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| Photo of Ignaz Semmelweis by Brittanica |
It is 1846, A spectre is haunting Europe – the
spectre of a disease. All the powers and knowledge of medicine have entered
into a rescue alliance to exorcise this spectre: doctors & patients, hospitals
and churches, academics & mythical.
But no form
of exorcising seems to drive out this disease.
The disease is causing havoc; ravaging and wrecking the lives of women
in Europe. Shortly after giving birth, women
would exhibit symptoms consisting of fever, Lower abdominal pain and bad
smelling vaginal discharge and within 24 hours this disease would thrush them
straight to their graves. Child Birth was a death warrant.
The
diseases came to be known as Child-bed fever (Puerperal fever). In medical
school students would be told “the causes of this disease is so complex that a
human could not understand it, the disease is due to forces of nature too
powerful for a human to do anything about it.” Humans were rendered helpless.
Ignaz Semmelweis
a doctor at Vienna General Hospital is determined to stop this merciless
murderer.
Vienna General
Hospital had two sections of maternity – Clinic one operated by Doctors &
Clinic Two operated by midwifes. Semmelweis noted that the Doctors Clinic, with
competent and qualified professionals had a mortality rate of about 16% and that
of the midwife a mortality rate of 2%. This was a big margin of clinics in same
locality.
The
situation was so bad that pregnant women would beg on their knees to be
admitted to the Midwife clinic to avoid being taken to the Doctors clinic. In
some cases, pregnant women preferred to give birth in the streets than be
admitted in the Doctors clinic.
The doctors
blamed the high morality to miasma (bad air). But Semmelweis could not accept
this explanation because both clinics were located at the same place and the
air was the same.
He decided
to investigate the reason for the big margin. He decided to question every
theory put forward. Why did the doctors section have more death than the
Midwife section?
He observed
there was speculation that the ventilation system in both clinics caused the
difference in air. On investigation the ventilation was in fact the same.
He observed
that the birthing position of women in the midwife section was different from
that of the doctors. He introduced the same birthing position to the doctors
section. No change.
He observed
in the Midwife section there was prayers with a priest every day. He introduced
the same in the Doctors section. No change.
He note
that every morning a bell would be rung in the midwife section. He introduced
the same in the Doctors section. No change.
He observed
there was a difference in schedule in both sections. The midwife would operate
their sections the whole day while the doctors would carry out autopsies in the
morning on dead bodies and in the afternoon they would come to the maternity ward
to assist pregnant women in delivery of children.
During this
period one doctor pricked his finger with a scalpel while carrying out an
autopsy on a cadaver of a woman who had died of child bed fever. The doctor
then died a few days later.
When an
autopsy was done on the dead doctor body the same observation that was made on
women who had died of child bed fever were observed on this dead doctor cadaver.
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| Graph by Brent Dykes |
Semmelweis
concluded that there must be a relationship between the death of the doctor,
the pricked finger and the infected autopsy. He reasoned that the disease must
have been transmitted into his body through the pricked finger. The disease was
somehow transmitted by human to human contact. Therefore, to prevent
transmission and stop death on women, he instructed doctors to wash their hands
after carrying out the autopsy with chlorinated lime before they go to help
women in the maternity wards.
When he
informed doctors of his findings he was laughed at, dismissed and ignored but
he persisted.
His hand
washing instruction was finally reluctantly implemented and the mortality rate
in the hospital plunged down. In the doctors hospital it went to as low as 1.0%
and in the midwife section to almost 0%.
The disease
problem solved? Sadly no.
Doctors
could not believe how a simple solution, as hand washing could solve a big
problem that kills thousands and thousands of women.
More so, by
telling doctors to wash their hands, it was implied that he was suggesting that
the doctors were murdering their own patients all along; they themselves were
the problem, they were the “irresponsible murderous” of their own patients.
In
opposition to Semmelweis suggestion of hand washing Doctor Charles Meigs wrote
a furious defense to ridicule Semmelweis stating, “Doctors are gentlemen… and a
gentleman’s hands are clean.” In short, Dr. Charles would rather see women die,
than see men put their pride and ego down.
