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Fantome Island Lock Hospital and Aboriginal Venereal Disease Sufferers 1928–45
Meg Parsons
In this article the Queensland government's response to suspected and confirmed cases of venereal disease amongst the state's Aboriginal population is examined through the micro history of Fantome Island lock hospital, which operated between 1928 and 1945. This history offers an interesting case study into the complexities of medical and racial segregation in twentieth century Queensland. While other scholars have positioned Fantome Island lock hospital as a justifiable attempt to control syphilis and gonorrhoea infections amongst the Queensland Aboriginal population, I propose a different interpretation and argue that white perceptions of Aboriginal sexuality and health contributed to government depictions of an Aboriginal venereal disease 'epidemic.' I demonstrate that disease diagnosis was still highly problematic prior to World War II and was differentially applied across different sub-populations.
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| In Queensland, from 1928 until 1945, Aboriginal people suspected of a venereal disease (VD) infection were banished to a place where they could be contained and controlled—that place was Fantome Island.1 Located seventy kilometres northeast of Townsville, North Queensland, Fantome Island is part of the Palm Islands group.2 The island served multiple functions during the twentieth century, with the Queensland government using Fantome as an Aboriginal lock hospital, quarantine station, and later a leprosarium. In this article I will explore the establishment and operation of the first of these medical institutions, the Fantome Island lock hospital, which operated between 1928 and 1945. Although partly influenced by the existing Queensland Aboriginal reserve system, the lock hospital was not an Aboriginal settlement or mission but rather a medical institution designed to isolate and treat Aboriginal VD sufferers. Thus the history of Fantome Island lock hospital presents an interesting case study of the complexities of medical and racial segregation in early–twentieth century Australia and highlights the merging logics of penal, quarantine, therapeutic and racial segregation in the Queensland government's attempts to manage Aboriginal VD.3 |
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Government officials viewed sexually transmitted infections, specifically syphilis, as the paramount health problem of Queensland Aborigines in the early–twentieth century. Many scholars, including Rosalind Kidd, Milton Lewis and Gordon Briscoe, have accepted historical medical, and government accounts depicting rampant VD amongst Queensland's Aboriginal population and have positioned Fantome Island lock hospital as a legitimate attempt to control the spread of syphilis and gonorrhoea.4 However, in this article I propose a different interpretation of the 'Aboriginal VD problem' and the operations of Fantome Island lock hospital, and argue that white assumptions about Aboriginal sexuality affected the way officials' interpreted statistical and anecdotal evidence of VD. I will firstly provide a brief overview of existing historical literature on British and colonial VD control, before turning my attention to the establishment of Fantome Island lock hospital. I will then proceed to outline the two large-scale medical surveys into Aboriginal VD infections on Fantome Island, conducted in 1941 and 1945, which found '[v]ery little active syphilis' and minimal gonorrhoea cases at the facility. The findings of these surveys complicate existing understandings of Aboriginal VD and demonstrate that disease diagnosis was highly problematic prior to World War II. Moreover the merging of medico-moral and racial ideologies in early–twentieth century helped construct an inclusive vision of an Aboriginal VD 'epidemic' largely based on pre-bacteriological disease diagnosis procedures. |
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Numerous scholars have explored the question of how western medicine sought to control VD in Britain and its imperial territories.5 In more recent years Sarah Hodges, Philip Howell and Philippa Levine have explored the introduction and practice of VD legislation in diverse imperial territories and concluded that colonial governments' surveillance and medical policing of female prostitutes for signs of VD inevitably involved the racialization of sexuality.6 In the Queensland context Philippa Levine draws attention to the fact that Queensland's Contagious Diseases Act (1868) and later VD legislation did not apply to Aboriginal women; rather Aboriginal VD control fell under the jurisdiction of the Chief Protector of Aboriginals' Office.7 In this article I draw upon the work of scholars, including Levine, and attempt to extend, complicate and revise current historical knowledge about the control and management of VD in twentieth century Queensland through the micro-history of Fantome Island lock hospital. |
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Queensland pioneered the introduction of systematic VD controls in Australia with the passage of the Health Act Amendments Act in 1912.8 The wide-ranging act included provisions for the compulsory notification of all VD cases by doctors; the provision of free medical treatment for both sexes; the distribution of pamphlets that outlined treatment options; and compulsory medical examinations of all prostitutes and their detention if infected.9 However these wide-ranging provisions applied only to Brisbane; more limited VD controls were introduced to the rest of the state, and did not apply to the state's Aboriginal population.10 |
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Levine identified that dual VD control systems operated in Queensland during the first half of the twentieth century: one for the white population, another for the Indigenous.11 The Department of Public Health was responsible for the administration of VD control amongst Queensland's white communities, and focused on education campaigns and the provisions of free outpatient treatment throughout the state. The Department of Public Health favoured a policy of voluntary treatment rather than coercion for the majority of the state's white population, with the exception of one group—Brisbane prostitutes—who were required to attend the women's VD clinic regularly for examinations and if found to be infected, were sent to Brisbane's VD Isolation Hospital for several months' treatment. The rest of the white public could voluntarily attend the VD clinics or local hospitals to receive free medical examinations or treatment for VD infections. Provisions were made to ensure VD patients completed their full course of treatment, the Department of Public Health sent letters to defaulters, and if they still failed to return for treatment the department would prosecute them.12 |
