Public Health at Goldhanger in the past

Background

“Public Health” is the term used to describe the well-being of a whole community rather than the individual, which includes monitoring and recording of the health of the community. From the Victorian era onwards there were great advances in medicine, public health, building standards, and sanitation. These changes had a huge influence on the health of the nation generally and would have had the same impact on this village, albeit some of the changes appear to have been slow in arriving. Since records began, life expectancy has steadily increased everywhere, and a study of past conditions in this village gives some understanding of why lives were so short in times gone by.

Locally published material referring specifically to the village has been used to learn about past conditions in the village:

o Dr. Salter’s Diaries, complied by J.O.Thompson in 1936 (HS)

(Dr Salter was the local medical officer of health from 1864-1933)

o Goldhanger - an Estuary Village, by Maura Benham in 1977 (MB)

o Goldhanger Parish Magazines from 1895 to 1940 (PM)

Colchester Library, Local Studies Section, ref: E.GOL.1

This has been complemented by additional information available from other sources:

o Public Health in Gt Bowden in the mid 1800’s and beyond by Dr Paul Harrison (PH)

available from the Great Bowden Historical Society, weblink…

www.greatbowden.freeserve.co.uk

o The Terling Fever – 1867, by M.R. Langstone, 1984 (ML)

Essex library Ref: E.TER.614.511

o Tour through the Eastern Counties by Daniel Defoe in 1722 (DD)

o Documents held in the Essex Records Office (ERO)

o Early photographs taken in the village

o The internet

Housing standards

The earliest photographs available record the condition of the housing in the village in about 1900. Its not know what the conditions were like before these photos were taken, but they were unlikely to have been better.

Tithe Awards listing (ERO) for Goldhanger in 1820 indicate that most small cottages were tied or rented properties, many with absent landlords. Some of the early photos clearly show a very poor standard of construction and maintenance by today’s standards. The presence of ivy, lichen, mould, and holes in walls, floors and roofs, resulted in damp and very cold properties, and encouraged vermin(PH).

The Tithe Awards do not identify children, so there is no sense of their numbers at the time from the documents, but other genealogical data indicates that families of 12 and 17 were not uncommon in the village, so overcrowding in the small two-up, two-down cottages must have been a major factor in transmission of diseases, particularly amongst the children. (PH)

In 1918 Dr Salter recorded in his diary(HS): “Attended a women with her 10th child, all of whom I have brought into the world. Her mother was present as a nurse, who had 13 children, all of whom I brought into the world. Her daughter was also present with her 2 children, also attended by me. A total of 25”.

Most cottages in Goldhanger had no sanitation before the 1930s and the only safe fresh water for the majority of residents was from the well and pump in The Square.

Several early photographs of cottages show signs of crumbling brickwork at ground level and holes in the plasterwork. Many had poorly maintained roofs and no gutters.

A well reported(ML) typhoid epidemic at Terling, Essex, in 1867 provides evidence of housing and sanitation conditions in the area at that time. Terling (pronounced locally as “Tarling”) is just 8 miles from Goldhanger, was (and still is) a similar size with about 900 residents, and is a similarly isolated village. The Terling Fever report describes “labourers cottages constructed merely of lath and plaster with thatched roofs in a great part of wood, often rotten and worm-eaten, with shallow wells often at a lower level than that of the neighbour’s “privies”.

"The wretched accommodation, which with few noble exceptions, was available throughout the agricultural districts of the county. The degradation and ruin of the miserable hovels called cottages, which the farm labourers have no alternative but to reside in, is beyond belief to all who have not eye witnessed, it is notorious that many of the noble Lord's Terling cottages are unfit for a pig to sleep in." The author of the report also found that a Royal Commission on housing standards in Essex conducted a few years after the 1867 epidemic did not identify Terling in a list of the worst villages in Essex.

