A Day’s Routine at the Peel Island Lazaret

(Eric Reye & Rosemary Opala, Peel Island)

The Lazaret (Leprosarium) operated at Peel Island from 1907 until 1959 as the home and treatment centre for Queensland’s leprosy patients.  Like all medical institutions, it was run to a daily routine. Doctor Eric Reye, the island’s resident Medical Officer from 1945 until 1949, and Rosemary Opala (nee Fielding), a Nurse there during the late 1940s and again during the early 1950s have supplied the following,” typical” day’s duty roster for Peel’s medical staff. Two events were to modify their duties there in 1947: the introduction of electricity generation, and the introduction of Promin, the intravenous sulphone drug which was to finally control leprosy, the most dreaded of all contagious diseases.

Peel Island Lazaret – c.1955 – day surgery (red roof) and hospital (silver roof) (photo Dr Morgan Gabriel)

DAYS OFF

Nurses worked several weeks ‘on’, then took cumulative leave off the island. Originally no overtime was ever claimed but by Rosemary’s second term on the island during the 1950s, overtime payments were the norm.

Doctor Eric Reye spent alternate weekends off duty.

AN AVERAGE DAY

4.30AM            Nurses go to the surgery to start the two primuses that heat the big sterilizer. Water takes about an hour to boil.

6.00AM            The helpless hospital patients are washed, beds made, and medications given. The hospital orderly bathes the mobile male patients and takes care of the hospital generally.

8.00AM            Staff breakfast.

8.30 AM           Surgery (“clinic”) commences. Patients present themselves for dressings, check-ups, plasters.

On Mondays, “smears” are taken on a monthly rotational basis.

These involve the removal of a small blood sample from the patient’s ear lobe or eye brow (where the Leprosy bacteria is most intense).

These samples are sent to the Health Department Laboratory in Brisbane for testing. positive for the presence of the leprosy bacillus, negative for its absence. The patients are vitally interested in the results because they will be allowed to leave the island only when they have accumulated twelve monthly continuous negative smears. If one positive smear should be recorded, even after eleven months of negative results, they must begin counting all over again from their next negative smear. Such a result can be heartbreaking.

Chaulmoogra oil injections are given by nursing staff. (The only treatment for leprosy until the advent of Promin, chaulmoogra oil injections were very painful. It was also available as an extremely nauseating oral liquid. Although it produced symptoms indicating it was helping to kill the leprosy bacillus, it may have been only a placebo effect.) 

10.00AM          Medical & administration staff morning tea on the quarters’ verandah.

                                                Mail arrives at about this time.

10.30AM     Medical rounds of hut-fast patients either with the doctor or for routine dressings. Medical equipment has to be carried on a large tray.

 Basically, nursing care on Peel is as much as for any hospital ward.

 Doctor Reye’s particular jobs include:

 1. Fitting walking plasters for trophic ulcers.

These are time consuming to put on and remove.

     Staff make the plaster bandages by hand.

 2. Sharpening IV needles (non-disposable).

 3. Minor surgery. First aid.

 4. Dispensing (usually afternoons).

 5. Microscope work.

 6. Simple dental work (foot pedal drill and wooden barber’s chair).

 NOON:                       Lunch.

Life at Peel is “governed by the cook’s roster”.

All activities must be slotted in around the cook’s self-declared meal times.

  PM:           All staff have free afternoons until compulsory afternoon tea at 3.30 pm. This afternoon break is used for recreation with or without patients (tennis, swimming, bikes, etc.) also for reading to blind patients.

 Sometimes extraneous work is performed such as whitewashing the inside of an old hut for use as a makeshift laboratory.

 4.30 PM          Evening meal (cooks again!)

5.30PM            Evening surgery lit by pressure lamp on table. Usually minimal patient attendance. Day jobs finished. Patients’ temperatures charted. A medical round is held of any sick patients. No night nursing staff are rostered. Matron is called if there are any problems.

BASIC SURGERY HYGIENE

* Only tank, no sink. Hands are washed in a basin on a tripod, ‘Dettol’ is first added to the water.

* Zephiran solution (benzalkonium chloride) is used for skin preps and gloves.

* While on duty nurses wear theatre gowns.

* Hagedorn needles (for eyebrow and ear smears) are”flamed” between patients.

* “Sharps” are soaked in lysol.

* Blunts and enamel dishes are boiled up in primus operated boiler.

* Phenol is used for disinfecting commodes and sanitary tins.

Minimal cross infection recorded, except when “self-inflicted” by patients using their own ulcer treatment etc. (e.g. Grated apple and flower paste). Occasionally fly maggot infestation.

Eucalyptus full strength or iodoform sometimes needed as deodorant for discarded dressings.

AFTER THE INTRODUCTION OF PROMIN

6.00 AM           * Doctor Reye administers intravenous (IV) doses before breakfast, firstly in the surgery to the mobile patients.

 * Syringes (glass, luerlock) and needles are boiled between patients.

 Only 3 or 4 syringes are kept because they are expensive. Needles are sharpened at night. No disposables originally.

 * Patients’ blood is tested before Promin treatment is started.  Hb, WCC, and MCV are done weekly by Doctor Reye. Nurses help with slide preparation. Eventually, to ease the workload, a laboratory technician and assistant are employed.

 * A Blood bank is set up in case a patient experiences an adverse reaction to the Promin. Six bottles of blood are kept in the kerosene fridge on the hospital’ s south verandah.

* With the success of Promin in the treatment of leprosy, patient numbers gradually fall as the patients are allowed home. This lightens the nursing workload to the extent that it is necessary to “make work” on the afternoon shift.

Extract from Moreton Bay People – The Complete Collection. This book is still available from Boolarong Press at Boolarong Press.com.au

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