Princess Margaret Hospital: The Story of a Bahamian Institution

Copyright © 2005, 2009, 2014 by Harold Alexander Munnings Jr.

First edition ISBN: 976-8170-75-1

Library of Congress Control Number:   2009909522

ISBN:      Hardcover      978-1-4415-7830-3

      Softcover       978-1-4415-7829-7

      Eboook          978-1-4628-1698-9

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.

Dr. Harold Munnings

Grosvenor Medical Centre

PO Box SS 6587, NP, Bahamas.

Rev. date: 03/25/2014

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CONTENTS

Acknowledgments

Foreword to first edition

Introduction

Gestation, Birth, and Childhood 1780-1964

1.   The First Hospitals

2.   The New Providence Asylum

3.   The Bahamas General Hospital

4.   The New Bahamas General Hospital

5.   Princess Margaret and Her Tour of the West Indies

6.   An Eye Injury that Shaped a Nation

7.   The Bahamas Tackles Tuberculosis

8.   A Remarkable Mind

Adolescence 1965-1980

9.   The Yarmouth Castle Disaster

10.   A Tragic Explosion

11.   The Blood Bank and Laboratory

12.   The New Outpatient’s Wing

Adulthood: Makeovers and Major Surgery, 1981-2005

13.   New Epidemics

14.   Specialized Units for Specialist Care

15.   Obstetrics, Orthopedics, and the Yellowbirds

16.   The Historical Wall

Epilogue

Appendices

Bibliography

LIST OF IMAGES

1.   Princess Margaret, signed portrait (1970)

2.   West Hill Street entrance to the African Hospital. Author’s photograph.

3.   Bahamas General Hospital compound (1928). View from the newly built water tower. Courtesy of Mr. Ronald Lightbourn

4.   The Infirmary: From Reminiscing II, Courtesy of Mr. Ronald Lightbourn

5.   The Materials Management warehouse on the infirmary site. Author’s photograph.

6.   The Bahamas General Hospital as photographed by the Geographical Society of Baltimore in 1902. Courtesy of Captain Paul C. Aranha

7.   The Private Ward and old entrance gate

8.   The Hospital cornerstone. Author’s photograph.

9.   Christ Church Cathedral pulpit. Given in memory of Sir Aubrey Kenneth Solomon, chairman of the hospital fundraising committee. Author’s photograph.

10.   Princess Margaret at Clifford Park, 1955. Courtesy of the Department of Archives

11.   Dr Jan Steele-Perkins. The nation’s first ophthalmologist. Courtesy of Vanessa Tancock

12.   Nurse B. Strachan and a patient return to the Childrens Ward. Author photo

13.   The Original Entrance to the Chest Wing and commemorative plaque. Author’s photograph.

14.   Mr. James Rand Jr. Courtesy of Dupuch Publications

15.   Yarmouth Castle docked in New York. From Journal of The Steamship Historical Society of America

16.   The Tribune front page, November 16, 1968. Courtesy department of archives.

17.   Dr. Segismundo Obregon, 1916-1983. Chemical pathologist, PMH

18.   Original Entrance to the new 1976 Outpatient Wing

19.   Shirley, parking attendant

20.   Dr Winston Campbell (left) and Harold Munnings Sr, Permanent Secretary (right) look on as Mrs. Rosen presents a textbook written by her late husband to the Honorable Perry Christie, Minister of Health. Photograph courtesy of Dr Campbell

21.   Dame Dr Ivy Dumont, Minister of Health 1992-1996. Photograph courtesy of BIS.

22.   L-R: Drs. P Gomez, C Bethel and the author, Heroes of Health Ceremony, 2001.

23.   Dr. Percival McNeil and Bain

24.   Dr. Carlos Thomas at work in the SCBU

25.   Nurse Patricia Bethel, founder of the Burns Unit

26.   Accident & Emergency Entrance, 2004. Author’s photograph.

27.   Nurse Joan Lunn. Courtesy of Rene Roth

28.   The Historical Wall

29.   President Clinton at PMH President William Clinton, Dr. Perry Gomez, Honorable Dr. Marcus Bethel, 2005 Courtesy of Derek Smith, Bahamas Information Service.

