By  Ray Jones

At the start of the ni neteenth century, there was little or no significant concept of disease prevention or ‘public health ‘. ln l805 the Privy Council established a Board of Health because it was concerned about the potential spread  of  yellow  fever,  then  endemic  in  Spain  and Gibraltar. This threat did not materialise and the Board  met until 1806 when  it was disbanded.1 The cholera epidemic of 1831 led to the formation of another central Board and as a result about 1 ,200 Local Boards were formed. As the epidemic receded, Local Boards disappeared and the central Board was dissolved in l832. From 1834-1847 public health and sanitation became the concern of the Poor Law Commission.

Following the report of the Royal Commission  on the  Health  of Towns, the Public Health Act was passed in 1 848. This established the General Board of Health which enabled the formation of Local Board s of Health (after an inspection by the General Board). These inspections could be carried out following a petition by at least one-tenth of the ratepayers of  any place having a defined boundary, by the General Board itself  where local death rates exceeded 23 per 1 ,000 living for seven years or follow­ing a request by a ‘prominent person’ .2 However, Local Boards were voluntary and unpopular. They were thought to be expensive and represented  national  control over local  matters.

As well as Local Boards, such bodies as Registration authorities, parish vestries, Boards of Guardians, highway boards and  various  Commissioners had input into public health. The  1871 Local  Government  Board Act together with the Public Health Acts of 1872 and 1875 consolidated public health matters. It established  rural  and  urban  sanitary  authorities and made compulsory the appointment of medical officers  of  health  (MOH). County Councils, with their  own  MOH,  were  set  up  in  1888  and in 1894 urban and rural district councils were designated health administrators. In Pembrokeshire, these were Tenby Urban Sanitary Authority, Pembroke Rural and Pembroke Urban Authorities , Haverford­ west Rural and Haverfordwest Urban Authorities and Narberth Rural Authority together with Milford Port Sanitary Authority. However, Narberth Authority  had  the  same membership as Narberth  Union  Board  of Guardians and others, for example Tenby, Pembroke Urban and Haverfordwest U1:b n, were t he Town Counci ls ‘meeting as the Sanitary Authority’. Milford Port A uthority was princpally made up of representatives of the nearby Urban and Rural Authorities. Some Authorities, e.g. Pembroke Urban appointed ‘Sanitary Committees’ and later  ‘Ward Sanitary Com­mittees    which  appeared  to act as sub-committees  of  the main Council. 3

These Sanitary Authorities appointed  Inspectors of Nuisances and MOHs as required by the Act, but the MOH was always part-time and salaries  were low. Most MOHs appeared diligent, reporting to their Authorities, in some cases every three months, with statistics of diseases and complaints abou t percei ved sanitary problems. Sanitary Authority Minute books sur­viving show that in  most cases, the MOH Reports were merely  ‘received’ or ‘noted’. Despite  this,  most of the Authorities  conscientiously  pursued nuisances, cleaned streams, closed suspect wells, sunk others, ordered privies, drains and water to be supplied  to houses and improved  sewerage and water supplies. On the other hand , a few Authorities were rebuked by  the Local Government Board. For example, a letter  from  the  Local  Government Board to Haverfordwest Urban Sanitary  Authority  dated March 9, 1885 stated  ‘. . . the Town Council  will  incur a serious respon­sibility  if  they  do  not  proceed  with  the  Works  of  Sewerage  which  are required  for the Borough ‘.4

From 1848-1857, a total of  399 reports were made by  the  General  Board of  Health covering some 414 town s and villages  in 49 counties. Of  these,
35 were in Wales but only one in Pembrokeshire, Tenby. This was the ‘Preliminary Inquiry into the Sewerage, Drainage, and Supply of Water, and the Sanitary Conditions of the Inhabitants of the Parish of St. Mary, w1thin the Borough of Tenby in the County of Pembroke’. The author was George  T.  Clarke,  a  sanitary  engineer  and  one  of  the  General  Board’s
Principal  Inspectors. A public meeting  was held and the Report was published in 1 850. 5

