Until 1905, when the St. John's Municipal Council agreed to pay part of the salary of a permanent medical health officer for the town, public health in St. John's was the exclusive responsibility of the Newfoundland Government, as it had been since the establishment of the colonial legislature in 1832. Until 1888 the legislature had, in fact, been responsible for all the services that in other jurisdictions a municipal government might have provided to St. John's residents. In that year, however, the colony, in order to undertake an expensive sewerage system and other costly street improvements, was forced to impose a limited form of self-rule on the town. The Council elected in that year received authority over the water supply, streets, sewers, the fire brigade, and building regulations. Public health remained and had been under the authority of the legislature. In the following year, the Council did consider taking over the functions of the ad hoc Boards of Health the government appointed from time to time when a contagious disease threatened to spread to St. John's from infected ports overseas. However, the Council shied away from this course of action for reasons of economy. With limited revenue available to it, Council was quite willing to let the colonial government control that for which it was prepared to pay. (1)
In mid-1888 the town's Board of Health, which had been appointed in October, 1887 and consisted of public officials and medical doctors, informed the government that the Medical Society considered "St. John's more free from infectious disease than for a great many previous years more free than ever in their experience." In fact, the Society was highly confident that the Board had successfully contained a recent outbreak of diphtheria among several infected persons. However, concealment of the disease by the poor who had contracted it had actually made any detection of diphtheria by the medical and Board of Health authorities difficult. The reason for such concealment, Board Chairman J.G. Conroy later noted in March, 1889, was the "self-interest" of the labourer "whose daily wage is his all, to the supreme motive of self-preservation." In one instance, Conroy had observed, a woman whose children had diphtheria hid knowledge of the disease from her sister, the latter's children being frequent visitors to the infected household. (2) Despite the widespread practice of concealment, by late 1888 the Board of Health was successful in uncovering 273 cases of diphtheria which affected 99 families in the town and resulted in 67 deaths. The full fury of the diphtheria epidemic did not break until the following year; then, for 1889 the Board of Health had 1,881 cases reported to it affecting 878 families and resulting in 350 deaths. For 1890 and 1891 the number of deaths were 133 and 140 respectively. By April, 1892, when diphtheria had all but disappeared from St. John's, the number of deaths for the first three months of that year were 23. (3)
In response to the outbreak of diphtheria, the Board of Health was given additional authority to deal with the disease. In 1889 legislation was passed to enable the Board of Health to have a doctor visit any person sick or suspected of having a communicable disease, if that person was known by the Board not to have been visited by a doctor. A penalty not to exceed fifty dollars was to be levied against any person interfering with a medical visit ordered by the Board. Again, every medical doctor was required under penalty to report immediately to the Board on every case of communicable disease treated by him. Finally, the 1889 Public Health Act allowed the Governor-in-Council to appoint a medical health officer for the town, his duty being to advise the Board of Health in combatting diphtheria. The term of office of this new official was for the life of the Board itself. (4)
The first medical health officer appointed under this act in February, 1890, was Dr. Philip T. Hubert, a 23 year-old Newfoundlander. Hubert's salary was to be determined by the amount of work he did as requested by the Board of Health. His tenure in office was shortlived for Hubert soon contracted the disease himself and died in July, 1891. (5) No immediate successor was evidently made to replace him and in April, 1892, the Board of Health itself was disbanded, the government now being confident that diphtheria was no longer a health problem in St. John's. However, Daniel W. Prowse, who following a change of government in 1889 had replaced Conroy as chairman of a new Board that had been appointed on February 14, 1890, was retained in office on salary as chairman, becoming in effect a one man Board of Health. (6)
In June of that year the legislature passed further legislation amending the 1889 Public Health Act to allow for the appointment of a public health officer when there was no Board of Health in place. (7) With this change, on September 7, 1892, Prowse was appointed the first Public Health Officer for St. John's. (8) Prowse held this position until December, 1895, when, for financial reasons following the collapse of the Island's banking system and the colonial treasury nearing bankruptcy, the government gave the position to Dr. Kenneth D. McKenzie. A 49 year-old native of Prince Edward Island and a graduate in 1877 of the Halifax Medical College, McKenzie had first come to Newfoundland in 1877 to work as a physician for a local mining company operating outside St. John's. At the time of his appointment, McKenzie had been engaged by Prowse as Medical Health Officer for St.John's. (9) He held both offices of Public Health Officer and Medical Health Officer until May 6, 1897, when for health reasons he was replaced by Dr. Alexander Stewart Pike. Pike, in turn, in December of that year gave way to Dr. Alfred Joseph Harvey, whose appointment was no doubt influenced by a change of government a month earlier. (10) Harvey held the two positions until 1901 when McKenzie was reappointed by the Liberal Government (1900-1909) of Robert Bond which had won the election of the previous year. This time McKenzie's tenure in both offices was short for on Christmas Eve, 1902, he died of apolexy. (11)
