Journal of a Seaplane Cruise Around The World
THE GRENFELL MISSION AT CARTWRIGHT, LABRADOR
Reprinted with permission from the New England Journal of Medicine, Vol. 211, No. 17, pp 791-793, Oct. 25, 1934, Richard U. Light, MD, author.
On the third day of the flight we crossed the Strait of Belle Isle and proceeded northward along the Labrador coast. The country was rocky and barren as far inland as we could see, and was full of raintraps. Habitations were frequently seen along the coast and for a hundred miles we were rarely out of sight of a fishing schooner. The thrill of finding the first iceberg came early, just across from Belle Isle, but after that ice appeared only at infrequent intervals. The trip was without particular incident, although at American Tickle the sky began to darken ahead, and we asked VOK (Cartwright Radio Station) for his weather. He assured us that it was still good at our destination. We landed in Sandwich Bay (Cartwright) at 4:10 local time, and tied up to the Hudson Bay Company's dock.
Five days were spent there before leaving for Greenland, and the visit gave excellent opportunities for observing the work of the Grenfell Mission. It is thought that notes of this work may be of interest to readers of the Journal because New England people have supported the endeavor so generously, both with financial contributions and through the services of the many men and women who have gone north for a summer or for an entire year in order to render aid to the inhabitants of the outlying districts. The medical work at Cartwright is of particular significance this year, because it is being carried on in spite of the losses of equipment occasioned by a disastrous fire early in the summer, and the difficulties of the undertaking have been greatly increased.
The town of Cartwright lies 120 miles north of the Strait of Belle Isle. It is inhabited by Newfoundlanders and Indians, and the total number of people in the region of the town and the outlying Islands is between two and three hundred. During the fishing season there are also many schooners in the vicinity, so that the summer population is somewhat greater. Since the village itself contains only a small proportion of the people, the Grenfell doctor must carry on his practice over a radius of action thirty miles or more in extent. There are no roads; in the summer the only means of travel is by open boat, in the winter, by dog team.
The hospital staff consists of a doctor, a graduate nurse and her assistant, and three or four volunteers from colleges and medical schools who have been designated by the title of "wops". Occasionally the doctor remains at Cartwright through the winter, but more frequently he goes south on the last boat and the nurse must take charge alone. During this season Dr. Harrison Kennard has taken the post, in a free period preceding his term as surgical resident at the Boston City Hospital.
It has often been observed that medical missionaries among primitive and frontier people cannot rest content with technical accomplishments in medical treatment alone, but must become guardians of the public health in broad ways. Thus in Labrador it has frequently fallen to the Grenfell groups to provide for the education of the children, since families are so widely scattered that few are within reach of any type of school. So it has become the practice to send out dog teams early in the winter to make a round of visits to the trappers' homes and to bring their children back to the central boarding school where they are fed, clothed and educated until returned to their parents in the spring.
To this end a large building had been erected, on a hill overlooking the harbor. A supply of fine water was gained by damming a stream a mile or two above the settlement, from which it was led through a buried pipeline to the mission;--this was in fact the first healthful water supply in the community. The building was then equipped to care for 60 people: the staff, a large group of children, and the hospital patients. It had succeeded splendidly in its purpose, and the fire which occurred in June of this year was a disaster of major importance. The entire structure was demolished, and it lies now a heap of ruins, with only the foundations and the chimney to invite the reconstruction which must soon follow.
After the fire the staff retired to the several small buildings standing nearby, and converted these into bunkhouses, storage rooms and the like. One was taken over for a hospital, and now provides two "wards" to accommodate six beds. The valuable equipment of the operating room had been destroyed, but with the ingenuity which flourishes on the frontier these industrious workers have reconstructed many portions of the lost apparatus. Surgical operations are carried out on a table built up from the wooden boxes which brought tins of gasoline to Balbo's fleet last year! These useful crates also form their shelves, desks and chairs. Instruments and dry goods are sterilized over a wood fire in the corner stove, and this same heater, with its doors closed tightly, warms the room while the patient is under ether anesthesia. Even such handicaps have not prevented good surgery and three patients, after convalescing from major surgical procedures, had returned to their homes during the week before our visit to the Mission.
The hospital's beds did not remain idle long, however, for the arrival of the mailboat "Kyle" on August 22 brought five patients from the coastal settlements. Three of these were children for tonsillectomy, one being a youngster who was deaf because adenoids blocked the Eustachian tubes; one was a ship's master with a carbuncle of the neck; the other was a Newfoundland fisherman suffering from cellulitis of the arm. Hand and arm infections are common among the fishing people because of the peculiar circumstances under which they labor. They fish for cod steadily through the summer months, with the hands constantly immersed in cod slime. Protection to the body and arms is gained by wearing heavy oilskins, but these chafe at the wrists and it is all too frequent that a line of furuncles, which are known as "water-pups," encircles both wrists. Often the infection spreads through the lymph channels and involves the entire arm, as in this case. It is considered by the fishermen that wearing brass chains about the wrists for a few weeks before the fishing season opens somehow immunizes them against these infections, and many of them follow the practice.