The  Report  followed  the general pattern  of such reports. There was a map and a general description of the town – ‘a pleasant, well-ordered and clean wateri n g place . . . [with] various rows of new and commodious houses built upon the  several sea-fronts ‘.6 There followed a description of the corporation  with  extracts  from  financial  affairs  and  details  of     debts.
Mortality figures gave a death rate of 22.3 per 1 ,000 living for Tenby. This was above the death rate in the Pembroke Union which was 20 per 1 ,000. Inspection of areas described as ‘of the poorer classes’ showed an ‘accu­mulation of rubbish and filth’ with  open  sewers and  a  ‘vast  accumulation of decayed animal and vegetable matter’ at  the  south  sands.  In  one row there were 26 houses with 173 inhabitants with one house holding 18 individuals. The next row had 23 houses  with  159 inhabitants.  There  was no drainage in any of the houses and a total of  II privies  with  cesspools. One tap supplied water for the whole of the row. Several drains were described as ‘most offensive’ as were the  smells emanating  from  pigsties and the drains from the fish market. The lockup  was  described  as  the ‘worst . . . in the Principality’. Houses were described as  ‘poor,  ill-built, undrained, very damp . . . and rarely provided with privies’. Sewers were also inspected and found to be ill-regulated and inefficient with numerous private drains discharging into the fields and seashore. Some streets were kept in good order; others were filthy and ill-paved . The burial ground was said to be ‘insufficient for the needs of the inhabitants  and  should  be  closed’  and  the  sands  were  ‘disfigured’.

There are three pages of suggested remedies including that the Public Health Act be applied. Tenby was said to be in need of ‘water, sewerage, [and] a proper burial ground . . . there is a great want of privies . . . pigsties are a common nuisance . . . and the gardens within the town are receptacles for damp and decayed  vegetable  matter’. The  population  of Ten by at this ti me was about 3,000 (2,803 at the 1 841 census) with about 570 houses and the inspection was made following a petition  by the ratepayers  of the parish. As a result of the report, Tenby petitioned the General  Board  of Health to establish a Local Board of Health 7  and a motion  to carry out  the  provisions  of  the Act  was  passed  on  November  15, 1851. This Local Board  first  met  on  November  21,   1851. 8   The  November   15  motion   was rescinded on December 22, 1851 but this December motion was  over­  turned  on January  12,  1852 and  the Act  was adopted.

During 1852 Tenby enacted a number of byelaws concerning Lodging Houses and Slaughter Houses and a Surveyor, Clerk, Treasurer  and  Inspector of Nuisances were appointed.9 Appointment  of  an  MOH  was also discussed but nothing was done until 1872 when an appointment was made at a salary of £10 per annum pl us £3 expenses .10 Over the years there was no mention of infectious diseases in the Minutes of  this Board  but  the local Gas Works was taken over  and  Byelaws  concerning  sea-bathing, boating and cabs  were instituted.  Drainage  was  established  and  a  number of houses were ordered to install privies. 11 The Tenby  Board  of  Health continued  in  this  vein  until   1894 when   it  became  a  Sanitary Committee.

As well as the Local Reports referred  to  above,  a further  series  of  reports, also termed Local Reports, was made to the Local Government Board. 12 Between   1869  and   1 908,  a  total  of  799  were  made.  Many  were  specific investigations of outbreaks of disease on various  parts  of  the  country  and  were often  made  by  temporary  medical   inspectors  from  the  London Hospital appointed for this purpose. A  number  were  done  in  Pembroke­ shire  when   local  outbreaks  of  disease  were   investigated.

One of the earliest such investigations  in  Pembrokeshire  was  when  Dr Parsons reported to the Local Government Board on typhoid fever and the sanitary state of Haverfordwest in April 1881 .13 This rather scathing 11­  page report begins by giving the actual number of deaths from typhoid and fever,  it  ‘having  been  stated  that  before  the  [present]  epidemic  . .  . typhoid fever had not often been prevalent in Haverfordwest ‘.14 The report went on  to  state that:

‘. . . opportunities for the dissemination of the infection . . . abound throughout the town. Badly made and foul sewers, defective and untrapped house drains. Ill contrived waterclosets, large privy middens, and other depositories of filth poison the air. . . . The public water supply is, or has been till lately, liable to dangerous pollution, . . . and has been shown to be . . . seriously contaminated; and the shallow wells and other subsidiary sources are in no better case.’ 15

The report continued with details of the various water supplies and likely sources of contamination and includes Professor Wanklyn’s analyses of the local water where two samples were said to be ‘bad,’ one ‘contaminated’ and one of ‘fair average organic purity’ .16 There is also a detailed description of ‘the sewers in the principal streets’. The report recom­mended a better system of excrement disposal should be adopted,  sewers and drains be improved , nuisances be abated and pig-keeping  be given ‘due attention’. Better death returns should be kept and bye-laws promul­gated to regulate new streets and houses . There was need for overcrowding to be repressed and unfit houses closed. Further recommendations  were that the water supply should be increased and purified and additional sources secured and that the Sanitary Authority should ‘diligently exercise . . . the powers which they posses under the Public Health Act of 1875 for the prevention  of infectious disease’.17

