"...the introduction of diagnosis and treatment of tuberculosis at public expense was one of the early and essential steps in developing a program of health services available to all."
- Allan Blakeney, Saskatchewan Minister of Health, 1964.
One of the primary public health concerns in the first half of the twentieth century was the spread, control and treatment of tuberculosis. The disease is caused by a bacterial infection. Sometimes referred to as "consumption" or "white plague" it was, until the late 1920s, the number one killer of Canadians. Though Saskatchewan was not alone in treating this disease, much of the strategy and process was unique.
The 1920s saw a number of firsts in Saskatchewan’s treatment of TB. Ferguson persuaded the government to form the Saskatchewan Anti-tuberculosis Commission to determine the prevalence of TB and to plan future actions. As part of the research necessary for the commission report, arrangements were made with school boards to conduct the world’s first representative cross-sectional school study.
About 200 children between the ages of six and fourteen in each of seven selected communities were examined. The Commission’s recommendations, published in October 1922, stated the need for increased sanatorium accommodation to care for the spreaders of the diseases. The Commission recommended the construction of two new sanatoria of at least one hundred beds each and thus providing accommodation for the average patient’s twelve months of treatment. The two additional sanatoriums were built in Saskatoon and Prince Albert.
The Saskatchewan Anti-tuberculosis League was formed in February 1911 and by 1917 the province’s first sanatorium was built in the Qu’Appelle Valley, near the town of Fort Qu’Appelle. It became known as Fort San. The superintendent of the new sanatorium was Dr. Robert Ferguson. He would prove to be a leader in the war on tuberculosis and would set policy, harness to public’s cooperative spirit and promote educational initiatives for his staff and the population at large.
1923 saw the first traveling TB clinics and in 1929 Saskatchewan became the first jurisdiction to implement universal free diagnosis and treatment of TB. The previous policy of “all who could pay were required to pay” left many patients financially crippled.
Ferguson reported “the effect of removing the financial barrier is earlier treatment, earlier isolation, and an [initial] increase in the number of days treatment and the gross cost, but the end result will be more cures and a shorter period of disability, lessened spread of the disease, a lower death rate, and eventually [fewer] cases.” In 1928, Ferguson presented a landmark epidemiological study concluding that Saskatchewan’s native population was particularly susceptible to the spread of tuberculosis. This and continuing research lead to a comprehensive program to control TB in the native population.
Further innovations such as the first BCG vaccination among student nurses in 1934 and the first province-wide photofluorographic survey in 1942 helped to improve tuberculosis control. In the majority of years, from the 1920s through the 1960s, Saskatchewan had Canada’s lowest TB death rate.
With the advent of TB medicines in 1948, the TB death rates fell sharply. The Prince Albert Sanatorium was closed in 1961, Fort San in 1972, and the Saskatoon Sanatorium in 1981.
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