What do emigration and low wages do to Irish health? Social conditions
result in an extraordinary percentage of tuberculosis and lunacy, and in a
baby shortage in Ireland. Individual propensities to sexual excess or
common crime are, incidentally, responsible for little of the ill health in
Ireland.
Ireland's tuberculosis rate is higher than that of most of the countries in
the "civilized" world. Through Sir William Thompson, registrar-general of
Ireland, I was given much material about tuberculosis in Ireland. An
international pre-war chart showed Ireland fourth on the tuberculosis
list--it was exceeded only by Austria, Hungary, and Servia.[1] During the
war, Ireland's tuberculosis mortality rate showed a tendency to increase;
in 1913, her death list from tuberculosis was 9,387 and in 1917 it was
9,680.[2]
Emigration is heat to the tuberculosis thermometer. Why? Sir Robert
Matheson, ex-registrar-general of Ireland, explained at a meeting of the
Woman's National Health Association. The more fit, he said, emigrate, and
the less fit stay home and propagate weak children. Besides, emigrants who
contract the disease elsewhere come home to die. Many so return from the
United States. Numbers of the 50,000 annual migrants from the west coast of
Ireland to the English harvests return to nurse the tuberculosis they
contracted across the channel. Dr. Birmingham, of the Westport Union, is
quoted as saying that in September a disease known locally as the "English
cold" is prevalent among the young men who have been harvesting in England.
Sometimes it is simple bronchitis. Mostly it is incipent phthisis. It is
easily traced to the wretched sleeping places called "Paddy houses" in
which Irish laborers are permitted to be housed in England. These "Paddy
houses" are often death traps--crowded, dark, unventilated barns in which
the men have to sleep on coarse bags on the floor.[3]
The Irish wage causes tuberculosis to mount higher. Dr. Andrew Trimble,
chief tuberculosis officer for Belfast, comments on the fact that the sex
affected proves that economic conditions are to blame. Under conditions of
poverty, women become ill more quickly than men. Dr. Trimble writes: "In
Belfast and in Ireland generally more females suffer from tuberculosis than
males. In Great Britain, however, the reverse is the case.... In former
years, however, they had much the same experience as we have in Ireland ...
and it would be necessary to go back over twenty-five years to come to a
point where the mortality from tuberculosis among women equalled that now
obtaining with us. It would seem that the hardships associated with poor
economic conditions--insufficient wages, bad housing and want of fresh air,
good food and sufficient clothing--tell more heavily on the female than on
the male, and with the march of progress and better conditions of living
... tuberculosis amongst women is automatically reduced."[4]
The Irish wage must choose a tuberculosis incubator for a home. Ireland is
a one-room-home country. In the great "rural slum" districts, the one-room
cabin prevails. Country slums exist where homes cannot be supported by the
land they are built on--they occur, for instance, in the rocky fields of
Galway and Donegal and in the stripped bog lands of Sligo. Galway and
Donegal cabins are made of stones wrested from the ground; in Mayo, the
walls are piled sod--mud cabins. Roofing these western homes is the "skin
o' th' soil" or sod with the grass roots in it. Through the homemade roofs
or barrel chimneys the wet Atlantic winds often pour streams of water that
puddle on the earthen floors. At one end of the cabin is a smoky dent that
indicates the fireplace; and at the other there may be a stall or two. The
small, deep-set windows are, as a rule, "fixed." Rural slums are rivaled by
city slums. Even in the capital of Ireland the poor are housed as badly as
in the west of Ireland. Looking down on the city of Dublin from the tower
of St. Patrick's cathedral, one can see roofs so smashed in that they look
as if some giant had walked over them; great areas so packed with buildings
that there are only darts of passageways for light and air. In ancient
plaster cabins, in high old edifices with pointed Huguenot roofs, in
Georgian mansion tenements, there are 25,000 families whose homes are
one-room homes. Dublin's proportion of those who live more than two to a
room is higher than that of any other city in the British Isles--London has
16.8; Edinburgh, 31.1; Dublin, 37.9.[5] In one-room homes tuberculosis
breeds fast. A table from the dispensary for tuberculosis patients, an
institution built in Dublin as a memorial to the American, P.F. Collier,
shows that out of 1,176 cases 676 came from one-room homes.[6] As a type
case, the report instances this: "Nine members of the W---- family were
found living in one room together in a condition bordering on starvation.
Both parents were very tubercular. The father had left the Sanatorium of
the South Dublin Union on hearing of the mother's delicacy. He hoped to
earn a little to support the family that had been driven to such a state
through illness that, houseless, it had had to sleep on stairs. The only
regular income was $1.12 a week earned by the eldest girl, aged 16, in a
factory. Owing to want of food and unhealthy surroundings, she was in so
run down a condition that it seemed certain she would become tubercular if
not at once removed."