In 1938 Maldon District Council condemned 23 cottages in the Goldhanger as unfit for habitation and recommended their demolition. Ironically many of these cottages were previously owned by the village Rectors and then passed on to their decendants who didn’t live in or near the village, so were “absent landlords”. A temporary reprieve was granted in response to local opposition, and WW-2 deferred their demolition until the early 1950s. Then over 30 cottages were pulled down and new council houses were built on the Maldon Road to provided accommodation for the tenants who had lived in the cottages lost.

Public Health Facilities and services in and around the Village

Until the 1930s, Goldhanger had no mains water, sewage system or electricity, and hence no regular domestic hot water source. There were no telephones until the early 1900s and hence no emergency access to a doctor, the fire brigade or ambulance services. The nearest doctor was located in Tolleshunt D’arcy, and Dr Salter’s diary records a telephone was first installed in his house in 1908. Before the creation of a National Health Service patients paid their GP directly for services, the doctor would probably have only visited the wealthier patents at home, others would have had to travel to D’arcy to see him, however sick they were.

The nearest hospital was St Peters in Maldon, between (but before 1930 it was a workhouse), this would have been an agonizing journey by horse and cart for the very sick. It is notable that Dr Salter referred to: “isolation tents up at Goldhanger for diphtheritic patents”, and the Terling Fever report describes the installation of a temporary wooden“ Fever Hospital”. Maldon Museum and ERO have photos of an isolation hospital at Broad Street Green, Heybridge, with tents in the grounds. Originally located in a rural location, Broomfield Hospital at Chelmsford was built as a TB isolation hospital. There may also have been a small isolation hospital at Tiptree.

The use of temporary hospitals were probably the result of both overcrowding in the small cottages, and the need to isolate the sick from the healthy. Another benefit would be increased exposure to fresh air, with greater oxygen content. However, as most epidemics occurred in winter months, hypothermia probably also took its toll on patients in these exposed environments.

Probably the only facility directly related to public health in the village before the 1930s was the well and pump in The Square to supply fresh safe drinkable water. The water from this source was always said to be of quality good, except for a period in the mid 1920s when the water table began to drop and it became necessary to dig new well adjacent to the old one. The cause of this loss of water is said to be due the large number of naval personnel stationed on Osea Island at the later part of WW-1 using the underground water. A new well was funded by a locally organised collection of £400, so even at that time the local authority had not accepted any responsibility for the facility. All the farmhouses and larger properties had private wells.

Mains electricity was first installed in the village in 1937, a mains water supply followed, and finally a sewage system. When electricity first became available refrigerators would not have been generally affordable, and ice would have been carted from Maldon and stored and sold by the butchers. The poorer residents would probably not have been in a position to purchase ice.

Considering that electricity, water and sewage had been installed progressively in towns across the country from 1890 onwards, one wonders why it took until 1937 for these services to reach the village. There are two possible reasons why mains electricity was so late: Initially towns and cities had their own separate coal and steam generators producing low voltage direct current (DC) of differing standards, and it was inefficient to transmit this type of power any distance over cables. A “national Grid”, using high voltage AC was only initiated in 1926 and took until 1937 to be completed across the country. The second reason is that, rightly or wrongly, the Rector of the time the Revd. Gardner, was strongly opposed to overhead cables being laid over his land and through the village. This could also have delayed implementation for some years before it was agreed that the much more expensive underground cables should be installed.

In hilly areas (but not apparently at Terling) gravity provided the means to both distribute fresh water and collect sewage through pipes, however in low lying flat regions pumping is required. Towns and cities could afford coal fired steam pumps, but rural areas had to wait for electricity to arrive.

Before the 1930s most cottages relied on “night soil” collections from their privies, however the farmhouses and larger properties had individual cesspits. In Tudor Britain “Gong Farmer” was the term used for a person employed to remove human excrement from privies and cesspits. Gong farmers were only allowed to work at night and the waste they collected had to be taken outside city and town boundaries.