John Cline,
an old doctor, and strong believer in old medicine teaching criticized Semmelweis
and considered him to be challenging the established order and said to him,
“Keep yourself to what is old, for that is good. If our ancestors have proved
it to be good, why should we not do as they did? Mistrust new ideas. I have no
need of learned men; I need faithful and obedient subjects. He who would serve
me must do what I command.”
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| Graph by Brent Dykes |
Semmelweis
ideas of hand washing were totally disregarded even after the evidence of low
mortality rate. The doctors returned to their old practices and abandoned hand
washing; mortality rates shot up, thousands of women continued to die in the
hands of the “clean gentlemen’s hands.”
Semmelweis,
faced with great opposition from fellow
doctors maintained his push with the idea of hand washing and vigorously advocated
for hospitals to observe hand washing and educated mothers not to accept to be assisted
during delivery by a doctor who had not washed his hands.
Other
doctors considered him a threat to the profession, his reputation was soiled, he
lost his job and ultimately committed to a mental asylum where it is suspected
he was beaten by guards, suffered a wound that would be infected leading to his
death.
His funeral
was unattended and fellow doctors refused to give him the commemorative service
given to all doctors as was the norm at the time.
Years later,
long after his death, in the late 1850s Louis Pasteur came up with the
Scientific Germ Theory, which proofed the existence of germs with capacity to
cause infections and in fact Ignaz Semmelweis was right all along and in deed hands
could be sanitized by hand washing. Finally Semmelweis ideas were accepted and the
people realized the horrible mistake they had made by rejecting Semmelweis ideas
and how more lived would have been saved if they had adopted these ideas
earlier on.
Semmelweis was a man ahead of his time. It is
impressive of how he could deduce this hand washing idea at a time when
infection by germs was unknown and Germ Theory had not been invented. He would
be nicknamed as the savior of women and father of infection control.
Ignaz
Semmelewis experience is a case study to all who want to establish a new order.
Change is never easy.
The people
who benefit from the maintenance of status quo will oppose any one who wants to
challenge this status. The corrupt will not accept the accountability agenda. The
warlords will not accept peace. The unjust will not accept an effective
judiciary. The oppressor will not easily let go the oppressed. But we can always speak the truth, for truth
is truth even if only one individual states it and in the fullness of time it
shall defend its self like a loose lion.
Truth will
always be offensive to the social order.
Ignaz Semmelweis
led to the phrase “Semmelweis reflex” to refer to the tendency to reject new
ideas and new knowledge because it contradicts established ideas, norms and
belief. All truth begins as blasphemies and human nature has always got in the way
to resist new ideas and thoughts.
As pioneer
of change we should continuously and consciously be aware of this Semmelweis
reflex. Questioning the social order and its integrity is not an easy task. People
are often indoctrinated with existing and established dominant doctrines and
norms. When exposed to new information and
norms, it will often be interpreted based on these established norms which will
lead to biased, predetermined and prejudiced conclusions rejecting the new
information and ideas.
New wine
cannot be placed in old wine skin. Our task is to be mentally ready not only to
accept all new wine, but to also question it without bias or fear and use it
for the good of all.
And as
Barack Obama would put it, “change requires
more than just speaking out -- it requires listening, as well. In
particular, it requires listening to those with whom you disagree, and being
prepared to compromise… And democracy requires compromise, even when you are
100 percent right. This is hard to explain sometimes. You can be
completely right, and you still are going to have to engage folks who disagree
with you. If you think that the only way forward is to be as
uncompromising as possible, you will feel good about yourself, you will enjoy a
certain moral purity, but you’re not going to get what you want. And if
you don’t get what you want long enough, you will eventually think the whole
system is rigged. And that will lead to more cynicism, and less
participation, and a downward spiral of more injustice and more anger and more
despair. And that's never been the source of our progress. That's
how we cheat ourselves of progress.”
