Public health and hospitalisation in Gozo : 1850-1914

Abstract

As the title of this dissertation attempts to show, the focus of this work is to evaluate the charitable institutions that existed in Gozo along with other charitable services provided by the state and its agencies outside these institutions. This work aims at examining the on-goings of such institutions, both in terms of administration but more interestingly still from the patients view. My primary intention is to analyse how many people used such institutions and why there seemed to be a fear of the hospital in the poor classes. From early times, hospitalization and charity were institutions which fell under the domain of the church and it was later on that the state began to understand the importance of opening such institutions for the benefit of the public. This could also be seen locally, where it was during the Order of St. John that new institutions were opened and reconstructed on the Maltese islands. The influence of the church through charity, as we shall see, was detailed by the Royal Commission of 1836, sent by the British government to report on the internal affairs of the Maltese islands. But hospitalization in Gozo had a longer tradition, at least starting during the period of the Hospitaller of St. John, when a 'commission' was established by two friars in order to build a new civil hospital for Gozo to replace the one which had been built in 1454 in Cittadella, Victoria. At this point, this was the only hospital available for the civil population along with another church institution which catered for labouring mothers and single mothers. The state's hospital situated in the main town (Victoria) of the island was redeveloped during the two years of French rule which was passed on to the British government in the beginning of the nineteenth century. This, however, catered for only male patients up till 1838. It was during the nineteenth century, in time with what was happening in other European countries that the state started to become really involved in charitable institutions, as could be seen in Gozo, where in 1850 the civil governor opened up a poor house there. This institution was to cater for the old and infirm aged 60 years or over. From 1848 onwards, local government dispensaries were opened in the districts around Malta and Gozo assuring the common people more medical assistance because of the vicinity of the dispensary in their own locality. Charitable institutions in Gozo is a subject that has been barely touched upon in academic Maltese historical literature and with one or two chapters in some books dealing with this topic. Thus mostly my research was based on primary sources in the main archives, but being guided by reading on the history of hospitals and charitable development around Europe during this period. Moreover, as is to be expected in the local archives, information available on these institutions is quantitative in nature. Using the Blue Books of Statistics, I gathered much information on the staff working at such institutions, the number of patients making use of such services, a plan of the three hospice institutions and the number of beds available at the Gozo hospital and the Gozo hospital for Contagious Diseases. With the help of the Censuses, I could compare the approximate number of people living on the island with those people making use of the Gozo hospital. Other available documents which I found useful in my research were the Reference Books and some of the Charitable Institutions' Letters that covered part of the period under review (1880 -1900). These outlined the type of administrative work being done and the suggestions made by the department of charitable institutions via its correspondence with the assistant secretary for Gozo. I also made use of newspapers, mainly the Malta Government Gazette and the Malta Times and United Services Gazette, the former being useful to ascertain certain dates and advents for instance the opening of new institutions; government Ordinances made with regards to public health and also new appointments within such institutions. The Malta Times and United Services Gazette was useful for information on the current state of the established institutions of the time. In this time frame, as mentioned earlier, all over Europe the state started to become involved in these institutions which could be considered the basis of the welfare state. In Malta, the British government did try to improve the situation but the expenditure of finances was the main obstacle. Thus, the first chapter deals with the authoritative and administrative procedures and changes which prove that the department in charge was not stable enough to deal with new reforms being made every couple of years. In chapter two, my direction will be directed onto the number of people receiving different kinds of out-door relief and on the measures implemented by the government to secure public health in general. In the last chapter, my main focus is the number of patients using the established institutions and whether or not the medical treatment being given was effective and also the changes in the people's mentality in regards to hospitals.