For my parents, Harold and Gweneth Munnings

Praise for the first edition of Princess Margaret Hospital

A well-written pioneering volume… filled with interesting details and information about health personalities and events connected with the hospital… well researched and illustrated, with informative appendices and an expansive bibliography… an important contribution to Bahamian historiography.

—D. Gail Saunders, PhD, Historian

Highly informative and interesting reading… a seminal work on one of the Bahamas’ most historic institutions… this work should be highly prized.

—Dame Ivy Dumont, DCMG,

Governor General of the Bahamas

I enjoyed reading this piece of history.

—The late Sir John Templeton, Nassau

It was a pleasure to read.

—Cecil Bethel, FRCP,

Senior Consultant Physician

It is well organized and beautifully written.

—Nicholas Kouchoukos, MD, St. Louis, Missouri

I love the book!

—Jamie Barkin, MD, Professor of Medicine,

University of Miami

I thoroughly enjoyed the vignettes.

—The late Dr. Trevor Jupp, Nassau

The book is truly a hit—everybody I know either has a copy or wants one!

—Virginia Ballance, Health Sciences Librarian,

The College of the Bahamas

I enjoyed this important historical text.

—Dr. DJ Spenser, Sydney, Australia

I read your book cover to cover. Very enlightening indeed. Thanks for keeping history alive.

—Vance McKenzie, Nassau

Couldn’t put it down!! Very interesting reading.

—Dr. Caroline Burnett-Garaway, Nassau

It was delightful reading, most informative.

—Dr. Robin Roberts, Consultant Urologist, Nassau

Acknowledgments

I am indebted to Mrs. Virginia Ballance, Health Sciences Librarian of the College of the Bahamas, who provided the initial encouragement, helped with the retrieval of information, and reviewed the manuscript. I am also deeply indebted to Dame Dr. Ivy Dumont, for graciously giving a detailed critique with her suggestions marked with her famous red pen and for writing the foreword. Much of the information in this book came from the Department of Archives, and I am happy to acknowledge the assistance from the staff there, as well as that of Mr. Christopher Bain of The Tribune and the Librarian of The Nassau Guardian . Drs. Merceline Dahl-Regis, Cecil Bethel, Reginald Carey, Perry Gomez, Andrée Hanna, Barrett McCartney, Percival McNeil, and Patrick Roberts, nurses Emily Osadebay, Patricia Bethel, Mary Thompson, and Carimenda Ferguson, and Mrs. Norma Allen, provided historical details on the departments under their direction. I am grateful to Dr. Ada Thompson for the text of her C. R. Walker Memorial Lecture given at the 2007 Medical Association of the Bahamas conference and to Dr. Nicholas Kouchoukos of Missouri and Professor Hiram Polk, Chairman of Surgery at the University of Louisiana, who took the time to share with me recollections of their personal involvement in the care of victims of the Yarmouth Castle disaster. The Public Hospitals Authority, particularly the Managing Director Mr. Herbert Brown, is thanked for providing access to official reports on the hospital, and the additional information provided by Mrs. Hannah Gray, Andil LaRoda, Tyrone Burrows, and Jennifer Mackey proved valuable. Mrs. Patricia Hamilton, Dr. Herbert Orlander, the late Mr. Michael Bullard, and Mrs. Carol Bischoff provided useful information on the Historical Wall. Thanks go to Mr. Anthony Jervis for describing the architecture of the hospital, to Lady Marguerite Pindling for her personal recollections from the 1950s, and to Sir Orville Turnquest, Magistrate Carol Misiewicz, Mr. Gordon Higgs, Mesdames Linda Jarrett, Barbara Thurston, Nazel Johnson, Virginia Jones, and Ms. Lynette Saunders. For photographs I am indebted to Messrs. Etienne Dupuch, Franklyn Ferguson, and the late Eric Albury, Captain Paul Aranha, Vanessa Tancock, and Derek Smith of Bahamas Information Services.

