Houses were fumigated, people quarantined, and entire families ostracised. Desperately worried parents resorted to hanging pungent camphor around their children’s necks in a misguided effort to ward off the virus and some fled to the mountains to escape.
This was the small town of Railton in Tasmania during the worst outbreak of polio in Australia in 1937. For more than half a century, through to the 1950s, Australians were periodically terrified by recurrent epidemics of polio that could potentially leave its victims paralysed, sometimes permanently.
Hospital wards filled up with paralysed victims bandaged into splints and families built special carts to move around their stricken children.
At its worst, victims would be left reliant on artificial respiration for the rest of their lives. It wasn’t until the 1950s that an effective vaccine was developed that would eventually eradicate the disease in developed countries; it’s estimated that 20,000-40,000 Australians developed paralytic polio between 1930 and 1988.
The release of the movie Breathe, the inspirational true story of Englishman Robin Cavendish’s battle with paralytic polio, is a reminder of a disease that was nothing short of a scourge.
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But today it is almost forgotten, except by those whose lives were and remain directly affected.
Polio Australia estimates that Australia has some 400,000 polio survivors. But in recent years adults who suffered minor illnesses or had mild muscle weakness during the earlier epidemics are now also suffering Post-Polio Syndrome with unanticipated muscle weakness and atrophy.
As a physiotherapist who began working with polio victims, the film is a reminder of the long legacy of polio, the ongoing role of rehabilitation and the crucial role of vaccination in finally tackling the disease.
My mother, Freda Kimpton, graduated as a physiotherapist at the end of 1937, at the peak of the largest epidemic. She immediately joined the Royal Children’s Hospital domiciliary service, treating children in North Melbourne, Carlton and Footscray.
It was women like my mother who devoted much of their professional lives to people who had been paralysed by polio.
Twenty years later, as a physiotherapy assistant in the summer holidays from 1957 to 1962 at Fairfield Hospital, I helped the physiotherapists in mobilising joints, stretching and exercising muscles, making plaster splints and abdominal corsets. Breathe rekindled the memories of those years, particularly of Fairfield’s respirator ward and the people in its ‘iron lungs’.
Polio is caused by an enterovirus. It is contracted orally through infected faecal matter, such as on someone’s hands or an object, and is contagious during the incubation and acute phases. If polio affects the central nervous system it can lead to paralysis and the subsequent atrophy of muscles, ending in contractures (the permanent shortening of a muscle or joint) and permanent deformity.
People who survived the acute stage with paralysis faced years of rehabilitation. In most cases patients used respirators for only a short time, but others like Australian June Middleton, who contracted polio as a young, active woman of twenty-three, remained in an ‘iron lung’. When I first met her, June had lived in her ‘iron lung’ for fourteen years - she died at the age of 83, the world’s longest surviving person living with polio in a respirator.
Outbreak! Managing human pandemics
An iron lung is a large, elongated sealed cabinet enclosing the patient up to the neck. It requires a mechanical pump to produce negative pressure which replaces the action of the respiratory muscles during breathing in. When the negative pressure is released, the patient breathes out.
The story of Tasmanian Rebecca Round is emblematic of the hardship and determination of Australians forced to live with the impact of polio.
Rebecca grew up on a farm near Railton and contracted polio in the 1937 outbreak, aged just seven. Her twelve-year-old sister and two cousins also contracted the disease. One friend died and another was left badly paralysed.
The children were hospitalised and put into Thomas splints, which maintains the joints of the lower limbs in a comfortable position. The process sees patients bandaged in at ankles, knees, hips, waist. An upper body and head piece keeps the arm joints in neutral positions and if neck muscles are involved in paralysis, the head is ‘blinkered’. Hospitals created long balcony wards and open wards that allowed children to enjoy fresh air and sunshine.
Rebecca Round spent three years in hospital in Launceston. Adults with paralysis spent up to two years in hospital, but for growing children it was often longer.
Rebecca’s mother rode her push bike along the gravel road the 56 miles (90km) to and from Launceston every Sunday as hospitals only allowed parents to visit children on the weekend. But there were opportunities to play – for example, children confined at Frankston Orthopaedic Hospital were taken to the hospital’s beach.
When she eventually left hospital, Rebecca wore callipers. Although her left leg and foot and left arm were weaker than the right, she learned to ride a bike again. Boots made especially for her cost her father two weeks’ wages, and at age twelve she had surgery to lengthen the shortened tendons to her foot.
But she was determined to go to school, and did well, ultimately earning a university scholarship to go to Hobart and train as a teacher.
But not all patients could go home due to more severe problems, particularly with breathing or widespread paralysis.
These days, most children are vaccinated against polio before school age and this has seen the disease nearly completely disappear in most westernised countries. But in Afghanistan, Nigeria, Pakistan, Equatorial Guinea, Iraq, Cameroon, Syria, Ethiopia, Somalia and Kenya, polio still paralyses and kills. In fact, the Global Polio Eradication Initiative reported twenty-one cases in 2017.
In the end, Robin Cavendish died in 1994, at the age of 64, after he was awarded an MBE for his work with the disabled. Despite his prognosis, he defied doctors’ predictions that his life would be a short one outside of a hospital.
Breathe also serves as a reminder of the importance of vaccination; because almost the entire population must be immunised to prevent epidemics, global eradication is still in jeopardy, and an effective cure remains elusive.
Banner image: Boys with polio at Frankston Children’s Hospital in 1936. Picture: State Library of Victoria/ Lyle Fowler