R.G. Ferguson

Robert George Ferguson, OBE, (12 September 1883 – 1964) was a pioneer in North America's fight against tuberculosis (TB) who worked for the introduction of free medical treatment.

As Medical Director, and later as General Superintendent of the Saskatchewan Anti-Tuberculosis League Canada, he achieved many firsts for the province, including:

* 1921, provincial survey of school children: 54% of non-Indigenous children and 92.5 % of Indigenous children had positive reactions to tuberculin tests indicating infection or exposure
*1929, First province in Canada to provide free treatment of tuberculosis.
*First province to initiate a vaccination program for its sanatorium personnel (student nurses, 1938) and the First Nations population (infants, 1930).
*1941-1947, First province to conduct province-wide tuberculosis surveys''Canadian Medical Association Journal'' April 18, 1964, Vol.90.
Furthermore, Ferguson was a pioneer in long-term BCG vaccine research, quite controversial at the time.

Biography

R. G. Ferguson was born on 12 September 1883 to Robert Ferguson and Margaret Jane Fisher. The couple had moved from Kincardine township in Ontario, Canada to North Dakota, USA in 1881, in part due to concerns about Margaret's health. Her family had a history of tuberculosis.
At the time of R.G.'s birth, the family lived on a farm near Joliette, North Dakota. In 1903 the family moved to a homestead near Yorkton, Saskatchewan, Canada. "George's" education was interrupted following public school by a spell of homesteading on his own before starting high school in Winnipeg at the age of 20.

At first Ferguson planned a career in the Church, and attended Wesley College (Manitoba), carrying out mission field work in Alberta in 1908 and 1912. After earning a Bachelor of Arts degree, a Bronze Medal in Arts ''and'' being selected Senior Stick by classmates, his path changed and in 1916 he graduated in medicine, earning another Bronze Medal.

In his final year of medical school he worked part-time in a laboratory making typhoid vaccine for the Canadian Expeditionary Force (CEF). Dr. Ferguson's post-graduate work included training at the London Hospital in England, and at Harvard School of Medicine, Harvard University.

Concurrent to his medical training Ferguson worked in the laboratory of Dr. S. J. S. Pierce in Winnipeg where he helped to make typhoid vaccine for the Canadian Expeditionary Force. His two youngest brothers, Vernon and Frank had by then enrolled at the same University and subsequently left school to join the CEF. Vernon joined in 1915 and was wounded at Ypres as a member of the Princess Patricia's Canadian Highland Light Infantry. He received the Mons Star, contracted tuberculosis and died in 1930. His youngest brother Frank was discharged from the CEF and joined No. 87 Squadron RAF. Frank flew a Sopwith Dolphin and was shot down by Bavarian Ace, Michael Hutterer, near the German-Canadian lines (Marcoyne) on the evening of September 3, 1918. Hutterer was a member of Jagdstaffel 23. Second Lt. Frank Ferguson is buried at Arras Road Cemetery near Roclincourt, France.

Ferguson married the former Helen Ross of Wynyard, Saskatchewan in 1916. They had seven children, one of whom, John Vincent (Jack), twin of Sheelagh, died 9 December 1925.

In 1929 RG Ferguson wrote, ''The Wood Fairies' Christmas Deed'' for his 6 surviving children. In 2014 this story was published, made available via Amazon with proceeds donated to the Lung Association of Saskatchewan. A short animated feature of the story was filmed and uploaded to YouTube.

RG Ferguson's children Robert Ross Ferguson , Sheelagh and David served in the Royal Canadian Air Force during the second world war. His son in law, Major John Vernon (Jack) Love of Yorkton, Saskatchewan, was killed leading D company of the Regina Rifles Regiment onto Juno Beach at Normandy France, June 6, 1944 (D-Day). Jack Love is buried in Bény-sur-Mer Canadian War Cemetery.

Medical career

Following his graduation Dr. Ferguson was appointed Assistant Medical Superintendent, Acute Infection Hospital, Winnipeg. From here he went to the Fort Qu'Appelle Sanatorium intending to stay for six months. He remained for 31 years. He was a skilled administrator with a knowledge of economics and the ability to analyze the dire challenge presented by rampant TB infection in the community.
Native populations were particularly susceptible. In 1917 the Province of Saskatchewan had the nation's highest incidence of tuberculosis with a rate of 50 cases per 100,000 population.

Dr. Ferguson saw quickly that the only way to deal with this situation was to provide diagnosis, treatment and hospitalization at no cost to the patient. This was a huge political challenge. Dr. Ferguson persisted in his efforts, working patiently to gain support from TB sufferers, the public, members of the medical profession, and, last but not least, politicians.

As one of three members appointed by the Provincial Government to form the Saskatchewan Anti-Tuberculosis Commission in 1921 he wrote the entire report. Nineteen of the report's 22 recommendations were implemented. Chief among them was making the cost of diagnosis and treatment of TB a public responsibility. Upon Ferguson's death in 1964 then Saskatchewan Minister of Health Minister Allan Blakeney said, "The introduction of diagnosis and treatment of tuberculosis at public expense was one of the early and essential steps in developing a program of health services for all."

In October 1928 Ferguson gave a landmark presentation entitled Tuberculosis Among the Indians of the Great Canadian Plains at the 14th Annual Conference of the National Association for the Prevention of Tuberculosis at British Medical House, London.
It established him as an international authority on TB. Later on the same trip he attended the Council of the International Union Against TB (CIUA) where the double barred cross of Lorena was adopted as a symbol of the worldwide fight against TB. A further achievement in 1928 was integration of the native population into the sanitorium. Saskatchewan, under Ferguson's guidance, was the first province by eight years to fully integrate the native population into sanatoria. Previously they were segregated.

Ferguson found an ally in incoming Premier James G. Gardiner, and on 1 January 1929 the Saskatchewan Sanatoria & Hospitals Act was passed. Saskatchewan became the first province in Canada to make tuberculosis treatment free to all who needed it.

BCG Research

At the time Dr. Ferguson began his career at Fort Qu'Appelle, BCG vaccination was, controversial. This grew to a fever pitch in 1929 when 270 infants in Lubeck Germany were vaccinated with a vaccine which was supposedly BCG but which turned out to be virulent tubercle bacillus. Seventy seven children died of tuberculosis. The idea of introducing live tubercle into the human body was considered dubious from perspectives of both health and morality. However, the reality in 1926 was that natives were ten times more likely than non-natives to die from tuberculosis. And the risk of BCG vaccination was theoretical; not proven. Dr. Ferguson felt it was justified. He was so convinced of the value of BCG vaccination that to prove its safety he vaccinated his own children, before vaccinating anyone else.

In 1932 Ferguson received approval to begin BCG vaccination of newborn infants in the Fort Qu'Appelle Health Unit, and an increase in his annual National Research Council (NRC) grant for BCG research which, remarkably, was renewed for 21 consecutive years. In collaboration with Austin Simes, a former classmate now working with native populations nearby, Ferguson embarked on a long-term studies of families of equal status with respect to living, social and economic conditions likely to impact health outcomes. In spite of some questions concerning "randomization", the Panel on Tuberculosis of the NRC Associate Committee on Medical Research recognized Ferguson's and Simes's study as "the most scientific trial of BCG yet made".

In 1937 the Ministry of Indian Affairs introduced drastic funding cuts to medical care. Ferguson considered Indian Residential schools to be the battleground in the fight against tuberculosis and sent an angry letter to the Minister protesting the cuts and warning the Government that some of the worst conditions were to be found in the Prime Minister's own riding of Duck Lake, Saskatchewan. He advocated for the conversion of Residential schools into TB sanitoria. Ferguson later wrote a private letter to the President of the National Research Council,

The funding was not only restored but increased, however, the request to convert a Residential school into a TB hospital was ignored leaving students with active TB in Residential schools wards of the government.

Ferguson's study also demonstrated, for the first time, that due to the number of deaths among vaccinated infants which were not related to tuberculosis, "poverty, not tuberculosis, was the greatest threat to Native infants."