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In contrast, under the Chief Protector of Aboriginals' system of VD management, quarantine took precedence over education or treatment. Any Aboriginal person suspected of a venereal disease was quickly removed from their homes and transported to government facilities. Prior to 1911, the policy of Chief Protector of Aboriginals' Office was to remove and detain Aboriginal VD suspects on government-run Aboriginal reserves such as Barambah.13 The absence of hospital facilities and medical personnel at Barambah, the largest government-run Aboriginal settlement in Queensland, severely limited the treatment of Aboriginal disease at the settlement.14 One staff member declared that 'nothing could be done' for Barambah's VD cases and Aboriginal people were simply lying 'in the camp all day and night and ... waiting for death.'15 The Chief Protector's Office also endeavoured to remove Aboriginal VD patients to local hospitals for treatment. However, admission was at the discretion of local hospital boards and many hospitals refused to treat any Aboriginal person suspected of a sexually transmitted disease.16 Accordingly, the government's decision to establish an Aboriginal lock hospital at Barambah settlement in 1911 was partly a result of the absence of medical treatment facilities for Aboriginal VD sufferers. |
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Queensland government's VD policies were informed by dominant medico-moral ideology that positioned VD as both a physical disease and a symptom of wider societal degeneration. Moreover the use of medical segregation as a method to control VD amongst two specific target groups—prostitutes and Aborigines—was indicative of the popular perceptions of both groups as immoral and potentially diseased: prostitutes by reason of their profession; Aborigines by reason of their race.17 However, the nature of government detention differed markedly between Aboriginal and white prostitutes VD sufferers, as I outline throughout this article.18 |
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Initial planning for the establishment of an island-based Aboriginal VD facility began fourteen years prior to the 1928 opening of Fantome Island lock hospital. The Chief Protector of Aboriginals' Office was determined to construct another more isolated medical segregation facility in North Queensland based on the presumption of high incidence of Aboriginal VD infections. Bleakley, like his predecessor Howard, firmly believed that isolation was the best method of managing Aboriginal VD.19 Fitzroy Island, situated twenty-two kilometres off the coast from Cairns, was initially selected as the site for an Aboriginal lock hospital. The outbreak of World War I delayed the government's Fitzroy scheme. In the intervening war years the establishment of Palm Island Aboriginal settlement in 1918,and its rapid development into a 'penitentiary,' prompted the Chief Protector's Office to reconsider the proposed location in favour of Fantome Island.20 Fantome's close proximity to Palm Island (the two islands were six miles apart) was the primary reason for the government's decision to establish a lock hospital there. Moreover the Chief Protector's Office was able to economise the operation of the new institution by extending the duties of Palm Island's medical officer to include the provision of medical care to Fantome Island's VD patients (in addition to his medical duties on Palm Island settlement).21 |
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Construction of the hospital buildings began on Fantome Island in 1926. Superintendent Curry sent Palm Island Aborigines to the island to built the new facility. A cyclone demolished the partially completed buildings and delayed the opening of the facility until 1928. Fantome Island lock hospital was finally opened in 1928 and placed under the direct control of F.H. Julian, who was appointed Charge Attendant. Palm Island's medical officer Dr. Charles Maitland Pattison was appointed visiting medical officer for the facility and contracted to make twice-weekly visits (although he and later medical officers made only occasional visits).22 Eight Aboriginal workers also assisted Julian in his duties.23 No medical personnel were stationed at the lock hospital during its first five years in operation, as the Chief Protector's Office was reluctant to commit the extra funding for staffing. |
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By 1932 Fantome Island lock hospital consisted of a hospital, complete with operating theatre, dispensary, treatment room, hospital ward (for 'bed cases'), obstetric room, irrigation blocks, administrative offices, communal kitchen, and barrack wards. Male and female patients were housed separately. Aboriginal men and boys lived in the 'barrack wards': large open-aired huts, which provided them with a roof over their heads but no walls. Each barrack housed approximately thirty male patients and was used only 'for sleeping purposes,' with patients required in the hospital and kitchen daily. These barracks, developed by Dr. Murray and Charge Attendant Julian during the early 1930s, were described by Bleakley as a successful 'experiment' that supplied 'suitable and economical' accommodation 'popular with the walking [male] patients.' In contrast, Aboriginal female patients were housed in 'proper wards,' in close proximity to the main hospital building, presumably to ensure Aboriginal females were properly supervised.24 |
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Removal to Palm and Fantome Islands was often a long difficult journey—physically and emotionally—for Aboriginal people, away from their family and country. Neck chains continued to be used on Aboriginal men in North Queensland throughout the 1930s; women and children were either handcuffed or left unrestrained.25 Transportation typically involved Aboriginal prisoners walking (as frequently was the case in North Queensland where chained prisoners were required to walk behind mounted police) or taken by train to Townsville.26 From there detainees boarded a government launch for the four to five hour journey to Palm Island, and hence VD suspects endured another boat journey to Fantome Island. Newly removed Aborigines to Fantome Island ensured the patient population steadily increased, despite the high mortality rate of the institution (see Table 1). |
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| Year |
Patients at start of the year |
Admitted |
Discharged |
Deaths |
Births |
Patients at end of the year |
| 1928 |
NA |
70 |
44 |
6 |
0 |
20 |
| 1929 |
20 |
Unrecorded |
Unrecorded |
Unrecorded |
Unrecorded |
30 |
| 1930 |
30 |
55 |
37 |
12 |
0 |
36 |
| 1931 |
36 |
70 |
22 |
8 |
2 |
73 |
| 1932 |
73 |
128 |
17 |
28 |
4 |
156 |
| 1933 |
156 |
44 |
6 |
21 |
0 |
227 |
| 1934 |
227 |
36 |
21 |
16 |
4 |
230 |
| 1935 |
230 |
69 |
43 |
30 |
4 |
230 |
| 1936 |
230 |
213 |
195 |
19 |
4 |
233 |
| 1937 |
233 |
193 |
183 |
28 |
Unrecorded |
244* |
| 1938 |
224 |
266 |
210 |
6 |
8 |
273* |
* Denotes when various government reports different patient totals for the same year.
Table 1: Fantome Island Lock Hospital statistics: 1928–38. (Sources: Queensland State Archives, A/58860; A/69717; A/58860; SRS 505, 3A/66, Box 444; and the Aboriginal Department Reports for the Years 1928–38 included in the Queensland Parliamentary Papers).
