Pigeonholes and mustard seeds: Using data to improve health

The Northern Ireland local group of the RSS held an online meeting on Monday, 7 December 2020, at 2pm, titled: 'Pigeonholes and mustard seeds: using data to improve health from the time of the Crimea to the time of the coronavirus'. The speaker was the President of the RSS, Professor Deborah Ashby, of Imperial College, London, UK.

Professor Ashby gave a wide-ranging talk on the life and times of Florence Nightingale (12 May 1820 – 13 August 1910). Nightingale's, ‘Lady with the Lamp’ nursing exploits at Scutari hospital during the Crimean war (1853-1856) are well-known to the Society. However, Florence's nursing achievements are only a part of her life story.

Deborah traced Florence's birth certificate and family tree, mentioned her early interest in mathematics and that she was taught by JJ Sylvestor (1814-1897) of matrix theory fame. Florence felt a religious calling, began to take an interest in social issues and in 1850 entered training as a nurse (against her family's wishes) at the Institute of St Vincent de Paul in Alexandria, Egypt.

In 1854 she was asked by the British Secretary for War, to become a nursing administrator - 'Superintendent of the Female Nursing Establishment of the English General Hospitals in Turkey' - in order to address the appalling conditions in military hospitals there. Nightingale arrived in Scutari, in Constantinople with 38 nurses in November 1854. Her period in Scutari, was one of dealing with Cholera, Typhus, vermin, unsanitary conditions and obdurate military men. During her sojourn the in-hospital death rate dropped from 60% to 2.2%. Florence had of course installed a proper record keeping system and had deployed her mathematical skills, developing hospital statistics and illustrating the results with her polar area diagrams - 'coxcombs'. In effect, using data to make evidence-based decisions. In short, her period there was a triumph and her reputation was established.

Florence's work in the Crimea was contrasted briefly with the modern day Covid-19 pandemic. The President described a number of major Covid-19 trials currently being conducted in the UK, describing some early findings, and emphasising the need for evidence-based decision-making and, just as in Florence's time, the need to educate politicians.

After the war Florence took a continuing interest in the health of the British Army working with her Vital Statistics mentor William Farr (First Registrar General). There was  the 1857 Royal Commission on the 'Health of the Army' for which she had lobbied hard and in 1858, Nightingale became the first woman to be elected fellow of the Royal Statistical Society.

Professor Ashby went on to describe Florence's advocacy of greater influence for women, her interests in education, the establishment, in 1860, of the Nightingale Training School  based at St Thomas's Hospital in London, of the her reforming zeal - 'action women' - and the influence she brought to bear on Victorian Society.

Professor Ashby's very enjoyable talk was received with acclaim. She was asked more about Florence's iconic, inspirational, role for women, about Florence's admiration for Quetelet* and about whether Florence actually supported the Koch-Pasteur germ-theory of disease transmission (c1861).

*Adolphe Quetelet (1796-1874), the Belgian statistician, also had a significant influence on Florence Nightingale who shared with him a religious view of statistics which saw understanding statistics as revealing the work of God in addition to statistics being a force of good administration. Nightingale met Quetelet in person at the 1860 International Statistical Congress in London, and they corresponded for years afterwards (see Wikipedia).

Gilbert MacKenzie, secretary of the Northern Ireland local group, April 9, 2021

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