Follow @PoliticsIE
 
 
 
Page 1 of 53 123451151 ... LastLast
Results 1 to 10 of 526

Thread: The statistical, biological and other reasons why the Tuam Home mortality rate is misleadingly high

  1. #1

    Default The statistical, biological and other reasons why the Tuam Home mortality rate is misleadingly high

    First of all we might as well launch our stat attack. This graph gives you the numbers of children, of all ages, in the Home for those years (including 1924 when it was in Glenamaddy) and note that this is an estimate for many years:

    This is the number of deaths of all children in the Home as derived from the death certificates (there were no deaths in 1961):

    The national Irish Infant Mortality Rate (IMR), i.e. (number of deaths of <1 aged infants in a given year/live births in that year) X 1000, for those years is given here:

    Although we aren't using the exact same type of statistic, of necessity because we don't have the full data to work on as described below under 'sources', this graph compares the national IMR with that in the Home:

    So for those years, 1925-60 excluding 1961 when there were no deaths in the Home but also when it was being wound down so it would be very difficult to estimate numbers, our best statistic is that on average you have a national IMR of 60 and a Home IMR of 128, but because of the unsatisfactory way we have to calculate the Home figure we have to estimate that the gap is in fact wider than this.

    Hence the six million dollar question is why is the Home rate seemingly more than double the national rate? I think there are five basic biological, statistical and understandable reasons why this was so:

    1. One thing that has exercised the minds of statisticians and historians for those years with regard to the Irish Infant Mortality Rate is that in urban areas, particularly Dublin, we find that the rate is much higher, in fact its much closer to the Home rate. So for example when the national rate of 66 was calculated for 1938, in Dublin Borough it was 102 and Cork 103.(1) Also this urban/rural gap closes about the early to mid 50s at the same time that the Home rate falls to below the National one. So it seems to this observer that the special problems that caused the high IMR in Irish urban areas of that time, and which were solved by the mid 50s, could shed a light on the problems that the Home faced during the same time. It seems there are two basic reasons why the Dublin/urban Infant Mortality Rate was so much higher, and these were:
    a) Sanitary issues in the overcrowded Dublin slums. In some cases families in apartment blocks, and even whole streets, were using the same toilet facilities and also the water supply was in some cases also primitive which in turn had a bad effect in terms of deadly infant infections. So if you read up on the literature of this you will find that the state put great store in more modern sewage and water facilities and felt that this was a key reason why the Dublin IMR rate eventually fell.

    Of course we hope that the Home facilities were quite good and not at all in that primitive state but that is not to say that this didn't effect the Home IMR. The point is that on occasion government inspectors would go into homes in the area and if they found that some children were living in apalling sanitary conditions they sometimes took the children away and placed them in the Home. So in a sense children from the very worst sanitary conditions are actually in the Home and this it was felt did impact on the cause of death there, as the Inspector mentioned in 1947:
    "First there is the constant risk of infection brought in from outside by the admission of whole families of itinerants, destitutes, evicted persons etc." (2)
    b) It seems clear that the second big reason why the rate was much higher in Dublin etc was because in the overcrowded conditions in the cities the very contagious and then deadly infant diseases of measles, influenza, whooping cough and diphtheria were able to spread in a type of pandemic fashion across the infant population whereas in the more spread out rural areas, especially if children were held back from school, these then incurable diseases could be more easily contained. Again the rate fell as you get into the 50s because modern medicine developed better drugs and vaccines to deal with these diseases.

    This I think is clearly the story in the Home as well. They seemed to have great problems with these terrible diseases for the simple reason that they had a lot of children housed together in the same building. This was hardly their fault, and it was hardly the fault of anybody because the state could surely not have afforded at the time to have say 10 different Children's Homes in a given county so of necessity they had to place these children together but this was bad news when it came to the deadly wave of measles attacks etc that clearly affected the Home.

    This is a very major issue as a half glance at the death certificates will show. So for example if we take the worst years in the Home we find that in 1926 64% of the deaths were attributed to measles, in 1936 it was 48% and in 1947 35%. Also in 1933 37.5% of the deaths were due to Whooping cough while in 1943 24% of the child deaths were due to the same disease while 20% were due to influenza in that year. John Cunningham who stayed in the Home also refers to it:
    "Some of the women, like my surrogate mother (Mary), stayed on for life - possibly because they were briliant nurses for newborn babies that were there in lines in cots. They had to be brilliant nurses for the infants were then potential victims for diseases which we now regard as just a nuisance, like measles, whooping cough, scarlet fever, the mumps." (3).
    But are we to blame the staff for not being able to cure infants of these then incurable diseases? There was talk of isolation chambers, and in fact the staff frequently pressed the state for funds to create facilities like this but improvements were slow in coming and anyway those diseases are exceptionally contagious.(4) Its very unlikely they could have contained them to only a part of the Home without elaborate, and then very expensive and rare, isolation chambers.