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Government and medical officials portrayed VD, alongside leprosy, as the pre-eminent health problem affecting Queensland's Aboriginal population throughout the early–twentieth century. Yet estimates about the prevalence of VD among the Aboriginal population varied greatly, with much of the evidence unreliable. In 1915 Chief Protector Bleakley declared that Queensland's Aboriginal settlements were overrun with VD sufferers; but statistics from his own department indicate that only seventeen VD cases were identified amongst the entire Queensland Aboriginal population for the year.27 Palm Island's medical officer (Dr. Murray) declared in 1933 that venereal diseases were the 'biggest problem' for Aboriginal population and will continue to 'constitute one of the major health problems [for] the Aboriginal Department for many years to come.'28 Whilst I do not dispute the presence of VD amongst Queensland's Aboriginal population, I do however suggest that white assumptions about Aboriginal sexuality and health directly influenced the way government officials' interpreted statistical and anecdotal data on venereal diseases and helped construct an inclusive vision of an Aboriginal VD 'epidemic.'29 |
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Bacteriological testing was not required to confirm the initial diagnosis and all clinically diagnosed Aboriginal VD cases, from 1928 onwards, were simply removed to Fantome Island. This contrasted with the diagnosis of white VD cases, which required bacteriological evidence in support of initial clinical diagnosis.30 Dr. Bancroft, Palm Island's medical officer (1930–31), recognised the pitfalls of the Fantome Island system of diagnosis and wrote to Chief Protector Bleakley in 1931 requesting permission to send smears to a Townsville laboratory for testing.31 |
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Despite the absence of bacteriological confirmation and the reliance on clinical diagnosis Dr. Murray, Bancroft's successor to the position of medical officer, maintained that syphilis was the primary problem amongst Queensland Aborigines and warned that syphilis lowered 'resistance to other diseases' and could 'incapacitate, sterilise or even prove fatal to women.' In his 1932 Annual Report on the Fantome Island lock hospital Murray drew upon doomed race theories and argued:
Many writers have noted that the aboriginal cannot withstand contact with white civilisation. The real factor which is so fatal to him is venereal disease—this ... lowers his birthrate and raises his deathrate—so it appears to me after nine months' experience at Palm and Fantome Islands. The deaths at Fantome are eloquent testimony to the accuracy of this statement.32
The death rate at Fantome Island Lock Hospital for 1932 was exceptionally high, 28 patients died during the year out of a total population of 201 giving the institution a death rate of 139 deaths per one thousand people (see Table 1).33 Bleakley considered Fantome Island's death rate 'not surprising' given the 'condition of many of the cases on admission,' and went so far as to declare the rate 'good under the circumstances.'34 Fantome Island's high mortality rate was undoubtedly influenced by the poor accommodation, inadequate food rations and toxic medical treatments provided to patients.35 Public Service Inspectors Johnson and O'Brien recorded in 1941 that the food provided to patients was nutritionally inadequate and 'dangerously low' in vitamin contents. Moreover patients' diets, they noted, had a, 'complete absence of fresh fruit or dried fruit and fresh vegetables except potatoes and onions.'36 This paralleled the situation on neighbouring Palm Island, and the mainland settlement of Cherbourg, where cases of malnutrition were common and government food rations consisted of just three main substances: white flour, tea and sugar.37 |
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Sexuality and morality were at the heart of government discussions about VD during the early–twentieth century. Queensland government officials, including those working on Fantome Island, viewed VD infections as further evidence of Aboriginal immorality and sexual dysfunction. Chief Protector Bleakley argued that Fantome Island's expanding lock hospital population was partly a result of Aboriginal promiscuity, and declared, 'one has to accept that, owing to their nature and often their condition, these people are over-sexed.'38 Similarly Sir Raphael Cilento, in his position as Chief Quarantine Officer for the Commonwealth Health Department, declared it was 'impossible for any aboriginal woman to escape venereal infection' in North Queensland because '[p]romiscuity [wa]s encouraged by circumstances almost impossible' for the government to control. Accordingly Cilento recommended that all Aboriginal people be transferred to Aboriginal settlements as a method to increase government regulation of Aboriginal sexual behaviour.39 In line with this view, female patients at Fantome Island lock hospital were sometimes chained to hospital beds in punishment for disobedient and 'immoral' conduct.40 |
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Aboriginal patients, unlike their white counterparts, were charged fees for their medical treatment despite Fantome Island lock hospital's status as a government-run hospital. Chief Protector Bleakley declared the 'chronic cases' at the hospital an 'economic problem' to his department since officials found it 'at least necessary to give sufficient treatment to keep [the patients] well.'41 From March 1933 the Chief Protector of Aboriginals Office withdrew money from inmates' Savings Bank Accounts to pay for their 'treatment costs' and lessen departmental expenditure on the facility. This practice came under review in April 1941 when the Deputy Director-General of Health and Medical Services found the 'total cost of maintenance and administration of the Lock Hospital was 17.9.9 [pounds] per head per annum, yet the aboriginal with a bank account of 20 pounds or over was to be charged 36.10.0 [pounds] per annum.'42 In contrast, he noted, 'white people with venereal disease are offered free treatment in all states of Australia.' There was no parallel fee system operating at Brisbane's lock hospital; prostitutes received their VD treatments free of charge. The Deputy Director therefore recommended the charges be reviewed by the Department of Public Health, which assumed control of the lock hospital in June 1941.43 However there is no record of the Department of Public Health's decision on the matter. The decision of the Chief Protector's Office to extract fees from patients to pay for their confinement corresponds to the department's general Aboriginal monetary policies, specifically the taxing of Aboriginal workers through the Aboriginal Provident Fund.44 By charging Aborigines for their medical treatment the Chief Protector's Office went against the Queensland (Labor) government's policy of universal free public health care, and reinforced the view that medical treatment was not an indelible right but a privilege of (white) citizenship.45 |
16
