Victoria is the capital city of British Columbia, Canada’s Pacific province. Incorporated in 1862, Victoria’s metropolitan area recorded a population of 344,615 in the 2011 census of Canada.
In 1918, Greater Victoria comprised four municipalities of the thirteen now within the metropolitan area: the City of Victoria, the Districts of Saanich and Oak Bay and the Township of Esquimalt.
From 1906 to 1950 the District of Saanich extended north to the boundary of North Saanich.
Map of Greater Victoria circa 2013 showing the District of Central Saanich, until 1950 part of the District of Saanich. Courtesy Spacing Vancouver.
The population of Greater Victoria at the time of the Spanish Flu was estimated to be about 56,000.
Health care services in British Columbia at that time were modest and of access often limited to those who lived in or near population centres.
Hospitals
Hospitals in the Victoria area were few and tiny but well-equipped and staffed.
Provincial Royal Jubilee Hospital
It was operated by the City with a grant from the Province.
St. Joseph’s Hospital
It was operated by the Sisters of St. Ann.
Royal Jubilee and St Joseph’s hospitals had schools of nursing that trained Registered Nurses (RN).
The City Isolation Hospital
Victoria City Isolation Hospital, constructed in 1893-4 to treat an outbreak of smallpox. Photographed 1940s? Photographer undetermined. BC Archives Call No. B-09498. Catalogue No. HP044562. Courtesy Royal British Columbia Museum Corporation.
The Isolation Hospital was on Mount Tolmie Road (now Richmond) north of Royal Jubilee Hospital, as indicated (location not shown) on the 1913 fire insurance map:
Insurance Plan of Victoria. British Columbia. Volume II. Atlas of Street Maps of Victoria, B. C. Surveyed June 1911; revised 1913. University of Victoria Digital Collections. Provided by BC Archives. Courtesy Royal British Columbia Museum Corporation.
Chinese Hospital
Victoria’s Chinatown, 1909, showing the location of the Chinese Hospital between Herald and Fisgard streets, west of Government. In David Chuenyan Lai, The Forbidden City within Victoria. Orca Books, 1991, Figure 4, p. 7.
These hospitals also served surrounding areas of Saanich, Oak Bay, Esquimalt and the unincorporated districts near Victoria, where there were no civilian hospitals.
Craigdarroch Military Hospital
Craigdarroch Military Hospital, Victoria; staff on the steps, 1920. Photographer undetermined. BC Archives Call No. G-00239. Catalogue Number: HP020379. Courtesy Royal British Columbia Museum Corporation.
The converted “castle” in Rockland for convalescing soldiers.
Irving House Military Hospital
The James Bay home of Captain John Irving, photographerd by Richard Maynard in about 1888. Located on the southwest corner of Michigan and Menzies Streets, the house was painted in twelve colours. BC Archives Call No. A-01388. Catalogue No. HP003145. Courtesy Royal British Columbia Museum Corporation.
Convalescence hospital for officers.
Esquimalt Naval Hospital
The Royal [Canadian] Naval Hospital, Esquimalt, 1920. Photographer undetermined. BC Archives Call No. G-00239. Catalogue No. HP0073434. Courtesy Royal British Columbia Museum Corporation.
A world apart in Metchosin was the William Head Quarantine Station, where inbound passenger ships stopped to have the resident medical officer examine passengers for communicable diseases.
William Head, lower left, between Parry Bay and Pedder Bay, in relation to Victoria, upper right. Detail of Haro and Rosario Straits Surveyed by Captn, G. H. Richards & the Officers of H.M.S. Plumper 1858-9. Courtesy Washington State University Libraries Digital Collections. Downloaded April 20, 2014.William Head when occupied by the Quarantine Station (1872-1959). Courtesy Library and Archives Canada. By download April 21, 2014.
Some who were detained (on federal authority) never left the place, and a small cemetery bears witness. Was the quarantine station visited by Spanish influenza? The weight of scientific and historical evidence now leans to an original source of the virus in north China. Some 85,000 workers, recruited into the Chinese Labour Corps, passed through William Head in 1917 and 1918, and thousands more returning from the battlefields of Europe in 1919 and 1920.
Mark Osborne Humphries, ”Paths of Infection: The First World War and the Origins of the 1918 Influenza Pandemic.” War in History 21 (January 2014), pp. 51-88.
Peter Johnson, Quarantined: Life and Death at William Head Station, 1872-1959. Victoria: Heritage House Publishing Company, 2013, pp. 147-57.
Chinese Labour Corps at William Head Quarantine Station, March 28, 1918, about to embark for France via Vancouver and Halifax. Photographer uncertain. City of Vancouver Archives, Major Matthews Collection. Catalogue No. Mil P194. Digital download here.
The cemetery has 35 Chinese graves but is now within William Head [Penitentiary] Institution, so inaccessible to the public.
The 1918 Henderson’s Victoria City Directory lists 44 physicians and surgeons. Using the B.C. Vital Statistics office’s estimated 1919 population of about 56,000 for Greater Victoria, the ratio of doctors to populace was roughly 1 for every 1,340 people, or .75 doctors per 1,000.
That was fewer doctors than the most poorly supplied parts of the province today. A recent study of different regions of B.C. calculated that physician-population ratios vary from a low of 0.76:1000 in the Peace-Liard region to a high of 1.65:1000 in Vancouver. Harvey V. Thommasen et al, “Physician : population ratios in British Columbia.” Canadian Journal of Rural Medicine, 4:3 (1999), pp. 139-45
It’s not clear how many more doctors would have been away on wartime duty.
