BREAKING
THE BARRIERS
Chapter I: Introduction
“It is disquieting to reflect that as regards
to education
and vocational training of cripples, Sydney
has been heedless
of its obligations. In both respects, the
children have been
victims
of sheer neglect.”
- Rev AP Campbell, Handwritten Account of the New
South
Wales Society for Crippled Children, 1929
“When your Club [the Rotary Club of Sydney] raised
money
that brought into being the NSW Crippled
Children's Society,
you did a national work.”
- Dr W Vickers, Community Responsibility Towards
the Cripple,
The Pinion, May 1938, p 6
The Northcott Society began its life as the
New South Wales Society for Crippled Children on 17 December 1929. It was the outcome
of the community project that Rotary Club of Sydney undertook as its major
activity for 1928-29: The Education and Vocational Training of Crippled
Children.
As early as 1925, Dr Robert Wade, who was
prominent in the orthopaedic section of local branch of the British Medical
Association (BMA), had drawn the Club's attention to the deficiencies in the
medical and curative treatment for crippled children in Sydney. On his request,
BR Gelling, a club member, brought back from a visit to the United States
information about the International Society for Crippled Children, which had
recently been founded there. This was the impetus for Rotary’s decision to draw
attention to the needs of crippled children and the recommendation of the
planning committee stated its intention:
To lay the foundations for a NSW branch of the
International Society for Crippled Children which would permanently care for
the surgical aid of crippled children and which would make plans for their
education and vocational training. 1
1 Rotary Club of Sydney, Community Service
Committee Crippled Children's Service Report and Recommendations to the Board
of Directors, 1929.
Throughout the 1920s more informed attitudes
to physical disability had been emerging, mainly as a result of World War 1. As
well, the incidence of wounded soldiers in need of orthopaedic repair had
advanced medical procedures. The disadvantaged situation of crippled children,
a hitherto neglected area, was encompassed in these more enlightened viewpoints.
As early as 1916, in Cleveland, Ohio, a survey and record of the number of
crippled children there had occurred. This set the model for other American and
English cities to follow, as the periodic outbreaks of infantile poliomyelitis
brought the condition of polio victims into prominence. The League of Nations
in 1925 proclaimed a Children's Charter stressing the importance of health,
nutrition, fresh air and self-respect as basic rights of all children.` Fresh
scientific data established their essential contribution to child growth and
development. It was in this context that the International Society for Crippled
Children was founded in the United States, and that the attention of Rotary
Clubs around the world was attracted.
In Australia, within the framework of the
sparse State or Commonwealth welfare measures of the day, official recognition
of disabled children was minimal. There was a Child Welfare section within the
State Department of Education, functioning since 1923, but its responsibilities
were mainly to implement the regulations under the Child Welfare Act of 1923.
With this legislation the major task was to protect the children "at
risk" — the neglected and destitute children within the community. The
medical, psychological and social needs of physically disabled children were
too specifically medical to come within official guidelines, which at that time
accepted no obligation to provide care.
Prevailing attitudes to disabilities were not
positively inclined towards physical defects either. These generally reflected
the unwarranted assumption that physical disability included mental deficiency,
categorised as incurable. Therefore to be born with a physical disability
condemned many children to an anonymity in their community and sadly sometimes
within their families. Exempted from the compulsion to attend school and often
hidden from sight by ignorant and fearful parents or, at the other extreme,
"mollycoddled" to such an extent that they were doomed to a life of
total dependency. These children had little hope of leading any semblance of a
normal life. The plight of poorer families, faced with the additional burden of
a disabled child, was compounded by their inability to take advantage of the
limited hospital services available, given the practical problems and costs of
transportation and orthopaedic equipment.
2 Sutton, Harvey, "The Australian
Child and the Progress of Child Welfare", Australian Medical Journal, 14
November 1931.
