Talk:Raphael Cilento

Notes for possible expansion

19080000[1]

After attending Jamestown Public School, in 1908 Raphael Cilento became a teacher

1910-19110000 [2]

During 1910 - 1911 Raphaeol Cilento taught pupils at Port Perie, South Australia

19170000[3]

Those leading the development of public health tended to overstate the threat of hookworm in Australia. There was a concern that the effects of the disease on Aborigines was to create a permanent pool of infection which would always pose a threat to the broader Australian population. Cilento was one whose views, on this subject, were extreme. In his diary of 17 December 1917, Cilento reveals a perspective of prejudice and a tinge of compassion about Aborigines, when he writes that:

..my Aboriginal patient was in a meanly built cottage…As the car drove down it was greeted by scores of mongrel dogs…Their furious barking brought natives old, young and middle-aged, black, yellow and almost white to every door and window….The home of the sick women was floored with mud and stamped hard….The living room was crowded with waiting gins….The bedroom was smaller dirtier and similarly floored and roofed with bags that bulged with many a hint of vermin and dirt.

These comments seemed naive and prejudiced to Yarwood, who wrote about Cilento in the early 1990s.

Sanitary conditions in the cane plantation regions had been poor and as a result most plantation workers became infected. The same was true for the Aboriginal communities. Sanitary closets were not extensively provided because of the costs of installation. In the mid-1920s Bleakley had difficulty in showing that the Aboriginal population was increasing on reserves. However, populations were increasing in the fringe camps and information on their size was never properly collected. The demand for toilet facilities was never accepted as a legitimate health need.

19180000[4]

MB, BS from studying medicine at University of Adelaide

19181126[5]

Appointed captain, Australian Army Medical Corps, Australian Naval and Military Expeditionary Force. Next month he arrived in Rabaul.

Raphael Cilento became acquainted with the field of tropical medicine and sent reports on medical conditions in New Guinea to senior administrators in Rabaul and Melbourne.

19190900[6]

Failing to secure a continuing role, he returned to Australia in September 1919 and his military appointment terminated

19200000[7]

Raphael Cilento obtained a post as a physician to the sultanate of Perak, Federated Malay States, where he gained expertise in tropical medicine and acquired a lifelong interest in the countries of the Asia-Pacific region

19200318[8]

18 March 1920 at St Columba’s Church of England, Hawthorn, Cilento married Dr Phyllis Dorothy McGlew who had been a fellow student

1921[9]

he was offered employment back in Australia, as medical officer for tropical hygiene with the Commonwealth Department of Health, based at the Australian Institute of Tropical Medicine, Townsville, Queensland.

1922[10]

study at the London School of Tropical Medicine (DTM&H, which he completed with distinction... became a leading figure in the field; appointed director of the Australian Institute of Tropical Medicine, Townsville

19230000[11]

Cilento, the new Director of the Division of Tropical Hygiene, had a different view of treatment: the public were to be educated. His view was that

the new hookworm campaign was basically educational. Illustrating pamphlets in Maltese, Italian were distributed in the community and lantern light slide lectures were held to demonstrate…[the need] for clean sanitary habits. Hookworm nurses and inspectors visited schools and other public places. There were laboratories in most centres for testing samples of faeces for the presence of hookworm eggs….It was difficult to collect faeces from sugar farmers…among whom domestic sanitation was appalling…[they] had little or no English, lived in poverty in squalid hovels and kept to themselves.

..Cilento had changed the research orientation of the Institute from a preoccupation with disease conditions to preventive medicine or, as he put it, ‘from sickness to health.’ He knew that ‘by the early twentieth century the aetiology and cure for hookworm infestation had been well understood.’

Cilento obviously understood workers’ habits in the cane cutting districts.

1923[12]

MD from studying medicine at the University of Adelaide

1924-19280000[13]

he was seconded in 1924-28 to Rabaul as director of public health for the Mandated Territory of New Guinea. Developing a research interest in the survival of Europeans in tropical environments, he published The White Man in the Tropics (1925), in which he defended the White Australia policy.

With J. H. L. Cumpston and J. S. C. Elkington, Cilento helped to shape policy and practice in the development of quarantine and tropical disease management

19280000[14]

he succeeded Elkington as director of tropical hygiene and chief quarantine officer, Brisbane.

19310300[15]

Raphael reported to the fifth session of the Federal Health Council that, in an effort to better understand epidemiology of leprosy, and to be better manage leprosy, a system had been set up in Queensland for recording all new case of leprosy .. the data for which was to be reported to the Director of the Division of tropical hygience in the Commonwealth Department of Health

19320000[16]

At a 1932 conference on the problems facing Australia in the tropics Cilento emphasised the point that adequate medical services were an important part of developmental activities in the tropics. He argued that Australia with its dependencies had ‘the largest tropical possession in the British Empire.’ This took account of Northern Territory, Papua and the Pacific Island possessions which were much bigger in area than African and South American tropical areas. Institutions such as the Australian Institute of Tropical Medicine, had been created in order to eradicate many of the diseases introduced between 1860 and 1900.