    Hence it seems to this observer that there are good reasons why the Home rate mimicked the much greater Dublin/urban IMR of that time, rather than the lower national rate, and for reasons that were not the fault of the staff there.

    2. We can assume I think that the vast majority of the illegitimate children in the Home, which again would be about three quarters of the total children in the institution (in 1928 the Home had 118 children of whom 96 were illegitimate (5) but the latter proportion might have been somewhat less for the War period), would be first births to young unmarried mothers (who obviously, in almost all cases, went without asistance from fathers or a wider family). Its interesting then to read about one wide ranging 2011 study of infant mortality data in 55 low and middle income countries which shows that:
    "The first-born children of adolescent mothers are the most vulnerable to infant mortality and poor child health outcomes. Additionally, first time mothers up to the age of 27 have a higher risk of having a child who has stunting, diarrhoea and moderate or severe anaemia." (6)
    While its true that this study is also talking about social issues, which we hope do not then impact our analysis of the Home in 1925-61, nonetheless they found that there are both "biological and social mechanisms" at work in giving this high infant mortality rate in children of young first time mothers. These biological reasons may therefore be another cause why the infant mortality rate was higher in the Home than nationally and through no fault of the staff there.

    I should add here, for the sake of completeness, two other potential biological issues that could impact on the IMR in the Home. The first point is a rather dark and, hopefully, not important one to make which is that in three cases 'consanguinity' is mentioned in the death certificates. This seems a very strange reason to give as a cause of death unless the writer knows that the parents of the dead child are 'very' closely related, e.g. brother and sister or father and daughter? Obviously this would then cause serious biological reasons for a higher IMR and again through no fault of the staff although this is only true of three certificates anyway.

    The second point is that the Inspector in 1947 raised the prospect of venereal disease being a factor in the health of the children, complaining that there is insufficient testing for it:
    "Secondly, there is no routine examination and testing for venereal diseases." (7)
    Presumably he had reason to believe that this was strongly merited, maybe because e.g. a significant proportion of the mothers were working as prostitutes? Without knowing why he felt so strongly about VD being a factor in the infants health we cannot judge now the significance of these diseases in the IMR in the Home but at any rate it could be another biological reason for the high IMR and again through no fault of the staff.

    3. While the Home tried to insist that mothers stay for at least a year after the birth with their child nonetheless there were in fact also a proportion of totally abandoned children who had to be brought up in the Home without any mother and this must have been difficult and also understandably impact on the mortality rates. You hear stories of the Gardai placing an infant in the Home who was found abandoned (8) and of mothers being chased for maintenance who completely deserted their children,(9) of children sent to the Home because their mother died when they were very young (10) - or even perhaps during childbirth? -, and even of infants being left behind on trains who were sent to the Home,(11) etc. At least for the early period this seems to have been quite a factor in the mortality rate as reported here from 1924 while the Home was still in Glenamaddy but about to go to Tuam:
    "...but the death rate amongst the infants has been higher than it ought to have been because of the difficulties of rearing motherless babies." (12)
    But surely we can always accept that motherless infants - no matter how much care they get - are bound to have a higher mortality rate than those with mothers present - which would obviously be the case for the vast majority of the infants in the national mortality figure - especially for the very early weeks or months and again this is surely not the fault of the Home.

    4. Although the facts are somewhat slight in this case nonetheless it seems fair enough to speculate that there may be a selection factor causing bias in our statistics whereby some of the legitimate children in the Home may have been sent there because their parents were unable to rear them at home due to some chronic type of illness or disability. This I admit is speculative but surely its reasonable to guess that since the Bon Secour nuns in the Home ran an acute hospital in Tuam during this period that maybe in cases where an ill child couldn't be cared for at home, and had a chronic illness/disability not urgent enough for an acute hospital, that the child would have been admitted to the Home as a last resort? Again we have this from John Cunningham:
    "My mother died shortly after I was born and because of the close proximity of the Children's Home to my family home, and because rearing a sickly infant would be well-nigh impossible for a widower who already had four young children, I was reared in the Children's Home, though regularly spending some time at home as well." (13).
    Hence if a significant proportion of the infants in the Home were admitted there at least partly because they were too 'sickly' to be reared in their own homes then we have a clear reason why the IMR would be higher in the Home than the general population.