Last but not least, I am happy to thank my wife, Moneira, for her patience and support that makes everything that I do possible.

Foreword to first edition

By Her Excellency the Governor General

Dame Ivy Dumont, DCMG (2005)

I am honoured to congratulate the author on the completion of this manuscript. Had he been an obstetrician, Dr. Munnings might have likened the experience to that of delivering a baby. In the circumstances, and having been privileged to view his first draft, I am happy to acknowledge that his fleshed-out work provided me with several hours of highly informative and interesting reading.

As far as I can confirm, this is a seminal work on one of the Bahamas’ most historic institutions, the Princess Margaret Hospital. Dr. Munnings deserves every commendation for undertaking such a task and for seeing it to completion in such a short period. Memories can be, and often are, very short; a personal recollection is sometimes clouded by one’s intimate knowledge, as mine would be for the two and a half years that I served as Minister of Health. This work, then, should be highly prized.

I expect this book to be read as a novel for its style and general overview; as a basis for discussion, policy making, and strategizing by healthcare and national leaders. I so commend it.

The must be other topics to which, in the future, Dr. Munnings will turn his literary attention. In due course, I trust we shall see more of Dr. Munnings’ books on whatever subjects pique his interest.

Introduction

I feel it is my duty as a citizen to record some of the past that has added to the present as we now have it.

—Dr. Cleveland W. Eneas Sr.,

Let the Church Roll On (1976)

Just a word and a sound

Sometimes handed around

By jokers and clowns seeking fame

But it’s also a claim to my past and my name

And I shout without shame

I AM A BAHAMIAN.

—Pat Rahming, "Thoughts in Black

and White" (1986)

I f you are a born Bahamian and under fifty years old, chances are that you were born at the Princess Margaret Hospital (PMH) in Nassau. You almost certainly have a relative who died at the PMH. And if you are an average citizen, if there is such a thing, and you became really ill, chances are, you would be admitted to the PMH.

According to the 2000 census, it has been around longer than 85 percent of the population of the Bahamas. Only a few are old enough to remember life in the Bahamas before the PMH. Thanks in part to this hospital, more persons in the Bahamas can expect to approach old age. The average life expectancy was only sixty years between 1950 and 1955 when the hospital was established; it has climbed to seventy-three years of age in the last decade. For its utility, the PMH is a treasured institution in Bahamians.

The Princess Margaret Hospital may be a mere youth by comparison with its Old World counterparts, but few of those institutions have witnessed a transformation of their communities like this hospital in Nassau has seen. During its life, the population of the Bahamas has tripled, and the system of government and the economy of the Nation has transformed. These challenges, combined with the dramatic changes in the practice of medicine over the past half century, have led more than one Government consultant to declare that the hospital was obsolete and recommended that it should be replaced. It would have been doomed decades ago were it not for the millions of dollars invested by the Government and others for expansion, upgrading, and refurbishment. The life-extending upgrades to the hospital have allowed it to play a significant part in the National development, and its history has become a part of the Bahamian heritage.

On October 5, 2003, a luncheon celebrating the fiftieth anniversary of the hospital was held under the patronage of Lady Marguerite Pindling, wife of the late first Prime Minister of the Bahamas. On that occasion she remarked:

The history of this evolutionary institution is unique and rich, and one of which all Bahamians can be proud. The Princess Margaret Hospital has come from humble beginnings to a now state-of-the-art facility. It has experienced tremendous growth, in terms of development of our healthcare professionals [and] in the diversity of disciplines.

—Hospital 50th Anniversary Luncheon booklet (2003)

In 2009, as the Public Hospitals Authority celebrates its tenth anniversary, we are presented with an excellent opportunity to broaden the public’s knowledge of unique and rich history to which Lady Pindling referred. Much of this is held in fading personal memories, in old archived newspapers, and in dry technical reports that are scattered in out-of-the-way places.

