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Medical Care on Pitcairn Island

[Education][Religion]

Photo by Maria Amoamo

                          The Pitcairn Island Study Center

From the landing of the mutineers at Pitcairn Island in 1790 until well into the 20th century, medical care for the Pitcairn people was on a truly hit-and-miss basis.

During the nearly two decades (1790-1808) immediately following the arrival of the mutineers at the island, it appears from what little information is known that the Polynesian women who come to Pitcairn on the ship Bounty provided most of the medical care, using such remedies to ill health as they had learned before they left their island homes.

When in 1830 the Pitcairners immigrated to Tahiti, a sudden-onset illness led to more than a dozen deaths soon after their arrival there. It is likely that had they had access to the medical care practiced in Tahiti at the time, a number of those lives might have been saved. Once the islanders returned to Pitcairn, what little care for serious illnesses there was came mostly from those with medical care knowledge on whaling ships and other sea-going vessels that called at the island.  By 1840, somewhat regular visits to Pitcairn Island were being by ships of the British Royal Navy, and surgeons aboard these vessels began providing medical care when the ship’s visits coincided with illness on the island.

In August of 1841, the Pitcairn Island Register Book recorded: “Arrived, H.M.S. Curacoa, Captain Jenkin Jones, and a most opportune arrival it was, for there were at least twenty cases of influenza amongst us.” The Register goes on to describe “the valuable services rendered by Captain Jones and the surgeon of the ship, Dr. Gunn.” The doctor later prepared an extensive report on the health of the Pitcairn people.

In July and August, 1849, shortly after a ship had left Pitcairn Island, the whole population succumbed to an epidemic.  “So general was the attack that the public school was discontinued and religious services performed but once on each Sabbath in consequence; the teacher being fully occupied in attending the sick. Just as the Pitcairners were recovering, the barque Elizabeth Archer from Sydney called at the island. Within a few days, the majority of the islanders were sick again. Pitcairn's pastor and teacher, George Hunn Nobbs, recalled that some of the passengers of the ship had been ill. By September 4, the school was again discontinued, “partly from the ill health of the teacher, and in part from the continual demand, night and day, for his services among the sick. By September, “Almost every person was afflicted with a most distressing cough. A remittent fever attended with slight rigors and much prostration of strength is the type of disease at present.”

Between ship calls, medical care on Pitcairn was most often given by the island pastor. Pitcairner historian Rosalind Amelia Young writes that “A few medicines which were sent from Valparaiso in H.M.S. Reindeer (in 1869) are administered as required by the pastor.”


A Strange Malady Appears
Some strange maladies among the islanders in the 19th century may well have been beyond even the healing power of the most skilled medical practitioner of the day. Rosalind Young tells of one such case: It was during this same year, 1880, that an unusual and very peculiar visitation appeared among the community, affecting only the younger members, eleven or twelve young persons in all having been subject to it. The disease, if such it may be called, was temporary insanity, the case that lasted the longest not extending over two years.

“The first symptom of the attack was a strange hallucination of the mind, the person afflicted seeing some object which greatly terrified him, or hearing voices calling to him, then gradually losing all recollection of former events, until the mind became an utter blank. One peculiar feature of the disease was a distorted vision, that transformed every object into something different to what it was, as, for instance, a full-grown man or woman appeared as but a child, while a mere baby would assume the full proportions of a man. In almost every case the patient was calm and quiet; the power of speech seemed taken away, while the vacant stare showed that the mind had lost control over itself.

“Many and various were the phases that the disease assumed, each patient being acted upon in a different manner. There has never been any satisfactory explanation of the cause that produced it. The case . . . of the longest duration was that of a young girl whose mind became affected in April 1884, and was restored in the early part of the year 1886.  Since that time the peculiar disease has not made its appearance.”


Visiting Ships Bring Illness
On several occasions disease was spread among the Pitcairners during ship visits to the island, or when shipwrecks nearby brought survivors for a forced stay among the islanders. In April of 1893 the shipwrecked crew of the ship Bowdenwhich was lost on the reef of Oeno Island arrived. In July the British warship H.M.S. Hycainth called at Pitcairn and the ship’s doctor treated several ill Pitcairners, calling the disease a form of la grippe.“Several of the persons who were suffering at that time had their lives despaired of, but all of them eventually recovered,” writes Roaslind Young.

