In a Strange Garden: The Life and Times of Truby King
Chapter Eleven: The Plunket movement
Chapter Eleven: The Plunket movement
It is wiser to erect a fence at the top of a precipice than to maintain an ambulance at the bottom' is a common saying that was adopted by Truby King as motto for his weekly 'Hygeia' newspaper column.
One of King's more notable successors at Plunket, Dr Neil Begg, made the profound observation that 'the treatment of disease is very different to the prevention of disease'. Both the medical profession and the government, in Begg's opinion, were slow to recognise this. King, he believed, was one of the first to appreciate the difference and to formulate a solution. This was to involve women in the promotion of their own health. The involvement of women signals the beginning of the Plunket movement.
By 1906 King's public utterances in Dunedin were coming thick and fast. 'An Appeal to Mothers' was published in May, followed by page 128 'The Training of the Human Plant' in July. The work of Nurse MacKinnon and her assistants (still funded entirely by King) was becoming widely recognised. He lost no opportunity to address public meetings, often with Nurse MacKinnon, or Miss Beswick, his Matron at Seacliff, following up with a practical demonstration. King often managed to emphasise that the need for reforms in infant feeding and education were part of what he described as the 'prevention of mental illness'.
He had less success with the conservative medical profession, who were not always keen to embrace change or new ideas. Doctors also criticised King in his role as a government doctor, believing he had no right to encroach on their practices. While the majority of the profession was unprepared to embrace the outspoken and publicity-seeking asylum doctor's ideas, chinks in the professional armour were beginning to appear, and at least three Dunedin doctors were sufficiently impressed with the work of Nurse MacKinnon and team in ministering to their own wives, that they publicly endorsed King's work. One of them was Dr Louis Barnett, later Sir Louis, distinguished Professor of Surgery.
By mid-year King was finding the increasing workload as propagandist for the infant-welfare movement was deflecting him from his mental health duties at Seacliff. He raised the profile of Nurse MacKinnon, letting her take over the answering of letters to the newspaper. 'I feel the time has come to leave matters entirely in her hands,' he wrote, 'though I am willing to accept a general responsibility for any advice she may give.'1
At the beginning of the following year the system of infant care as demonstrated by Nurse MacKinnon had become accepted in the Dunedin community. Together with sisters of various churches, she was providing a valuable service. Production of humanised milk for mothers had reached 200 pints per day. King was not wasting his time, either. Realising the importance of propaganda, he was busy bending the ears of any politician, businessman or person of influence. Shrewdly, he reasoned that the upper- and middle-class women were the key to its continued success, and spent as much page 129 time as he could preaching to them his messages of 'saving infant lives'.
The influenza epidemic of 1907 claimed the lives of many babies, but served as a focus for King's mission. With the support of a number of influential Dunedin people, an enthusiastic public meeting was held in the Dunedin Town Hall on 17 May 1907. This was his most significant speech. The big hall was abuzz with interest. With cooperation from the newspapers, he was assured that the meeting would be well attended. The stooped, slightly dishevelled character took the podium and launched into his address. He called on all the persuasive powers and emotive tricks he knew, conjuring up the spectre of the Yellow Peril, declining birth rates, insanity resulting from poor infant nutrition, and the shocking infant mortality rate, especially among illegitimate babies. He offered them solutions, ones that they could implement and control themselves. He had pitched his talk at women, stressing humanitarian issues with which they could empathise.
The outcome of the meeting was the decision to form a Society to continue the work begun by Truby King. The Society was soberly named the Society for the Promotion of Health among Women and Children. The steering committee comprised Truby King, his wife Bella, and five influential women who had helped Truby in the initial experimental period.
A week later he had approached all the women he wanted to make up the committee. They all accepted. As Nurse MacKinnon said, 'There were few who grudge time or effort for Truby King.'"
