A nightmarish pandemic: Arthur Beesley on Noël Browne and the battle against TB

One afternoon as Covid-19 eased, we went for a spin. Near Newcastle in west Co Dublin we drove past the former tuberculosis sanatorium at Peamount, home now to a healthcare group specialising in rehabilitation after illness. Long ago it was on the front line of battle waged against TB, the big disease of its time that killed and maimed with nightmarish ferocity.

The coronavirus deaths of almost 11,000 people on the island in 26 months recall the human destruction unleashed by TB, although it went on and on for decades, laying a great many lives to ruin and instilling dread and fear among those it did not touch.

The disease, known since early times, had been a major scourge since the late 1800s and independence brought no improvement.

How many died? CSO data show TB killed more than 114,000 people in the State between 1921 and 1950, the loss all the more grim when considering that the population then was less than three million. Today it is about five million.

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It was only after a crusade led by Dr Noël Browne, health minister from 1948 to 1951 in the first coalition government, that control was finally asserted over the disease.

Browne’s ministerial career came screeching to a halt when he was forced out after clashing with the Catholic hierarchy and his own medical profession over the mother-and-child scheme to provide healthcare free-of-charge to children under 16 and their mothers. That notorious episode made Browne’s reputation as liberal icon, his resistance to colleagues’ slavish adherence to bishops marking him out as one who would never take the expedient political path in pursuit of social justice.

But work he had already set in motion – with the help of key health officials and streptomycin, a new antibiotic – was decisive in suppressing TB. This included a huge programme to build hospitals and sanatoriums, using sweepstakes money and raising more capital for thousands of beds by mortgaging projected sweepstakes income.

The blood transfusion service was introduced, as was free X-ray testing for TB.

The strategy worked. 1955 was the first year in which fewer than 1,000 people died of TB – 889 fatalities, down almost 60 per cent since 1951. By 1960, the death rate was less than one-seventh the levels in the worst of the 1930s and 1940s

Browne’s 1986 autobiography, Against the Tide, cast the campaign against TB in terms all too familiar in the Covid era: “The first essential was the limitation of the disease by the isolation of existing known possible sources of infection. The nearly pandemic nature of the disease stemmed from the failure to establish a disease control organisation in which diagnosis, followed by isolation of the index-case, was the most immediate need.”

All of this was personal for Browne, who died 25 years ago this month. His book tells of the harrowing toll wrought on his own family by TB.

Both parents died of the disease when he was a boy, his father Joseph in 1925 and then his mother Mary Therese. She was buried in a pauper’s grave in London. TB also claimed the lives of an infant sister, Annie, and his adult sisters Eileen and Una.

His brother Jody, buried in another unmarked grave in London, was also infected.

“Each of those whom I had known and loved had disappeared and left me.”

Taken into Eileen’s care in England after their mother died, Browne won a scholarship to Beaumont, a Jesuit public school near Windsor. After school he was befriended by the wealthy Chance family in Dublin, who took him into their home and financed his medical studies at Trinity College Dublin.

He contracted TB in both lungs but recovered.

Browne’s personal experience left him with a lasting impression of the need for political will to confront the disease.

He started out in Seán MacBride’s Clann na Poblachta but the party leader abandoned him in the mother-and-child affair. Never a politician to be cowed by authority or orthodoxy, he went to serve as an Independent and spent time in Fianna Fáil and Labour. He also co-founded the National Progressive Democratic Party (not to be confused with the PDs) and Socialist Labour, both short-lived.

There is a monument in Browne’s honour in Waterford, where he was born, a limestone bench by his grave in Co Galway and a wing was named after him at Connolly Hospital in Blanchardstown, Dublin. But all that seems somehow insufficient.

If coronavirus provides new perspective on the horrors of TB, the same goes for Browne’s fleeting ministerial spell.

A quarter-century after his death, an online Eircode search shows that no street is named after him in the capital city or anywhere else.

That would be a good start, in recognition of his abiding commitment to public health.