My own interest in the history of the PMH grew out of a search for information the predecessor to that hospital, the Bahamas General Hospital, where my grandparents Edgar and Dorothy Munnings met. My grandfather was a respected stonemason and builder in his day, and sometime in the early 1900s he contracted tetanus and was admitted to the Bahamas General Hospital. Mr. Stanley VS Albury, who later founded a well-known manufacturer’s agent and wholesale business that bore his name, was the hospital superintendent and the institution he managed existed in an era before antibiotics and antitoxin. Edgar’s nurse happened to be a twenty-three-year-old native of Eleuthera with seven years experience, and during the fight for his life, they fell in love. They later married, and my father was their first child.

Our discovery of the history of the hospital began at the Health Sciences Library of the College of the Bahamas where the dearth of information available and the encouragement of the librarian, a respected scholar and historian in her own right, propelled me on a demanding and rewarding journey.

At the outset, I photographed and transcribed every commemorative plaque on the hospital compound; each one has a story to tell. In the National Archives I obtained details on the commemorated events from old newspapers on microfilm and from other official records and documents. The hunt took me to the hot and dark hospital attic, where by flashlight and wearing a mask for protection from the dust, I pored over worm-eaten files. In air-conditioned comfort, thanks to the chief medical officer who allowed me to use her suite, I studied files from the Ministry of Health Registry. Veterans and management executives of Bahamian healthcare and other individuals were interviewed and information was pieced together from various books and from sites on the worldwide web. In the process, I learned how the hospital overcame and grew over the years, through challenges in administration, staffing, disasters, and industrial action. Uncanny parallels between past and contemporary issues in the Bahamas and in the West Indies became apparent.

When this book was first published in 2005, the limited printing quickly sold out. In this edition, the corrections and enhancements prompted in feedback from well-informed readers in four countries have been incorporated. In addition, we have unearthed a landmark 1915 Hospital Commission of Inquiry, recorded the fate of the first tourist ever admitted to the Intensive Care Unit, and penned firsthand accounts from survivors of the Yarmouth Castle disaster and the Taylor Gas explosion.

Our original objectives remain unchanged: to encourage a wider appreciation for the historical value of the Princess Margaret Hospital in Nassau.

Gestation, Birth, and Childhood 1780-1964

Chapter 1

The First Hospitals

I n 1492, Christopher Columbus set out from Spain on his voyage of discovery. With a physician on each of his ships, the expedition first made landfall on Guanahani; they dubbed the island San Salvador. There was no hospital in Guanahani; the Lucayans whom they met there isolated their sick in a separate hut where they were frequently bathed and placed on a diet of cassava with no meat or fish allowed.

Later, in the Bahama Islands there were makeshift facilities that accompanied expeditions and military campaigns—the Bahamas Historical Society Museum has a marble slab that may have been used as an operating table by early military surgeons, but it appears that the first hospital in the Bahamas was built in the eighteenth century and it was called The African Hospital.

The African Hospital

On a 1788 map of Nassau that is held in the department of Archives, a hospital is shown on West Hill Street, up on the New Providence ridge, at the top of Queen Street.

The hospital seems to have been built around 1780; it was situated in a prime location, overlooking the city and Nassau harbour. In 1789, the Chief Justice Stephen Delancey acquired 150 acres behind the hospital and formed Delancey town. A long narrow alley running south from the hospital was subsequently cut through the limestone hill into Delancey town; it was appropriately named Hospital Lane.

The hospital appears to have been primarily for the use of slaves; its very existence indicates the establishment made some effort to provide healthcare, even if its quality was dubious. Historical records show that in any case, slaves in the Bahamas were generally healthier than in other colonies, thanks in part to a wholesome diet and the absence of the rigour of the sugar plantation.

Some slave owners paid