing station. King George awarded her the Royal Red Cross, first rank. She lived in Saskatoon after her marriage to J.D. Macdonald in 1914.

Sophia Dixon of Saskatoon lobbied for change in the law governing birth control in 1931, through the United Farmers of Canada. A founding member of the CCF, she later won a Governor-General’s award for her involvement in the famous Person’s Case.

Allen May of Saskatoon was a university student in 1937 as civil war raged in Spain. A devotee of Dr. Norman Bethune, then pioneering mobile blood transfusion units there, May led a massive blood drive in Saskatoon, inspiring four hundred local donors to donate blood, in just ten days.

Jean Ewen of Saskatoon accompanied the famous Dr. Norman Bethune to China in 1937 and helped him perform operations in the far northwest during the civil war. After she and the truculent Bethune parted ways, she continued to nurse in the war-torn country on her own for a couple of years. At her request, she was buried in China, next to Bethune. Her family quipped that she probably would have said, “Move over Norman, I’m back.”

Kathleen Ellis, first professor and director of the nursing school at the U of S. Ellis Hall was named for her, the only building on campus named after a woman.

Mary Pyne worked as a nurse for two years in Angola and four years in Zaire (aka Congo). She got her pilot’s license in Medicine Hat in 1976, was a member of Amelia Earhart’s “99s”, and was a founding member of its Saskatchewan chapter, the “Flying Tigers.” As a nurse, she flew into many northern communities in her Cessna two-seater. She received a global citizen award from the Sask. Council for International Co-operation

Barbara (Kirkby) Carpio, formerly of Saskatoon, was a public health nursing supervisor from 1971-75 in Pucallpa, Peru when she was called to attend victims of an airplane crash in the jungle. Unfortunately, the plane she was riding in also crash landed, but the occupants were all unhurt and able to tend to patients. They had to catch a ride home in a military helicopter. Back in Canada, Carpio taught community health nursing at the U of S from 1975 to 1979.

The Canadian Red Cross awarded their Florence Nightingale Award to Dawn Marie Anderson, a U of S graduate, for her service during the Israeli-Gaza conflict in 2015.

Jo-Ann Hnatiuk received a U of S alumni award for outstanding service. She went to Afghanistan as a critical care nursing officer for the Canadian armed forces.

Nurse Gerri Dickson of Saskatoon (PhD in community health and epidemiology). did two-year stints in Nicaragua, Papua New Guinea, and Mozambique, and also worked in Saskatchewan’s north with Aboriginal people. A faculty member at the U of S, she received a global citizen award from SCIC.

[May: StarPhoenix 26 July 1937. Ewen: Ewen, China Nurse. Anderson: Green & White fall 2015: 31. Pyne: SCIC, Ned Powers, “Pilot Project”, StarPhoenix. Hnatiuk: www.alumni.usask.ca/awards. Dickson: StarPhoenix Sept 2016]

Spanish Flu, 1918

Deadliest epidemic in Saskatchewan history

The first cases of this H1N1 influenza variant in the province, reported in October, 1918, were soldiers returning from the Great War, then railway and restaurant personnel who had come in contact with them.

One of Saskatchewan’s heroes during the Spanish flu was Usask president Walter Murray who quarantined the university campus for seven weeks after all those who wished to leave had left, in the fall of 1918. Until the university re-opened in January 1919, the campus was influenza free — except for Emmanuel College. It was used as an emergency hospital staffed by sixteen volunteers, only one of whom died. Off-campus, Saskatoon was “like a city of the dead.”

This flu spread rapidly, as in the case of the farmer who — with his wife and one of his daughters— died of it within days of getting a haircut from an infected barber in Rouleau.

The Saskatchewan government received several reports in late 1918 of frozen corpses of families, on homesteads, who died from this flu.

Saskatchewan records don’t include the number of deaths on First Nations due to this flu, but it is known to have been higher than the provincial average. Children in residential schools were particularly susceptible, such as at Onion Lake where the dead were reportedly buried in a trench.

There were 4,916 recorded off-reserve deaths due to Spanish flu in the province between September 1918 and December 1919. About half of these occurred after Armistice celebrations in November, 1918.

Of the 2,217 recorded off-reserve deaths due to this flu during 1918, 716 occurred in cities (including 167 in Saskatoon and 255 in Regina), 417 in towns, 546 in villages and 538 on farms.

The provincial Temperance Act was amended by order-in-council in October 1918 to allow druggists to sell a customer up to eight ounces of alcohol “for medicinal purposes”, while the Spanish flu was prevalent.

October 20, 1918 was the first “Churchless Sunday” in the province, when all gatherings for church services were cancelled to prevent the spread of the flu.

To reduce the chances of the flu spreading, there were often burials without funerals that year.

As a further precaution, schools and places of entertainment in cities and towns across the province were also closed for much of the fall of 1918 and into 1919.

[See article in Saskatchewan History (journal) v. 49, no. 1 (spring 1997) and other sources]

Coping:

How people in Regina handled the Spanish flu pandemic of 1918

Regina suffered a loss of 350 lives. Could we cope with a pandemic today? Would people obey these rules?

Formed an influenza relief committee to coordinate public health efforts

Isolated houses where the residents had flu, with placards in front

Banned church services, public meetings and entertainments

Wore masks, especially barbers

Imposed $50 fines on spitters, sneezers and coughers

Disinfected streetcars every night.

Ate garlic and onions as a preventative measure, along with dubious vaccines.

Volunteered to do clerical work at the relief office

Women staffed soup kitchens, and men provided transport

Nurses, trained and untrained, cared for severely ill patients.

[Riddell, 5]