One of the sad results of the mission fire was the death of a patient, a girl of seventeen who was in the recovery stages of scarlet fever. Her remains were discovered some weeks later, and the funeral arranged. The Grenfell doctor was requested to serve as pallbearer; he marched at the head of the procession, bearing in his hands a small box containing the few bones recovered. Behind him in slow procession filed Cartwright's seventy-two inhabitants; all, except one man who remained to toll the bell over the silent marchers, until the ceremony was ended. In the graveyard a Bible was produced, and old Judge Murphy read several passages while the box was lowered into its resting place. It rained, and the grave was already filled with water before the burial was completed.
It rains often in Labrador, a light stinging rain driven hard by the wind. It does not fall in large quantities, however, and the radio operators find difficulty in collecting sufficient water with which to supply their batteries. The frequency of the storms, and the mean way in which the water penetrates the seams of one's clothing, form a considerable hardship for the doctor who must make the rounds of his patients in an unprotected open boat. Moreover, sickness is no more limited to daylight hours in the country than in the city, and many of Kennard's most thrilling experiences have been encountered at night while navigating his one-cylinder boat through the little-known waters of the outer islands, striving to reach a patient whose courier had arrived at the Mission only after sundown. Getting lost, drifting with a balky motor, even shipwreck, have been his lot. His efforts have been well received, however, and the natives are devoted to him, cooperating unusually well in following the prescribed medical treatment.
The charts of the coastlines are incomplete and give poor indication of the "lay" of the land, so that the doctor welcomed the opportunity to fly over his dominion for a first-hand reconnaissance. We went first around the headwater's of the bay, where the people move into winter quarters during the trapping and hunting season. The houses were deserted for the most part, although a few inhabitants had remained behind to tend the vegetable gardens, a practice which Grenfell and his coworkers have introduced. Twice we saw groups of "husky" dogs marooned on small islands, and learned that the natives put them out during the summer in order to protect the children. It is not unknown for dogs to attack and kill helpless infants. A load of fish is brought to these animals once or twice a week, and in this way they seem to survive until the snow returns, when they are taken ashore and broken to harness again.
At the head of the bay, rain was dripping from low clouds, and this shut off the route inland, so that after circling the shore we turned eastward to cross over some of the channels which led among the numerous islands between Cartwright and Gready Island, the most easterly laud in this region. Several schooners were sighted and we passed a whaling factory which seemed busily engaged, with black smoke pouring from the stovepipe chimney. We came finally to Cape North and at Dr. Kennard's suggestion landed there to visit a patient whom he had seen a month earlier. The ship was anchored in deep water and we went ashore in a rowboat which was put out for us.
One's first experience in a codfishing boat is not apt to be pleasant, nor is it reassuring to leave it by way of a slippery ladder to a trestle on which are dressed annually some tens of thousands of the fish, whose ugly skeletons are seen lying on the beach beneath. If you can picture this, you may perhaps appreciate the misgivings with which I followed the others along the muddy path to an unpainted two-story house in which our patient was said to be found.
Once inside, the whole grim atmosphere seemed to fall away. These people were not living in hopeless filth as I had hastily imagined. The room was warm and clean and was tinged with the odor of a dozen loaves of bread which followed each other at regular intervals into the baking oven. On the floor were bright rugs which had been hooked in this very room. A row of guns stood racked in a corner, but over their muzzles hung a fiddle which "they all played". In the adjoining room, the parlor, there were a sewing machine and a foot organ.
The patient was a girl of eighteen, suffering from rapidly advancing pulmonary tuberculosis. She was discouragingly sick, in spite of the excellent care which the mother had given since the doctor's last visit. His instructions, written in one-two-three form, were still pinned to the wall beside the bed: fresh air. good food, complete rest, etc., a difficult regime in this land. She might have fresh air during the summer but in winter economic necessity would force them to nail the windows shut; the diet could hardly be adequate in a community which subsisted mainly on codfish, and it would be much worse in midwinter when the butter would probably run short; complete rest for the patient would depend on the energy and stamina of the already busy mother.
The doctor did what he could, and we started for home. The weather was shutting down and compelled us to dodge back and forth in the rain to avoid the islands. Frequently we flew close to a fisherman's home, and it interested me in passing to reflect on the splendid assistance that has been given to these people by Sir Wilfred Grenfell's organization. Their livelihood is not easily gained and injuries and diseases are frequently encountered. Without the sound hospital system which forms the background of the Labrador coast, the hardships of their existence would be immeasurably increased.