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The Chief Protector's Office was unwilling to invest the finances or personnel required to properly administer the institution. This is especially evident in the department's decision to appoint Julian as the lock hospital's Charge Attendant despite his lack of medical training, instead of a medical officer. Although Palm Island settlement's medical officer was supposed to make twice-weekly visits, the various medical officers' visits were always of a sporadic nature and patients were left without medical supervision or treatment for long periods of time. Thus, Julian was required to administer the majority of medical treatments (mainly injections) without the supervision of any trained medical staff.46 For this work Julian informed Public Service Inspectors Johnson and O'Brien in 1941 that he had received 'little or no direction in the treatment of V.D.' during his fourteen years of employment at the lock hospital and was 'compelled to work out his own doses' of the highly toxic VD drugs (comprised of arsenic and bismuth) through a method of trial and error.47 It was during this time that Julian, left in charge of patients for weeks at a time, began to refer to himself as 'Doctor' and insisted that Aborigines call him by that title. This infuriated Dr. Drew, Medical Superintendent of Palm Island in 1936, who informed Chief Protector Bleakley of the 'ridiculous statements ... [written] by "Dr" Julian' in patients' medical cards.48 |
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By the early–twentieth century medical scientists had identified the micro-organism Treponema pallidum responsible for syphilis and understood the bacteria's systematic infiltration of the body's internal organs, blood, nervous system, bone and brain. If left untreated syphilis could be fatal. Treatment options included frequent injections of arsenic, bismuth, and occasionally mercury, in rotation until blood tests (Wassermann test) were negative for the presence of Treponema.49 However, the continual injection of toxic substances into the body was risky, and patients regularly suffered reactions to the drugs including angioedema (swelling), unconsciousness, stomatitis, and toxic poisoning.50 For those infected with the Gonococcus bacteria the outlook was not as bleak, in so much as gonorrhoea (unlike syphilis) typically remain localised in sufferers' reproductive organs, and was not a fatal disease. Gonorrhoea infections caused only mild symptoms in men, including penile discharge and painful urination. In comparison the impacts of gonorrhoea on women's bodies were far more severe, with the infection causing sterility and chronic pelvic inflammatory disease. Urethral washes, a common treatment for gonorrhoea in the early–twentieth century, offered little physical relief to patients and appeared to be palliative in nature. Thus, until the arrival of sulphonamides in the late 1930s, medical science provided no effective treatments for gonorrhoea (sulphonamides were not introduced to Fantome Island lock hospital). Penicillin (developed during World War II) was an effective treatment for both syphilis and gonorrhoea and replaced the earlier forms of treatment.51 |
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The medical treatments performed at Fantome Island lock hospital, although based on current medical knowledge, were in many cases performed in a medically negligent manner. Dr. Murray described the lock hospital as an institution designed for 'investigation purposes' and 'practically a closed experiment in health care.'52 Mervyn Nicholas an Aboriginal man interviewed as part of the 'Bringing Them Home Oral History Project' recounts his experiences as a teenager on Fantome Island, and the painful regime of injections he was forced to endure.
Oh it was no good. I just went through—needles, injections with needles ... Oh, it was a rough time and I was under ... sedation a lot of the time, with these needles ... I was all swollen in the hips and crippled ... [Even now] I got all the big scars all over my lower back.53
The injections, given in the arm (intravenous) or buttocks (intramuscular), were very painful and sometimes caused him to vomit. Nicholas maintains, 'no-one seemed to know what they [the injections] were for,' and associates the injections with government experimentation. However from his descriptions of the treatments it seems likely he underwent the standard syphilis treatment regime of arsenic and bismuth injections. |
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The arsenic-based drug novarsenbillion, known by its abbreviated name NAB, was used at Fantome Island lock hospital from the early 1930s as a treatment for syphilis.54 NAB was administered through intravenous injections, with patients supposed to receive four to six injections per week (until their blood tests were negative for syphilis).55 Bismuth was also used to treat syphilis and was administered through intramuscular injections into the buttocks.56 Both bismuth and NAB were highly toxic and caused painful localised swelling, vomiting, cramps and even death in some patients.57 Until the introduction of penicillin to Fantome Island lock hospital in December 1944 no effective treatments were available for gonorrhoea, however hospital officials seemed to have used NAB and bismuth injections on both gonorrhoea and syphilis sufferers (although there was no scientific evidence to support its usage on gonorrhoea cases). |
20
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Queensland medical officials, in contrast to the US counterparts, did not explicitly theorise any differences between the aetiology, form or treatment of Aboriginal and white sexually transmitted infections. No official attempts were made to study Aboriginal VD infections at the hospital. Fantome Island lock hospital was not an Australian version of the US Tuskegee experiment, but rather another example of the Chief Protector of Aboriginals' Office ongoing mismanagement and sometimes neglectful treatment of Aboriginal people and their health.58 |
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Over a two-year period (1940–41) Johnson and O'Brien filed five separate reports concerning the operation of Palm and Fantome Islands in which the widespread mismanagement of the lock hospital was revealed. The inspectors reserved their most severe criticism for Dr. C. A. Courtney, Palm Island's medical officer, outlining his unprofessional conduct and inadequate medical supervision of the Fantome Island lock hospital. Courtney maintained throughout the inquiry that 'it was not part of his duty' as medical officer to administer drugs to patients, and freely admitted that he relied 'almost wholly' on Julian and Nurse Brumm (despite their lack of medical training) to treat patients.59 In addition he informed the inspectors: 'he did not make any entries or sign anything during his visits' to the lock hospital, and stated:
I do not examine new arrivals [to Fantome Island] as to the condition of blood or urine, or conduct any tests for hookworm. I do not examine new arrivals with a stethoscope as a rule. If Julian says they are fit to discharge they are discharged.60
Johnson and O'Brien reported numerous cases of medical negligence at the hospital, including the death of one patient from an intravenous injection in September 1940. In addition Johnson and O'Brien were 'most alarm[ed]' at the staff's failure to perform routine blood tests and argued 'the taking and examination of a smear is very simple, but very important' procedure.61 Overall, the inspectors declared the lock hospital a 'classic illustration of the bungling administration of the sub-Department of Native Affairs,' and recommended the facility be removed to Palm Island and significantly re-organised.62 However, the Queensland government chose to follow a different course of action, transferring control of the lock hospital to the Department of Public Health (another sub-department of the Department of Health and Home Affairs) in June 1941.63 |
