Care for the sick

The Asylum journal for 1882. Berbice [British Guiana]: printed for the Asylum Press, 1882 [FCDO Historical Collection]At the time of emancipation public health services in the Caribbean were all but non-existent. Many of the larger sugar estates made some provision for the care of the sick (it was in the planters’ interest to keep their slaves fit and healthy) but medical expertise was in short supply and when the estates closed there was little to take their place.

The passing of the Public Health Act in Britain in 1848, however, made health the concern of the state, and this sea change was reflected in the Caribbean colonies, as health services were introduced in the second half of the nineteenth century.

The Asylum journal, the 1882 issue of which is on display, is a remarkable testimony to the advanced and enlightened state of care provided for the mentally ill in British Guiana. Written by Dr Robert Grieve (1839-1906), medical superintendent of the public lunatic asylum at Berbice, it documents his dedication to the welfare of his patients and his determination to make the asylum a place of humane care.

Grieve, a Scotsman, was later appointed surgeon-general of British Guiana, largely on the strength of his achievements at the Berbice asylum, and was to be responsible for major improvements in sanitary provision and in clinical standards at the public hospital in Georgetown, the colony’scapital.

At the asylum Grieve adopted a policy of non-restraint of inmates whenever possible, introduced occupational therapy, had the asylum wards decorated in bright colours and adorned with pictures and flowers and arranged a programme of activities and entertainment. There was a weekly dance and a weekly band concert. Patients could work on the farm, in the carpentry workshop , in painting and decorating, in tailoring or shoemaking or in the asylum bakery.

The Asylum journal was printed by patients at the asylum’s own printing press. In the journal, as well as reporting on these activities, Grieve gives mortality, sickness and discharge rates and includes features on recent developments in medical knowledge, on public health issues in the colony and on his own findings from observation of his patients.

He observed that admissions to the asylum were notably higher for people not born in the colony, attributing this partly to the fact that native inhabitants were more likely to be looked after at home by family members and partly to the recent lone immigrant’s sense of alienation and rootlessness in an unfamiliar environment.

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