Those children coming from a more affluent
background were not much better off because of the limited amount of
orthopaedic surgery performed and the prevailing medical knowledge in Sydney at
that time. Unfortunately, there were serious limitations in the orthopaedic
surgical procedures at this stage. The dangers in bone operations presented an
extremely high risk of blood infections in the pre-antibiotic age. One
historian of the specialty explained how the fear of infection haunted every
operation when foreign materials such as plates and screws were introduced.
"Replacing whole joints," he further claimed, "was a fantasy,” 3
Doctors in Sydney in the forefront of
orthopaedic treatment throughout the 1920s looked overseas for guidance and
post-graduate training. The hospital established by Dame Agnes Hunt at Oswestry
in Shropshire in 1921 became famous for its progress in the orthopaedic
specialties. It became the model for long-stay after-care hospitalisation and was
judged a crucial follow-up to any surgical treatment to restore mobility and
health. The hospital became a training ground for many Australian doctors who
brought back the newer approaches.
Orthopaedic facilities in the public hospitals
were not plentiful, even in the teaching hospitals, with very few beds reserved
for orthopaedic cases. Despite the need, it was not until 1935 that the Royal
Alexandra Hospital for Children opened a special department. As yet,
orthopaedics was not acknowledged as a separate specialisation within the
medical profession and most orthopaedic surgeons performed as general surgeons.
There were always practitioners such as Robert Wade, Wilfred Vickers and John
Hoets who campaigned persistently for the expansion of medical and surgical
care and for the recognition of a separate orthopaedic specialisation. Dr John
Hoets (1885-1961) as head of the orthopaedic section of the British Medical
Association (Australian Branch) was particularly insistent. His lament was that
children suffering from rickets, diseases of the bone and disabling accidents
could be cured and that "such crippling caused by these diseases and
injuries could have been prevented had the subjects been handled before they
reached the age of ten years. " 4 Intervention at the earliest
possible stage was the appropriate starting point for any successful recovery.
His earnest and successful arguments helped to produce the widespread medical
support for Rotary's project.
When Sydney Rotary embarked on its project, it
had some local experience in a survey method and well-established precedents to
follow from.
3
Barry, Hugh (1983) Orthopaedics in Australia, the History of
the Australian Orthopaedic Association, Sydney: p.165
4
"The Care of Crippled
Children" Australian Medical Journal, 6 July 1929, p 26.
The United States and England, and many
reports to absorb about overseas experiences. Apart from the international
models, Rotary was able to consult local groups such as the Civilian Crippled
Association, and more specifically the Far West Children's Health Scheme, which
had been operating since the mid-1920s, and the Yooralla Society in Victoria,
founded in 1917. The Far West scheme as its name implied, was concerned with
the general health problems of country children, although given the high
incidence of disabling diseases such as polio and tuberculosis of the Bone,
many of its patients were orthopaedic cases. The Yooralla Society organised a
hospital and school for physically disabled children and was predominantly an
educational venture 5
The Club's ultimate objective in initiating
this activity was to inaugurate and sponsor a local Sydney branch of the
international body. Such a society would focus its efforts on the needs of
children with congenital impairments, bone and joint diseases and those left
crippled by the recurrent outbreaks of polio. From the outset, this voluntary
organisation established practical objectives that aimed:
not only to cure these young people but also
to help them earn their
living as self-supporting members of our
social structure. A number of them
have no education at all; that has to be repaired
as fast as possible, and in
addition some must have vocational training in
order to give them
a chance of life after the correction of their
physical disabilities. 6
Sydney Rotary was ideally suited to undertake
the project it had set itself. Its members were drawn from the commercial,
professional and business elite of Sydney — the leaders of society — imbued
with the Rotary ideal of service to the community and well able to provide a
seeding fund of £1000 to cover expenses. These men were well positioned to tap
interest and support from the highest level — orthopaedic surgeons, government
officials, employers' organisations, welfare groups and the clergy of all
denominations. These interlocking contacts gave advice, co-operation, financial
aid and widespread newspaper and magazine publicity. Prominent politicians
such as the Premier expressed their personal and official appreciation, whilst
the Governor, Sir Philip Game, offered his sympathetic endorsement and willing
patronage for the intended organisation. Thus the endeavour was economically
strong and socially prestigious.