The next report concerned an outbreak of diphtheria in Clunderwen and Llandissilio in 1888 and was prepared by Mr Spears. 18 Mr Spears reported that most, but not all cases had been  in contact with  one another   but:

‘No incidence upon the  consumers  of  any  special  food-stuff  could be discovered; nor did such an influence  appear  to  be  probable .  What little milk was used was from several  sources;  the  water supplies, too, were various. No evidence of infection from domestic animals could  in these cases be obtained.’  19

The home of one set of sufferers was ‘an ancient cottage: damp, dilapidated ill-ventilated . . . dirty, without privy accommodation, and surrounded by solid and liquid refuse of various  kinds’.20

In Llandissilio:

‘The houses are mostly small, ill-ventilated and often damp and dilapidated . . . cleanliness  is . . . unsatisfactory  . . . overcrowding is not uncommon.
In the long straggling  village  foul  sewage deposits  meet one on
either hand . Privy accommodation is occasionally altogether absent and . . . is generally of the most objectionable   kind.’ 21

Clunderwen was thought to be a bit better but there and at other nearby villages visited by the Inspector, ‘homes were damp and dilapidated ‘ and ‘the means of sewage disposal inadequate’ .22

Pembroke Rural Sanitary Authority was inspected in 1890 following several earlier  outbreaks  of  diphtheria  in  its  Districts.  The report 23  reminded the Board that in 1885, the Authority had been prompted to exercise their powers under the Publ ic Health Act more efficiently, to protect water supplies against surface pollution, to  provide  apparatus  for  disinfection and to provide some means of isolation. In 1887 the Local Government Board had authorised a large loan to the Rural District Council but after much vacillation the Council decided, in 1890, not to take up this  loan.  The report went on to say that there was no drainage at Llanstadwell and that privies were ‘dangerously near ‘ water  supplies. At Angle  there were 12 drains and 6 cess pits choked and there was no sewage in new houses. Neyland needed a better water supply and throughout the area there was a ‘general  state of  filthiness’ .

Apart from the 1890 report above, Pembroke and Pembroke Dock were the subject of several ‘general ‘ reports, that is not related to an outbreak of  a particular disease. Reports of 1878, 1884, 1885 and 1893 together with the 1890 report were summarised in a further report dated 1895  24 reiterating comments in the earlier reports. The water supply was inadequate and a better method than privy and pit was needed. Nuisances should be strictly repressed, slaughtering prohibited in the town , sewerage improved and byelaws introduced to control building of houses, laying of drains and similar improvements. Finally the report commented on the ‘imperfect degree in which the majority of the Town Council appear to realise their responsibilities as the Local Sanitary Authority  . . .’ .25

In 1899 there was a ‘general’ report on the St Dogmells (sic) Rural District.26 It was inspected because of the ‘plurality of Medical Officers’ and the fact that the District was divided among two medical officers who ‘rarely confer with each other or give concurred advice regarding  the  district as a whole.’ The report noted that Dr Havard, the MOH  for Newport (Pembs) was unpopular with the (local) Authority as his 1896 Annual Report had criticised sanitary arrangements. However, he was formally thanked for his 1897 report which was ‘of a brief and meagre nature’. There had been outbreaks of Enteric fever (typhoid) in St Dogmaels and Cilgerran and the water supply was defective and prone to pollution. There was no proper provision for disposal of excrement, ashes and house refuse and no proper sewerage. ‘Privy vaults’  were  still found and the author recalls a smallholding at St Dogmaels in the early nineteen­ fifties where the sanitary arrangements were built on a ‘pier ‘ over a   stream and the excrement dropped directly into the water! A better class of houses, more in accordance with modern sanitary requirements had recently been constructed at Newport and Llanfihangel but most cottages were old and dilapidated, a few thatched. ‘Proper drainage, with few exceptions is absent.’ The report added that the 1890 Infectious Diseases  Act  had  not  been adopted and that there was no provision for isolation of infected patients. Details of cases and deaths from diphtheria for 1894-1897 were given but without  commentary.