    Meanwhile reading the 1947 report its interesting to speculate that they seem to have a disproportion of disabled infants living there:
    "...a baby with mis-shapen head and wizened limbs...deaf and dumb who is awaiting a vacancy in the Institute for Deaf and Dumb...there is an albino child...5 years, atrophied areas - hands growing near shoulders..." (14)
    Possibly whats happening is that some parents, maybe on the advice of medical professionals, faced with rearing disabled children are in fact placing them in the Home?

    Also there are very consistent reports of a large proportion of infants described as 'mentally defective', or even 'idiots', being in the Home, for example in the above 1947 report, in the death certificates, and in some media reports of the time including this one from the closing of the Home in 1961 when they found:
    "...an unduly high number of mentally defective children in the Home." (15)
    Of course this has generated much outrage in the popular press but I think there is no point is getting excited about the accepted medical terms of the day, surely they are describing here Down Syndrome children? After all how would they know that a child of age about 1 was mentally defective anyway, unless in fact they are basing their diagnosis on the well known physiological characteristics of Down Syndrome children? The 'unduly high' number mentioned is then probably a reflection of the fact that a Down Syndrome child was frequently sent into the Home during this period, when our understanding of mental handicap in children was slighter than it is today.

    But Down Syndrome children frequently have unique medical problems caused by their special genetic condition, as often do other disabled and, obviously, chronically ill children, which unfortunately makes the rate of mortality in those children higher than the normal infant population, much higher probably at this period when these medical problems were less understood than now. So if we find that Down Syndrome was a common reason why legitimate children were sent into the Home, and the frequent reports of 'mentally defective' children make this very likely and a significant statistical bias, then we find again a good reason why the infant mortality rate is higher in the Home than outside, caused not by bad care but only by genetics!

    To finish off the point about statistical bias we should point out that we are not talking about a static population here. At least after 1 year, and possibly before that in some cases anyway, (16) mothers are taking their children out of the home and also there are children being fostered and adopted out all the time. But the point is that presumably the ones going out of the home in those cases are the healthy children, doubtless a mother will not take a sickly child out nor will it be fostered or adopted, while the unhealthy ones remain so it provides a good reason why in the unique conditions of the Home you would have a higher IMR than in the normal population. But this is complicated by the fact that most of the children who leave would be over the age of 1, which is an age usually above that recorded in the IMR anyway and hence it shouldn't be too big a factor in creating bias in our statistics.

    5. But there is one other very important statistical issue here that I think anyway could have a very big impact in artificially increasing the IMR in the Home as opposed to the national rate. In both cases we are basing our figures on deaths registered, ultimately, in the national register of deaths in Dublin which had been started in Victorian times. While these are incredibly valuable records for genealogy and all kinds of statistics nonetheless for this period it has to be pointed out that the degree of registration of births and deaths was far more patchy across Ireland at that time than people realise. For example note this quote from the Oireachtas in 1926:
    "Sir Edward Bigger: Fully 70 per cent. of the deaths that occur in many districts are uncertified by any medical attendant. There is nothing to indicate the cause of death, and the whole of our statistics about deaths are worth nothing and are absolutely useless.
    ...
    Mr. Farren: The people that you have in mind here are very poor people and these people do not really require a certificate, because the number of uninsured amongst those people would be relatively very small. They are nearly all insured in the Prudential or the Royal Liver.
    Sir Edward Bigger: Speaking of the urban districts that is true.
    Mr. Farren: Yes, and in the rural areas also it is largely true." (17)
    Where Mr Farren is talking there about poor people not needing a certificate he is referring particulary to the fact that somewhat wealthier people with life insurance or property would need a certificate but the poor people he mentions would not. Obviously babies and infants are not likely to fall into either category so they are probably less likely to be registered.