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The findings prompted inspector Johnson, an infectious diseases expert, to instigate a medical survey of the entire Fantome Island lock hospital population in an attempt to determine the correct diagnosis of patients in May 1941. Dr. Johnson was shocked to discover the majority of patients showed no signs of any type of sexually transmitted infection, old or new. He declared 146 patients, out of a total population of 192, disease-free and cleared for discharge. However, the Department of Native Affairs was reluctant to release the patients declared disease-free and refused to discharge any Aborigines to their home areas and instead insisted that they be discharged to the government Aboriginal settlements of Woorabinda, Cherbourg and Palm Island, which were already significantly overcrowded.64 Thus in the months following Johnson's survey Cherbourg and Woorabinda patients were quickly discharged from Fantome Island and 'returned to their own Settlements,' while Palm Island and 'country natives' remained at the lock hospital awaiting the construction of more accommodation on Palm Island. Fantome Island lock hospital's Acting Superintendent Mahony advised the Secretary for the Department of Public Health that not all 'clean' cases should be discharged because: 'In more than a few cases the treatment of V.D. was not the only reasons for detention and to return them to their homeland would contravene the policy of the Department of Native Affairs.'65 While white prostitutes were free to return home after treatment at Brisbane's lock hospital, the Department of Native Affairs' refused to discharge Aboriginal patients to their home districts.66 Instead the department was determined to continue their detention on government-run Aboriginal settlements. This leads us to question what was the meaning and effect of detention in the Fantome Island context. Detention was not exclusively about sexually transmitted infections, although that was a significant part, but rather was result of convergence of segregationist rationales (punitive, quarantine, therapeutic, and racial). |
23
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Detention at the lock hospital was based more on popular racial attitudes about the need for racial segregation rather than racist medical knowledge. Johnson and O'Brien reported that, 'since 1936, aboriginals ha[d] been sent [to Fantome Island] for punishment for bad conduct.' In addition, authorities allowed the removal of entire families to the lock hospital; often only one member of the family was diagnosed with VD. In 1940 a total of twenty-nine inmates of the lock hospital were recorded as family members (sixteen of whom were children), another five patients were defined as 'mental cases' and a further four were simply labelled 'undefined.' The detention of children at the lock hospital conflicted with official policies, which dictated that all 'clean' children of VD patients, including infants born on Fantome, be sent to Palm Island settlement's dormitories.67 |
24
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These practices breached department guidelines and made a mockery of Fantome Island's status as a quarantine island. Ironically, in 1940—the year in which Johnson and O'Brien reported to the Queensland government on the failure of the Fantome Island quarantine system—another medical segregation facility (Fantome Island Leprosarium) was opened on the island, an indication of the government's persistent belief in spatially isolating Aboriginal people, both for medical and disciplinary reasons.68 In 1941 Johnson and O'Brien condemned Fantome Island's quarantine system as, 'inefficient and inconsistent, and quite useless in preventing the entry of venereal or other infectious disease[s] into Palm Island settlement,' or the general Queensland Aboriginal population.69 |
25
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Palm and Fantome Island officials continued to delay the discharge of patients, citing overcrowding on Palm Island and four months after Johnson's visit only one third of patients certified as VD-free had been discharged from Fantome.70 However, the Department of Public Health, which assumed control of Fantome Island lock hospital in June 1941, declared the arrangement unacceptable.71 Acting Secretary O'Shea informed Bleakley that although he 'appreciated' Palm Island's housing difficulties, nevertheless, 'the detention without authority of persons who have recovered from venereal disease or who have never had the complaint is ... a matter of serious consideration.' He warned that if 'any instance' of patients being 'wrongfully detained' was discovered it would be Bleakley's 'direct responsibility.'72 However Bleakley and his subordinates appeared to take little notice of the Secretary's criticisms and the lock hospital continued to function as it had prior to the Public Service Inspectors' reports: essentially operating as a remand centre for medically or socially troublesome Aborigines. |
26
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The Department of Public Health's take over of the facility in June 1941 did not herald a new era of hospital management but rather the continuation of the old dysfunctional system, with all existing lock hospital staff (including Julian, Brumm and Dr. Courtney) retained by the Public Health authorities.73 However, four years after Johnson and O'Brien concluded their inquiries on Fantome Island, the Minister of Health and Home Affairs requested another survey be conducted into VD on Palm and Fantome Islands. The month-long survey was led by well-known Australian VD expert Dr. G. S. Hayes, assisted by Dr. Beatrice Warner (in charge of female examinations) and Mr. Morrissey (laboratory technician).74 In contrast to the Aboriginal department's official rhetoric of the 'Aboriginal VD problem,' the VD inspectors again found a low incidence of the diseases on both Fantome and Palm Islands. On Palm Island the entire adult population, which totalled 625 inmates, were examined for signs of VD. Gonorrhoea infections were of declared of moderate incidence, with twenty-six people (ten males and sixteen females) identified with the disease. In comparison, no active cases of syphilis were detected amongst the Palm Island Aboriginal population, although approximately ten percent of both male and female inmates gave positive Kline reactions—an indication of previous exposure to either the yaws or syphilis bacteria. The results from the Fantome Island lock hospital survey were even more surprising, with the supposed VD patients described by Dr. Hayes as 'fairly clean' of VD infections. Of the forty-nine 'gonorrhoea patients' housed at the institution only one case (a female) gave a positive smear result, prompting Hayes to suggest that the other forty-eight patients 'had either been effectively treated or some at least never had gonorrhoea.'75 Similarly all syphilis cases at the hospital were identified as 'latent cases' which were 'perfect[ly] safe' to be discharged as 'none were in an infectious stage.' The inspectors therefore recommended the patients 'provided they continue with [their] weekly injections' be 'returned to ... the settlements' where they could 'live a more useful life.'76 |
27
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Hayes condemned the policies of the Department of Native Affairs, and its predecessor the Chief Protector of Aboriginals' Office, as medically unsound. He noted, 'it would seem that at least some of these [patients] [we]re sent to Fantome Island on clinical evidence or suspicion only.' Upon arrival on Fantome 'any native suspected to be suffering from V.D.' was 'apparently accepted' as a VD case and was 'treated accordingly.' In gonorrhoea cases, suspected or otherwise, Hayes argued that after treatment was given it became 'most difficult to make head or tail of the original' diagnosis.77 Overall the inspectors' criticisms were not directed at individuals, or Fantome Island staff members, 'but rather [at] the system [which] ha[d] grown up over [the] period' 1928–45. Hayes argued the 'scheme of sending all V.D. suspects to Fantome Island ... f[ell] down because of the absence of a V.D. specialist [on the island] to evaluate cases [when] they arrive[d].' He suggested an alternative scheme be established whereby all VD suspects were sent to Brisbane, 'where the services of specialised officers [were] available.'78 |
