Ninette complex a reminder of TB scourge

Hey there, time traveller!
This article was published 12/06/2005 (7588 days ago), so information in it may no longer be current.

NINETTE — A nurse would place two-year-old David Stewart on the lawn of the Ninette Sanatorium, where his mother was secluded because of her tuberculosis. Then another staffer, wearing a breathing mask, would wheel Ida Stewart’s bed onto a screened-in balcony so she could watch her son play, an arrangement that lasted four years.

Many people have forgotten how tuberculosis ripped apart family life in Canada in the first half of the 20th century. Thousands of people died from TB, or disappeared into a sanatorium for years or decades.

TB was the No. 1 killer in Canada in the early 1900s. It claimed up to 400 Manitoban lives per year, and up to 4,000 people per year were carrying the lung disease, according to research by that boy on the lawn, now retired physician David B. Stewart.

But it’s not forgotten here, where the buildings of Manitoba’s largest sanatorium still stand, like monuments, along the shoreline of Pelican Lake, 200 kilometres southwest of Winnipeg.

Stewart was the son of Ida and Dr. David A. Stewart, who founded the Ninette Sanatorium and ran it for almost three decades. Perhaps due to exposure to TB inside the sanatorium, Ida herself became a patient, until radical surgery allowed her to live another dozen years in the outside world. She died in 1936.

TB is a highly infectious disease spread by germs through the air, usually by coughing from an infected person. Anyone diagnosed with TB was whisked away almost immediately to a sanatorium like the one in Ninette. Ninette’s TB sanatorium, the third in Canada, operated from 1910 to 1972. By the time it opened, there were already more than 100 sanatoriums in the British Isles. Roughly half the people who contracted TB died before antibiotics were developed in the latter half of the 20th Century.

A major source for this article is the new book Memoir of a Living Disease, by Marcel Mierau, a powerful account of the history of tuberculosis in Manitoba, and the heroes who fought it. The book was commissioned by the Manitoba Lung Association, formerly the Sanatorium Board of Manitoba.

Another source is Holy Ground: The Story of the Manitoba Sanatorium at Ninette, self-published in 1997 by David B. Stewart, the founder’s son.

TB is usually an infection in the lungs. Bacteria eat holes in the lungs, causing breathing problems, and people eventually choked to death, if they didn’t die sooner of a lesser infection their weakened immune systems couldn’t combat. Symptoms include coughing, loss of appetite, weight loss, night sweats and fever. Historically, it has gone by such names as galloping consumption.

The Ninette Sanatorium — now being converted into one of Manitoba’s largest youth camps by Youth For Christ, a non-denominational faith-based organization — held almost 400 patients at its peak. It had 24 buildings and 150 employees, many of whom lived on the 100-acre grounds. It also had its own power plant, bowling alley by the lakeshore, movie house, school and staff residences, and its own water supply, with a 190-gallon reservoir and a chlorine treatment system. There was even a sanatorium orchestra.

Records show that by 1956, the Ninette Sanatorium had seen 11,500 admissions. A rough guess is it had at least another 4,000 patients after that.

A person would have spent anywhere from a year to two decades or more secluded in a sanatorium, if they survived. The Ninette Sanatorium even had its own morgue at one time. The local undertaker, a Mr. Box from Belmont, was a frequent visitor.

One male patient spent 27 years in the Ninette Sanatorium, before the arrival of antibiotic drugs cured him. The man had learned to be a watchmaker in the sanatorium, and took up the trade once released.

Sanatoriums served three purposes: to protect the community by removing an infected person; to provide patients with the prescribed treatment — plenty of rest, good food and fresh air; and to protect TB patients with compromised immune systems from common germs and flu that could easily kill them when combined with TB (the sanatorium was almost completely locked down to the outside world during the deadly Spanish Flu epidemic from 1917-19).

Patients were not allowed to exert or stress themselves, and spent their days in hospital gowns or pajamas. The doors and windows were always wide open to maximize the flow of fresh air. Even in winter, windows were often open to provide fresh air, and patients were wheeled out to a screened-in verandah where they slept.

“We put hot stones out there to try to keep it a little warmer,” said former sanatorium nurse’s aide Mary Houghton in an interview from her farm house just outside Ninette. Patients were covered in mounds of blankets pulled up to their noses. “We had bed-pullers, people who pulled them out every evening and pulled them in every morning,” she said.

Patients were also urged to get lots of sun. One photo in the sanatorium archive shows topless women patients sunbathing. People had relationships, some children were born out of wedlock, and some people even got married, like Jake and Helen Neufeld.

The couple met at the movie theatre. Helen worked in the sanatorium kitchen, and Jake was a patient.

Jake was 18 and a big, strapping farm boy from Morden when he was first sent to the Ninette Sanatorium. He’d tried to enlist in the Canadian Armed Forces to fight in the Second World War. However, an X-ray showed a cloud on his lung, the tell-tale sign of TB. Within days, he was in Ninette.

“I didn’t even know I was sick,” he said.

“The way people used to put it, you went there to die. A lot of them did. Every so often a hearse came around,” he said. “You just laid in bed and did nothing. It was a dreary life for a few years.”

Neufeld was lucky in one respect. His father and two sisters were also admitted into the sanatorium. All survived, although his father stayed for about six years.

There were always two classes of TB patients at Ninette: those testing positive, meaning they were infectious, and those testing negative, or non-infectious. Jake had been upgraded to non-infectious status when he met Helen. They married in 1948 and are still married today. Like most of the population around Ninette, Jake ended up working at the sanatorium, too, as a groundskeeper for 16 years. He bought a farm nearby in 1966. “The truth is, I enjoyed working there, and so did everyone else,” he said.

That included Mary Houghton.

“I thought I’d died and gone to heaven,” said Houghton of her time working as a nurse’s aide at the sanatorium from 1962-72.

People have difficulty explaining how attached they became to the job, and the togetherness they felt with one another as they fought TB. Their descriptions sound like something out of the famous literary novel The Plague (1947) by Nobel Prize winner Albert Camus, in which a city quarantined by plague draws people closer together — plague standing as a metaphor for German-occupied France in the Second World War.

“It was like one big family. Everybody got along and worked together for the communal good. I even hated to take days off,” Houghton said.

Some staff got sick with TB, too, which often happened when staff workers let themselves become too run down, or didn’t follow safety precautions, like wearing breathing masks in patients’ rooms, Houghton said.

“You came out of a patient’s room and washed your hands for three minutes. Then you went into another patient’s room and washed for two minutes. You had no skin left by the end of the day,” she said.

In the last decade, the sanatorium took mostly aboriginal and Inuit patients, and many were children.

In 1929, the aboriginal rate of TB was 24 times that of Manitoba’s non-aboriginal population.

As a general rule, northern people had less resistance to overcome TB, and that included people of Icelandic descent, said Stewart.

Antibiotic drugs to treat TB began to surface in the 1950s. By 1967, all antibiotics currently used to treat TB were introduced, a combination of four pills a day, and sanatoria started to be phased out.

TB remains a major disease in many parts of the developing world, as well as in the far north, and some remote first nations, including several in Manitoba TB is also the cause of death in many people with compromised immune systems from AIDS.

In Manitoba, York Factory First Nation is a hot spot for TB, registering 24 TB cases last winter out of just over 400 people.

In Canada, the TB rate was 24.3 per 100,000 people among aboriginal people, and 18.8 per 100,000 among foreign-born Canadians, versus a rate of 1.1 per 100,000 for the rest of the population. Nunavut has the highest rate, with 138.4 cases per 100,000.