Preventoriums at Residential Schools
By: Kaila Johnston
Kaila Johnston
Contributing Writer
As the Supervisor of Education, Outreach, and Public Programming at the National Centre for Truth and Reconciliation, Kaila oversees matters related to the support of educators, development of resources, establishment of outreach initiatives, as well as public engagement on residential schools and their legacy. Prior to joining the NCTR, Kaila worked with the TRC as a statement gatherer and coordinator to support statement gathering activities. She holds a BA (Hons.) in Criminal Justice from the University of Winnipeg and a MSc in International Crimes and Criminology from Vrije Universiteit, Amsterdam. Kaila is Cree and was born and raised in Winnipeg, Manitoba.
Have you ever heard of a preventorium? The word sounds a lot like sanatorium – so how are they different from each other?
Sanatoriums in Canada were provincially managed institutions focused on the treatment and care of patients with tuberculosis. These institutions were not built with Indigenous patients in mind, however. As treatments evolved for non-Indigenous patients, including the development of outpatient care, Indigenous patients were brought in to fill beds and were subjected to invasive procedures.
There was a belief that Indigenous patients would not follow through with the instructions provided or there were no medical facilities or medical staff in communities to assist in the administration of medical care. Consequently, sanatorium staff kept Indigenous patients in institutions in order to ensure patients would complete their prescribed treatment even if non-Indigenous people did not have to do the same.
So, what is a preventorium? I’ll give you a clue: its purpose can be found in its name: “prevent.”
Preventoriums served as institutions for school-aged children with slight infections of tuberculosis or who were pre-tuberculosis. These children could be described as weak, wan, malnourished, or pale and exposed to infection. These institutions included educational facilities and were sometimes attached to an existing sanatorium or residential school. Preventoriums opened on site of some residential schools to serve as isolation units for sickly children and were meant to prevent the advancement or spread of tuberculosis.[1]
In a 1938 letter, Dr. H.W. McGill, Director of Indian Affairs, outlines that there are two classes of children suffering from tuberculosis. One class are children who have an active form of the disease and should receive treatment in sanatoriums. The second class are children who are “slightly affected and who have the prospect of being fit” after they spend time under special care.[2] These students could remain at the school if they received that special care.
The churches who ran residential schools preferred preventoriums over sanatoriums since these institutions allowed them to maintain enrolment at the school and control over the students. This also meant they could control who could and couldn’t be admitted to the preventorium on their property.
The first of these facilities was opened at the Coqualeetza Institute in Chilliwack in 1935 after a survey found 164 of 214 students, or 77%, had tested positive for tuberculosis. Located in a converted farm building, Coqualeetza’s preventorium housed fifteen students, who were supervised by a nurse.[3]
Preventoriums were also established at Alert Bay and Mission, also in British Columbia. The Alert Bay Preventorium was located in the former principal’s residence and had been renovated by the students as part of their manual training. There was also a preventorium at the Fort Alexander school in Manitoba that opened in 1938 and was closed only a year later. Preventoriums at residential schools were not open for very long and we can see why based on what happened at the Fort Alexander Residential School.
At the Fort Alexander Preventorium, which was connected with the Roman Catholic Fort Alexander Residential School, Doctor E.D.R. Bissett stated that “no non-Catholic child will be admitted, except on direct request of the department.”[4] In this letter Doctor Bissett states that it’s too bad this policy exists as there were many children on the reserve that he believed would benefit from the care received at the preventorium.
Children in Catholic-run Manitoba and Ontario residential schools would be admitted to the preventorium with parental permission and if there were challenges or objections the principal of the residential school was instructed to contact Indian Affairs for further instruction.[5]
Children who were only slightly affected by tuberculosis or at risk, were not considered to be eligible for admission to a sanatorium. Instead, at the preventorium they would receive “additional food, general care and shortened school hours so that after a year or so of this rest they may resume their original school life at the school from which they came.”[6]
In a 1941 report by Dr. P.E. Moore, he advised children under observation should be kept from athletic activities and manual labour, violent exercise or chores should be prohibited, they should have rest periods, they be isolated as much as possible from other students.[7]
In January 1938, there were 28 children, 13 girls and 15 boys, between the ages of 6 and 13, at the Fort Alexander Preventorium which had a total of 30 beds. Their temperatures were to be taken twice daily and noted on the charts. Each child was to be weighed once a week and also noted in their charts. It was important for these records to be kept to give the best indication if they their condition was improving.[8]
In a letter, Dr. E.D.R. Bissett also outlined some general rules and guidance for the preventorium:[9]
No child with tuberculosis of the lungs is to be admitted, nor any with a discharging tuberculous wound, nor any child which by reason of any discharge or excretion might be considered a menace to others.