The Terling experience may be typical of the region at that time: “Although brick and wooden privies were built after the epidemic and galvanised pails were provided to encourage more efficient disposal of their contents, they were still empted on the gardens and allotments well Into the twentieth century. This usually happened on Saturday night after dusk. Later the night soil tanker made its rounds and when it arrived it was well to keep doors and windows shut. For those who were lucky to have WCs the situation was improved, but the effect on the river Ter was disastrous. It became a stagnant cesspool as the supposedly clear effluent from the cesspools drained into it. It was not until 1966 that Braintree District Council laid sewers throughout the village to the small pumping station which it is pumped to the sewage works in Hatfield Peverel.”

Before the streets were tarmaced in the early part of the 20^th century, there were probably no surface rainwater drains or pipes in Goldhanger village, and a network of ditches around the village leading to the creek would have provided drainage. These would have been essential and effective in wet winter weather, but in warmer drier times misused and contamination would have led to smell, insects and vermin.

Ironically, it was a local man Cuthbert William Johnson (1799–1878), of Heybridge who is famed for introducing many of the environmental health improvements that we are familiar with today through the introduction of a major public health legilation in 1848. His association with the Heybridge salt works, which his father owned, led to a passion for salt and its potential uses in agriculture and health. Both he and his brother George were admitted to Grays Inn, and Cuthbert went on to help bring about the passing of the Public Health Act of 1848.

Cuthbert Johnson was a commissioner of the metropolitan sewers and he campaigned for the legislation which resulted in the 1848 Public Health Acts. He resided at Waldronhurst, Croydon, where for thirty years he was associated with the local board of health, which pioneered a number of sanitary improvements under his chairmanship. His knowledge of law was very valuable to the local board, which was involved in extensive legal actions over matters of water rights and river pollution. He is listed in the Oxford Dictionary of National Biographies (ref: odnb14871) and amongst many other books and articles wrote:

The Advantages to Be Derived from the United Application of Wilson's Baylis's Patents for the Manufacture of Salt from Seawater, 1838

The farmer's encyclopædia, and dictionary of rural affairs, 1842

On the Cottages of Agricultural Labourers, 1847

The Acts for Promoting the Public Health, 1848-1851

The Benefits of the location and Isolation of village

The location and degree of isolation of the village would have offered some defence from the transmission of diseases that were prevalent in overcrowded towns and cities. Before the days of public transport, most residents of the village would not have travelled far, so catching an infection in a town and city while visiting would not have been a frequent occurrence. Furthermore, the close proximity of tidal salt water in the Estuary could be used for swimming, washing and even effluent disposal.

The many small fresh water Glacial ponds in and near the village also had benefits, these were used for animal drinking water and could have had other uses such as water for washing clothes, etc. The availability of fresh food from the local farms: meat, vegetables, fruit, milk, etc., and fresh fish from the Estuary, which was stored temporarily in the Fish Pits, would also have had significant benefits that may not have been available all other villages.

Diseases and Epidemics (in approx. chronological order of major epidemics)

Leprosy, St Giles Leper Hospital, Spital Road, Maldon, was founded by Henry II in the twelfth century for the relief of the inhabitants of Maldon and the surrounding district suffering from Leprosy. The ruins of the buildings remain and are listed.

The following in taken from… www.dartfordarchive.org.uk/medieval- Lepers

Leprosy was a common disease in medieval times and was thought to have been introduced into England as a result of the Crusades. The epidemic was most severe in the thirteenth century. Lepers were treated as outcasts from human society. Leper hospitals became a prominent feature of town life; there were over 200 in England.

Although now identified as a specific disease, in medieval times, leprosy was the name given to many skin conditions including eczema, psoriasis, dermatitis, scabies, syphilis, tuberculosis and smallpox. Lepers were forced to wear a distinctive style of clothing consisting of a mantle and beaver-skin hat, or a green gown. In their hand they carried a bell or clapper, through which they were to give warning of their approach so that everyone could get out of the way in time.

Leper hospitals were known as Spital Houses, [hence Spital Road in Maldon], or the Lazar House, after St Lazarus, the patron saint of lepers. The segregation of lepers and those suffering from other skin diseases in purpose-built hospices, away from the rest of the community, was very effective in bringing about the eradication of leprosy in England by the middle of the sixteenth century.