The first step was, however, to devise a
strategy to chart a proper sequence of activities. The starting point was to
locate the crippled children within the Sydney metropolitan area — no easy task
since there were no useful lists held either by the hospitals or the school
authorities. The Society's foundation President, in looking back, described
these early circumstances as -rather odd" and went on to explain:
we enquired here and there and everywhere for
information about
crippled children in Sydney and were
embarrassed and astounded
that there was no official information of any
kind. 7
5
See Marshall, N (1978) The Yooralla Story, 1918-1977, Melbourne, and Author Unknown, The Royal
Far West — Golden Jubilee 1924-1974.
6
Braddon, Sir Henry,
"NSW Society for Crippled Children Hold First Annual Meeting" The
Pinion, 1931 p 8.
The Community Service Committee that was
formed to prepare a plan of action could only rely on statistical information
compiled from several American surveys from 1916-24. This data offered a guide
to the numbers of disabled children under the age of 21 who might be
identified. Accepting the American statistics that between three to five
children in every thousand people suffered a physical disability, the Rotarians
expected that Sydney, with a population of one million, should evidence between
two and three thousand children in this category.
After
extensive consultation with local orthopaedic surgeons, some of whom were
Rotarians, it was decided to undertake a survey within the Sydney metropolitan
area to locate the crippled children. The focus was then on identifying their
medical, surgical and educational needs. 8 A register containing relevant
information of the social background of the family, as well as the medical
situation of the child, allowed immediate medical attention where necessary to
be arranged in the special clinics. The overriding authority of the doctors in
this process was the undenied starting point and each step was closely
monitored and referred back to them, as it was clear that the maintenance of
harmonious relations with the surgeons was vital to the success of the project.
Sir Charles Clubbe, the most respected voice in orthopaedics, praised this
approach in a letter to the Sydney Morning Herald on 23 September 1929, giving
his wholehearted support to the Rotary effort. He wrote:
7
Braddon, Sir Henry, The Rotary Club of Sydney,
1921-1946.
8 See Rotary Club of Sydney, "The Draft Scheme for The Crippled Children's Activity" for all the details of
the
survey.
All
orthopaedic surgeons in Sydney endorsed this favourable opinion and cooperated
fully in conducting the free clinics at Sydney Hospital. Rotary members
transported the children there and covered all expenses.
They
adopted as their guiding definition the New York State Commission's
classification that:
A crippled child is one whose activity is or may
become,
as a result of a progressive disease, restricted by
loss, defect
or deformity of bones or muscles to such a degree
as to
reduce his normal capacity for education and self
support.
The survey restricted its attention to
children who fitted this description. Categorically it excluded children
suffering mental disabilities, mainly because they were not considered as
educable, always the long-term goal of the project. Nor was it deflected from
its central purpose when cases of need were uncovered, as charitable activities
were not its concern. The "grave and difficult crusade" to identify
and register the classified children saw every member of the club engaged in
house to house interviewing to record the individual details and collate the
results for a register to include all the socio-medical details pertinent for
each child. Each Rotarian was allocated a particular locality, notwithstanding
the salubrious state of some suburbs and was contracted to assume personal responsibility
to register at least three children. This commitment proved a "real test
of Rotarian time and faith" and as Rotary's historian judged, the survey
was "the most outstanding community service ever attempted by them." 9
The sensitivity with which this intrusive
activity was performed can only be measured by the positive results of this
massive effort. The survey took place over six months and was funded by the
club, the military like operation managed to register 1145 children, most of
whom were in receipt of no medical attention. No blame was attached to the
existing orthopaedic hospital care, which was satisfactorily coping with those
who presented but measured against statistical expectations; the findings
showed that medical attention was the first priority.