    If you read the Dail and Seanad reports this was a constant complaint about Irish death statistics,(18) even for example the CSO estimated that as late as 1949 some 11% of deaths were uncertified.(19) (By the way, to clarify, there is a difference between the two, some deaths were registered without being certified - by a doctor - for various reasons but the two problems were linked, as pointed out in the Dail in 1973:
    "The incidence of uncertified deaths is falling steadily and in 1970 represented 1.5 per cent of all deaths registered. It is hoped that this progress will be maintained. An associated problem is the failure to register deaths." (20))
    As late as a study conducted in a number of parishes in the West of Ireland in 1966-69 which double checked the death registers with funeral entries in parish registers and other sources, we find, by some calculations, that about 10% of deaths were not registered:
    "In 1966-69 out of a total of 806 deaths 90.2% were registered and 85% were certified whereas in 1974-77 out of a total of 885 deaths 95.2% were registered and 92.7% were certified, an improvement of 4.8% and 5.3% respectively." (21)
    Now the point here is: could this cause some bias in our death certificates that could be a factor here? Well you see in the institution there was a dedicated Medical Officer, doctor, paid for by the state so naturally it was a simple matter to get a doctor to register the deaths, i.e. that Medical Officer.

    But picture the scene in a rural cottage in Galway in 1926 or whatever. Obviously nearly all births that time - and for all the period 1925-60 - were at home and delivered with the assistance of a midwife not a doctor. So for example in the Home certificates we have a few babies who unfortunately died after only a few hours and I would say the chances are very high that if that happened in our hypothetical cottage they just aren't going to go to the trouble of registering that death, or birth indeed. And since we know that the main bias in favour of registering people was if they had property or life insurance, both conditions highly unlikely to pertain to an infant, we can say that infant mortality figures are very likely to be heavily under reported in the national death statistics.

    Actually this is a recognised phenomenon seen around the world, where in some cases you can get artifically high IMR rates not because the actual rate is high but because the reporting is better in a hospital setting:
    "Another seemingly paradoxical finding, is that when countries with poor medical services introduce new medical centers and services, instead of declining, the reported Infant Mortality Rates often increase for a time. This is mainly because improvement in access to medical care is often accompanied by improvement in the registration of births and deaths. Deaths that might have occurred in a remote or rural area, and not been reported to the government, might now be reported by the new medical personnel or facilities. Thus, even if the new health services reduce the actual IMR, the reported IMR may increase." (22)
    Then we have a clear reason why the Home infant death rate would be much higher than the national one, because many people across the country probably didn't bother registering these type of infant deaths frequently at that time but with a resident doctor they did register them promptly in the Home. And if it was as high as 70% in some areas where deaths are unreported then we could be onto something here as the real cause of the bias in these figures.(23)

    For these five reasons then, statistical, biological and understandable, I think the difference between the IMR rate nationally and locally in the Home can be satisfactorily explained without casting aspersions at the staff in the Home at that time.
    Last edited by scolairebocht; 2nd July 2014 at 03:37 AM.

  2. #2

    Default

    Sources
    National Irish Infant Mortality figures 1925-60 are derived from the graph at: Dr Liam Delaney et al, From Angela's Ashes to the Celtic Tiger: Early Life Conditions and Adult Health in Ireland (Dublin), p.5. The number of deaths in the Home are derived from the list of death certificate data published in the Irish Mail on Sunday, 15/6/2014, p.31-32 and 65-66. The numbers of children in the Home are derived from the following newspaper reports with the figures evened out for the years without data: Connaught Tribune 21/6/1924: 87 children (while still in Glenamaddy), Connaught Tribune 19/2/1927: 92, Connacht Senteniel 12/6/1928, p.4: 129, Irish Times 12/9/1928: 125, Tuam Herald 24/9/1938, p.2.: 138 (of whom 95 were illegitimate), Connacht Senteniel 17/1/1939, p.3: 259, the 1947 report has 271 children (various sources), and in 1955: 120 (Sunday Independent 8/6/2014).
    I assume the national figure to be: (total number of deaths of <1 aged infants in a given year/total number of live births in that year) X 1,000.
    The Tuam infant mortality figure in contrast is: (total number of deaths of children of all ages in a given year/total population, sometimes estimated, of all children in the home in that year) X 1,000.
    This unsatisfactory contrast in the way the figures are calculated is necessitated by the fact that the author has no way of knowing a breakdown of the ages of the children in the Home at any one time and hence when they were born. This data is there for the death certificates, and the graph could have been derived by excluding those infants >1 who died but this (reduction in the numerator) would seem to create a greater distortion in the light of their being no way to limit the overall child population to those born in one given year (which would reduce the denominator).