The committee comprised twenty-four members, all with influence and commitment to the cause. King had covered his bases well. There were wives of four lawyers, six prominent businessmen, a member of parliament and eleven members of the medical or nursing professions. Their religious affiliations included Presbyterians, Jews, Anglicans, Methodist and Wesleyan. Even the Salvation Army was conscripted. Mrs Hosking was elected president. Her husband was a noted lawyer who would shortly take silk and eventually become an influential judge, and had collaborated on the drawing up of the page 130 Society's constitution, which was a normalisation of King's aims and objectives and is reproduced in Appendix Two.
In the three years since Truby and Bella had adopted Mary, Truby King had gone from an outspoken holistic farmer and asylum superintendent to leader of a movement that would sweep him on to bigger and better schemes 'to save the babies'.
Soon after the Society was formed, the indefatigable Nurse MacKinnon uncovered the scandal of licensed foster homes for babies. This was to drive Truby King in yet another direction, which would lead to the formation of Karitane hospitals.
Illegitimacy was a problem that the Edwardians didn't want to acknowledge. Babies born out of wedlock found their way into licensed homes, created by the Infant Life Protection Act of 1896, administered grudgingly by the police. The system did not work well, allowing unscrupulous women known as 'baby-farmers' to profit from looking after babies in dubious conditions and with little regulation. At the time, there were only four 'police matrons' responsible for all licensed baby homes in the country.
Nurse MacKinnon found three babies in an 'ill-treated, starved condition'3 in a stable adjoining a Dunedin house. King, never one to worry about rules or protocols, shipped two of them off to his home at Seacliff to be cared for. The police did not share Truby's horror and declined to close the home.
On 23 May 1907 the inaugural meeting of the Society for the Promotion of Health of Women and Children was treated to King reading an anonymous letter received by the Mayor of Dunedin: 'The women of this city should go a little further ... it is no use adopting precautions ... if a child's future during the helpless period of its existence is not also provided for . . . The State cares for the stock of the colony by providing veterinary surgeons. The welfare of the mother is provided for by maternity homes — but what of the child?'4
King suggested a licensed home should be set up to care for infants. He offered the Society his Karitane cottage for a six-month trial period. Naturally the Society accepted, passing a remit: 'To ensure to all infants in the community of the type now lodged in page 131 licensed homes that they should be well fed and well clothed; that they should have plenty of air and sunlight; that they should be kept clean and be kindly treated, and that they should not be placed in homes where they would be the sole source of livelihood.'5
And so the Karitane cottage was licensed as a home, pressed into service to look after the first two customers — Lilian (5l/2 months) and Cecil (41/2 months). They began their recuperation at Seacliff but after two months moved to the newly prepared cottage at Karitane. Lizzie Hughes, the nurse who had brought up Mary King, was put in charge, with the assistance of two nurses from Seacliff. Truby King supervised the babies' feeding regime, and so began the first 'Karitane' hospital. King equipped the cottage, Society ladies donated baby clothes. Within months thirteen babies were in the care of four nurses. Milk was provided gratis by the dairy company, sent by train packed in ice, collected at the station by locals and ferried by horse and trap to Karitane. Truby King had conscripted not only the ladies, but the community to his cause.
King went back on the campaign trail in mid-1907. After a run-in with Dunedin sceptics, he set forth to Wellington with some of the committee in tow. Their lobbying of the Minister of Justice did not succeed, but King won considerable praise and respect from the politicians. Another trip to Wellington followed to lobby members of parliament debating the Infant Life Protection Act. The reported debates have a curiously familiar ring to them, suggesting a number of members had come under his influence. It appears that sometimes it was easier to fall into step with King than to oppose him. The Society's campaigning had succeeded on many fronts. The Act was passed, the Dunedin Society acknowledged, and the name of Truby King reached a wider audience.
Enter Lady Victoria Plunket, wife of the Governor-General and mother of eight children, already well aware of the problems of infant feeding. She met Truby King and was immediately won over. The ability to influence the rich, famous and privileged is a testament to his persuasive skills as a communicator. With enthusiasm she accepted his invitation to become Patroness of the Dunedin Society.page 132
This was a coup that he would later regret.