The next stage then was to organise nine
clinics at Sydney Hospital usually on a Saturday morning with the voluntary
participation of the orthopaedic surgeons whose support and encouragement was
so readily forthcoming. The first cohort of 448 children was examined in late
1929 and a firm diagnosis and a prescription for future treatment was given. A
fairly crude classification system divided the children thus:
Urgent and
hopeful
Hopeful but
not urgent
Doubtful but
hopeful
Hopelessly
incurable
9
Hunt, H (1972), The Story of Rotary
in Australia 1921-1971, p 35.
But it did cover the widest range of
prognosis. However brutal the categorisation, the results proved very
encouraging and almost 80 percent were in the hopeful group, while relatively
few were assessed as hopeless. The disquieting news, however, which showed how
essential Rotary's project had proved, was that of the 448 children examined
initially, only 138 — a little over 30 percent —had received previous medical
attention. The undertaking was clearly worthwhile and had uncovered a serious
medical deficiency in health care. More significantly the positive outcomes
from the clinical examinations indicated that adequate and appropriate medical
care resulted in immediate amelioration and provided the potential to
"reclaim" from total dependence many physically disabled children.
Facilitating and organising further stages of post-medical attention were fully
justified.
Keeping in mind that the ultimate objective
was the establishment of a voluntary society, Rotary followed the usual
procedure for involving the community. A Citizens' Crippled Children's Service
Fund was established by an interim committee drawn from a public meeting held
in October 1929, which attracted great interest. A working party of men and
women was set up, an office opened on the second floor of the Hotel Australia —
Sydney's most prestigious residential hotel — and a campaign conducted through
direct mail, collection boxes and newspapers to raise £15,000 as the necessary
seeding base for the planned society. It was in this group of early fundraisers
that women who were to become prominent throughout the early years of the new
society surfaced. Lady Julius, wife of Sir George Julius a well-known
businessman and Rotarian, Mrs Margaret Watts whose Quaker background attracted
her to philanthropic effort, Mrs Bernard Muscio, President of the National
Council of Women and a public spirited and energetic charitable worker, played
active roles in the initial fundraising efforts. Many of the wives, sisters and
daughters of the Rotarians shared in the early campaigning for support and were
later to form the nucleus of the auxiliary system.
The public response was generous, despite the
ominous downturn in the economic activity which was appearing. Publicity with
photographs in the press of Rotarians transporting smiling children to the
clinics and accounts of early medical successes presented an irresistible
appeal. A final public meeting was called on 17 December 1929 at the Sydney
Town Hall to announce that the target financial requirement had been met,
indeed over-subscribed. The New South Wales Society for Crippled Children was
launched as an organisation to continue the good work commenced by Sydney
Rotary. While sharing the Rotary objectives it was completely independent of
it, and was a non-profit-making voluntary organisation which aimed to address a
particular area of need while relying on the benevolence and sense of morality
of the wider public for its support.
The remaining assets of £211.8.2, unspent from
Rotary's original flOOO and all records and existing office equipment were
handed over to the new Society whose headquarters were in 32 Castlereagh
Street." It was incorporated and registered as a limited company under the
Companies Act 1899 and this was subsequently adjusted when company legislation
was modified.'' The constitution followed the conventions of like voluntary
organisations, prescribing a President, up to six Vice Presidents and a Board
of Directors to manage the affairs of the Society. Membership was by donation
and Sir Henry Braddon became the foundation President. This appointment was an
appropriate and popular choice. He had chaired the interim committee and his
links with the Rotary movement were long-standing as the inaugural President of
Sydney Rotary in 1921. His reputation as a businessman and a sportsman was
widely appreciated and his Presidency of the new organisation brought prestige
and underlined the continuity of Rotary's interest. With the wholehearted
support of other influential Rotarians, the Society's viability was assured.