    It should be pointed out that this methodology could be quite seriously underestimating the Home rate as against the National one. I say this because we do have one piece of data on births within a year which could yield a better statistic here, it comes from this quotation in the 1947 report:
    "During the year ended 31.3.43 the number of births plus admissions was 159, the number of deaths was 54 about 34%
    During the year ended 31.3.44 the number of births plus admissions was 169, the number of deaths was 42 24%
    During the year ended 31.3.45 the number of births plus admissions was 153, the number of deaths was 36 23%
    During the year ended 31.3.46 the number of births plus admissions was 143, the number of deaths was 39 27%"

    Putting that in an equation, while subtracting from the deaths those over the age of 1 which we can see from the death certificate data and also correcting slightly the death data from the same source, we get something like:

    year span (deaths in time period according to report) deaths in timespan according to death certificates - deaths >1 age => (deaths/admissions plus births) X 1000 = IMR (IMR calculated by the previous cruder method, albeit for a slightly different time period)
    1/4/1942 - 31/3/1943 (54) 53 -7 => 46/159 X 1000 = 289 (178)
    1/4/1943 - 31/3/1944 (42) 43 -4 => 39/169 X 1000 = 231 (189)
    1/4/1944 - 31/3/1945 (36) 36 -13 => 23/153 X 1000 = 150 (150)
    1/4/1945 - 31/3/1946 (39) 39 -5 => 34/143 X 1000 = 238 (127)
    Which looks like our previous method is underestimating the Infant Mortality Rate in the Home, at least for those years.

    Actually in 1951 there was a question asked in the Dail about infant mortality in the urban areas and in the Children's Homes which elicited these statistics:
    "Area Infant mortality rate per 1,000 live births
    1949 1950(provisional)
    Dublin County Borough 64 48
    Dublin County 51 54
    Cork County Borough 74 55
    Cork County 53 39
    Galway County 41 49
    (including Galway Borough)
    As the Deputy is aware, the failure of unmarried mothers to take adequate care of their health in the ante-natal period results in a higher infant mortality rate amongst illegitimate children than amongst legitimate children. Despite this well-known fact, the following table, which shows in respect of the year ended 31st March, 1950, the number of deaths of infants under one year in the four main homes for unmarried mothers which receive financial assistance from public funds, expressed as a percentage of the total number of children born in the home concerned or admitted to it after birth, indicates that the rates compare favourably with the general rate in some, at least, of the homes:-
    Home A. 1.3%
    Home B. 6.5%
    Home C. 8.3%
    Home D. 10.1%"
    (Dail 15/11/1951.)

    1. Dail 30/3/1939.

    2. 28th April 1947, p.3, Access Denied | Andrew Downes Photography .

    3. Connaught Tribune 24/4/1998.

    4. The threat of fever was always taken seriously by the staff:
    Dr Costello was quite conscious of the threat of fever on the Home "with such frail children" in 1929: Connacht Senteniel 5/2/1929.
    In 1938 the MO and the matron were looking for a laundry and disinfecting chamber to combat the risk of fever. Six months later the matron was still looking for it and hoping its provision could be speeded up
    (Connaught Telegraph 23/4/1938 and later comment on the @limerick1914 twitter feed).
    The Matron, in 1944, suggested that children be immunised against diphtheria before being admitted: Connaught Tribune 1/1/1944.
    The MO, Dr Thomas Bodkin Costello, wanted some whooping cough vaccine in 1944 because there was an outbreak in the vicinity. Also at that time there was a measles outbreak in the Home:
    "The stonger children were doing well but the weaker children suffered seriously...[also he wants]...no children be boarded out or sent to school until the epidemic had ceased"
    (Tuam Herald 27/5/1944).
    This is probably a reference to the building of an isolation unit:
    "The County Manager, having referred to a proposal to transfer the children's home in Tuam to Bon Secour nuns, mentioned improvements to be carried out there and said that the estimated cost was somewhere in the region of £3,800"
    (Connaught Tribune 19/10/1946, https://twitter.com/Limerick1914/sta...858881/photo/1 ).

    5. Irish Times 2/9/1928.

    6. Jocelyn E Finlay, Emre Özaltin and David Canning, The Association of Maternal Age with Infant Mortality (2011), BMJ Open, vol 1, issue 2, The association of maternal age with infant mortality, child anthropometric failure, diarrhoea and anaemia for first births: evidence from 55 low- and middle-income countries -- Finlay et al. 1 (2) -- BMJ Open .

    7. 28th April 1947, p.3, Access Denied | Andrew Downes Photography .

    8. "Guards found a deserted child and took it to the Children's Home."
    (Tuam Herald 23/11/1939, p.4.)

    9. An example of a mother rejecting her child, they sent the child down to her in an ambulance but she rejected it and the state proceeded to chase the mother for maintenance: Connacht Senteniel 8/9/1931, p3.