Diphtheria was also a problem at Fishguard in the late nineteenth century. There were no deaths from the disease in 1897 and l 898 but an epidemic struck i n early 1899 and continued in 1900. The outbreak was investigated and a report made to the Local Government Board i n 1 901 .27 There was a total of 83 cases with 12 deaths. The disease had started at  the  National School which was found to  have  blocked  drains  and  ‘several  years’  accum ulation of sewage’. The subsoil around the school was ·sodden wi th filth’. Although the schools had been closed for three weeks there was no isolation of victims and no disinfection . No true records of infectious  diseases were bei ng kept and Publ ic Health duties were not being carried out. It was recom mended that sewerage at Fishguard be i mproved and  sewers constructed at Goodwick. Isolation accommodation should  be provided for victi ms of infectious diseases and apparatus for disi nfecting bedding and clothes supplied. This inspection found that sanitary administration had been much neglected and following  this,  a  further  report, to Haverfordwest Rural District was issued  in  1904.28  This  found that the Council’s arrangements for public health were in  disarray  and  needed to be re-organised.  This was  perhaps  the  most  prescri ptive  report of those perused and required four ful l-time MOHs to be employed together with two i nspectors of nui sances, isolation accommodation and disinfect­  ing apparatus. Water supplies and sewerage needed to be attended to, scavenging systems put in place and unhealthy houses and those unfit for human  habitation  closed.

The totality of these reports, spread across Pembrokeshire, confirm that living conditions and sanitary measures in both urban and rural areas were of a very low standard even for the times. Further, there was reluctance by local government to accept both that these conditions existed and to implement the remedies recommended. Similar reports 29  on other areas of south-west Wales and other regions show that this was by no means unique to this County.
1.  National  Archives.  Catalogue Research Guides. Leaflet  ID = 117. 2002.
2. Urban and Rural Social Conditions in Industrial Britain. Series One: Local Reports to the General Board of Health,  1848-1857.  Brighton.  Harvester Press.   1979 (Microfiche).
3. Pembs.R.0.  Minutes  Pembroke  Sanitary Authority.  1892-1900. PEM/SE/2/3.
4. Pembs .R.O. Minutes Haverfordwest Corporation acting as Urban Sanitary Authority  1874-1891.  HAM/SE/ l/5
5. George T. Clarke, Preliminary Inquiry into the Sewerage, Drainage, and Supply of Water, and the Sanitary conditions of the inhabitants of the parish of St. Mary,  within the Borough  of  Tenby in the County of  Pembroke  (London, 1 850).
6. Ibid ., 4
7. Tenby  Museum.  Minutes  Tenby  Local  Health  Board   1851. TEM/BOOKS/ 12/3.
8. Tenby Museum . Minutes Tenby Local Health Board 1852-1872. TEM/BOOKS/ 3/6/I/I.
9. Tenby Museum . Minutes Tenby Local Health Board 1872-1894 .  SE/24/ 12/1/3.
10. Idem.

11. Idem .
12. Urban and Rural Social Conditions in Industrial Britain. Series Two: Reports to the Local Government Board, 1869 – 1908 (Brighton, 1979) Microfiche .
13. Pembs.R.O. Dr Parson’s  Report  to the Local Government Board  on the  Pre­valence of Typhoid Fever in the Borough of Haverfordwest, and on the General Sanitary  Condition of the Borough  (April,  1888). HQ/7/1881.
14. Ibid., 1.
15. Ibid., 3.
16. Ibid., 5.
17. Ibid., 11.
18. Urban and Rural Social Conditions in Industrial Britain, Report No. 402. Mr Spear’s Report on the Outbreak of Diphtheria in Clynderwen and Llandisilio in March 1888.
19. Ibid., 2.
20. Ibid.
21. Ibid .,
22. Ibid.
23. Report on Pembroke Rural Sanitary Authority . Urban and Rural Social Con­ ditions in Industrial Britain. Report s to the Local Government Board 1869- 1902. Series Two. Report No. 462. 1890.
24. Report on Pembroke and Pembroke Dock. Urban and Rural Social Conditions in Industrial Britain. Reports to the Local Government Board 1869-1902. Series Two. Report No. 549.  1895.
25. Ibid ., 12.
26. Report on the St Dogmells District Rural Sanitary Authority. Urban and Rural Social Conditions in Industrial Britain. Reports to the Local Government Board  1869-1902. Series Two. Report No. 602. 1899.
27. Report on the Diphtheria Outbreak at Fishguard and Goodwick  in  1899. Urban and Rural Social Conditions in Industrial Britain. Reports to the Local Government Board  1869-1902. Series Two. Report No.642.1901.
28. Report on the Sanitary State of Haverfordwest Rural District Council. Urban and Rural Social Conditions in Industrial Britain. Reports to the Local Govern­ ment Board / 869-1902 . Series Two. Report No. 685. 1904.
29. See for example the reports on Carmarthen (Report 71), Llandeilo Fawr ( 199) and Llangadock (20 I). Urban and Rural Social Conditions in Industrial Britain. Series One: Local Reports to the General Board of Health, 1848- 1857.