“That the awful fever that attacked the people was introduced with the shipwrecked crew was evident When the Hycainth left, a slight attack of influenza spread among the people, aggravating the more serious disease. Everything that was possible to be done under the circumstances was accomplished, the missionaries, exerting themselves to the utmost to help the stricken people, who one by one rapidly fell victims to the dread sickness.

“On the 26th of August the first death occurred, opening the way for many others, and before the terrible work of death was ended, twelve persons were taken away, the last death occurring on the 19th of October. So urgent were the calls for help from those who were helpless, that there was scarcely time to weep for the dead, and the few who passed unstricken through the fiery ordeal were constant in theirattendance, night and day, until nature itself nearly gave up the struggle.”

Seeming to ignore Pitcairn’s medical history, the Commander of the warship H.M.S. Icarus in 1901 wrote that “disease appears to be still unknown” (among the Pitcairn people), his report failing to take into account several serious epidemics that had afflicted those on the island before that time.

An extensive report on the teeth of the Pitcairn islanders was prepared in 1911 by Staff Surgeon L. Lindop of H.M.S. Algerine. He took special note of the unusually high number of islanders who had lost most of their upper front teeth and the disfigurement that had resulted.

A news report appearing in The Mercury of Hobart, Tasmania on June 30, 1923, took note of a study done by Dr. Hugh Campbell Ross, a research specialist, comparing the rate of cancer among Eskimos and Pitcairn Islanders. Based on a trip that he and Dr. N. M. Gregg took to Pitcairn on the ship Dorset, Dr. Ross declared that cancer did not exist on Pitcairn Island, “and has never existed since the landing of the mutineers in the Bounty in 1789.” Ross said he believed that isolation of the Pitcairners from the rest of the world was a major factor in the absence of the disease on the island.

By December of 1934, Dr. George Lyman, a physician on the schooner Zaca which called at Pitcairn, observed a host of medical afflictions: high blood pressure, cancer, osteomyelitis, fibroma, asthma, arthritis, varicose veins, arteriosclerosis, and tuberculosis. On the whole, though, Dr. Lyman “found the islanders very healthy and free from any endemic diseases.”


Island Medical Care Described
Writing in 1936 about medical care on Pitcairn Island, anthropologist Harry Shapiro noted: “They (the Pitcairners) do exactly what any very isolated doctor-less community does. They have a variety of home remedies, native herbs, infusions of ginger and of the ti-plant, and a small supply of standard pharmaceuticals. A few of the most skillful islanders are summoned when their services are required.If the complaint is a minor one and easily diagnosed, there is ordinarily no difficulty, but for serious illnesses nature takes it course, and the patient dies or recovers. They see the working of Providence when the surgeon of a passing ship can be secured for an ailing islander. Cases demanding surgery are, if possible, reserved for the ministrations of a ship’s physician. Acute attacks of illness such as appendicitis find the islanders completely helpless. Fortunately these are few.”

In the mid-1930s, a New Zealand dentist, Dr. Cooze, settled temporarily on Pitcairn and found a rich field for the use of his dental instruments. “He furnished many on the island with sets of false teeth which not only improved their appearance, but increased their masticatory efficiency.”

In 1937, J. S. Neill wrote that “Pitcairn is better situated for medical assistance (from surgeons on warships) than most isolated communities. I have considered the question of the training of a Pitcairn boy at the Central Medical School, Suva, for service as a Pitcairn medical practitioner. If revenue was available it would be advisable to incur expenditure in such training for Pitcairn as for any isolated community. As, however, medical facilities are so frequently available, I am of the opinion that a properly-trained teacher is more essential to Pitcairn than a Pitcairn medical practitioner. My medical colleague, with whom I have discussed the matter at length, holds a similar view. He is suggesting the possibility of training a Pitcairn girl as a public health nurse.

Neill reported that from the time of the return of the Pitcairners to Pitcairn from their second immigration to Norfolk Island in 1856 until the time of his report, there had been 122 deaths on Pitcairn Island. “Of these, 23 have been due to accidents – falls from the cliffs, accidental shootings and drownings,” Neill stated. “There has never been a resident medical officer on the island . . . physically the islanders are strong and healthy. There is no evidence whatsoever of degeneracy. The early loss of teeth gives them a peculiar appearance. This loss may be attributed to defect in diet. . . . Mentally the islanders are of average intelligence.There are only three (of a population of 209) who are in any way deficient in this respect.”