Black Death or Bubonic Plaque of 1348 “swept away half the clergy of Essex and probably between a third and a half of the population” (MB). At that time it was generally considered necessary to bury the dead well outside the towns and villages, which has resulted in legacy of cemeteries and chapels being located well away from village centres, as at Great and Little Totham, and Tolleshunt Major. However, as the Goldhanger burial ground is in the middle of the village, this may indicate that the disease was less severe here.

Ague now called Malaria is a disease transmitted by mosquitoes that thrived in stagnant water in the fens and mashes and ponds and was prevalent in Essex and along the Thames estuary until just after the First World War. Daniel Defoe wrote about the Blackwater and Osea Island in the 1722 (DD) that local men acquired “14 or 15 wives” because they were immune from the effects of the damp and foggy marshes and the associated disease of Ague, whereas their young wives “succumbed to the disease within a year or two”, so the men went back to the “uplands” to find new wives to bring back to the marshes. The progressive building of seawalls over the centuries, mainly to benefit agriculture, had the side effect in this region of reducing the mosquito population and hence the disease. Epidemics of ague were always associated with warmer ambient temperatures.

In 1837 John Argent, Malster of Goldhanger, churchwarden, “Overseer of the poor”, together with his family, were removed from the village and conveyed to Glemsford in Suffolk by order of the court. In manuscript papers preserved in ERO, references: Q/SBb 528/53/1,2&3 vague medical reasons are given but no specific illness is identified. It may have been malaria.

From the Journal of the Royal Statistical Society of 1857…

Cholera In 1866 Dr Salter “attended a meeting of the local Cholera committee”.

Typhoid The 1867 outbreak on typhoid fever in the village of Terling has been well researched and documented (ML). Terling is about 8 miles from Goldhanger and was a similar size village with about 900 residents. 300 inhabitants contracted the disease and 44 died. This unusual rural epidemic merited reports in The Times and The Lancet at the time. Lack of clean water, poor sanitation and poor housing were all blamed. Early deaths during the outbreak were mainly amongst the women and girls, probably due to the males spending more time outdoors or because they drank beer rather than water. Later on however, as the men were obliged to spend more time at home looking after sick relatives they too succumbed. Major typhoid epidemics ended in the UK around 1912.

Smallpox In 1871 Dr Salter was “busy vaccinating everyone in consequence of an epidemic of smallpox” (HS). In July 1884 Dr Salter was “Vaccinating like mad to stop small-pox” and again in Aug 1884 “Vaccinating from calf at Tollesbury all afternoon”. Smallpox epidemics appear to have ended in 1905.

Tetanus In 1882 Dr Salter wrote an article in the Practitioner about a case of Tetanus in a 51 year old labourer. With the doctors recommended medicines the patent made a full recovery and returned to work. There have been other recorded incidents of Tetanus in the village, usually associated with garden implements, but it is not known if these are exceptional.

Diphtheria In October 1883 the Epidemiological Society of London reported on a diphtheria case in Goldhanger affecting two boys and one died. The report claimed disease had been brought from Halstead in some needlework and a paper bag used had been given to the boys to “cut up”. In 1890 Dr Salter wrote “Up to our necks in Diphtheria”. In 1900 Dr Salter recorded that “isolation tents are up at Goldhanger for diphtheritic patents” (HS). The need for tents was probably the result of overcrowding of children in small cottages. A vaccine for diphtheria was introduced in 1942.

Scarlet Fever there was an epidemic in winter of 1918.

Tuberculosis (Consumption) In Jan 1911 Dr Salter wrote “Placed on the county committee for fighting consumption”.

Influenza There were epidemics in the summers of 1891,1905,1909 &1918. Dr Salter made many references to influenza epidemics in his diary (HS) over this period. Deaths from flu were not uncommon resulting from pneumonia. Children and 20-30 year olds were most affected (PH).

Measles, Mumps, Rubella(German measles), Whooping cough mainly affected children. Schools were frequently closed in an attempt to contain the spread (PH).

