Emergency Services => Medical => Topic started by: kyn on March 09, 2012, 23:52:39

Title: Dover Castle Hospital
Post by: kyn on March 09, 2012, 23:52:39
Report of 1858

Dover Castle Hospital

The Hospital for the garrison sick is an old brick building, situated in front of and below the new Officer’s Quarters.  The position is an airy and healthy one, but the building itself is deficient in some important requirements.  It is two stories high and has four large wards with small wards at the ends, the only entrance to which is through the large wards.  All the wards are too low for efficient natural ventilation, although the large wards have windows on both sides.  It would be desirable in this case, to provide ventilating shafts rising from the ceiling of the wards through the roof, for giving exit to the foul air; and also inlets for air near the ceilings, and under control of the medical officer, who would regulate the ventilation according to the state of the weather and force of the wind.
The following, according to the dimensions returned to us, is the present accommodation of this Hospital, as contrasted with what it would be if 1,200 cubic feet were allotted to each patient:-

Wards.Total regulation Number of Beds.Total Number at 1,200 cubic feet per Bed.Total Deficiency in bed space.
1, 2, 3, 4722844
Total 7783345

The Hospital contains accommodation in these seven wards for not more than thirty-three beds, at rather less than 1,200 cubic feet per bed.  The building requires to be extended to accommodate the present sick, and were the garrison increased in numbers, a corresponding additional increase of the hospital accommodation would be necessary.
There is a water-closet on each floor, constructed within the building, but these water-closets are unventilated, and have no windows to the outer air.  They are only lighted and ventilated into the passage by a window opening into the passage.  These closets drain into a cesspit immediately behind the Hospital, an arrangement which ought to be altered as soon as possible.
Shafts and inlets for air should be at once provided for the present closets, but it would be greatly better to erect suitable water-closets, bath rooms, and lavatories, outside the hospital buildings, with separate light and ventilation: to fill up the existing cesspool, and to drain the whole buildings to the sea.
The kitchen and scullery are situated at the end of one of the lower wards, and it appears that it is custom to carry all the hospital diets through that ward, as being more convenient than carrying them through the open air outside.  It is supposed to be contrary to rule to do so, but no rule will prevent such a thing being done where the convenience is so much greater than carrying the diets outside in all states of the weather.
The kitchen is in fact situated where the lavatories, baths, and water-closets of the ward ought to be.  Its cooking arrangements are tolerably good; it has an oven and an open fireplace, and is considered sufficient.
There is a detached privy behind the Hospital, which has a receptacle for water, and is flushed daily.  There is a good arrangement at the back to cause water to flow down constantly by means of a pipe similar to those which supply water to urinals, by which the back is kept clean.
Thee ashpit is uncovered; it should be done away with, and the refuse removed by an iron cart.
There is no ablution room, and no bath room.  One ward is used as a bedding store.
The pack store is used also as a provision store, which is objectionable.
We would recommend that this Hospital be extended on a plan to include every improvement.  But the following requirements are necessary for the present building:-

1.   Reduction of number of beds, as pointed out.
2.   Ventilation and warming of wards by shafts and inlets for air, and be remodelling grates.
3.   Abolishing the cesspool, and draining the hospital buildings to the sea.
4.   Ventilating the present water-closets by shafts and inlets for air, and by a window, until better closets are constructed outside the building.
5.   Abolition of ashpit, and daily removal of refuse.
6.   Ablution and bath room to be provided.
Proper pack, provision, and other stores, also a  room for orderlies, are very much required.