Intended for healthcare professionals

Doctors In Conflict

Medicine in Ulster in relation to the great famine and “the troubles”

BMJ 1999; 319 doi: (Published 18 December 1999) Cite this as: BMJ 1999;319:1636
  1. Peter Froggatt, former vice-chancellor
  1. Queen's University of Belfast

    See pp 1609, 16483 Strangford Avenue, Belfast BT9 6PG

    In the past two centuries doctors in Ulster, and in Ireland in general, have had to face unique challenges over and above the demands of their normal practice. In the 19th century they had to endure the nightmare of the great famine, which in five years (1846-51) accounted for at least a quarter of the country's population of eight and a half million through death or emigration. 1 2 This century they have had to deal with the consequences of the sectarian violence that has scarred Northern Ireland. Such tests have forged a profession whose integrity and clinical skills are second to none.

    Summary points

    In the past two centuries Ulster's doctors have had to face unique challenges over and above the demands of normal practice

    In Ireland's great famine many Ulster doctors lost their lives to “famine fever” and cholera while treating patients at home and in fever hospitals

    During “the troubles” in Northern Ireland, health professionals have again been in the front line helping, often quite literally, to pick up the pieces

    Recognition of these extraordinary demands has often been sadly lacking, exemplified by the miserly five shillings a day paid to doctors for working in the fever hospitals during the great famine

    These tests, and the underlying character of Ulster society, have produced an Ulster medical profession with great cohesion and coherence and, more importantly, strengthened the existing common cultural and historical identity between doctors and patients

    Medical practice in the great famine

    In the great famine the cause of death was shared between diseases of nutritional deficiency (including the ultimate one of starvation) and “famine fever,” mainly typhus and relapsing fever, from which no one was immune—certainly not the 3500 physicians, surgeons, and apothecaries and the over 3000 “medical auxiliaries.” In 1849 these terrible twins …

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