Lost Hospital — DC General Hospital, Washington, DC

The Washington Infirmary was the first public hospital established in 1806. The facility moved its location in 1846 (known as the Washington Asylum at the time).

The hospital housed the city’s indigent patients, as well as serving as a work house for convicted criminals (for minor crimes).

Over the years DC General Hospital was a smallpox hospital, a quarantine station, a disinfection plant, and crematory. In 1922, Gallinger Municipal Hospital was built at the location, and in 1953 officially changed its name to District of Columbia General Hospital.

DC General Hospital closed in May 2001 after serving the community for almost two hundred years. Although hospital inpatient services ended in 2001, the campus still offers a variety of services such as a Women’s Services Center, Detoxification Center, and Southeast Sexually Transmitted Diseases Clinic. The city Jail is located to the south of this historic health care facility.

Before DC General Hospital closed, those wishing to keep the hospital open made the following arguments against its closure:

  • The hospital was strategically located in the eastern half of the city, which was an area already feeling the impact of other hospital closings.
  • Closing the hospital would increase the risk of shortages in the city’s ability to deliver health care.
  • Closing the hospital would create even greater problems in the future, as it would deprive the city of having the right hospital in the right place.

When DC General Hospital closed, many questioned the future of public hospitals in cities across the United States.  A July 2001 article in Health Affairs offered the following:

Public general hospitals like Bellevue (in New York City), Philadelphia General Hospital, and Boston City Hospital were once staples of urban America. Bellevue remains active today, but Philadelphia General closed more than twenty years ago, and Boston City has melded into the quasi-private Boston Medical Center. The expense, complexities, and “marketization” of health care have combined to cause cities to consider alternatives to the public management of large medical centers. Protracted debate over the closing of D.C. General Hospital in the nation’s capital is the latest high-profile battle over a public hospital. Paul Offner, a former health care finance commissioner, writes of his skepticism about the public hospital as the best buy for local taxpayers—a position that seems to have influenced subsequent events in Washington. As the CEO of Denver Health and a thirty-year veteran of public hospitals, Patricia Gabow writes from a very different vantage point. Civic will and clinical commitment, she argues, are the key ingredients to making a public hospital work. Where they exist together, public institutions can be powerhouses of service, education, and research.

District officials closed DC General Hospital because they could no longer afford to keep it open. At the time this was, and continues to be, a common pattern across the country.  In the seven years before DC General Hospital closed, the number of facilities with emergency departments decreased by 15%.

The FDA Discusses the Future of Electroshock Treatment

Next week the United States Food and Drug Administration (FDA) will meet to discuss the future of electroshock devices, whether to downgrade the restrictions on its use or make the treatment more available. Each year an estimated 100,000 Americans undergo the treatment for major depression and other conditions. Two-thirds of these patients are women.

Electroshock therapy is a historically controversial, psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect.  The American Psychiatric Association and other leading experts are recommending that the FDA downgrade the devices, making the now “high-risk” treatment “medium-risk.”  If this occurs, equipment for such treatment would be regulated like syringes and surgical drills.

According to Dr. Matthew V. Rudorfer, a psychiatrist and top specialist at the National Institute of Mental Health: “These tend to be mom-and-pop operations. So I think the dilemma might be that undergoing new expensive clinical trials might be too expensive.” According to Vera Hassner Sharav, president of the Alliance for Human Research Protection, an advocacy group in New York: “It’s all trial and error — it’s all experimental. All the years it’s been controversial and there have not been clinical trials. Why not?”

The FDA review was recommended by the U.S. Government Accountability Office in 2009 as part of an examination of the treatment’s regulatory status, as well as other less controversial medical devices (such as pacemaker electrodes and implanted blood access devices).

More information about the FDA’s review can be found at NewYorkTimes.com.

The Living Dormant: MicroZombies

There’s life.  There’s death.  And there is dormancy. Somewhere in between a zombie and a hibernating bear, dormant microorganisms potentially have a profound impact on the natural environment.

A recent study in Nature Reviews: Microbiology examines the cellular mechanisms that allow these microbes to exist in a dormant state.  The study also explores the impact these dormant microbes can have on larger ecosystems, including the ground, the oceans, and humans.

Study author Jay Lennon, Michigan State University assistant professor of microbiology and molecular genetics, explained:  ”Only a tiny fraction is metabolically active at any given time. How would our environment be altered, in terms of carbon emissions, nutrient cycling and greenhouse gases such as nitrous oxide, by dramatic increases or decreases in the dormancy of microbes?”

“Dormancy” has properties of low metabolic activity, and it is considered a reversible state. Organisms sometimes enter into this state in response to freezing temperatures or lack of food. These organisms do not follow a linear growth pattern, and dormancy could occur at any time.

Lennon added: “However, it does take a certain level of commitment, a certain energy investment to make it happen. Just as people don’t run out and winterize their homes if it gets cool in August, microbes want to be sure that truly hard times have set in before shifting into a dormant phase.”