The following is a suggested daily routine:
7:00AM – children arise, wash, dress, and make their beds. Temperatures taken and noted on their charts. Examination is made for any acute infection. If any adverse signs are found the child is to be removed to the isolation ward provided for that purpose, and the medical officer notified.
7:50AM – breakfast
8:25AM – dental and toilet
8:30AM – school
10:30AM – return from school and play outside until 11:45AM
12:00PM – noon meal
12:30PM – rest period for 1 hour
1:30PM – school, 1 hour
2:30PM – afternoon lunch, play outside until 4:30PM
5:00PM – evening meal
5:45PM – shower baths, evening temperature (which is noted on the chart)
7:00PM – to bed
Each child is to have a tablespoon of Cod Liver Oil twice a day, and a teaspoon of Iron Tonic once a day, routinely. In addition it would be advisable around the noon period to have each child take a sun bath for about 15 or 20 minutes.
Have you ever had to take Cod Liver Oil before? If not, ask a parent, guardian, or grandparent if they have and what their thoughts are about the taste!
I would suggest that during the warm months that an open air classroom be set up. In addition to the ordinary class work could you arrange to have classes give in basketry, sewing, fish net making, shoe repairing, and some modelling and painting to those who show special aptitude for that type of work. Nature talks and the life history of Native birds, flowers, and insects, giving special attention to those insects which are a pest in garden would be instructive as well as interesting.
Here is a sample menu of what children were to be fed while at the preventorium. This would have been a more robust meal that what was being served to students not under the special care.[10]
How close does this menu look like to what you eat when you’re not feeling well?
| Monday | ||
|---|---|---|
| Breakfast | Lunch | Dinner |
| Apples Cereal Brown bread and butter Milk | Poached egg Carrots Potatoes Blanc mange Milk | Tomatoes Brown bread and butter Fruit salad |
In December 1938, Dr. J.D. Adamson and Inspector A.G. Hamilton visited the Fort Alexander Preventorium. After a review of patient records and x-ray reports, all of them (27) were marked healing in tuberculous lesions and none of them needed to go to the sanatorium.
Although there was improvement in their condition, there was also major concern that if new cases were sent to the preventorium, that tuberculosis could be spread to the healing children but also those in the school. Children in the preventorium were still eating, playing, and taking classes with children not in the preventorium. Separate dining room, classroom, and play grounds would be needed and children should not mix with each other.[11]
On March 3, 1939, Dr. P.E. Moore sent a memo to Dr. H.W. McGill, Director of Indian Affairs, to report on a recent inspection he did with Inspector Hamilton and Dr. Bissett.[12] He informed Dr. McGill that he didn’t believe the preventorium at Fort Alexander was satisfactory and even considered it to be dangerous due to the possibility of spreading tuberculosis to other students.
At the Lebret Residential School in Saskatchewan they allowed “observation cases,” like those at the Fort Alexander Preventorium, to continue to attend school with the rest of the student body. Despite these students being segregated and given special care, there were 25 new cases of tuberculosis in the school by the end of the year. Since all cases were removed from Lebret, there had been no new cases over 2 years.
Based on the Lebret case, and what he observed at the preventorium, Dr. P.E. Moore recommended that the Fort Alexander Preventorium be closed.
In the end, Dr. H.W. McGill issued a memorandum to the Deputy Minister of Mines and Resources, where the Department of Indian Affairs belonged. It stated that Dr. Stone, Dr. Moore, Mr. Hoey, and himself believed the Fort Alexander Preventorium was not meeting the needs for which it was built and they were of the opinion that the preventorium should be abandoned.