Meanwhile, at Karitane the staff and facilities were stretched beyond their limits. King had another room added to accommodate more babies, the stables were converted for the staff to sleep in, and babies slept on the verandah under a canvas awning. Lizzie Hughes worked six months without respite, a fact unnoticed by the totally dedicated but blinkered Dr King. A neighbour was co-opted to do the washing. Miss Beswick, matron of Seacliff, walked the five kilometres from Seacliff to assist the exhausted staff on her days off. As ever, King was at his best when under self-imposed pressure.
At the October meeting of the Society, it was decided the 'experiment' had been successful. By that time the home had cared for as many as twenty malnourished infants, who had, with the benefit of scientific feeding, fresh air, sunlight and clean clothing, put on condition and blossomed. Once babies were considered 'recovered', they were returned to their homes or adopted.
A sub-committee of Society ladies was formed to find a suitable home in Dunedin to continue the work. Mrs Leslie Harris, daughter-in-law of philanthropist Wolf Harris, headed the group. She arranged for the Society to lease one of the family's homes in Anderson's Bay. Founder of the importing firm Bing Harris, Wolf became a life member of the Society, and would continue to support it handsomely, eventually gifting the property to the Society. After he moved to London, his wife would play an important part in supporting Truby King's work at 'Home'.
Within months the Dunedin home was ready for occupation and the babies were transferred from Karitane. The six-roomed villa, set in three and a half acres of grounds, was an ideal baby hospital, with all the sunshine and fresh air that King insisted babies needed. Nurses lived in the converted stables. The Karitane Home for Babies was officially opened in December 1907, to a blaze of publicity. The 'Karitane' name would be used for all baby-care hospitals from this point on. Notable guests included four members of parliament, six doctors, several clergy and many leading citizens. The motto 'Save the Babies' was adopted for the home, with the grand mission 'to give page 133 a chance for a healthy life to babies who are brought into the world either without a home at all or under conditions that would not allow their being properly nurtured and cared for'.6 On his return to Wellington, Cabinet Minister J. A. Millar announced a grant of £100 to assist the Society. The next year this subsidy would be increased to £500.
At first there was no resident doctor and the home lacked the facilities to care for 'serious' medical cases. Initially, the staff were unqualified, but later were registered midwives after Mrs Gordon joined as Matron. The ever-reliable Nurse MacKinnon was also present. In the first year thirty-four babies were treated. Success was mixed, as many babies were seriously ill and beyond the level of care the home could provide. The system of care was the same as devised by Truby King at Karitane: humanised milk, regular feeding and plenty of fresh air, sunshine and exercise. Accurate records of weight and fluid intake were kept. King's fanaticism for regular weighing, measuring and recording would become a cornerstone of Plunket dogma.
Despite their grand ideals, the first year was less than fully patronised. Public acceptance was not total. Three infant deaths cast a pall over the project. King's ambitions were clear and the project was not allowed to fail. With his clarity of vision, single-mindedness and ability to communicate and motivate, he kept the concept on track.
Training was one of the major goals. King's vision was to impart the message to everyone. This started with trainee nurses, extended to mothers and then to the general public. He held lectures wherever he found an audience. His now-enlarged pamphlet, The Feeding and Care of the Baby, was heading towards 100 pages, printed at his expense, with profits going to the Society. He articulated the message of breast-feeding wherever possible, supported by feeding with humanised milk for infants that could not be breast-fed. Large fat babies that had been fed on patent foods were not necessarily healthy, he told his audiences. They should be aiming for 'firm, bright, clear skin and fresh complexion like breast-fed babies'.7
Not content to stick to the knitting, King could not resist the temptation to stray into dubious territory. He had an aversion to dummies page 134 or comforters. Woe betide an infant that was so pacified. A baby admitted to the home was quickly broken of the habit. King believed that it was important not to separate the infant from its mother, contrary to the view then current that a baby didn't need 'mothering'. His concept of 'mother and baby' saw the extension of the Karitane home to encompass 'mothering' which allowed the mother to be admitted to the home along with their baby. In 1909 it was decided to admit a mother who needed help with weaning her infant who was not thriving on breast milk. She was to be the first of many.