Lennon and his co-author, Stuart Jones at the University of Notre Dame contend that 90 percent of microorganisms in the ground are usually dormant and only half of bacterial species are active, creating an enormously large “seed bank” that could have profound implications.  According to Lennon: ”The idea of a microbial seed bank is a rather novel concept, but from our research we found that dormancy and seed banks are prevalent in most ecosystems. What’s fascinating is that there’s only a small fraction that are active, which means there’s a large reservoir that could potentially be activated at any given time.”

Among other things, the authors contend that dormancy may explain the sudden outbreak of diseases, triggered by environmental changes.  Lennon noted:  ”One-third of world’s population carries dormant tuberculosis microbes. Obviously, you can live a long time with the dormant cell in your body, but it’s important to understand what can trigger its reanimation or what maintains its dormancy.”

Rodents: Uninvited Winter Guests

This time of year we should all be vigilant in our battle against influenza. The winter months, however, bring additional health concerns from some little creatures who roam freely throughout our communities and inside an estimated 21 million homes. This threat comes from rodents.

Rodent infestation can contaminate food sources, especially since rodent feces can spread Salmonella and Hantavirus. Food contamination aside, rodents can also bring lice, fleas, ticks, and mites into the home. And if that was not bad enough, mice can cause extensive damage to homes by  gnawing on wood, walls and wires.

According to Missy Henriksen, vice president of public affairs for National Pest Management Association, Inc. (NPMA): “Rodent infestations are cause for concern because not only do they pose risks for your home, but for your family’s health and safety as well. It is crucial to take steps to prevent rodent infestations and to recognize the signs that you might have one.”

NPMA offers some tips to identify and avoid rodent problems this winter:

  • Inspect wires, insulation and walls for any signs of gnaw marks, which may indicate an infestation.
  • Store boxes and containers off of the floor and organize items often to prevent rodents from residing in undisturbed areas.
  • Install gutters or diverts to channel water away from your home.
  • Seal cracks and holes on your home’s exterior, including areas where utilities and pipes enter.
  • If you find rodent feces, hear sounds of scurrying in the walls or observe other signs of an infestation, contact a licensed pest professional to inspect and treat the pest problem.

For additional information, visit the NPMA Website.

Rodents: Uninvited Winter Guests0

This time of year we should all be vigilant in our battle against influenza. The winter months, however, bring additional health concerns from some little creatures who roam freely throughout our communities and inside an estimated 21 million homes. This threat comes from rodents.

Rodent infestation can contaminate food sources, especially since rodent feces can spread Salmonella and Hantavirus. Food contamination aside, rodents can also bring lice, fleas, ticks, and mites into the home. And if that was not bad enough, mice can cause extensive damage to homes by  gnawing on wood, walls and wires. … Read more →

The World’s Largest Hospital — Chris Hani Baragwanath Hospital in South Africa

Chris Hani Baragwanath Hospital in South Africa is the largest hospital in the world. Located southwest of Johannesburg, the Hospital expands over 173 acres, consists  of 429 buildings, and has 2,964 beds.

The Hospital is the only public hospital providing medical care to approximately 3.5 million, and as a specialty hospital, patients travel there from all over the country and the surrounding African nations. The hospital employs almost 5,000 people, including 600 doctors and 2,000 nurses.

Patients pay according to income and marital status, with approximately 80% classified as “hospital patients”. There is no charge for maternity cases and all children under the age of 6 years old. Approximately 20% of patients are classified as “private patients,” which include medical aid plan members.

The Hospital dates back to 1939 when there was a great need to treat a backlog of patients in the British Empire, including military personnel. In September 1940, the Secretary of State in London formally asked the South African Government to provide health care facilities for the Imperial troops under command in the Middle East.  Two hospitals were suggested, and in November 1941 one was constructed near Johannesburg. The British Government paid 328,000 pounds for 1,544 hospital beds, and they named the facility “The Imperial Military Hospital, Baragwanath.”

Due to an urgency created by the Second World War, the Hospital admitted its first patients in May 1942, with an official opening in September 1942. The Hospital originally treated the casualties of the war, mainly from the Middle East. Toward the end of the war, the Hospital treated mostly Tuberculosis patients.

After the war, the South African Government had bought the hospital for one million pounds. Over the next 30 years the Hospital grew in size and status to its nearly 3,000 hospital beds today. In 1997, the hospital name changed to “Chris Hani Baragwanath Hospital” after the murder of the prominent activist, Chris Hani.

The World’s Largest Hospital — Chris Hani Baragwanath Hospital in South Africa0

Chris Hani Baragwanath Hospital in South Africa is the largest hospital in the world. Located southwest of Johannesburg, the Hospital expands over 173 acres, consists  of 429 buildings, and has 2,964 beds.

The Hospital is the only public hospital providing medical care to approximately 3.5 million, and as a specialty hospital, patients travel there from all over the country and the surrounding African nations. The hospital employs almost 5,000 people, including 600 doctors and 2,000 nurses. … Read more →

England and Organ Recovery

England’s National Health Service (NHS) established in 2005 a Special Health Authority, the NHS Blood and Transplant (NHSBT). NHSBT’s mission is “the provision of a reliable, efficient supply of blood, organs and associated services to the NHS.”