Diarrhoea Baby & Infant deaths were often caused by bottle feeding un-pasteurised cow’s milk (PH).

Bronchitis and Pneumonia in children was associated with dark, damp mouldy overcrowded housing. However, by 1920 rural areas had lower infant mortality rates generally than the towns due to the available of fresher food (PH).

Other illnesses and Fatalities not related to epidemics

While Public Health is primarily concerned with epidemics, other non-contagious chronic illnesses would have had an equally serious impact on village life in the past.

Fifty five young men from the village “took up arms” and participated in the Great War and 17 were killed and are remembered on the war memorial. However, many others returned home seriously injured and some were known to have suffered from the effects of gas and shell-shock for the rest of their lives. Army discharge papers were frequently marked “LMF” which is an abbreviation for “Lack of Moral Fibre”, now known as “combat stress" or “Post Traumatic Stress Disorder” (PTSD). The saddest cases in WW-1 were the young men suffering from this illness who appeared to be physically fit enough to be sent back to The Front. If they couldn’t cope and deserted when caught they were shot for “cowardness”, but there is no record of Goldhanger men suffering this fate.

In the 18^th and 19^th century when fishermen sought entertainment in the village, Fish Street is said to have been the location for several unlicensed Alehouses. In fact, there was a period when alehouses did not need licences, this was introduced in an attempt to reduce gin consumption in cities like London, which had been creating even greater problems of alcoholism. Some of the cottages built right on the roadside in Fish St and Church St had shutters on ground floor windows as protection from the drunken fishermen using the local ale houses, these can be seen in some early photos. So vandalism, alcohol related injuries and illnesses must have been a problem. Dr Salter’s diary makes various mentions of drunken brawls in the streets at D’arcy and Tollesbury at the turn of the century (HS).

With many of the poorer families having large numbers children, and with a lack of maternity and emergency medical facilities, there must have be a much higher death rates in the past during birth of both mothers and babies.

Strangely, a paper in the Lancet of August 1900 written by a Witham doctor George Melmoth Scott, identified that Cancer rates on the Essex coast, including Goldhanger, were lower than the national average. Tollesbury had the lowest death rate of all. The author attributes this to number of rivers and marshes in the area, and suggests that the clay content and alluvial matter of the water could be responsible.

In Victorian times and until the second world war, virtually all men smoked and many of the diseases now recognised as smoking related, such as Emphysema, Bronchitis, lung Cancer, heart disease etc. were not recognised for what they were, and many premature deaths would have resulted.

Accidents

With little or no emergency services available in the area, or a general knowledge of basic lifesaving procedures that today might save lifes, many more accidents in the past would have resulted in a fatality or permanent disability. Several incidents of drowning and near drowning in the estuary have been recorded in newspaper reports over the years from weather, shipping, fishing and swimming related accidents.

The Great Tide of 1736 destroyed parts of the Goldhanger seawall, swamped decoy ponds and caused in the death of five Goldhanger men.

In 1875 Dr Salter wrote:

“Sent for in a hurry to Goldhanger. A boat capsized and one of its occupants was reported drowned, but by four hours diligent perseverance of artificial respiration and rubbing I got him round”(HS). In 1885 he recorded: “Attended an inquest on a man who had swallowed some sheep dip in mistake for beer”.

Form The Royal Humane Society Awards, Case Number 42,487:

May 1916, The Creek, Goldhanger. Frank Butcher, Age 16, got out of his depth when bathing in the 7ft tidal Creek. Richard Phillips, Age 18, went in from the other side, swam over to effected the rescuer. The Case submitted by the Revd. Field of Goldhanger.

It is on record that in the early 1900s Mrs Ethel “Poppy” Gardner, the Rector’s wife, had accident with an diesel electric generator in the Rectory cellar and lost an arm and in the same period a young boy of the Page family died after falling out of a tree in the garden of the Old Rectory.

