The Institutions of Cruelty: The Oxford Regional Centre

In my multi-part discussion about eugenics I've been talking mostly about individuals up until now. But as I've pointed out with regard to Dr.s Helen McMurchy and Frederick Tisdall, there is also an institutional side to the issue. I've mentioned in passing that most of the characters mentioned so far lectured at the Macdonald Institute at the Ontario Agricultural College in Guelph. I think it's important to realize that many of the young women who were taught there then went on to professional careers in fields like nursing. Indeed, my mother was a Registered Nurse who graduated from Victoria Hospital in London Ontario during WW2 and I can remember her talking about the "dull sub-normals" (ie: the "feeble-minded"), how they would "out-breed" the intelligent members of the population, and, how this was going to cause problems for humanity. I certainly wouldn't be surprised to find out that the people who taught her nursing had in turn been graduates of the Macdonald Institute. 

This leads me to another way of looking at this problem. I've found that there were also a lot of institutions in Ontario that seem to have grown out of the general "social Darwinism" way of looking at the world. I'm expanding beyond eugenics here, because as I hope previous articles have shown, there seems to have been an equal push to "institutionalize" people at the same time that there were voices arguing for sterilization. Ontario never did actually formally legalize sterilizing people against their will---as happened in Alberta. But as I have pointed out, Dr. Helen McMurchy argued strenuously for the creation of institutions where the "feeble-minded" would be separated out from the general community. I also showed how Indian Affairs were actively using "euthenics" to try to alter the culture of First Nations people's so they would become "less dependent" on the government. That's why they hired people like Dr. Frederick Tisdall to test nutritional supplements on people who were starving rather than give them the same amount of relief that were available to members of the settler community during the Great Depression. The use of residential schools and adoption to white families were also attempts to destroy Aboriginal culture in order to end the "Indian problem".

In this article I thought I'd expose readers to one of the institutions that we grew up around and explain exactly what it was meant to do, what it did in fact do, and, how that has affected the world we live in today.

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The Oxford Regional Centre

I spent a few of my teenage years in Woodstock Ontario and recall that at that time one of the few places that teens could get summer jobs was at the Oxford Regional Centre. Then it was a home for what we now call "developmentally disabled" individuals, but then were called "mentally retarded". This institution was founded in 1906 in Gravenhurst and was originally a rural property of 100 acres with two cottages on it where 58 people suffering from epilepsy were housed. At that time it was called "The Hospital for Epileptics".

The Oxford Regional Centre, Woodstock Ontario.
Undated, unattributed photo from a government of Ontario website.

It's hard for modern people to understand, but until relatively recently epilepsy was viewed with horror by the general public and a great deal of discrimination was levied against people with the disorder. Perhaps the best way to understand this situation is to compare them to people with various psychiatric disorders now---like some of the visible folks who congregate downtown and who talk to themselves loudly and act in peculiar ways. In most cases, the real problem isn't the behaviour that these people manifest---which generally is at most a minor inconvenience to others---but rather the disproportionate emotional discomfort that people feel in their presence. I suspect that this is an unconscious reaction to the question that such illnesses pose to our sense of self-identity. Any disease that affects behaviour in such a subtle, yet profound way poses an existential question about what exactly it means to say that we have "free will" and what it really means "to be me". These can be very scary questions to contemplate---.

In 1919 the hospital was moved to Woodstock and then renamed "The Ontario Hospital", and by 1932 it had 486 patients and 120 staff members. In 1939 a "chest disease division" was created to deal with tuberculosis patients. This was a necessary addition because this disease was often transmitted between patients in hospitals, so it was decided that they needed to be quarantined from others. In 1958 a large new building was opened for tuberculosis patients. By this time the two categories of patients came to over 1500 individuals with 860 staff members.

Tuberculosis is another disease that people have traditionally dreaded---unfortunately, with good reason. It is contagious, and it will kill you. It was---and still is---very common in many parts of the world, and still a significant threat to public health. Even now it is endemic in First Nation's communities today, as a recent official government of Canada website states:

For most people in Canada, the risk of developing active TB is very low. However, the rates of active TB are higher among Canadian-born Indigenous people. The rate of TB among Inuit in Inuit Nunangat was over 300 times the rate of Canadian-born non-Indigenous people in 2016. The TB rate is over 50 times higher among First Nations living on reserve than non-Indigenous Canadian-born people.

Dr. Trudeau, a TB survivor himself.
A US postage stamp, and as such, public domain.
Image from the Adirondack Almanack.

It was also an issue of wealth and class. As a recognized expert on the treatment of TB, Edward Livingston Trudeau, stated

"There is a rich man’s tuberculosis and a poor man’s tuberculosis. The rich man recovers and the poor man dies."