McKenzie's successor on January 10,1903, was a fellow Maritimer, 32 year-old Dr. Robert Almon Brehm. A Nova Scotian native and Dalhousie University medical graduate, Brehm had come to Newfoundland in the 1870s with his father who had been hired to manage a St.John's butter factory. (12) In response to the outbreak of a smallpox epidemic in St. John's, in May, 1903, the Bond Government appointed a Board of Health consisting of colonial and municipal politicians and medical doctors to deal with the situation, which saw Brehm, however, retained in the office of Medical Health Officer to the new Board. It was this Board which in October, 1903, called upon the government to increase the salary of the Medical Health Officer and broaden his responsibilities with regard to the public health of St. John's. What was needed, according to this Board, was a medical officer who could regularly examine the town's drainage and water systems and food supply and quarantine houses where communicable diseases were known to exist. Since St. John's needed a system for the registration of deaths and their causes, the holder of this office would need training in bacteriology and pathology. For a doctor to assume the position it had in mind, the Board informed the government, the salary offered should be at least $2,400 per annum. (13) Bond accepted the need for this change and in January, 1905, asked the Municipal Council to appoint a medical health officer for the town and to pay his salary and define his duties. (14)
Although Council saw the need for such an official, it was hesitant to make an appointment on the conditions laid down by the government. Council was not only unwilling to pay the full salary, but feared that the government might make it responsible for the cost of medical relief in the event of an epidemic in the town. (15) In April, 1905, a compromise was reached: government would remain responsible for epidemic relief and donate annually the sum of $600 towards the salary of the medical officer; for its part Council would pay the new officer $800 and define the duties of his office. (16) This, however, was not the end, for in June the government changed its mind on the grounds that the salary proposed was too small to induce any doctor to take the position. (17) Finally, in November, Council and government agreed to a salary of $2,000, half to be contributed by each party.
Not surprisingly, the first Medical Health Officer appointed under the 1905 arrangement was Dr. Brehm whose responsibility was to the Municipal Council, but he also had general colonial responsibilities, reporting on these to the Executive Council. (18) The following year the government established a public laboratory in which Brehm was to carry out his work and opened a fever hospital for the reception of persons having infectious diseases. (19) However, a separate public health department for the government was not established until 1934 when the Commission system of Government was set up in Newfoundland. As for Brehm, he remained the health officer for both capital and dominion until 1936 when he was retired by the Commission of Government, but not by Council. (20) Consequently, after 1936 both levels of government proceeded to employ their own medical health officer, but the Commission's officer was to play a more active role in the public health field in St.John's.
1. On the incorporation of St. John's in 1888, see Melvin Baker, Aspects of Nineteenth Century St. John's Municipal History (St. John's, 1982), 48-63
2. Provincial Archives of Newfoundland and Labrador (PANL), GN2/2, Incoming Correspondence of the Colonial Secretary's Office, J. G. Conroy to Maurice Fenelon, March 21, 1889; and Daily News, November 26, 1895.
3. Evening Telegram, October 19, 1892.
4. Statutes of Newfoundland, 52 Victoria, Cap. 13.
5. PANL, GN2/ 1, Outgoing Correspondence of the Colonial Secretary's Office, Robert Bond to Dr. Philip T. Hubert, February 18, March 15, 1890; and Evening Telegram, July 15, 22, 1891.
6. Evening Telegram, May 2, 1892.
7. Statutes of Newfoundland, 55 Victoria, Cap. 3.
8. PANL, GN9/1, Minute of Executive Council, September 7, 1892.
9. Ibid., December 8, 1895. See also Daily News, December 27, 1902 and Evening Telegram, December 29, 1902.
10. PANL, GN9/1, Minutes of Executive Council, May 6, December 21, 1897.
11.Daily News, December 27, 1902; and Evening Telegram, December 29, 1902.
12. Newfoundland Who's Who, 1930 (St. John's, 1930), 239.
13. Daily News, October 15, 19, 22, 1903.
14. St. John's Municipal Council Minute Book, January 27, 1905 (located at St. John's City Hall, St. John's.)
15. Ibid., March 4, 1905.
16. Ibid., April 17, 1905.
17. Ibid., June 30, 1905.
18. Ibid., November 24, December 15,30, 1905, May 17, 1906. See also PANL, GN9/1, Minute of Executive Council, December 18, 1905.
19. Joyce Nevitt, White Caps and Black Bands: Nursing in Newfoundland to 1934 (St. John's, 1978), 80-2, 85-6; and PANL, GNI/3A, Governor's Office, Box #299-677, 1943, file 658/43, Memo of the Commissioner of Public Health and Welfare, October 31, 1944.