28
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The category of VD was used as convenient medical rationale by the Department of Native Affairs, which allowed for the removal of any medically problematic Aborigine to Fantome Island lock hospital for the purposes of isolation and treatment. |
29
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However, misdiagnosis of large numbers of Aborigines with VD and their subsequent removal and detention on Fantome Island should not be interpreted in a simplistic manner—as simply an extension of the wider policies of racial exclusion operating in Queensland—but rather as evidence of what Ann Laura Stoler has termed the 'uneven, imperfect and even indifferent knowledge' of colonial regimes.79 Disease diagnosis was still highly problematic during the first half of the twentieth century. The diagnosis of syphilis, in particular, was difficult in tropical Queensland because of the prevalence of yaws, a disease of tropical climates, which caused skin lesions to the face and extremities similar to those caused by secondary syphilis. Additionally, yaws and syphilis were serologically identical, both producing positive Wasserman reactions, which increased the potential for misdiagnosis. Yaws is caused by the disease pathogen Treponema pertenue. A chronic disease transmitted through non-sexual bodily contact, (infection usually occurs in childhood); symptoms include skin lesions, painful joints and bone deformities. Yaws, part of the same bacterial family as syphilis, was endemic to the Aboriginal population prior to European contact. Infection with yaws provides strong cross-immunity meaning that people who lived in areas of endemic syphilis were 'less likely to contract syphilis.' Judy Campbell definitively argues that yaws continued to be a major health problem for Aboriginal populations in the post-contact period, until the introduction of antibiotics in the mid–twentieth century. However, Australian medical professionals did not recognise yaws as a separate disease until the 1920s, and it was not until the 1930s that Queensland medical officials began to draw a distinction between yaws and syphilis and warn of the potential to misdiagnose the two diseases. The findings of the 1941 and 1945 VD surveys suggest that at least some of the supposed syphilis patients at Fantome Island lock hospital were in fact yaws sufferers.80 |
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The Department of Health and Home Affairs in the months subsequent to the publication of the Hayes' report contemplated the continued operation of the Fantome Island lock hospital, and in August 1945, following discussions with the Director of Native Affairs, announced the closure of the institution.81 However the decision was mainly due to financial considerations. Director-General Cilento and O'Leary, who replaced Bleakley as Director of Native Affairs in 1942, concluded that it was far too expensive to remove all Aboriginal VD sufferers to the remote location of Fantome Island. Instead O'Leary, under Cilento's watchful eye, decreed that each settlement was responsible for treating any inmates infected with VD. O'Leary's decision was undoubtedly influenced by the introduction of penicillin treatment for Australia's civilian VD sufferers from 1943. And by 1945 penicillin was the standard treatment for both gonorrhoea and syphilis infections among both white and Aboriginal populations throughout Queensland. Accordingly, a sharp decline in gonorrhoea and syphilis infections rates was noted amongst both populations. Yet despite this decline government officials continued to consider VD a major Aboriginal health problem throughout the 1940s and 1950s. Palm Island officials, following the Minister's decision to close Fantome Island lock hospital, demanded a VD isolation facility be established on their settlement.82 Palm Island's lock hospital quickly came to fruition because officials were able to recycle Fantome Island's buildings and re-establish them beside Palm Island's existing hospital. While the ten remaining patients were transferred to other facilities, Aboriginal labourers were employed to remove the buildings and transfer them over to Palm Island where they were re-erected to form the basis of Palm Island's new 'Infections Hospital for V.D. cases.'83 Despite the results of Hayes survey, Palm Island's white officials continued to perceive VD patients as a dangerous public health concern; evidence that often officials 'paid less attention to detail than the sorting codes.'84 |
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This article questioned the status of Aboriginal VD patients on Fantome Island lock hospital and proposed an alternative reading of the institution as a site for isolating, controlling, and treating Aboriginal disease in a largely unscientific (pre-bacteriological) manner. The history of Fantome Island lock hospital demonstrates that despite late–nineteenth century advances in the field of bacteriology, disease diagnosis was still problematic and differentially applied across different sub-populations. Medico-moral ideology continued to inform Queensland government VD policies, with VD constructed as both a physical pathology and an indication of moral transgression. The government's decision to detain both white prostitutes and Aborigines in separate lock hospital facilities was an indication of white society's persistent belief in spatial isolation as a method to control racially, medically and socially problematic groups.
University of Sydney
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Notes
1. Official correspondence from the period usually uses the generic term VD to refer to three main diseases, syphilis, gonorrhoea and granuloma. See Rosalind Kidd, "Regulating Bodies: Administrations and Aborigines in Queensland 1840–1988," (PhD thesis, Griffith University, 1994), 374; In the Australian context lock hospital was used exclusively to refer to government institutions devoted to the detention of VD sufferers. See Mary Anne Jebb, "Isolating the 'Problem': Venereal Disease and Aborigines in Western Australia 1898–1924," (Honours thesis, Murdoch University, 1987).
2. See Joanne Watson, "Becoming Bwgcolman: Exile and Survival on Palm Island Reserve, 1918 to the Present" (PhD thesis, University of Queensland, 1993).
3. I am drawing on the general themes and arguments made in Alison Bashford and Carolyn Strange, eds., Isolation: Places and Practices of Exclusion, (London and New York: Routledge, 2003).
4. Kidd, 350–360; Milton Lewis, Thorns on the Rose: A History of Sexually Transmitted Diseases in Australian in International Perspective (Canberra: Australian Government Publishing Service, 1998), 357–79; Gordon Briscoe, Counting, Health and Identity: A History of Aboriginal Health and Demography in Western Australia and Queensland, 1900–1940 (Canberra: Australian Institute of Aboriginal and Torres Straight Islanders Studies, 2003), 221–341.
5. Also see the work of; David Arnold, "Race, Place and Bodily Difference in Early Nineteenth-Century India," Historical Research 77 (2004) 254–73; Allan M. Brandt, No Magic Bullet: A Social History of Venereal Disease in the US since 1880 (New York: Oxford University Press, 1985); Kenneth Ballhatchett, Race, Sex and Class Under the Raj: Imperial Attitudes and Policies and their Critics. 1793–1905 (London: Weidenfeld and Nicholas, 1980); Kay Daniels, ed., So Much Hard Work: Women and Prostitution in Australian History (Sydney: Fontana Press, 1984).