    10. As was the case with John Cunningham: Connaught Tribune 24/4/1998.

    11. In 1957 a two week old baby abandoned on a train was taken to the Home: Irish Press 29/8/1957.

    12. Connacht Tribune 21st June 1924, p.5.

    13. Connaught Tribune 24/4/1998.

    14. Michelle Fleming grew up with the Tuam babies stories | Mail Online .

    15. Connaught Tribune 1/7/1961.

    16. An example is mentioned in the Connacht Sentinel 1/1/1929, p.1, of a mother leaving the Home with her baby of five or six weeks of age.

    17. http://oireachtasdebates.oireachtas....onth=03&day=10 .

    18. An example of some of the Oireachtas debates on the scandal of uncertified and unregistered deaths:
    "Mr Haughey: ...It is eminently desirable that we have a higher number of deaths notified than we have at the moment. We have a very high proportion of uncertified deaths."
    (Dail 14/2/1962.)

    "Mr Haughey:...This provision has a twofold object. It is, of course, intended mainly to ensure that all suspicious deaths are notified to the proper authorities but it has the secondary object of improving registration of deaths and of the proportion of those registered deaths which are medically certified. At present, it is known that there are many deaths which are not registered at all. In the nature of things there are no statistics of them and their existence only comes to light, usually many years afterwards, when their statistical value has disappeared say, when it is necessary to take out a grant of administration to secure title to land or property. The percentage of registered deaths which are medically certified is also unduly low by comparison with Northern Ireland and European countries and I hope that the present provision, though it may cause some inconvenience until people have got accustomed to its working, will have the effect ultimately of ensuring that medical assistance is summoned in the final stages of fatal illnesses.
    ...
    Mr Moloney:...The only other point I want to make is in connection with the Minister's indication that in this part of Ireland the number of registered deaths which are medically certified was very low compared with the experience in Northern Ireland and other European countries. The fact that the office of coroner was still being maintained might in some way influence bringing that percentage to a more satisfactory level. That is very important because we all know from dealings we may have in certain lines of business that the non-certification of the cause of death can be a great handicap in some regards. Nowadays most people who are ill and in their declining years are attended by medical practitioners because the Health Act and other Acts passed in recent years have made it more convenient for people to have medical attention. By and large, as far as people in that category are concerned there is no reason why the cause of death should not be certified. The point the Minister makes there is very important, particularly in the matter of mortality statistics, and in this regard the Bill will serve a very useful purpose.
    ...
    Mr Mooney: ...On the question of uncertified deaths or deaths that have not been notified, only this morning I read the report for 1960 of the County Medical Officer of Health for Leitrim. We seem to have a very high proportion of such deaths in County Leitrim, higher I think than most counties. One often wonders, especially in rural areas, if these people die from natural causes when we hear rumours and read about people being robbed or attacked. The Minister should take cognisance of that fact and take steps to see that deaths are notified and registered. Surely, in this year of 1962, people should not die without somebody knowing the cause and their death being notified and registered.

    Mr. Haughey: The main idea of Section 18 is to achieve that."
    (Seanad 21/3/1962.)

    "Minister for Health, Erskine Childers:... Any short-fall in registration diminishes the validity of our vital statistics which are essential to all forms of social planning. The short-comings of the present system are especially serious in relation to registration of deaths. This applies particularly to deaths in rural areas of old people who are not property owners and not covered by life insurance. It is not possible to cite precise figures in this connection, but from studies carried out in recent years I am satisfied that there are areas where under-registration of deaths may be of the order of 7 to 8 per cent. Where a failure to register a death comes under the notice of a registrar, or of the Office of an tArd-Chláraitheoir, the omission is, of course, corrected, but this can account for only a small number of cases. It will, I am sure, be readily accepted that any organisational changes which will assist in achieving maximum registration should be effected, and this is one of the main objectives of the present Bill.

    Failure to register births is quite rare, but registration is sometimes delayed and effected only when the need to produce a certificate arises. Marriage registration can be accepted as comprehensive.
    ...
    Mr. Governey:...I am rather surprised to learn from what the Minister said that the number of unregistered deaths may be of the order of 7 to 8 per cent. That strikes me as an alarming figure. I had no idea that it was so high but I am sure the Minister has proof of it. I did not think there could be anything like that percentage of unregistered deaths.

