New Zealand Listener – August 10, 2019

74 LISTENER AUGUST 10 2019

80 YEARS

shared the water. That would be looked on

with horror now, but that was the way it

was.”

Ōhākune had neither a town water supply

nor sewage system, and although the family

had a septic tank, it often malfunctioned.

They used an outdoor privy. The can was

emptied weekly by the night-soil contractor

who’d arrive with his cart to collect it. “If he

didn’t arrive soon enough, Dad had to dig a

hole and empty it.”

He remembers their single-storey scrim-

lined weatherboard home as “very cold”,

even though they didn’t have to pay for the

electricity that powered their heater thanks

to their dad’s job with the council.

BUREAUCRATIC BLINDNESS

The year 1939 was notable not only for the

outbreak of World War II and the birth of

the Listener. The Labour Government had

just introduced the Social Security Act 1938,

with the intent of enshrining healthcare as

a fundamental right of all New Zealanders

and removing financial-access barriers

to treatment. It was also the last time

New Zealand’s health statistics – for non-

Māori at least – led the world. As the then

Department of Health’s annual report noted

in presenting the country’s birth and death

rates and disease incidence under “Vital

Statistics”, the reported numbers were

“Exclusive of Maoris”. This bureaucratic

blindness was one of the reasons New

Zealand’s (non-Māori) population boasted

the lowest mortality in the world for roughly

70 years, until 1940.

The annual reports of that era lay out the

government’s health priorities. In 1940’s

report, there are seven and a half lines on

cancer and six on hydatids. Venereal disease

has 22, diphtheria 18, and tuberculosis

(TB) commands a page and a half. It was

a time, says Woodward’s son, Alistair, a

public-health physician and professor

of epidemiology and biostatistics at the

University of Auckland, when the health

system was still focused on infectious disease

rather than cancer, even though, for non-

Māori, cancer and heart disease had already

overtaken infections as the most common

causes of death.

“Hydatids were something you were

worried about, but we didn’t talk about

cancer,” says Jack Woodward. “When I was

growing up, people didn’t dare think they

might have contracted cancer, because if

it was discovered, it was so feared.” Many

cancer deaths may have been listed under

other causes, says Alistair. “A lot of cases

were picked up very late and people died

of a combination of things. The death

records often talked about consumption –

just wasting away.” Diagnosis was usually by

sight – large, visible masses with treatment

usually restricted to surgery and “brutal”

radiotherapy.

Dementia, too, was alluded to but rarely

spoken of. “My wife used to talk about her

‘silly old aunts’,” says Woodward. “They

were obviously suffering dementia, but it

wasn’t talked about. Now it’s a big deal and

we know it’s so much more complicated.”

Another big change has been in attitudes

towards fathers being involved during the

delivery of their children. “When one of

my younger siblings was born, I remember

going up to the hospital with Dad and he

held me up on the road outside so I could

look through the window into the room to

see my mother and the baby. He could visit,

but at what stage he was allowed to hold the

baby, I don’t know. It wasn’t something that

suited hospital routines.”

When Woodward’s wife, Mary, went into

labour with Alistair, their first child, in 1953,

“I got a taxi and rushed her to hospital in

Christchurch; the nurses came and quickly

took her away and told me to go home.

Fathers couldn’t be there when they gave

birth. You couldn’t hold the baby. If I can

point to something that’s changed, it’s the

naturalness of having family members

present during and after birth.”

SHUT DOWN

Vaccines for polio and measles weren’t

introduced until the 1950s and 60s and

immunisation campaigns for diseases

such as diphtheria were haphazard at best,

apparently led by enthusiastic local doctors

rather than the Department of Health at a

national level. Says the 1940 annual report,

of 1939’s 517 cases of diphtheria and 24

deaths: “Viewed purely as an economic

proposition, the wholesale immunisation

of young children would seem to be well

worthwhile.”

Woodward remembers the polio epidemic

of 1937, which killed 39. “It shut down

Improvements in housing

conditions and water supply

(1940s and 50s). In 1938, a

survey of Māori housing in

South Auckland found 80%

didn’t have a safe water

supply and 60% had no

sanitary facilities.

Introduction of antibiotics

such as penicillin post-World

War II, and better infection

control in hospitals.

Dietary changes – recognition

of the heart-disease risks of

saturated fat, introduction

of frozen fresh vegetables

and refrigeration, which

reduced the use of salt as a

preservative.

Medical interventions – statins,

blood-thinning and blood-

pressure-lowering drugs for

heart disease; chemotherapy

and immunotherapy for

cancer treatment, and oral-

rehydration solutions to treat

infant diarrhoea.

Advances in imaging to

diagnose diseases, and

organised screening

campaigns.

Tobacco control, including

anti-smoking campaigns,

taxation and smoke-free

environments, from the late

19 6 0 s.

Immunisation – vaccines for

polio were introduced in the

1950s and measles in the

19 6 0 s.

Fluoridated water supplies.

Oral contraceptives.

Source: Alistair Woodward

Nine key

health

advances

• 1939-2019

“We were in smoke

all the time – no one

thought anything amiss

about smokers.”