The first Board members were all Rotarians,
appointed from the group that had played such an active role in setting up the
community project. Among these was RO Beale who chaired the Community Service
Committee and served as a Vice President until 1944, and GF Birks and the
Reverend AP Campbell who served as Vice President until the early sixties. The
latter was President of Sydney Rotary in 1929 when the enterprise was launched
and he maintained his connection with the Society as a Vice President until
1963. The former played a benevolent role in the hospital school area. BR
Gelling, who was so instrumental at the beginning, worked also as a very
dedicated Director. Two ladies, Lady Julius and Mrs Bernard Muscio, also served
on the first Board but they transferred their efforts to the Women's Auxiliary
organisation becoming long serving officers in the central body. Included as
Life Governors, having contributed generously to the Society, were GH Bosch and
FH Stewart, both well-known philanthropists. Finally, an Advisory Council of
orthopaedic surgeons was appointed from the local branch of the BMA to signify
the critical importance of the medical oversighting of all activities.' 2
10
Letter from AP Campbell to Sir Henry Braddon, 19 December, 1929.
11
The New South Wales Society for Crippled Children, Memorandum and Articles
of Association 1989.
The Board's workload in the first year was
very demanding. To implement the comprehensive targets of the Society,
sectional sub-committees were set up, concerned with a particular sequence of activities
and responsible for all decisions to the Board. The Surgical and Curative Group
arranged the clinics and roster of surgeons for the 27 clinics held in 1930.
Sir Charles Clubbe was the first Chairman until his death in 1932. Dr John
Hoets was a longer serving and active participant. The Welfare Committee was
headed by Norman Carts, a recent recruit to Rotary from the commercial area.
His first action was to hire Mrs Margaret Watts as Welfare Officer. She had
served on the interim committee and was an active charity worker, well suited
to the new position, Her role was to locate the children, arrange the medical
treatment and any further aid to distressed or disadvantaged families with
disabled children. The Educational and Vocational Committee was chaired by
James Nangle, Director of Technical Education for New South Wales, and its task
was to plan the appropriate schooling and vocational training following on from
the initial medical care. Transport was the province of FH Stewart, whose
generosity in providing free bus transport to the hospital school in the early
days epitomised the very personal involvement of this early group.
The optimism of the first Board of Directors
was palpable, if somewhat premature as economic events unfolded. The President
enthused, "the new Society starts under the happiest auspices" as it
began its work in all sections from the beginning of 1930.13 Its financial base
was certainly hopeful. £17,000 and two estates already willed to the Society
produced a further £7000 to be invested in government bonds. Encouraging too
were the reports of interest in other parts of the State — in Newcastle and
Wollongong and interstate in Brisbane and Melbourne. Australia now, through the
new Society, was in line with European and American examples, servicing a
clearly nominated area of need that governments neither wanted to serve nor had
the means to do so. There was confidence that continued public support would be
forthcoming %N here improvement in the children's health was so readily shown.
The Society was not a charitable organisation such as the Benevolent Society of
New South Wales, the Salvation Army or the Red Cross and eschewed any outright charitable
relief acts as specifically excluded by its Charter. In fact, as part of its overriding ideal of
developing self-reliance in the children and not engendering an attitude of
"pauperism" in their families, it encouraged small payments from them
for the services where possible. The arena of operation was restricted solely
to the betterment of children with physical disabilities. It was therefore a single-issue
organisation, completely secular, although many of its supporters and Directors
were imbued with Christian ideals of benevolence to the less fortunate. Nor was
there any hint of the underlying value that judged deserving and undeserving
recipients of its aid. As the Reverend A Campbell, a Congregational Minister
and President of Sydney Rotary declared in 1929, the Society's philosophy was:
to make available to every crippled child the best
treatment
and training possible... Its aim will be to make
available
for every sufferer the best that human willingness
and skill
can provide. 14
It proclaimed further its conviction that a
measure of economic independence was a realistic and achievable goal for many
disabled children as they grew into adulthood.
12
Biographical details of the first Directors are listed in Coles K and Donaldson
J (1976) The History of
The New South Wales Society for Crippled
Children.
13 Letter from Braddon to Campbell, 20 December 1929.
14 "The NSW Society for Crippled Children", Handwritten Account.