Today’s blog post was adapted from a paper entitled “A Culture of Cooperation: West Indian Inter-Colonial Tuberculosis Conference of 1913” presented at the 47th Annual Association of Caribbean Historians Conference, Bahamas 2015 by Dr. Debbie McCollin. Dr. McCollin is a Lecturer in the Department of History, University of the West Indies, St Augustine.
In 1913, the year prior to the First World War, West Indian medical representatives converged on Port of Spain, Trinidad, to wage another war, against the dreaded disease, tuberculosis. The West Indian Inter-Colonial Tuberculosis Conference, which ran from 23rd to 31st March and was primarily organised by a voluntary body, The Tuberculosis Association of Trinidad and Tobago, was intended to foster relationships among regional tuberculosis experts to generate information and strengthen the ability to confront the threat of one of the principal causes of death in the region.
In the West Indies the vast majority of the cases could be found within the capital cities where, in the aftermath of emancipation as more and more predominantly African individuals and families flocked to urban centres, overcrowding became a major problem.
The situation was further worsened by the ambivalence with which tuberculosis was treated by local governments- most likely due to its negligible impact on agricultural labour in comparison with diseases such as malaria and hookworm and the fact that it was considered an ailment of the poor African working class. The Surgeon General of Trinidad and Tobago noted in 1913 that tuberculosis:
more than any others (excepting perhaps only malaria) is responsible for the highest sickness and mortality rates [and]… that in spite of its widespread and devastating prevalence in the West Indies has attracted hitherto comparatively insignificant attention here, beyond allusions in official reports to its general effect on the vital statistics.
Thus those who worked in the medical field realised that only though their efforts and cooperation could this scourge of tuberculosis be checked.
Spearheaded by Dr. G.H. Masson, Secretary of The Tuberculosis Association of Trinidad and Tobago, the conference was organised to run for one week in March in Trinidad and Tobago and attracted delegates from all over the West Indies and neighbouring countries where tuberculosis raged. Representatives hailed from the British, Dutch, Spanish and French West Indian and South American territories and Europe. Renowned members of the local medical fraternities, foreign doctors, tuberculosis specialists, members of the diplomatic corps, government officials and mid-level public servants all converged on Trinidad, eager to discuss one of the most prevalent and formidable diseases of the West Indies.
The principal site of the conference was The Royal Victoria Institute (currently the National Museum) in the capital city of Port of Spain where delegates presented papers and speeches concerning the state of tuberculosis in their specific colony. They were treated to visits throughout the week to public health sites, specifically the Port of Spain Colonial Hospital, the Tuberculosis Dispensary on Frederick Street in the heart of the capital city run by The Tuberculosis Association of Trinidad and Tobago, the Yaws Hospital, the St. Clair Wells and a water filtration plant. Tours were also conducted of the Government Farm as well as of the Abattoir in southern Port of Spain to assess the conditions for the prevention of the distribution of infected meat.
On Friday 28th March, there were “simultaneous addresses by selected Delegates to school teachers, and scholars, at the colleges and elementary schools of Port of Spain, and suburbs.” Two days later, a mass meeting of Indian labourers and community members was organised at Paradise Pasture, San Fernando. “Tuberculosis Sunday”, on the penultimate day of the Conference, also allowed churches across Trinidad to educate their congregations about the spread of the disease as well as options for care. These invaluable opportunities for health education were maximised upon by delegates, reinforcing the fact that tuberculosis was preventable and that there was little formally in place for the protection and care of the public.
The Results of the Conference
The conference was able to establish a general profile of the West Indian tuberculosis problem. It was firstly evident that, unlike Britain, tuberculosis was largely transferred by human contact as there was little evidence of bovine tuberculosis within the region. It was found that structures within the West Indies were inadequate to deal with the vast problem, largely as a consequence of little to no research being conducted. Thus it was agreed that despite the stigmatisation of the disease, notification and registration of cases should be pursued as essential tools in determining the extent of the tuberculosis threat in the West Indies and progress over time of preventive measures.
The conference furthermore pointed to the lack of funding which hindered many public health departments from implementing tuberculosis schemes. Mr. Godfrey of British Guiana after listening to the paper from the Puerto Rican delegate proclaimed that it “made him green with envy to hear how much money Puerto Rico had it its disposal. He only wished his colony had one-tenth of the $8 000 in their treasury to their credit.”
The Conference, for the first time, effectively elucidated the reality of the tuberculosis threat throughout the West Indies and generated discourse surrounding the launching of tuberculosis campaigns in the region. However, the achievement of its long term goals was tempered by the impending Great War (World War I) which began the year after the conference and ran until 1918. The plan to make the conference into a biennial event for instance, did not come to pass. Additionally, there was no establishment of the critical collective organ, a Centralised Bureau, and many TB Associations took decades to get established.
For the next two decades, the issue of tuberculosis continued to be back-burnered, as governments faced depression and wars from 1914 to 1945. TB specialist William Santon Gilmour in 1943, acknowledged the importance of the conference, but was inclined to note that it was unfortunately not followed up by official enthusiasm. West Indians did not (or were unable to) maximise on the momentum generated by the first West Indian Inter-Colonial Tuberculosis Conference of 1913, the only one of its kind in the era.
Clyde, David. Health in Grenada: A Social and Historical Account (London: Vade-Mecum Press, 1985)
Daniel, Thomas M. “The History of Tuberculosis”, Respiratory Medicine 100:11 (November 2006)
—— “Intercolonial Tuberculosis Conference,” The Port of Spain Gazette, March 27, 1913, 5.
—— “The Conference on Tuberculosis,” The Port of Spain Gazette, Sunday March 23,1913, 11.
—— “West Indian Inter-colonial Tuberculosis Conference”, The Port of Spain Gazette, March 20 1913, 6.