19321100[17]

Cilento wrote to Cumpston, Commonwealth Director-General of Health, pointing out that he had prepared an itinerary for a proposed examination of Aborigines suspected of being infected with leprosy. He had prepared the schedule in consultation with Bleakley, who had helped arrange visits to missions, government settlements and distant Aboriginal camps. Cilento arranged to travel between October and November 1932. He wanted to visit Townsville, Cairns and the Atherton Tableland regions before returning to Brisbane.

19340300[18]

‘A Brief Review of Leprosy in Australia and its Dependencies’, Cilento stated ..:

When the question of the Aboriginal was investigated, the problem was seen as complicated. The native habit of changing their names repeatedly further disguised relationships already marked by the haphazard use of terms brother, father, uncle, cousin, etc. Their complete dread of white society’s medicines, made...[Aboriginal patients accept] surgical possibilities...in hospitals utterly impossible....[It was only possible] to contemplate...complete segregation for all Aborigines diagnosed with leprosy.

This report appeared in the records of the seventh session of the Federal Health Council, held 20-22 March 1934. Cilento used this venue to further claim that it was ‘utterly untrue’ to assume that Aborigines would cooperate like white persons. Aborigines, he argued, feared the unknown which often controlled their responses. Anything outside their experience in the way of medicines frightened them and, as aconsequence, they would not return for follow-up treatment nor would their relatives give them up to authorities.

Evidence from the report revealed that eight lepers from a number of settlements had been isolated on Peel Island. These Aboriginal patients came from Mona Mona and were discharged from Peel Island as cured.

19340900[19]

The tropical hygiene division closed in 1934 and in September he accepted an appointment as the first State director-general of health and medical services in Queensland and returned to Brisbane.

1935-19460000[20]

Raphael Cilento advocated the establishment of a medical school at the University of Queensland. The university awarded him an honorary MD in 1935. In 1937-46 he was honorary professor of social and tropical medicine and he served (1935-46, 1953-56) on the university senate.

He also pursued his own research, especially into the state of Aboriginal health.

19350000[21]

Knighted in 1935, he threw himself into the task of creating a new public medical system, writing legislation for general medicine and for mental health. To help him with this work, he studied law

19350428

Cilento became the first Director General of Health and Medical Services for Queensland on 28 April 1935, and subsequently carried out extensive surveys among Aboriginal mission and government settlements in that State. Cilento’s views on Jews and Aborigines later became a matter of controversy but, in his own defence, he argued that he did try consciously to channel his department’s resources to tackle Aboriginal health problems systematically. In doing so, however, his chief obstacle was the parsimony of both the Queensland and Commonwealth governments, which prevented him developing a Statewide Aboriginal health strategy in Queensland. As a result it was virtually impossible for him to provide better primary and preventative health services for Aborigines in Queensland, or to improve on the limited knowledge of the poor health of the State’s Aborigines

Some health programs in Queensland did fortunately come to Aborigines in rural towns and on pastoral properties. One instance was the program to combat trachoma, an eye infection mentioned in earlier chapters, which became a public health threat, mainly in rural Queensland in the 1930s.

The Chief Protector’s office was placed under the Department of Health and Home Affairs in 1934. As this transition was being effected Bleakley was required to report directly to his Minister on the operations of his office rather than to the Cilento the departmental head. These arrangements changes in 1938.

19370000[22]

Cilento was clearly perturbed about the spread of leprosy, and his concern was for infection among both Aboriginal groups and the wider white society.

19370300[23]

Under new circumstances of working together, Cilento and Bleakley adopted very similar points of view. In a report to his Minister on 23 March 1937, Cilento wrote that ‘settlements are large concentration camps where natives are isolated from the white population and where any education or training they receive is relatively valueless due to lack of outlet.’ He was convinced that the real problem among Aborigines was, to a very great extent, a medical problem. What this meant was that it was a problem encompassing ‘all aspects of welfare from diet to working hours and working conditions.’ This was a movement away from the colonial policy of protection and towards one of total control based on health. Cilento further explained his views in these words:

The developmental scheme put forward some years ago, …that a native state should be built up on the Torres Straits, Cape York Peninsular, Palm Island axis, with gradual concentration towards this axis of true native stock, and gradual dispersal from it of near-white stock, is the only solution that is a progressive one.

He doubted whether such a plan could be properly implemented under the present departmental structure and protection policy. He was, nevertheless, certain that the plan he was proposing was necessary to ‘solve the native problem in a way that…[would] be to the advantage of the native…and prevent conflict between white labourers and coloured.’

19390429[24]

admitted to the Bar on 29 April 1939.

19400000[25]

In 1940 Peel Island leprosarium was converted into a lazaret for whites only. Fantome Island and a small part of Greater Palm Island, became segregated as a temporary detention and screening depot for Aborigines exclusively.... big increases were occurring in the white population and, according to Cilento and Cook, the need to separate Aboriginal from white patients appeared to be because of the racial prejudice of white patients, and the segregated institutions had little to do with medicine.

19440000[26]

Not opposed to private practice, he nevertheless endorsed a salaried health service; his ideas, published privately in Blueprint for the Health of a Nation (1944), provoked serious conflict with other members of the medical profession.

19450000[27]

Active on the new National Health and Medical Research Council, he supported the establishment in 1945 of the Queensland Institute of Medical Research.

Bruceanthro (talk) 07:22, 3 March 2009 (UTC)