Six Months of Medical Care
Also in 1937, Pitcairn was fortunate to have for six months the volunteer service of Dr. Rufus Southworth who had earlier visited the island on the brigantine Yankee. In addition to his skillful medical care of the islanders, Southworth was able to assess on-going medical needs of the Pitcairn people, and to provide valuable counsel based on observations made during his time on the island.

Not long after Neill’s thoughts about a medical practitioner for Pitcairn, the Seventh-day Adventist denomination, whose principles of faith had been embraced by the majority of the Pitcairners, gave some answer by requiring that the wife of the clergyman assigned as pastor of the island’s church be a registered nurse. This was a medical blessing to Pitcairn since the call of British warships at the island were by then a thing of the past.

Following World War II, physicians on board the ships of the Blue Star Line, which frequently called at Pitcairn, often gave medical advice and care in serious medical cases that supplemented the skills of the island nurse. With the coming of telephone service to the island, calls for specialized medical advice were sometimes made to physicians or hospitals in the United States. Ham (amateur) radio operators on Pitcairn also played an important role in seeking medical counsel about Island illnesses from abroad.

A recurring medical problem on Pitcairn Island has been appendicitis. On a number of occasions there has been a life-or-possible-death race by ship to get Pitcairners with this affliction to hospital in time to save their lives. Sadly, on one or two occasions, death has occurred before reaching the hospital.

In the early 1960s a comprehensive study of the health of the Pitcairn people was conducted by Dr. T. R. Fogg, at the request of the South Pacific Health Service, Fiji. Dr. Fogg found that medical care of the Pitcairners “was difficult and in some fields unsatisfactory. . . . It is felt that the organization of medical and therapeutic services could be improved.”

His report also indicated an absence of tuberculous on Pitcairn Island, and that the care of the eyes of the Pitcairners could be considerably improved. “The main health problems (of the islanders), shared with more sophisticated populations, was the detection, control, and therapy of obesity and hypertension.” The report asked that “milk as a source of protein and calcium be promoted by education and availability, particularly to children, and that florine tablets also be advocated to attempt to reduce the incidence of dental caries.”Because of the discovery of “a possible curable carcinoma of the cervix (found during Dr. Fogg’s medical examinations of Pitcairn females) the female population had a forceful example of the benefits of gynecological examinations.” The report also called for more attention to the medical care of Pitcairn’s aged persons, and advocated “a pension be granted to those (living) outside family groups.”

By the mid-1990s, the need for a full-time medical practitioner for Pitcairn Island was becoming ever more apparent to the government of the United Kingdom. In 1997 the Pitcairn Island Health Center was completed and funded by the government’s Overseas Development Administration. The Center housed the work of a Resident Nurse, an Assistant Nurse and a local Dental Officer who also doubled as an X-ray Technician. From time to time physicians visited Pitcairn, usually as part of their own planned holiday, giving their valuable services to the community. In 2010, Pitcairner Darralyn Griffiths began nursing training abroad which will prepare her to return to the Island as a medical receptionist, using her newly acquired skills to assist the island’s medical practitioner in her enrolled nurse capacity.

In 2004, the United Kingdom moved to place physicians in continuous service on Pitcairn Island.  Here are the physicians who have served under the program:

Year/s

Name

March - May 2004

Tom Scantlebury

May -August 2004

Alastair McDonald

August - November

Ross Denton    

November 2004 - January 2005

Theresa O’Donnell 

January - February 2005

Geoff Norcliffe

February - June 2005

Ivan & Leonie Howie  

June - August 2005

Alastair McDonald

August - November 2005

Michael Schmittmann

November 2005 - February 2006

Daren Buhrkuhl   

February - August 2006

Valerie Archer 

August - December 2006

H. Peter Modlmayr

December 2006 - February 2007

Marc Shaw  

February - August 2007

Alastair McDonald    

August 2007 - August 2008

Madeleine Wilcock 

August 2008 - September 2009

Peter Cardon    

September 2009 - March 2010

Alastair McDonald  

March 2010 - March 2011

Bruce Dixon    

March 2011 - September 2011

Peter Cardon  

September 2011 September 2012

Kevin Donovan  

September 2012 May 2013

Peter Cardon  

May 2013 December 2013

Kevin Donovan  

January 2014 - Present

Carol Nicholson  


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