The Society did not rest with the Karitane home. Lizzie Hughes was employed to contact families having infants under six months old. Obtaining details from the Registrar of Births, she would visit the family to give them information about the Society: those families who showed interest would then be visited by Nurse MacKinnon.
The Karitane home made the public welcome. In 1909 1600 people signed the visitors' book. Ever the visible target, Truby King continued to attract criticism in areas of the press: 'Dr King is a public servant and as such should devote his whole time to public duties,' grizzled a letter to the Otago Daily Times of 7 January 1908. The editor, a King acolyte, was having none of this, thundering that 'the work for the babies was part of the work for preventing insanity'. The Inspector of Mental Health duly weighed in with his support as well, and the King juggernaut thundered on.
With the formation of the Dunedin Society in 1907, King's fame was spreading. He could no longer be dismissed as the 'eccentric doctor from Seacliff'.8 He had fashioned a name for himself as the spokesman for the Save the Babies movement and conscripted the influential ladies of Dunedin into a Society that was gathering momentum, a Society with the imprimatur of Vice-Regal patronage. King was beginning to get invitations from other groups, aware that something was happening and not wanting to miss out.
The Canterbury Mothers' Union had been the first. He talked at the monthly meeting on 'The Preservation of Infant Life' only a week after the Dunedin Society was formed, and next day to a public meeting. The Mothers' Union determined that if Dunedin could have page 135 a Society, so should they, and another public meeting resulted in the formation of The Canterbury Society for the Preservation of Infant Life. In a matter of months their first fundraising event had raised £125, and a nurse was recruited, trained by the ubiquitous Nurse MacKinnon, and set to work in the Canterbury community.
The Wellington ladies had already had a foretaste of Frederic Truby King when he and his entourage came to lobby parliament the previous year. The secretary of the Society for the Protection of Women and Children, Lady Stout, noted in a letter to the Dunedin group: 'I am much interested in your work in connection with the health of women and children ... I shall bring the subject before the members . . . and see what can be done in forming a Society . . . I think it would be better if we could undertake the work in connection with our Society.'
As the Canterbury group was forming, a Wellington public meeting resolved that the SPWC would undertake similar work to the Dunedin Society. Funds were raised, and a nurse appointed. The Wellington branch of the Society for the Promotion of Health of Women and Children was inaugurated in March 1908, with an executive committee from the SPWC.
In Auckland Lady Plunket was preaching the gospel of Truby King. As was the fashion, the Vice-Regal couple were in their Auckland residence for the summer. Lady Plunket summoned the burghers of Auckland to Government House in January with a zeal approaching that of the good doctor, 'to form a branch of the Infant Life Protection Society'.9 Nobody could refuse the invitation. The guest list included the Prime Minister, ladies, gentlemen, doctors, clergymen, nurses and mothers.
Lady Plunket was instrumental in the formation of sister societies in New Plymouth, Napier and Christchurch. She was accompanied by Nurse MacKinnon on her promotional tour. There is no question that the social standing of Lady Plunket helped immeasurably in giving the society credibility and status in its formative period. Equally there is little doubt that it was Truby's magnetism and force of character that recruited Lady Plunket to the cause.
By the middle of the year there were five separate societies, varying slightly in titles and specific objectives. At Lady Plunket's request they became branches of the New Zealand Society for the Health of page 137 Women and Children, with the Dunedin branch being the governing body. Then, in the tradition of Florence Nightingale, a nursing training system was implemented, but unlike the Nightingale system, which focused on the treatment of disease, the focus was on the maintenance of health and the prevention of disease. Instigated by Lord and Lady Plunket, the purpose was to train health visitors who would instruct mothers in infant care, free of charge. The training was to take place at the Karitane home in Dunedin under the supervision of Nurse MacKinnon. At the suggestion of a politician, the nurses were to be called 'Lady Plunket Nurses'.