Another famous doctor, Norman Bethune---who suffered from the disease himself and was treated at the clinic named after Trudeau---stated in a journal article:

We, as a people, can get rid of tuberculosis, when once we make up our minds it is worthwhile to spend enough money to do so. Better education of doctors, public education to the point of phthisiophobia, enforced periodic physical and X-ray examinations, early diagnosis, early bed-rest, early compression, isolation and protection of the young are our remedies.

I think it's a good idea for readers to stop and think a bit about this point. Tuberculosis used to be a

A statue of Norman Bethune in a meditative pose
from outside of U. of Toronto Medical School.
Image copied from an original photo from the blog
A Sibilant Intake of Breath and used under the "fair
dealing" provision of the Copyright Act.

real scourge in Canada. It still is for the Innuit and on people living on Indian reservations. I suspect most of us assume that the reason why it isn't a big deal anymore for most of us is because of modern medicine. But that's not really true. As the quote from Norman Bethune shows, tuberculosis isn't a disease of nature, per se, but rather one of irrational wealth allocation. If you jam together too many people, who aren't eating good diets, in unhealthy conditions, you get TB. Modern medicine does help, but to a certain extent that's like giving supplementary vitamins to someone who is starving. That's why even though we have modern medicine in the North, we still have lots of TB.

Controlling the spread of TB by putting people into centralized hospitals---like the "chest disease division" of the "Ontario Hospital" is the right answer to the wrong question. That's because the solution to diseases like TB isn't isolation, but rather ending poverty. And this wasn't something that people at the time didn't know, instead, it was something that powerful people didn't want to admit.

In 1968 the epileptic division was closed and patients were either sent out into the community or placed in other facilities. This was the result of new treatment options and the realization that except for very rare, extremely debilitating forms, the patients didn't need separation from the community.

In the post war period a combination of new therapies (ie: antibiotics) plus a decline in poverty among the general population due to the growth of the welfare state made it easier to treat existing cases of TB and dramatically reduced the number of cases in the general population. As a result, the "chest diseases division" was closed in 1972.

In 1974, the treatment of the mentally ill and mentally challenged was transferred from the Ministry of Health to the Ministry of Community and Social Services, and the name of the facility changed from being "The Ontario Hospital" to "The Oxford Regional Centre". At it's height of operations, it had 1,500 residents and continued in operation until it closed in 1996.

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Here we are in a country on a war-footing in the middle of a pandemic. I'm not going to ask for money (although I'm not going to turn it down), but I would suggest that people try to help one another in these trying times. It's not much, but for my part I'm making a habit of calling people on the phone just to let them know that there are people out there who care about them. 

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At this point in time it's important to emphasize an issue that I've mentioned before with regard to Helen McMurchy and her idea that the state should institutionalize the "feeble-minded". As Ivan Brown and John P. Radford point out in their article The Growth and Decline of Institutions for People with Developmental Disabilities in Ontario: 1876–2009, 

Today, it is almost impossible for us to understand the scale on which asylums were part of the way the more economically advanced countries of the world were organized. There were workhouses, poorhouses for people who could not pay their debts, insane asylums for people with mental health problems, orphanages, hospitals and asylums for those with limited intellectual capacity, and many others.

(Journal on Development Disabilities, Vol 21, # 2, 2015, P-11.)

These facilities grew dramatically as Ontario's population increased and peaked in the early 1970s. The Oxford Regional Centre was what was called a "Schedule One" facility. These were large institutions with many buildings that housed a lot of inmates and which were directly managed by the government. (In addition, there were many much smaller "Schedule Two" facilities which were run by non-profit boards and subcontracted---like universities and public hospitals.)

The "Schedule One" facilities for "Idiots", "Mentally Retarded", or, "Developmentally-Challenged"
---the technical term changes depending on the decade. (Brown and Radford, P-19)
Click on the image for a clearer picture. 

The thing with these institutions is that they tended to be very expensive to operate and didn't do much to get the inmates to move out into mainstream society. Part of the problem was that there never seemed to be enough money to actually pay for any programs that actually would help people make the transition.

Another issue was that these institutions were supposed to be as "self-sufficient" as possible.  By this was meant that they should raise as much of their own food, fuel, etc, as possible in order to control costs. Unfortunately, this put administrators into a bind because the inmates most ready to leave the institution were also the ones who most helped the make the institution the self-sufficient. If they were allowed to leave and go into the community, who would grow the food and cut the firewood?

As a result once admitted, people generally stayed until they died, which was often decades later. And once you built a facility, new inmates kept getting admitted every year. This meant that the government was either committed to a constant expansion of the program---or the one already in existence quickly became over-crowded.

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I've found it very hard to get quotations from people with personal experience of any of the institutions that I've called "cruel". I've heard stories only to be told at the end "but don't put that into the story". I had one academic request that she vet anything I write before I publish it. (I gently told her that that would be unethical and no real journalist would agree to such conditions.) I asked for a review copy of a documentary that another woman had done on different type of facility, and I distinctly got the impression that she was really angry with me for even wanting to write about what went on there.