    Mr. Childers: Only in certain areas.
    ...
    Mr. Tully:...I quite agree that the number of unregistered deaths can be 7 or 8 per cent, or even higher. It is not generally known that when people die, particularly old people living alone, somebody should register the death. Unless the doctor does it, it can be overlooked. Recently I knew of somebody who died in hospital and was registered as a widower. He was a married man and his widow was still living. When the registrar registered his death and recorded him as being a widower all sorts of complications arose. The matter had to be referred to the Custom House before the death was properly registered and the death certificate could be issued properly.
    ...
    It is amazing how many people have never been registered as having been born. Usually this is not discovered until they apply for a pension of one kind or another, usually the old age pension. It is then discovered that, so far as the State is concerned, those people do not exist. I have come across numerous cases of that sort which I have had to investigate. While it is possible on occasion, so far as the Department of Social Welfare are concerned, to get such evidence as school attendance or something like that to prove the date of birth sometimes that is not possible.

    I know of the case of a man who was born in an itinerant camp. Apparently nobody bothered to register the birth. When he reached 70 years of age, although he had left the itinerant life and had worked all his life, and had been insured by the Department of Social Welfare, the Department refused to accept statements from his employer that he was 70 years of age. They would not allow him to draw benefit. Eventually he ended up in an old folks home. He told me he started life depending on charity; he worked all his life and he did not think he would end his life depending on charity.
    ...
    I must say that during the time the British were here the RIC went to far more trouble to try to find out the names, ages and relationships of itinerants scattered throughout the country than do our present police force. Perhaps it is regarded as infra dig to visit a tinkers' camp to inquire for such particulars. As I have said, it was done very thoroughly by the British. Again and again I have had to try to help those people by getting their births registered."
    (Dail 7/11/1972.)

    "Mr. Davern: asked the Minister for Health if he is aware of the number of deaths that are unregistered in the country; and if he will make a statement on the matter.
    Mr. R. Barry: I am aware that a number of deaths are not registered. Steps have been taken to identify where and to what extent this lapse in registration occurs and to tighten up the procedure for ensuring that all deaths are registered. An important development has been the appointment in every health board area of a wholetime Superintendent Registrar who has a special responsibility for the registration of all deaths which take place within that area.
    Mr. Haughey: The Parliamentary Secretary appreciates that it is very unsatisfactory to die without even having the consolation of being registered.
    Mr. Davern: Does the Parliamentary Secretary realise the seriousness of the situation? Someone could be buried without any investigation at all if no death certificate is required. A certificate for burial is obligatory, as far as I know, in every other European country. Will the Parliamentary Secretary take some precautions in this matter?
    Mr. R. Barry: I am glad the Deputy has asked that question because, in reply to another question on the subject about 12 months ago, I said superintendent registrars were being appointed. They have since been appointed and the situation is now in hand."
    (Dail 13/2/1975.)

    19. Adrian Redmond edit., That was then this is now (Dublin, 2000), p.35.

    20. Dáil Éireann - 05/Jul/1973 Ceisteanna .

    21. The Medico-Social Research Board, Annual Report 1979 (Dublin, 1980), p.14.

    22. Infant mortality - Wikipedia, the free encyclopedia .

    23. One researcher who looked at this unregistering of infant deaths in Ireland in the period 1931-36, Jacques Verriere writing in his book La Population de l'Irlande, made an estimate of the degree of under reporting:
    "Thus for the period 1931-36 Verriere estimated infant mortality rate of 83 per 1,000 births contrasts with the recorded rate of 69 and on this basis approximately 20 percent of infant deaths went unrecorded for this period."
    (J Coward, Birth Under-Registration in the Republic of Ireland during the Twentieth Century, The Economic and Social Review, vol 14, no 1, October 1982, p.5-6, referring to J Verriere, La population de I'Irlande (Mouton, 1979), p.497.)
    Last edited by scolairebocht; 2nd July 2014 at 01:21 PM.

  3. #3
    Politics.ie Member The Field Marshal's Avatar
    Join Date
    Aug 2009
    Location
    The Imperial Throne
    Posts
    44,291
    Mentioned
    0 Post(s)

    Default

    Naturally your excellent research will not sit well with the enemies of truth on p.ie
    Repeal the thirty-fourth amendment of the Irish constitution :
    Children have a basic right to be reared by a mother and a father.