NHSBT recently announced that in 2010 there were more than 6,900 organ and cornea transplants throughout the United Kingdom, and over 2 million donations of blood were collected in England and North Wales. 2010 also saw a record number of patients across the UK receive a transplant while the number of people on the NHS Organ Donor Register reached 17.7 million.

According to Lynda Hamlyn, Chief Executive at NHSBT:

“We rely entirely on the generosity of donors who make the difference to so many patients who need lifesaving transfusions and transplants. I would like to thank every one of our regular blood donors and those who have joined the NHS Organ Donor Register. This has allowed us to help save and improve more lives in 2010 than ever before. [¶] Donation saves lives, and as we start a new year and a new decade, I would encourage anyone interested in helping save and improve the lives of others to consider becoming a blood donor, if they can, and joining the NHS Organ Donor Register by calling 0300123 23 23 or visiting our websites. [¶] Our priority is to maintain the goodwill and support of our generous donors – be they blood or organ. But at the same time we are mindful of the current economic climate and are particularly proud that we achieved these record results while continuing to deliver overall cost savings of nearly £30million. Money that can be reinvested in front-line patient care in the wider NHS.”

Even while the UK saw more transplant operations in 2010 than ever before, an estimated 10,000 patients remain in need of a transplant in the UK. About 3 people a day will die before an organ becomes available. Hamlyn noted: “Thanks to the altruism of donors and their families, a record number of organs were made available for transplantation in 2010 and a record number of peoples’ lives were saved or improved as a result.”

The full announcement can be read HERE.

Lost Hospital — The Renwick Smallpox Hospital, Roosevelt Island, New York

Smallpox is an infectious disease unique to humans. The term “smallpox” was first used in Europe in the fifteenth century as a way to distinguish this disease from the epidemic of syphilis.

Smallpox killed an estimated 400,000 Europeans each year by the end of the eighteenth century. As recently as 1967, the World Health Organization (WHO) estimated that 15 million people contracted the disease, and two million had died as a result.

The Renwick Smallpox Hospital (later the Maternity and Charity Hospital Training School) was located on Roosevelt Island in New York City.  When Renwick Smallpox Hospital opened on December 18, 1856 on Blackwell’s Island (the island’s name at the time), the hospital could treat 100 patients.

Designed in the style of Gothic Revival, the Smallpox Hospital was strategically positioned in an undeveloped area at the southern tip of the island. The facility was a three-story, “U-shaped” structure complete with two large wings and a front façade at the center. All of the windows on top floor had distinguishing pointed arches rather than curves.

Even with the smallpox vaccine, New York City had large outbreaks, in part due to the large immigrant population travelling to the New World. Before the Smallpox Hospitals, victims of the disease received care in what was described as “a pile of poor wooden out houses on the banks of the river.” Renwick Smallpox Hospital’s remote location was chosen to isolate and quarantine patients, but due to the seriousness of the disease, the hospital had both a large charity ward (on the lower floors) as well as private rooms (on the top floor).

In 1875, the Renwick Smallpox Hospital closed, and with its affiliation to City Hospital, it became a training center for nurses (and later renamed Charity Hospital). The hospital focused on academic training after a new hospital was built on North Brothers Island to treat smallpox and other similar diseases. Between 1903 and1905  the two wings were added to the Renwick facility to accommodate the school, officially renamed the Home for the Nurses and the Maternity and Charity Hospital Training School.

In 1921 Blackwell’s Island was renamed Welfare Island. Over the years, many of the buildings began to deteriorate into total disrepair. In the 1950s, both Charity Hospital and the nursing school were closed, and these operations moved to a new location in Queens, New York.

In 1972, the Renwick Smallpox Hospital was added to the National Register of Historic Places, even though the buildings were basically ruins. In 1973, Welfare Island was renamed Roosevelt Island (in honor of Franklin D. Roosevelt).

Over the years the famous and historically designated neo-Gothic ruins were illuminated at night in an attempt to raise money for the facility. Unfortunately, on December 26, 2007, part of the north wing collapsed, escalating the need to complete the upgrade. Finally, on May 28, 2009, renovations began to stabilize the Smallpox Hospital, including the addition of a memorial to Franklin D. Roosevelt, and a 14- public area.

With a cost of about $4.5 million, the Renwick Smallpox Hospital ruins were opened to the public. The old Renwick Smallpox Hospital is New York City’s only ruin that remains an official landmark, and it has  subway and aerial tram access to and from Manhattan.

England and Organ Recovery0

England’s National Health Service (NHS) established in 2005 a Special Health Authority, the NHS Blood and Transplant (NHSBT). NHSBT’s mission is “the provision of a reliable, efficient supply of blood, organs and associated services to the NHS.”

NHSBT recently announced that in 2010 there were more than 6,900 organ and cornea transplants throughout the United Kingdom, and over 2 million donations of blood were collected in England and North Wales. 2010 also saw a record number of patients across the UK receive a transplant while the number of people on the NHS Organ Donor Register reached 17.7 million. … Read more →