I get that abused people feel a lot of pain and they want their privacy. But there is also a "public good" aspect to journalism. People really do have to know about what does or doesn't work in society---and who gets hurt when things go wrong. Otherwise we keep making the same old mistakes over and over again.

That's why I've found it really hard to come up with first-hand examples of what happened in the homes for the mentally retarded in Ontario. There were obviously problems, because there were very substantial class-action lawsuits that were settled for millions of dollars. Here's a story about one for $36 million that was settled in 2016.  But I haven't found any details in any of them. I suspect that there were non-disclosure agreements. In addition, because of their disability I suspect that it's hard to get and publish first-hand accounts of what happened in places like the Oxford Regional Centre. It might be that people aren't very good at expressing themselves and it might be that care givers are trying to shield individuals from dredging up painful memories. Either way, it's hard to find "quotable quotes".

Having said that, I did find one article that gives a hint. The year that I was born, 1959, the late Pierre Berton published a story in the Toronto Star about his visit to a "Schedule One" facility in Orillia. It makes for fascinating reading. Here are a few quotes that I offer by way of a description.

Pierre Berton, photo by Martin Tosoian, Penguin Random House Canada.
(I couldn't find a public domain photo of Berton.)
Used under the "fair dealing" provision of the Copyright Act.

There are 2,807 others like him, jammed together in facilities which would be heavily taxed if 1,000 patients were removed. More than 900 of them are hived in 70-year-old buildings. There is nowhere else for them to go.

---The paint peels in great curling patches from the wooden ceilings and doors. Gaping holes in the worn plaster walls show the lath behind. The roofs leak. The floors are pitted with holes and patched with ply. The planks have spread and split, leaving gaps and crevices that cannot be filled.

The beds are crammed together, head to head, sometimes less than a foot apart. I counted 90 in a room designed for 70. There are beds on the veranda. There are beds in classrooms. There are beds in the occupational therapy rooms and in the playrooms that can no longer be used for play. On some floors the patients have nowhere to go except out into the corridors.

The stench here is appalling, even in winter. Many patients are so helpless they cannot be toilet trained. The floors are scrubbed as often as three times a day by an overworked staff but, since they are wooden and absorbent, no amount of cleansing will remove the odors of 70 years.

On one floor there is one wash basin to serve 64 persons. On another floor, where the patients sometimes must be bathed twice or three times a day, there is one bathtub for 144 persons — together with three shower outlets and eight toilets. Prisoners in reformatories have better facilities.

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I suspect that the reason why the government shut down these facilities was some mixture of the public beginning to find out how awful they were and the bean-counters realizing that the whole system couldn't survive over the long haul. At the same time, the emerging consensus was that developmentally challenged individuals were suffering a lot more from social stigma and isolation from the community than they were from their actual ailment.

When the Regional Centres were being closed down the term "mentally retarded" was being changed to "developmentally disabled". This wasn't a complete "one-to-one" mapping of the same individuals, however, as there was an understanding that a large number of disabilities were causing problems for children. According to the Centers for Disease Control website development disabilities can arise for a broad range of reasons, including:

• maternal infections during pregnancy
• fetal alcohol syndrome
• Down syndrome
• Fragile X syndrome
• autism
• untreated jaundice
• various problems in pregnancy such as low birth weight, etc

These different causes and problems come with a broad range of clinical responses, but most outcomes are made worse if the children are institutionalized and improved if they are integrated into the community. To a certain degree this has been recognized by modern government programs, and there are mechanisms aimed at integration. Of course, things could be much better, but I suspect that on average the present situation is a huge improvement over the situation that Berton described in his 1960 article. 

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I think that this is as good a point to walk away from this story as any other. Unfortunately, there is more to say about public institutions in Ontario, so I'll probably be talking about them in the future.

I've made the point in a previous opinion piece, but I think it bears re-emphasis. Cruelty comes about when ideology blinds us to the actual human being in front of us, and, terrible things happen when the people making the decisions are completely separated from the poor schmucks who have to carry out the orders from "on high". Ideology dictated that it was necessary to "protect the race" from the damage that "inferior individuals" would inflict on society if they were allowed to interact with everyone else. And the accountants and politicians who decided to "save money" ended up forcing administrators at the "Schedule One" facilities in Ontario to treat the people under their care like animals on a factory farm. The result was organized, institutionalized cruelty on an industrial scale.

I think that this whole experiment should tell us all that it's really important to investigate what the actual consequences are for other people when we base policy on the beliefs we hold. We also need to understand exactly what the implications are for people on the "front line" when we make decisions that affect them and the people they serve.  

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Furthermore, I say unto you we must deal with the climate emergency!