  4. #4
    Politics.ie Royalty toxic avenger's Avatar
    Join Date
    Jun 2007
    Location
    London
    Posts
    19,031
    Mentioned
    0 Post(s)

    Default

    Extraordinarily well-researched OP (not for the first time) - the truth seems to lie somewhere short of the hysterical over-reaction of certain media outlets, as with the unnecessary over-egging of the Magdalene Laundries story, where the truth was quite appalling enough (not to say that there aren't more than enough sources of shame for the Church despite the hysteria in these particular cases).

    I'd like to see a well-researched and sourced counter-argument made, and a civilised discussion based on finding the truth (rather than confirming prejudices), just to see if there might still be a cogent case that the Tuam death rate was outside the norm. I doubt it will happen, but this would be a nice opportunity for P.ie to do a serious bit of academic debate.

  5. #5
    Politics.ie Member Cruimh's Avatar
    Join Date
    Apr 2010
    Location
    County Londonderry
    Posts
    35,432
    Mentioned
    2 Post(s)

    Default

    I'd like to see a source for this .....

  6. #6

    Default

    Many many thanks for your kind comments and Cruimh if you look at the comment under it under Sources it should satisfy your curiousity that way...

  7. #7
    Politics.ie Member Cruimh's Avatar
    Join Date
    Apr 2010
    Location
    County Londonderry
    Posts
    35,432
    Mentioned
    2 Post(s)

    Default

    Quote Originally Posted by toxic avenger View Post

    I'd like to see a well-researched and sourced counter-argument made, and a civilised discussion based on finding the truth (rather than confirming prejudices), just to see if there might still be a cogent case that the Tuam death rate was outside the norm. I doubt it will happen, but this would be a nice opportunity for P.ie to do a serious bit of academic debate.
    It is late and I'm half asleep, but this caught my eye


    The second point is that the Inspector in 1947 raised the prospect of venereal disease being a factor in the health of the children, complaining that there is insufficient testing for it:
    "Secondly, there is no routine examination and testing for venereal diseases." (7)
    Presumably he had reason to believe that this was strongly merited, maybe because e.g. a significant proportion of the mothers were working as prostitutes? Without knowing why he felt so strongly about VD being a factor in the infants health we cannot judge now the significance of these diseases in the IMR in the Home but at any rate it could be another biological reason for the high IMR and again through no fault of the staff.
    Venereal disease was common in Ireland - and not just in women working as prostitutes. It had always been quite high, in part because of general and widespread ignorance about sexual matters exacerbated by state legislation, but also because of WWII. So, even if unintended, this part could be said to both insult and demean many of the women involved but also to devalue the worth of the children involved by the undercurrent that they were only the children of whores.

  8. #8
    Politics.ie Member Cruimh's Avatar
    Join Date
    Apr 2010
    Location
    County Londonderry
    Posts
    35,432
    Mentioned
    2 Post(s)

    Default

    Quote Originally Posted by scolairebocht View Post
    Many many thanks for your kind comments and Cruimh if you look at the comment under it under Sources it should satisfy your curiousity that way...
    Your "sources" merely give references from an original article - I'd like the original source.

  9. #9
    Politics.ie Royalty toxic avenger's Avatar
    Join Date
    Jun 2007
    Location
    London
    Posts
    19,031
    Mentioned
    0 Post(s)

    Default

    Quote Originally Posted by Cruimh View Post
    It is late and I'm half asleep, but this caught my eye



    Venereal disease was common in Ireland - and not just in women working as prostitutes. It had always been quite high, in part because of general and widespread ignorance about sexual matters exacerbated by state legislation, but also because of WWII. So, even if unintended, this part could be said to both insult and demean many of the women involved but also to devalue the worth of the children involved by the undercurrent that they were only the children of whores.
    Yes, it is quite a leap to presume that to be the explanation, and, at any event, the mother's former status is irrelevant to the plight of the children (though even if it were true, it only goes to further illustrate how vulnerable and tragic their plight was).

  10. #10
    Politics.ie Member Cruimh's Avatar
    Join Date
    Apr 2010
    Location
    County Londonderry
    Posts
    35,432
    Mentioned
    2 Post(s)

    Default

    Quote Originally Posted by toxic avenger View Post
    Yes, it is quite a leap to presume that to be the explanation, and, at any event, the mother's former status is irrelevant to the plight of the children (though even if it were true, it only goes to further illustrate how vulnerable and tragic their plight was).
    I was quite surprised at how common it was - Sean O'Casey's Brother-in-law ended up in an asylum as a result of it - and to find that Archbishop McQuaid, to his credit, had been supportive of attempts to tackle the problem.

Page 1 of 53 123451151 ... LastLast

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •