Imagine being someone a hundred years ago who needed intimate medical treatment for an STI. It was not pleasant because not only were these horrible to endure, they also were also the reason for thousands of deaths per year, with no effective medical treatment and facing a stigma if you did venture out to be treated. And then we come to pregnancy, one of the scourges of society back then. There was no antenatal care that we would recognise today, no scans or blood tests or dopplers for checking the heartbeat. It was left up to chance as to whether you had a healthy baby when you had an STI, and sadly the outcome often wasn’t a good one. In families with syphilis there was a 17% chance of both miscarriages and stillbirth and 50% of infertility in women was caused by gonorrhoea. 50%!!!! That’s a huge – and very sad – margin, that’s unthinkable today, just 100 years later. There were also schools for the blind back then and 30% of children in one of these were there because of syphilis during pregnancy.
During the First World War era, venereal disease presented a real problem. With very limited contraception options, the rapid spread of STIs couldn’t be halted easily or efficiently. And statistics prove this: syphilis deaths stood at 22-46 million. WW1 worsened things, there was a veritable explosion of STIs, as you can imagine. Men were stuck in trenches for years with few options for sexual gratification, and even less access to condoms, and for women left behind, the urge to have sex with other people was often too great to ignore. Basically, all of a sudden there were people having sex with other people where they wouldn’t normally have done and the inevitable result was the fast and uncontrollable spread of venereal diseases. 5% of men in British armies were infected with an STI, and sexual infections saw more than 400,000 of British and Allied troops admitted to hospital. Numbers that simply would not be seen today. Have you heard of the dreaded trench foot? It was a fungal infection as a result of wearing muddy, wet boots for weeks on end. It’s probably the best known medical condition to associate with WW1 trenches – so you might be surprised to learn that men were far more likely to have an STI. These were all too easy to pass on and without proper diagnosis and treatment they spread rapidly and uncontrollably.
Changes to sexual health provisions.
By now it was very clear that the situation needed to change, there needed to be far more comprehensive sexual health care available – and be easily available to those who needed it. The cost was a barrier to many, many people so that needed to be factored in too. The result was remarkable and inspiring changes that transformed sexual health in simple ways that had a dramatic effect.
In July of 1916 the Local Government Board went ahead and created the Public Health (Venereal Diseases) Regulations, which provided free, confidential diagnosis and treatment of STIs. This was a ground-breaking move – they’d always known of the existence of STIs, but never before had there been change on such a massive scale as this to start to control and eradicate them.
If this wasn’t enough, other measures included the setting up of specialist clinics for those suffering from VD, meaning that they had access to treatment specifically for it, no longer having to mix in with the general illness crowd and taking your chances with a generally trained doctor (doctor), now you could see the experts straight away. And when military medics returned after the end of WW1, these clinics went from strength to strength and it was this clinic network that formed the basis of the one we have today.
In May of 1917, the Venereal Disease Act was passed. This was another huge, iconoclastic leap forwards because it made it a criminal offence for unqualified people to treat VD, or to advertise remedies. This forced a pathway for appropriate training and competency of those managing people with STIs, and also promoted robust governance in clinics. It was a swift and effective move to get rid of the charlatans claiming to practice medicine whilst being wholly unqualified to do so.
Today, we have a beautifully expanded NHS which covers all state-provided sexual health provisions. But the only reason that we have this available now is because of the vital push forward in this field made over a hundred years ago. Without this innovative action, we almost certainly wouldn’t be reaping the rewards of progress yet. So when you go to a sexual health clinic, just pause for a moment and imagine what it would be like to not have access to this service, to have to suffer in silence as STIs/STDs tore through your body, unchecked. Scary, yes? Luckily, we now have a sophisticated National Health Service to diagnose, treat and protect us, plus a range of condoms to add to that protection.