6. Sarah Hodges, "'Looting' the Lock Hospital in Colonial Madras during the Famine Years of the 1870s," Social History of Medicine 18 (2005): 379–98; Philip Howell, "Sexuality, Sovereignty and Space: Law, Government and the Geography of Prostitution in Colonial Gibraltar," Social History 29 (2004), 444–64; Philippa Levine, Prostitution, Race and Politics: Policing Venereal Disease in the British Empire (New York and London: Routledge, 2003).
7. Levine, 235.
8. Lewis, 151.
9. Levine, 130.
10. Lewis, 251.
11. Levine, 235.
12. In 1924, for example, Queensland's Department of Public Health prosecuted twenty-six individuals (thirteen males and thirteen females) for breaching the VD provisions of the Health Acts. See: "Annual Report of Commissioner of Public Health for the Year 1925," Queensland Parliamentary Papers (hereafter QPP) 1 (1926): 7–10; Lewis, 221–2.
13. See: Memorandum, Chief Protector of Aboriginals to Superintendent Lipscombe, 8 December 1906, A/58676, Queensland State Archives (hereafter QSA).
14. The government assumed control of Barambah Aboriginal Settlement in 1905. See Rosalind Kidd, The Way We Civilise: Aboriginal Affairs – The Untold Story (Brisbane: University of Queensland Press, 1997); Thom Blake, A Dumping Ground: A History of the Cherbourg Settlement (St Lucia: University of Queensland Press, 2001).
15. Letter, J.M. Costin, Barambah Aboriginal Settlement, to Under Secretary, 13 December 1906, A/58676, QSA.
16. Letter, Secretary of Gympie Hospital to Under Secretary, 18 July 1913, HOM/J151, QSA.
17. Michael Sturma discusses the belief that VD was symptomatic of the breakdown of traditional gender roles and domestic arrangements in Australia during World War II. See Sturma, "Public Health and Sexual Mortality: Venereal Disease in WWII Australia," Signs 13 (1988): 725–40.
18. Levine, 73, 87, 251.
19. "Aboriginals Department: Report for the Year 31 December 1915," QPP 1 (1916): 10.
20. "Aboriginals Department: Report for the Year 31 December 1918," QPP 1 (1919): 232.
21. "Aboriginals Department: Report for the Year 31 December 1925," QPP 1 (1926): 1017; J.W. Bleakley, The Aborigines of Australia (Brisbane: Jacaranda Press, 1961), 146.
22. See various Aboriginal Department reports contained in the Queensland Parliamentary Papers, including "Aboriginal Department: Report for the Year 31 December 1936," QPP 1 (1937): 1203.
23. G.D. Bradbury, Report on the Aboriginal Settlements at Palm Island, Cherbourg and Woorabinda and Aboriginal Missions at Yarrabah and Mona Mona. Inspected April 1932, Cilento Personal Papers, Box 21, Folder 44/144, Fryer Library, University of Queensland.
24. Bleakley's based his report on Fantome Island lock hospital on Cilento's report of his visit to the island as Bleakley never visited the lock hospital. Letter, Chief Protector of Aboriginals to Home Secretary, 10 April 1933," A/69455, QSA.
25. Watson, 185.
26. See Briscoe, 238.
27. The Aboriginal population was approximately 10,000–15,000 in 1915 depending on the accuracy of statistics. See Briscoe, 70–5.
28. Letter, Dr. R. Elliot Murray to Superintendent Palm Island Aboriginal Settlement, 16 January 1933, A/69455, QSA.
29. Numerous officials referred to VD as an epidemic including Barambah's Superintendent Semple, see: Letter, Superintendent to Director of Native Affairs, 15 August 1940, SRS 505, 4B/3, Box 574, QSA; I am drawing upon the argument made by Susan L. Smith, in her discussion of white assumptions about African American VD incidence, see Smith, "Neither Victim nor Villain, Nurse Eunice Rivers, the Tuskegee Syphilis Experiment, and Public Health Work," Journal of Women's History 8 (1996): 95–113.
30. The diagnosis of VD at Queensland's VD clinics is discussed by Lewis, 221–2.
31. Letter, Dr. Bancroft to Chief Protector of Aboriginals, 9 March 1931, A/58795, QSA; Letter, Dr. Drew, Medical Superintendent Palm Island Memorandum to Chief Protector Bleakley, 16 May 1936," A/58795, QSA.
32. Letter, Dr. R. Elliot Murray to Superintendent Palm Island Aboriginal Settlement, 16 January 1933, A/69455, QSA.
33. Unknown Author, Handwritten Report entitled Fantome, 1934, A/69717, QSA.
34. "Aboriginal Department: Report for the Year 31 December 1932," QPP 1 (1933): 888; "Aboriginal Department: Report for the Year 31 December 1933," QPP 1 (1934): 884.
35. For a detailed account of standard treatments of sexually transmitted injections used see Amos O. Squire, "Penal Institution Hospital Treatment of Venereal Diseases," Journal of the American Institute of Criminal Law and Criminology 9 (1918), 253–259.
36. Public Service Inspectors Johnson and O'Brien Report Number 5 on the Operation of Palm and Fantome Islands, 2 April 1941, A/4232, QSA.
37. See Blake.
38. "Aboriginal Department: Report for the Year 31 December 1934," QPP 1 (1934): 884.
39. Raphael Cilento: Report of a Partial Survey of Aboriginal Natives of North Queensland October-November 1932, A/1928/1, 4/5 SECT 1, National Archives of Australia.
40. Bessie Lymburner, quoted by Watson, 246.
41. "Aboriginal Department: Report of the year 31 December 1934," QPP 1 (1934): 883.
42. Deputy Director-General of Heath and Medical Services, 29 April 1941, A/69500, QSA.
43. Ibid.
44. See Rosalind Kidd, Trustees on Trial: Recovering the Stolen Wages (Canberra: Aboriginal Studies Press, 2006), 57, 175.
45. See James Gillespie, The Price of Health: Australian Governments and Medical Politics 1919–1960 (Cambridge: Cambridge University Press, 1991), 69–86.