Legacy

Statistics alone provide evidence of Dr. R.G. Ferguson's lasting impact on the fight against tuberculosis. In 1917 the Province of Saskatchewan recorded a rate of incidence of 50 per 100,000 of population. The death rate for Saskatchewan's First Nations infants in their first year was even more appalling: in 1936 it was still 1,603 per 100,000. By 1948, the year Ferguson retired, the death rate was down to 17 per 100,000. These impressive numbers are the result of Ferguson's two-pronged attack. First, he established access to free diagnosis and treatment, and second, he established BCG as a safe and effective vaccination.

Statistics alone, however, do not measure Ferguson's full influence on public health policy. He charted a course that would not only guide the direction of treatment of tuberculosis, but that would inspire health coverage plans across the country for generations. In 1935, one of his contemporaries Dr. Norman Bethune, who himself had contracted tuberculosis, attempted unsuccessfully to organize a Montreal Group and extend this concept and introduce a free health care system across Canada.

On his retirement in 1948, the person voted through the English language branch of the Canadian Broadcasting Corporation to be "the Greatest Canadian", T.C. Tommy Douglas, who had been both Premier and Minister of Public Health from 1944–48, said of Ferguson:

Paradoxically, Ferguson's legacy was articulated as early as 1917 in his speech on the opening of the Fort Qu'Appelle Sanitorium:

It is testimony to his vision and tenacity that he achieved exactly what he set out to achieve.

Organizations

*President, Saskatchewan Medical Association, 1922
*President, Canadian Tuberculosis Association, (now the Canadian Lung Association) 1935 and 1936
*Fellow of the American College of Chest Physicians, and Governor 1944-48
*American Trudeau Society, 1945–1957
*President, Saskatchewan Hospital Association
*Member, World Health Organization Expert Committee on Tuberculin and BCG, 1948

Awards

In recognition of his achievements in the fight against tuberculosis, Dr. Ferguson received many awards and honours, including the Order of the British Empire. Others include:

*The King's Medallion (1935)
*The Charles Mickle Fellowship, (1961) awarded by the University of Toronto to the person judged by the University to have done the most to advance medical art or medicine over the previous 10 years
*Honorary Doctor of Laws, University of Saskatchewan (1946)
*Honorary Life Memberships in the:
**Brazilian Tuberculosis Association
**Canadian Medical Association (1953)
**Canadian Tuberculosis Association (1952)
**Royal Canadian Legion (1947)
**Saskatchewan branch of the Canadian Public Health Association (1959)
**Saskatchewan Medical Association (1948)

On June 3, 1939, King George VI and Queen Elizabeth visited the Sanatorium at Saskatoon where they were met by Ferguson and Veterans of the First World War who had also survived TB. A year later the Governor General, Lord Athlone, and his wife Princess Alice stayed in the Ferguson home while visiting the San at Fort Qu'Appelle.

Further recognition of Ferguson's achievements came in the form of the establishment of the Dr. R.G. Ferguson Professorship (1973) at the University of Saskatchewan; the Dr. George Ferguson School in Regina (1969), and Ferguson Island (Lac La Ronge) Saskatchewan, 1967. In 1935, Ferguson was named honorary chief of the three bands of the Qu'Appelle Valley (Muscowpetung, Piapot and Pasqua), and given the Cree name "Muskeke-O-Kemacan Ketche-na-na-ta we wayo" - "Great White Medicine Man".

Bibliography

*
*Ferguson RG, Simes AB (1941). Vaccination of Indian children with BCG in Saskatchewan. Report to the Committee on Tuberculosis of the National Research Council, 31 December. (unpublished).
*Ferguson RG, Simes AB (1949). BCG vaccination of Indian Infants in Saskatchewan. Tubercle 30:5-11.
*Saskatchewan. (1922). Report of the Saskatchewan Anti-Tuberculosis Commission. 1 online resource (94 pages, some folded)
*Ferguson, RG, The Wood Fairies' Christmas Deed. 36 pages.

References

{{DEFAULTSORT:Ferguson, R. G.
1883 births
1964 deaths
Canadian pulmonologists
Canadian medical researchers
American emigrants to Canada