Dame Agnes Hunt: pioneer of orthopaedic nursing.
Abstract: As a young surgeon in the early 1950s, I trained in various orthopaedic units. Much of the work was concerned with children and young adults suffering from two devastating diseases: tuberculosis and poliomyelitis. These were to vanish almost entirely from our hospitals soon afterwards, thanks to Bacillus Calmette-Guerin (BCG), antibiotics and the polio vaccines. However, the dedicated nursing that long term orthopaedic patients of today still require--those with congenital deformities, spinal injuries, multiple traumas and so on--owes much to the teaching of Agnes Hunt, pioneer of orthopaedic care.

KEYWORDS Agnes Hunt / Bone and joint tuberculosis / Crippled children / Orthopaedics / Poliomyelitis / Rehabilitation / Robert Jones
Author: Ellis, Harold
Pub Date: 11/01/2008
Publication: Name: Journal of Perioperative Practice Publisher: Association for Perioperative Practice Audience: Academic Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2008 Association for Perioperative Practice ISSN: 1750-4589
Issue: Date: Nov, 2008 Source Volume: 18 Source Issue: 11
Accession Number: 200343276
Full Text: Introduction

Agnes Hunt was born in London in 1866. At the age of 10 she contracted tuberculosis of the left hip and repeatedly suffered painful flare-ups of this condition, had a severe limp and walked with a crutch. In spite of this, she was determined to train as a nurse.

Hospital after hospital refused to accept a crippled girl, but eventually she was accepted for training by the Royal Alexandra Hospital in Rhyl. Agnes went on to qualify as a Queen's nurse, trained in midwifery and spent several years as a district nurse, during which time she encountered several epidemics of smallpox and typhoid fever.

In 1900 at the age of 34, she began her life's work, the care of crippled children. In the Shropshire village of Baschurch, where she lived, together with her friend Selina Goodford, she turned a three-sided wooden shed in the grounds of a farm into accommodation for four crippled boys and four crippled girls. The treatment was good food, fresh air, rest and loving kindness. The number of children and huts increased progressively.

In 1903, Miss Hunt persuaded her own surgeon, Robert Jones (1857-1933), of the Royal Southern Hospital, Liverpool, to see her problem cases in his clinic. This involved taking her youngsters in their wheelchairs for a three hour train journey, then on the ferry, then through the streets of Liverpool to the hospital. After three tedious years of this, Robert Jones was persuaded to come out to Baschurch one Sunday a month. Here he would see 40 to 50 in and out patients and perform anything up to 20 operations in the small theatre--an exhausting day. But after this, Agnes, on her crutches, would carry out an evening round to make sure that all was well with her hutted children.

Much of what she had learned about splints, plaster of paris and orthopaedic frames came from Jones, who himself had learned his art from his uncle, Hugh Owen Thomas (1834-1891), who had devised the Thomas splint for immobilisation of hip and femoral injuries and disease, and who had preached the value of prolonged, continuous and perfect immobilisation of diseased joints and of fractures.

Robert Jones brought distinguished visitors to the hospital, and the surgical staff doubled when he was joined by a young surgeon from St Thomas' Hospital, Robert Girdlestone (1881-1950), who later went to Oxford to found what is now the Nuffield Orthopaedic Centre. Remarkable results were being obtained. Girdlestone wrote that, having been used to seeing in hospital thin, pale, suppurating children with bone and joint TB, eventually dying of amyloid disease, he was encountering lively children in the best of spirits and good health.

The Great War of 1914-1918 saw dramatic changes in the work at Baschurch. Crippled soldiers were now being housed in still more huts, as well as tents, in the hospital grounds. The work of rehabilitation was now moving from TB and polio to the major mutilations and amputations of War. For her wartime services, Miss Hunt was awarded the Royal Red Cross and, in 1926, was appointed Dame of the British Empire.

In 1921, with the aid of a grant from the British Red Cross, the hospital was moved to proper buildings at Oswestry, where it stands today, and was named the Robert Jones and Agnes Hunt Orthopaedic Hospital.

Dame Agnes had long realised that crippled patients cannot readily travel long distances to attend out patients'. During the last years of the war, she organised clinics in the small towns of Shropshire and the surrounding counties, so that the surgeons could visit the patients, rather than vice-versa. Each clinic was supported by enthusiastic volunteers. This system of outreach orthopaedic clinics spread throughout the country and, indeed, throughout the world.

Cripples, once stabilised, need employment and independence. In 1927, she established the Derwen Cripples' Training College, near Oswestry, where young men and women were taught trades suited to their individual disabilities. She was delighted when her patients were finally returned to useful lives in the community.

Agnes Hunt was a strict disciplinarian but she had a great sense of fun and joy of life, coupled with unbounding energy and a complete freedom from pride. She died a spinster at Baschurch in 1948. Her living memorials are the orthopaedic clinics and rehabilitation centres of today.

About the author

Professor Harold Ellis

CBE, FRCS

Emeritus Professor of

Surgery, University of

London; Department of

Anatomy, Guy's Hospital,

London
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