Farm machinery and farm animal related accidents have always been a hazard in rural communities and would also have been more frequent, with more severe outcomes, in the past. As recently as the 1970s a young man from the village was electrocuted and killed when the tractor with a fork-lift attachment he was driving hit overhead power cables that ran across a local farmyard.

Windmills and steam mills were particularly venerable to fires and accidents, and the Goldhanger mill would have been no exception. Owners and workers could easily take too high a risk in high winds and the dust caused breathing difficulties. The dust and sparks from the rotating parts also started frequent fires and many mills were burnt down. It is not know what brought about the end of the Goldhanger windmill, but fire was the most likely cause.

With no local fire brigade, and no large manor house or stately home in the vicinity to support any form of emergency cover, which was frequently the case in rural areas, chimney fires and house fires must have been a major problem, particularly with so many wood and “lath & plaster” cottages, perhaps built this way because of the lack of a local stone. In 1919 the Parish Magazine(PM) reported there had been a fire at the Parsonage. “The Rector wishes to thank all the kind and energetic helpers who extinguished the fire at the Parsonage on the night of November 5th, but for whom the house would have been burnt to the ground, and to whom there is still a further recognition of their kind services forthcoming”.

Advances in public health standards and knowledge

Ignorance of disease carriers and the transmission routes was a major factor in the spread of epidemics the past. Until the mid 1800s, the “Miasma theory” was generally accepted, which was the notion that diseases were transmitted by bad smells in the air (PH).

The Public Health Act (which Cuthbert William Johnson of Heybridge had a large influence, see above) was introduced in 1848 and in 1854 Cholera epidemic in London led to the discovery of a contaminated water pump in Soho. In 1856 the “Great Stink of London” resulted in the beginning of sewage construction. The 1880s saw the first appointments of local medical officers of health and their resulting annual reports (PH). Dr Salter was the local medical officers of health.

Until the 20th century there was a general lack of understanding of basic food hygiene at all levels of society. In Goldhanger there were two farms right in the middle of the village up until the 1950s, and a large number of farm animals would have been right in the middle of the village: horses and donkeys for transport, cows, pigs, sheep for milk and meat and clothing. This meant that the disposal of animal waste was probably perceived as a much greater risk and a concern than the disposal of human waste. Manure heaps at the roadside were always very common (PH), which was spread on the fields in winter. Most villagers kept pigs and chickens at the bottom of their gardens to recycle food waste and the manure produced was put directly onto the vegetable patch.

Poverty

Before the creation of the welfare state and the National Health Service, the general health of the community was inseparable from poverty and unemployment. In her book Goldhanger - an Estuary Village Maura Benham(MB) wrote …

“A measure of the poverty in Goldhanger can be taken from the records of the Hearth Tax of 1671. Of the forty-nine names entered, nineteen were excused as too poor, a high proportion compared with Little Totham where twenty were to pay and only two were excused as too poor.”

Miss Benham also identified the existence of a poorhouse in the village in the 19^th century with eleven residents, evidence that the community accepted some responsibility for looking after the poor and infirm at that time. Early Church warden accounts for Goldhanger (ERO) refer to the distribution of “apabs”, which is a Latin abbreviation for food.

The Goldhanger Friendly Brothers is based on an early form of mutual sickness benefit and life assurance and was another way of helping local poor and unemployed people before national schemes was introduced which was unique to the village. The Friendly Brothers were originally associated with the Wesleyan Chapel and it had other names over its 200 year history, including “The Friendly Society” and “The Good Intent”. The Goldhanger Friendly Brothers still meet today, although since National Insurance and unemployment benefit were introduced in 1911 it has become largely symbolic. There are also many records of bequests to the poor and charities being established under the terms of the Wills of wealthy land owners in the locality.

Finally and perhaps surprisingly, these early photos showing children in the streets show the conditions in the village at the beginning of the 20^th century. The children appear to be well nourished, and clothed, and maybe by today’s standard appear to be over-dressed, which contrasts with many early photos taken in inner-cities at the same time.

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CONTENTS

Background

Other illnesses and Fatalities not related to epidemics

Accidents