This resulted in some opposition from the ranks of professional nurses, and resulted in the Society requiring a certificate in general nursing or midwifery as a prerequisite to training as a Plunket nurse. This comprised three months at the Karitane home in Dunedin. Nurses were not paid during their training period, which probably discouraged many younger or financially challenged nurses from being able to train as a Karitane nurse. Nurses worked with babies and attended lectures by Truby King and other doctors. Further Plunket nurse training involved spending time at the dairy company observing the modification of cow's milk, as well as community work visiting Dunedin homes with the Society's nurses. At the end of the training, nurses sat an oral and written examination. While all of this was happening, King was still in charge of Seacliff. There is no evidence in reports from his inspectors that exception was taken to his extracurricular activities.
Once qualified, nurses were provided with board and lodging and received a salary of £100—£150 per annum from the local branch. (By comparison, Truby King received a salary of £600 in his capacity as director of Seacliff.) Nurses worked six days a week and received one month's holiday a year. A bicycle and a uniform were supplied. Each nurse wore her Lady Plunket medal and a grey armband with the VP (Victoria Plunket) monogram in white. The role of the Plunket nurse was primarily educational. On application any mother could be visited by the nurse in her own home, with visits continuing for as long as necessary. The nurse reported monthly to the local committee.page 138
When Lady Plunket and her husband returned to England in 1910, they left behind them a society run by women, dedicated to the health of the mother and child. Its acceptance by the medical profession had, not unexpectedly, been slow and frosty, but by the general public it was seen as a success.
By 1912 the Society's work was becoming more widely appreciated. The Department of Health endorsed King and Plunket to the point where the state issued every new parent with a copy of Baby's First Month. The infant death rate had declined measurably. King was notionally back at Seacliff, but he still seemed to be everywhere at once.
The Minister of Health sensed King's mission and requested that Truby undertake a nation-wide lecture tour, taking the message to all parts of the country. Officially granted three months' leave from Seacliff, Truby with Bella in tow set off to preach the Plunket message. Today there would be an entourage of officials, secretaries and support people. In 1910 it was just Truby King, with Bella to keep the show on the road. In a gruelling six months, double the original time allocated, from July until Christmas, they gave more than 100 public lectures, met countless thousands of notables, answered the same questions, inspired tens of thousands of women and gave of their very souls. The outcome was the formation of sixty new committees. That the Kings could achieve this unaided is a remarkable testament to Truby's persuasive powers and Bella's organising skills. How the perennially unwell Truby coped is not recorded. As usual, he seemed to thrive on self-imposed pressure.
Motor vehicles were still a rarity, so their travel was mostly by train. Bella King's prosaic diary is all we have to go by, as Truby was not one to record daily events. A typical day would involve 'Fred' going for a swim, breakfasting, travelling to the next town, meeting a group of women, viewing the hall, having dinner with local identities, delivering the speech, more meetings, more talking, then off to bed, exhausted.
Bella's diary of four days from 24 November records:page 139
Glorious morning. Fred had a swim before breakfast. En route to Dannevirke. Reached D at 12. Mr Bickford and Mrs Knight met us and took us to lunch. Saw nurse and went to hall. Fred gave a lecture. Saw several mothers & babies — all much interested and asked many questions. Fred [had] a talk with several of the women then had afternoon tea & caught the train to Palmerston which we reached at 8.15 pm. Off to bed at 9, very tired.
November 25. Called at 5.45. Lovely morning. Left Palmerston at 7.10 and reached Marton at 9. Lucy met us with car and we drove to the Corbs and Coronation hall en route. At 11 met some members of committee and had a talk and an address. Walked back to Corbs for lunch, and left Marton by 2.30 train for Taihape. Heavy rain after address at Marton, showery later. Reached Taihape 5.22. Mrs & Mrs Arrowsmith and Studholme met us and motored us to the hotel where we met Dr McDiamid and Mr & Mrs Loughman at dinner. Had a talk about Society matters and arranged to return on the 14th Jan, going on to Auckland.