46. A certified nurse, Molly Gumley, was transferred from Palm Island Hospital following a recommendation made by Sir Raphael Cilento in 1932. Letter, Raphael Cilento to Phyllis Cilento, 23 May 1932, Cilento Personal Papers, Box 11, Folder 44/22, Fryer Library, University of Queensland, Brisbane; Public Service Inspectors Johnson and O'Brien, Report Number 3 on the Operation of Palm and Fantome Islands, A/4232, QSA.
47. Report Number 1 re Palm and Fantome Islands, 1940, A/4232, QSA.
48. Memorandum, Dr. Drew, Medical Superintendent, Palm Island Aboriginal Settlement to Chief Protector of Aboriginals, 23 August 1936, A/58819, QSA.
49. For a more detailed description of syphilis and gonorrhoea pathology see Parveen Kumar and Michael Clark, eds., Clinical Medicine, 6th ed. (Edinburgh: Sanders, 2005), 120–5.
50. A. Blanc, "What are the Venereal Diseases?" in Venereal Disease: The Shadow Over New Zealand (Wellington: Progressive Publishing Society, 1942), 10–14.
51. See Brandt., 12; Marc H. Dawson, "The 1920s Anti-Yaws Campaign and Colonial Medical Policy in Kenya," International Journal of African Historical Studies 20(1987): 427.
52. R. Elliot Murray, "Palm Island Memories," Sydney University Medical Journal 29 (1935): 16.
53. Mervyn Nicholas, Interviewed by Philip Connor, Cairns, 29 July 1999, Bringing Them Home Oral History Project, National Library of Australia, Canberra.
54. Unknown Author, Handwritten Report entitled Fantome, 1934, A/69717, QSA.
55. See Brandt, 12; Dawson, 427.
56. In 1921, French scientist Dr. Emile Roux announced that the compound bismuth sodium potassium tartrate could be used to treat syphilis. See Thomas Anwyl-Davis, "Bismuth in the Treatment of Syphilis," The Lancet 1 (1927): 148–52.
57. Dawson, 422.
58. The Tuskegee experiment refers to the US Public Health Services long-running medical study (1932–72) in which the progress of syphilis was observed in nearly 400 African-American men in Alabama without the patients being informed of their diagnosis or being provided with any medical treatments for syphilis. See Smith, 95–113; Susan M. Reverby, Tuskegee's Truths: Rethinking the Tuskegee Syphilis Study (Chapel Hill: University of North Carolina Press, 2000), 18.
59. Public Service Inspectors Johnson and O'Brien, Report Number 2 on the Operation of Palm and Fantome Islands, 16 December 1940, A/58861, 41/8301, QSA.
60. Public Service Inspectors Johnson and O'Brien, Report Number 3 on the Operation of Palm and Fantome Islands, A/4232, QSA.
61. Ibid.
62. Ibid.
63. Letter, Deputy Director-General of Heath and Medical Services to unknown recipients, 29 April 1941, A/69500, QSA.
64. The phrase 'country natives' was used by Bleakley to refer to those Aborigines who did not live on government Aboriginal settlements or church-run missions. Letter, Director of Native Affairs to Under Secretary, Department of Health and Home Affairs, 19 June 1941, SRS 505, 3A/198, Box 472, QSA.
65. Letter, Superintendent, Fantome Island Lock Hospital to Secretary of Department of Public Health, 4 June 1941, SRS 505, 3A/198, Box 472, QSA.
66. The examination and treatment of prostitutes is discussed regularly in the reports of the Commissioner of Public Health. See: "Annual Report of the Commissioner of Public Health to 30th June 1932," QPP 1 (1933): 639–61.
67. Letter, J.A. Krause, Palm Island Head Teacher to Chief Protector Bleakley, 24 April 1936, A/58860, QSA.
68. Fantome Island Leprosarium was established in the northern part of island, whilst the lock hospital remained in the south. See: Map of Fantome Island showing the proposed site of the leprosarium, March 1939, A/58861, 39/3097, QSA.
69. Public Service Inspectors Johnson and O'Brien, Report Number 3 on the Operation of Palm and Fantome Islands, A/4232, QSA.
70. Memorandum, Mahony to Director of Native Affairs, 11 June 1941, SRS 505, 3A/198, Box 472, QSA; 53 patients out of the 142 declared "clean" had been discharged by September 1941. Letter, Acting Superintendent Mahony, to Secretary, Department of Public Health, 12 September 1941, SRS 505, 3A/198, Box 472, QSA.
71. Bleakley's position was renamed Director of Native Affairs in 1939. He resigned, following government pressure, in 1942 and was replaced by his deputy Cornelius O'Leary. Kidd, Regulating Bodies, 403–7.
72. Letter, Acting Secretary O'Shea, Department of Public Health to Director Bleakley, 19 August 1941, SRS 505, 3A/198, Box 472, QSA.
73. Dr. Beatrice Warner visited the lock hospital in December 1944 to administer the first batch of penicillin treatment to patients. The Acting Medical Officer's Quarterly Report for the term ending 31/12/44, Palm Island Aboriginal Settlement, 6 January 1945, SRS 505, 3D/12, Box 510, QSA.
74. A Report of Recent Visit to Palm and Fantome Islands to Investigate V.D. Problems, 22 April 1945, A/58860, QSA.
75. Ibid.
76. Ibid.
77. Ibid.
78. Ibid.
79. Ann Laura Stoler, Carnal Knowledge and Imperial Power: Race and the Intimate in Colonial Rule (Los Angeles: University of California, 2002), 206.
80. Dawson, 417–35; Judy Campbell, Invisible Invaders: Smallpox and other Diseases in Aboriginal Australia 1780–1880 (Carlton South: Melbourne University Press, 2002), 2–9.
81. Letter, Director of Native Affairs to Under Secretary, Department of Health and Home Affairs, 8 August 1945, A/58860, QSA.
82. Memorandum, Director of Native Affairs to Superintendent, 15 August 1940, SRS 505, 4/B, Box 574, QSA.
83. Letter, Director of Native Affairs to Under Secretary, Department of Health and Home Affairs, 8 August 1945, A/58860, QSA; Letter, Acting Superintendent Roberts, Palm Island Aboriginal Settlement to Director of Native Affairs, 6 September 1945, SRS 505, 3D/10, Box 510, QSA.
84. Stoler, 206–7.
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