A Colony of Consumptives "H OPE and work create vitality." This
motto for the tubercular met my eye at Papworth Village Settlement near Cambridge. We might all take it to heart. If a colony of two hundred and fifty consumptives, managed by consumptives, can turn out £50,000 worth of articles for sale in a year and establish a claim to be the happiest village in England, it is surely an example for us all. • - " " The most perfect scheme of its kind I have ever seen " is the verdict of H.M. the King, and doctors and social workers from all over the world endorse this expert praise of Papworth. Here there is hope and health and reasonable proSperity for the broken men and women among us. • Here the sick may rise instead of sinking in their own esteem. Here is a successful experiment alike in medicine and in social economics. In other articles I have tried to outline my theory that disease goes deeper than its apparently physical aspect ; it is a symp- tom of wrong living, a phase of some general maladjust- ment. To cure a person, more than material agencies are needed the mental and spiritual surroundings must be right. Dr. Vairier-Jones at Papworth knows this. One day the principles he works upon will find general acceptance for all chronic diseases. Tuberculosis is a subtle thing. Lack of a lung is not like lack of an arm or leg, but worse, for the handicap is hidden. Those who come in contact with the sufferer cannot be expected to know of the inner struggle which affects both character and temperament, of the alternations between exaltation and depression, of the easily tiring vitality of the average patient, and of the immense energy and enthusiasm he releases for a time in certain cir-; cumstances, making him not less, but more vital than the normal. The consumptive, in short, does not receive the sympathy and understanding which are his due. The sufferer from ." T.B." cannot stand the racket of long :hours and nervous strain, but if his circumstances are assured and his hours of work not over-long, he is capable of an output equal in quality to that of his more fortunate brother. Yet what is the average consumptive to c19 ? If he is poor, he becomes a charge on the State. If he is rich, he often becomes a hopeless invalid, and in any case withdraws from other employment the energy and love of those on whom he depends. Left to struggle in the incomprehending outside world, the danger of breakdown is ever at the consumptive's elbow. Only in rare eases can those who are handicapped in one of the most central of the processes of life—the functions of the lungs—win through by themselves to happiness and independence. At Papworth the right conditions are found for such people and a place in the world where they are desired and desirable and therefore content. Such a place we all want, and should have.
When a patient arrives he is put to bed in one of the wards of the hospital. The treatment is the normal one, but as soon as possible he is made to feel that there are still tasks for him to do whereby he may serve the com- munity. He is, of course, paid for work done. When he improves he is asked whether he wishes to settle down in the Village or to return to his former home and occu- pation. Every individual must settle that for himself ; no one is ever persuaded to stay. If he does stay he is found a suitable occupation or trade and receives wages strictly according to skill and earning capacity. If a patient be a craftsman, he will be paid the trade-union rate ; if an apprentice, or ignorant of any trade, he will receive less, but the average rate paid to those working in the Village Industries is is. lid. an hour.
For everyone a suitable occupation can be found either in the many industries at Papworth or among the clerical staff required to administer them. Women are employed as cost clerks, shorthand typists, book-keepers, sign- writers, and in the upholstery, leather-goods, and book- binding departments. For men there is the carpenter's shop, where anything from a pighouse to a garden seat is made ; the building department, which includes painters and house decorators as well as bricklayers ; the leather travelling goods factory, which holds a Royal Warrant for suitcases, and turns out material of the very highest quality; the ticket-writing department, the printing presses (which I hope will soon he largely extended), and the boot- repairing department. There is also a poultry farm and a market garden, and I was interested to hear from Dr. Varrier-Jones that he considers gardening and looking after chickens far harder work for his patients than any- thing he asks them to do in the factory.
This is the day of the machine. At Papworth it has been harnessed to the cure of tuberculosis. A woman at her typewriter, a man at his lathe, can hold their own with the outside world as self-supporting, self-respecting units. The reason is simply that the conditions are right and that the management efficient. All the people here, in spite of their disability, are doing the work which they are most fitted to do in healthy surroundings. They are free to live their own lives and do not have to worry about the risk of losing their jobs and where their next meal is coming from. The medical director and his helpers do the worrying for them—that is the only (and the necessary) difference between a consumptive and a healthy worker.
If a colonist remains away front his work, the doctor is at once informed by a very careful system of checks which is kept in every department, and he at once visits the man and sees what is wrong. Delicate cases are not allowed to work for more than four hours. The average is about five. I talked to a man in a certain section who had been at Papworth for ten years. He looked in the most robust condition, yet he has only one lung and he is epileptic as well. The Works Manager and his assistants are all consumptives. I will not describe individual cases, for such personalities, although they would be interesting and instructive to the average reader, might justly be resented by some of the splendid men and women at Papworth who may chance to see the Spectator. It is enough to say that miracles are wrought there, not by any new drug or treatment, but by the old, good plan of putting love and hope into the patient's life. This brings me to what is perhaps the central feature of the com- munity. Many consumptives—those married especially— cannot be treated as isolated units. They are infectious, but they cannot be cut off from their families. Yet if they return to the damp, darkness, or other wretched- ness which bred the disease, a relapse is almost inevitable. Settlers, therefore, are encouraged to bring their families to Papworth. To train a man in an occupation and then to cast him out to fight his way against adverse odds is futile : he must have a shelter, a permanent haven for himself and those dear to him. Papworth provides this, and the amazing thing about the Settlement is that no single child out of the hundred and forty that have been born there during the twelve years' life of the Settlement has developed tuberculosis in any known clinical form, nor has there been a single case of meningitis.
Here, if we have the wit to see it, is the solution for many of the ills which depress society. To make a colony of consumptives self-supporting was no easy task, and perhaps there are not many men in England who could have done it. But it has been done and could be done again all over England, if the means were available. It is not my purpose to appeal for funds, but if I had the disposal of that hypothetical £50,000 which our readers considered how to distribute in a recent competition, I would send it all to Dr. Varrier-Jones.
F. YEATS-BROWN.
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