November 26. Reached Auckland before 7 am. Dr Beattie met us and drove us to Avondale. Lovely fresh morning. Went round gardens with Mrs Beattie while Fred developed photographs. In afternoon, Mrs Bloomfield and Miss Henderson came and we talked over matters until after 6, went to Tizards for supper.
November 27. 6 am on way to Hamilton, reached Hamilton 1.30. Saw mayor and several other men. Held meeting with some of the Hospital Board. Had tea then a walk around. Had a long rest after dinner. Dr ? called and we had a chat and then walked down town and then across the railway line to see Mrs ?, stayed about an hour.
November 28. Had a great sleep. Fred up at 6 and went off to get a swim — baths supposed to be open at 6, not open till 6.45. Met ladies at 11 and had a most excellent meeting. Mrs Bell was appointed Hon Sec and all ladies present formed themselves into a committee. Had lunch and then caught train to Rotorua.
Life on the road for Bella and Truby didn't leave a lot of time for relaxation, with Truby's lack of organisation often coming to the fore. There are several references to his absent-mindedness, as when he sent a telegram to his last hostess asking her to forward his forgotten pyjamas to the next town, only to find at bedtime that he was wearing them under his suit. Whether it was his hostess or Bella, Truby's unconscious reliance on his women was omnipresent.
Mary King's biography recalls:
The hour of the meeting would draw increasingly nearer as they lingered over a discoursive dinner at the home of the host. The hall would fill up and then would come the frantic ringing on the phone. 'Has Dr. King left yet?' 'No, but I'm doing my best, I'll get him away as soon as I can.' With huge bundles of outsized diagrams, jugs, measuring spoons, etc, they would try to fit him in to the taxi, whose door he would have to hold open, arriving at the hall with half a yard of chart protruding and three-quarters of an hour late.
Then he would electrify the audience, galvanising them into action on behalf of mother and child, and the following morning some worthy and hitherto unruffled house-wife would wake up to find herself the President of a local Branch of a Society which would absorb every fleeting moment for the rest of her life.11
Truby King recognised in all of this the crucial role played by women. He wanted to sell them a scheme that they could administer themselves; to mobilise them to form committees to promote infant health. He had to tell them about the importance of breast-feeding, fresh air, proper regular feeding and hygiene. Equally, he did not want to alienate the men. They too had to be mobilised to provide support for the women's committee. This he often achieved by fostering the setting up of 'advisory' groups of prominent businessmen, ensuring that he had covered all parts of the whole. Whether he was actively conscripting men to the cause, or simply being a clever manipulator, is unclear.page 141
It would be wrong to conclude that every town received Truby and Bella with open arms. Suspicion, especially from the medical profession, was still a problem. While his charisma worked well with audiences of mothers, King's short fuse and intolerance of opposition often got him into trouble with his peers. Some were converted, some would wait . . .
At the end of the 1912 Truby and Bella were back at Seacliff and the Plunket Society's foundations were laid throughout the country. Truby had sold to women the role of preventing disease by taking responsibility for the feeding and care of children. He had promoted the Dunedin society's model of well-to-do women, mostly married to professional people, in charge of the voluntary Plunket organisation. This model was to endure for the best part of fifty years, as was the centralised control of Plunket from Dunedin.
One of the later presidents of Plunket recalled attending the annual Plunket conference in the Regent Theatre in Dunedin in the 1970s and recoiling in horror at the elderly 'fur coat' brigade who still ran the organisation.12 However, these were influential ladies, born to administer a voluntary organisation, who had professional husbands with incomes substantial enough to keep their wives in twin-sets, pearls and sensible shoes, but also the wherewithal to devote time and resources. Truby King, dead for forty years, would have been proud of them.page break
1 Milne, The Plunket Society — an Experiment in Infant Welfare, p. 48.
3 Ibid., p. 54.
4 Ibid., p. 55.
5 Ibid., p. 55.
6 Ibid., p. 71.
7 Ibid., p. 77.
8 Plunket archives, Hocken Library.
9 Parry, A Fence at the Top, p. 45.
11 King, Truby King — The Man, p. 100.
12 Dianne Armstrong, personal communication, 2000.