On March 21, 1939, the Chief Executive Assistant to the Deputy Minister responded, and said the Minister agreed with the views expressed in the Memo and that arrangements needed to be made for the preventorium to close by the end of the school year.[13]
On May 15, 1939, Dr. J.D. Adamson advised about the children attending the Fort Alexander Residential School and Preventorium: 5 children should remain in the preventorium and 2 in the school should be admitted; 2 should to be sent to a sanatorium; and the other 20 could be discharged to the school or their home at the end of the school year.[14]
In the records at the NCTR, this is where the story of the Fort Alexander Preventorium ends, however, some of the other Preventoriums at Residential Schools remained open for later. In 1941, there were 4 preventoriums operating in British Columbia under the direction of a medical officer and full-time nurses at Alert Bay, Mission, Cranbrook, and Coqualeetza.[15] These institutions accepted fewer patients and any patient with “more than minimal lesions” was hospitalized and focused on providing localized care rather than caring for a whole province or region.[16]
The spread of tuberculosis from sickly students to healthy students at residential schools remained to be a problem and was the reason why the institutions eventually closed altogether.[17]
[1] Hackett, Paul. “That Will Not Be Done Again”: The Fort Alexander Preventorium and the Fight against Tuberculosis in Indian Residential Schools, 1937-39. Native Studies Review, 2012, Vol. 21, Issue 1, p. 1-41.]
[2] February 8, 1938, Letter from Dr. H.W. McGill, Director of Indian Affairs to Rev. J.O. Plourde, p. 4-6. R00007210. Library and Archives Canada.
[3] Canada’s Residential Schools: The History, Part 1, Origins to 1939. p. 434-435. Truth and Reconciliation Commission of Canada.
[4] February 8, 1938, Letter from Dr. E.D.R. Bissett to Dr. H.W. McGill, Director of Indian Affairs, p. 18. R00007212. Library and Archives Canada.
[5] December 22, 1937, Letter from Dr. H.W. McGill, Director of Indian Affairs, to Principal of Pine Creek Residential School, p. 6. R00007212. Library and Archives Canada.
[6] December 22, 1937, Letter from Dr. H.W. McGill, Director of Indian Affairs, to Dr. E.D.R. Bissett, p. 9. R00007212. Library and Archives Canada.
[7] Moore, P.E. Tuberculosis Control in the Indian Population of Canada. Canadian Public Health Journal, Vol. 32, No. 1 (JANUARY, 1941), pp. 13-17.
[8] January 1938, Monthly Report from Fort Alexander Preventorium, p. 27 and 29. R00007212. Library and Archives Canada.
[9] December 22, 1937, Letter from Dr. E.D.R. Bissett to Rev. J. Brachet, Principal of Fort Alexander, p. 19-21. R00007212. Library and Archives Canada.
[10] December 22, 1937, Letter from Dr. E.D.R. Bissett to Rev. J. Brachet, Principal of Fort Alexander, p. 22. R00007212. Library and Archives Canada.
[11] January 5, 1939, Letter from Dr. J.D. Adamson to Dr. E.L. Stone, Director of Medical Services, p. 18-19. R00007215. Library and Archives Canada.
[12] March 3, 1939, Memo from Dr. P.E. Moore to Dr. H.W. McGill, p. 25-26. R00007215. Library and Archives Canada.
[13] March 21, 1939, Memo from C.W. Jackson, Chief Executive Assistant to the Deputy Minister to Dr. H.W. McGill, Director of Indian Affairs, p. 1. R00007216. Library and Archives Canada.
[14] May 15, 1939, Letter from Dr. J.D. Adamson to Dr. H.W. McGill, Director of Indian Affairs, p. 6-7. R00007216. Library and Archives Canada.
[15] Hackett, Paul. “That Will Not Be Done Again”: The Fort Alexander Preventorium and the Fight against Tuberculosis in Indian Residential Schools, 1937-39. Native Studies Review, 2012, Vol. 21, Issue 1, p. 1-41.
[16] Moore, P.E. Tuberculosis Control in the Indian Population of Canada. Canadian Public Health Journal, Vol. 32, No. 1 (JANUARY, 1941), pp. 13-17.
[17] Canada’s Residential Schools: The History, Part 1, Origins to 1939. p. 434-435. Truth and Reconciliation Commission of Canada.