One important element of the health care system of the time that has almost completely vanished: doctors made house calls. Dr. Price advised people who felt the flu coming on to “go to bed at once and remain there warm and at rest, and send for the doctor” [added emphasis].
Equally important were nurses. Besides the R.N.s working in the hospitals and other care facilities, there were several nursing orders employed by contract. Mostly notable was the leading-edge public health nursing work the Victorian Order of Nurses did in Saanich.
The Victorian Order of Nurses for Canada (V.O.N.) was a society of qualified nurses visiting homes and institutions in remote areas. The organization was established in 1897 in Ottawa. A society was active in Victoria since at least 1898, when it was described thus:
They are an organized and endowed body receiving a salary of four hundred dollars a year, together with board and uniform; they are protected by personal interest and supervision in all dangerous and disagreeable undertakings, and they are ready to perform emergency or other work in isolated and outlying districts and among the poor of the cities, while at the same time fees are taken from all who can afford to pay them in proportionate scale.
“The Order of Nurses. Claims of Those Locally Trained to the Sympathy of the Public They Serve. Addresses on Behalf of the Yukon Party Produce Some Criticism.” Letter to the editor by Quo Vadis, Colonist, May 1, 1898, p. 6.
A 1920 report on the order included this description of the V.O.N.’s mission:
The activities of the Victorian Order are carried on by a body of graduate nurses with a post-graduate training in public health nursing. Their field lies in the homes of the people, in serving and teaching. The care for the mother during pregnancy, and assist the doctor at the birth, give post-natal care, and follow up the child till school age. They also do all other branches of nursing requiring the services of a visiting nurse.
In the small communities they inspect the school children, and, in addition, give talks on home nursing. They receive their post-graduate training in one of the six training centres of the order.
These nurses will also staff the small hospitals of the order, of which there are twenty-four.
“Public Health Nursing Department — Canada,” in The Canadian Nurse and Hospital Review, XVI:2 (1921), p. 100. On Archive.org.
This definition of public health nursing was offered in a later article in the same journal:
Public health nursing is a branch of nursing service which includes all phases of work concerned with family and community welfare, with bedside nursing as a fundamental principle and developing from it all forms of educational and advisory administrative work that tends to prevent disease and raise the standard of the health of the community.
“Victorian Order of Nurses for Canada” by J. Charlotte Hannington, in The Canadian Nurse and Hospital Review, XVII:9 (1921), p. 557.
Further accounts of the V.O.N. in Saanich during and after the Spanish flu epidemic: October Attack.
The V.O.N. continues today with a broad home-care mission. Only one branch survives in B.C., in Vancouver (http://www.von.ca/).
The durable Canadian Red Cross Society was “Canada’s leading wartime humanitarian aid organization” (http://www.redcross.ca) with a mission to serve the needs of soldiers. At the local level there were Red Cross societies in many neighborhoods; another local group provided nursing support in military hospitals.
Medical officers — local, provincial, military
Each of the four municipalities that comprised Greater Victoria had a Medical Health Officer:
City of Victoria: Arthur G. Price, M.D.
District of Saanich: James P. Vye, M.D.
District of Oak Bay: William P. Walker, M.D.
Township of Esquimalt: Eric W. Boak, M.D.
The Medical Health Officer reported to the elected council of the municipality. They also formed collegial committees when concerted action was needed.
The Provincial Board of Health and its ex-officio secretary the Provincial Health Officer reported to the Provincial Secretary, who was a cabinet minister and an elected Member of the Legislative Assembly. Through orders-in-council the Provincial Secretary could empower local authorities to protect public health by imposing restrictions on public mobility via such measures as quarantines and bans on public meetings. Short of that, the Provincial Board of Health provided advice and support to the many M.H.O.s in the province.
The Provincial Health Officer from 1916 to 1936 was Henry Esson Young, M.D. Dr. Young was by any measure an influential public servant. He was himself Provincial Secretary and Minister of Education from 1907 to 1915. The locale of the Provincial Hospital for the Insane in Coquitlam was renamed Essondale in his honour. After taking over the provincial health office, he piloted the establishment of the first nursing degree program and the first public nursing diploma program in the British Empire. Both were offered at the fledgling University of British Columbia, of which Young is considered the founder (when Minister of Education).
Henry Esson Young, M.D. (1862-1939) Provincial Secretary and Minister of Education of British Columbia 1907-1915, Provincial Health Officer 1916-1939. Portrait dated 1911. Frank F. Wesbrook fonds, UBC Libraries Digital Photo Collection. Access Identifier UBC 37.1/18. Courtesy University of British Columbia Archives.
A year before the outbreak of Spanish influenza, Dr. Young began implementing an initiative, unique in Canada at the time, to fund public health nurses province-wide. Canada’s first public health nurse began work in Saanich in 1917.
The Canadian military forces had a completely separate health care system. Military medical staff served the Esquimalt Naval Base, Willows (Army) Camp and the (Army) artillery garrison at Work Point.
![The Royal [Canadian] Naval Hospital, Esquimalt, 1920. Photographer undetermined. BC Archives Call No. G-00239. Catalogue No. HP0073434. Courtesy Royal British Columbia Museum Corporation.](https://onlineacademiccommunity.uvic.ca/spanishflu/wp-content/uploads/sites/3529/2014/03/Naval-Hospital-Esquimalt.jpg)
