It cannot be emphasized enough that the institutions that were introduced in post-emancipation Guyana were ultimately geared towards producing a more efficient workforce – more work for the least expenditure. Doctors and the field of medicine must be seen in this light.
A plantation hospital
In 1848, a year after the 1847 Hospital Ordinance was passed to provide a hospital on each plantation, there were only 98 hospitals on the 220 working sugar plantations. For example, on the 27 plantations on West Demerara between Philadelphia and Den Amstel, there were only 5 hospitals, with 77 beds for some 2000 persons. By 1895, with the huge influx of indentureds, there were 10 hospitals with 518 beds, attended by 4 doctors. The impetus was to get the worker back into the fields, and not stay in hospitals.
The Lunatic Asylum at Canje, Berbice
In the beginning, medical care, such as it was, had doctors generally treating all plantation workers, indentured and non-indentured alike. They were controlled by the plantation managers, but gradually this changed. The 1859 Ordinance to provide for the better management of estate hospitals shifted inspection of the hospitals to the Immigration Department. This was further expanded in 1873, after the COI into the Leonora strike, when the Government, through the Immigration Department and salaried medical practitioners, became nominally less dependent on the plantation managers.
Doctors were now District Medical Officers, and by 1886, Government Medical Officers.
With new statistics available, new interventions were implemented to maximise labour efficiency. For instance, where mortality on a plantation exceeded double the average death rate among immigrants over the previous five years, allotments of immigrants were suspended.
When higher-than-average mortality rate was discerned on particular plantations, the managers became liable for dispensing daily rations – including rice, dhall, ghee, curry stuff, sugar and salt – to new arrivals, the cost of which was met from the wages earned by the immigrant.
Asylums were another institution to control the immigrants, especially those who broke under the pressure of disorientation in new surroundings and the constant harassment from the overseers and could not work. One was first founded in Georgetown in 1842, housing some 17 mostly African patients, but was found deficient, and a new structure was built in 1859, where 60 patients of various ethnicities were accommodated. Finally, in 1867, it got a permanent location near the Canje Bridge, and a professional doctor, Dr Robert Grieve, was appointed its head.
Without irony, the Berbice Gazette of 23 April 1881 spoke of Dr Grieve’s work by noting how “an Institution which in former days was looked upon with horror as a place where cruelty and torture was inflicted on its unhappy inmates now appears as a pleasant Sanatorium for well fed and well-tended imbeciles”.
