ABSTRACT
In the face of massive numbers of casualties returning to the UK in World War 1, health services were rapidly reorganized under the leadership of Sir Alfred Keogh. Hundreds of military hospitals were set up. Sir Alfred personally asked two women doctors, both militant suffragettes and members of the British Women's Social and Political Union, to set up and run a hospital in London. This remarkable hospital was to pioneer new antiseptic treatments for wounds. Endell Street Military Hospital was set up in 1915 by doctors Flora Murray and Louisa Garrett Anderson. The hospital was staffed and run solely by women, treating 26 000 patients in 520 beds over the course of the war. One of their most heroic contributions was to the care of wounds in injured soldiers returning from France. Throughout the war wound infections led to the deaths of thousands of soldiers and contributed to significant morbidity such as limb loss in countless others. In 1916 James Rutherford Morrison, Professor of Surgery in Durham, invented bismuth iodoform paste (BIPP) for the treatment of wound infections. The paste has significant antimicrobial properties. The Endell Street doctors contacted Morrison in June 1916 and started using his formulation on injured patients. By early 1917 they had treated > 400 patients with gunshot wounds, compound fractures, septic wounds, through-and-through wounds and foreign body wounds with BIPP, reporting their findings in The Lancet (Garrett Anderson L, Chambers H. The treatment of septic wounds with bismuth-iodoform-paraffin paste. Lancet 1917;189: 331-3). They reported no cases of tetanus or gas gangrene and were able to explain side-effects such as iodine and bismuth poisoning, why it occurred and how it could be avoided. BIPP has been in use constantly since 1916, and is still used today in ear, nose and throat departments, especially for packing nasal cavities. By changing from the traditional eusol (sodium hypochlorite solution) to BIPP Drs Murray and Anderson reduced dressing changes from daily to once every 7-14 days, saving staff time, costs and hugely improving outcomes. These women doctors saved hundreds of lives and pioneered wound treatments that are still used today. Both were awarded the CBE for their services, but sadly the hospital staff were sacked at the end of the war, when the hospital closed. This form of pioneering work, conducted under great strain with limited resources is still to be seen today in the COVID-19 pandemic.
ABSTRACT
Background: The COVID-19 pandemic continues to worsen economic inequality, political unrest and violence resulting in unprecedented numbers of refugees and asylees globally. Various stressors related to forced displacement may impact cognitive function as refugees age in hosting countries. However, little is known about how forced displacement impacts perceptions and attitudes towards dementia and dementia risk reduction. Method(s): In-depth interviews with 61 older refugees aged 55-86 who were resettled in San Diego, California from Iraq and Syria, conducted between April-December of 2021. A phenomenological long-table approach was used to identify themes and categorize data on dementia knowledge, risk and attitudes. Result(s): The mean age of participants was 64.61 (SD: 7.19), 50.82% were female, 14.75% were employed, Median income was USD $15,001 - %25,000, median years since resettlement was 8 (SD7.06), 32.79% reported they could read and write English, 81.97% were Iraqis, 80.33% were married was. 16.39% have contracted COVID-19, and 85.25% reported being more forgetful since the pandemic started. Participants' responses about their attitudes about dementia were classified into three distinctive thematic domains: fear, acceptance, and practical challenges. Participants identified fear of developing dementia and the need to improve dementia knowledge as major motivators towards adopting healthier lifestyle and health behaviors. Acceptance emerged in relationship to the following areas: 1) religious;aging mentioned in the holy books as an experience associated with feelings of humiliation and helplessness, 2) cultural;dementia as an unavoidable part of normal aging, 3) experiential;displacement and war-related trauma increase risk of dementia. Practical challenges included the lack of age-friendly and trauma-informed care and services available for refugees which were identified as a major barrier for preventive, behavioral and lifestyle change. Conclusion(s): These findings can be used to develop effective and refugee-focused interventions that increase motivators and reduce barriers by tailoring interventions to refugees' dementia risk reduction literacy and motivations to change behaviors. Copyright © 2022 the Alzheimer's Association.