The Irish wage can't buy the "good old diet." Milk and stirabout and
potatoes once grew rosy-cheeked children. But bread and tea is the general
diet now. War rations? Ireland was not put on war rations. To regulate the
amount of butter and bacon per family would have been superfluous labor.
Few families got even war rations.[7] Charitable organizations doubt if
they should give relief to families who are able to have an occasional meal
of potatoes in addition to their bread and tea. In a recent pamphlet[8] the
St. Vincent de Paul Society said: "A widow ... who after paying the rent of
her room, has a shilling a day to feed herself and two, three, four or even
more children, is considered a doubtful case by the society. Yet a shilling
a day will only give the family bread and tea for every meal, with an
occasional dish of potatoes. By strict economy a little margarine may be
purchased, but by no process of reasoning may it be said that the family
has enough to eat, or suitable food." The Irish wage would have to be a
high wage to buy the old diet. For that is not supplied by Ireland for
Ireland any more. When Ireland became a cow lot, cereal and vegetable crops
became few. But milk should be plentiful? The recent vice-regal milk
commission noted the lack of milk for the poor in Ireland. Why? The town of
Naas tells one reason. Naas is in the midst of a grazing country, but Naas
babies have died for want of milk, because Naas cattle are raised for beef
exportation. The town of Ennis tells another reason. Ennis is also in the
center of a grazing country. Until the Woman's National Health Association
established a depot, Ennis poor could not get retailed pitchersful of milk,
for Ennis cows are raised to supply wholesale cansful to creameries which
make the supply into dairy products for exportation.[9]
Bread-and-tea, and bread-and-tealess families get on the calling list of
tuberculosis nurses. "The nurses often found," writes the Woman's National
Health Association, "that a large number of cases committed to their care
were in an advanced stage of the disease ... in a number of cases families
have been found entirely without food. This chronic state of lack of
nourishment ... accounts in part for the fact that there are two and
sometimes three persons affected in the same family."[10]
Has mental as well as physical health been affected? Lunacy is
extraordinarily prevalent in Ireland. In the lunacy inspectors' office in
Dublin castle, I was given the last comparison they had published of the
insanity rates in England and Wales, Scotland and Ireland. English and
Welsh insanity per 10,000 people was 40.8; Scottish, 45.4; Irish, 56.2. The
Irish rate for 1916 showed an increase to 57.1.[11]
Emigration, remark lunacy experts, fostered lunacy. Whole families withdrew
from certain districts. Consanguineous marriages became more frequent.
Weak-minded cousins wedded to bring forth weaker-minded children.
And Irish living conditions are a nemesis. They affect those who go as well
as those who stay. Commenting on the fact that the Irish contribute the
highest proportion of the white foreign-born population to the American
hospitals for the insane, as well as filling their own asylums, the lunacy
inspectors write: "As to why this should be, we can offer no reasoned
explanation: but just as the Irish famine was, apart from its direct
effects, responsible for so much physical and mental distress in the
country, so it would seem not improbable that the innutritious dietary and
other deprivations of the majority of the population of Ireland must, when
acting over many generations, have led to impaired nutrition of the nervous
system, and in this way have developed in the race those neuropathic and
psychopathic tendencies which are precursors of insanity."[12]
Babies don't like mentally and physically worn-out parents. Babies used to
be thought to have special predilection for Ireland. But as a matter of
fact, they come to the island less and less. Ireland has for some time
produced fewer babies to the thousand people than Scotland. During the
decade 1907-1916 Scotland's annual average to every thousand people was
25.9;[13] Ireland's was 22.8. From 1907 to 1917 Ireland's total number of
babies fell from 101,742 to 86,370.[14]
But as was said in the beginning, it is not to individual excess that most
of the ill health in Ireland is due. It was not until recently that
venereal disease as a factor in Irish ill health has been a factor worth
mentioning. In 1906 a lunacy report read: "The statistics show that general
paralysis of the insane--a disease now almost unknown in Ireland--is
increasing in the more populous urban districts. At the same time the
disease is still much less prevalent than in other countries, and in the
rural districts it is practically non-existent. This is to a large extent
due to the high standard of sexual morality that prevails all over
Ireland."[15]
Nor do the Irish suffer from the violence that accompanies common
crime--for there is little crime under the most crime-provoking conditions.
As the Countess of Aberdeen said: "In the past annual report by Sir Charles
Cameron, the medical officer of health for Dublin, there are again some
figures that tell a strange tale of poverty so widespread, of destitution
so complete, of housing so unsanitary, of unemployment so little heeded,
that one is amazed by the fact that no combined effort on the part of more
fortunate citizens has been made toward bringing about a wholesome change,
and this amazement is only lessened by the extraordinary freedom we in
Dublin enjoy from robberies, peculations, from crimes of violence and other
misdeeds that would sharpen our perception of miseries now borne with a
fortitude and a self-restraint that cannot but appeal strongly to any who,
either from personal experience or philanthropic reading, know how crime
and vice are associated elsewhere with conditions not more distressing and
often less long-lived than ours."[16]