Britain has been very impressed by the achievement of turning London’s ExCel conference centre into an emergency NHS coronavirus hospital, named after Florence Nightingale. Yet few realise that the Nightingale NHS Hospital London project follows the example of Isambard Kingdom Brunel over 160 years ago.
Brunel was the most flamboyant engineer of Victorian Britain. Most famous for his elegant railways, soaring bridges and pioneering steamships, he also designed a hospital in just six days during the Crimean War in 1855.
This largely forgotten project was prompted by catastrophic losses suffered by British troops fighting Russia. While history celebrates the suicidal Charge of the Light Brigade, soldiers faced greater dangers from wounds and disease in the Crimea. Early war reporters such as William Howard Russell from The Times drew attention to the scandal – ‘something must be done’ – in the same way that today’s media are highlighting the UK government’s woeful performance providing COVID-19 tests and personal protective equipment to NHS staff.
Brunel’s design consisted of a series of separate prefabricated buildings, divided into two lengthways, housing 13 beds each side. He followed Florence Nightingale’s principles for lighting, ventilation and hygiene. Flush toilets and hand basins were provided at one end, with a pump forcing air into the room through underfloor ducts. The prefabricated units were sent in five ships.
Opened in late 1855, the 1,000 bed hospital at Renkioi, Turkey, treated 1,500 men in its short life. Amazingly, only 50 died, a fatality rate of 3 per cent compared with 42 per cent at the notorious original military hospitals such as Scutari.
Brunel had much in common with Florence Nightingale: both were obsessive personalities with a determination to get things done regardless of bureaucracy. Brunel, facing obstructive officials during the project, gave a characteristic retort:
“It is only by the prompt and independent actions of a single individual entrusted with such powers that expedition can be secured and vexatious and mischievous delays avoided.”
Brunel would have been impressed by the creators of today’s Nightingale Hospital in London and others around the UK. He and Florence Nightingale would have been less impressed by the government’s terrible failure to provide COVID-19 tests and protective equipment. The delays have indeed been mischievous and vexatious.