Before the Motor Ambulances Came to Malta
“Nirrah min kisirli qalbi
jiħduh b’seba’ kataletti.”
The above two lines are reproduced from an old Maltese folk-song. They refer to a now forgotten means of transportation of patients to hospital, the “Katalett.” In bygone days that vehicle satisfied an ever present need and its utility was readily acknowledged. It constituted a very important aspect of the medical services of old Malta and made an impression on the social life of the Island so much so that the circumstances then surrounding it, have now assumed folkloristic importance.
The motor ambulances came to Malta during the First World War. Before that time patients were conveyed to hospital in a primitive and most uncomfortable manner. The well to do were carried in a calèche or, later, in a cab, sometimes even on a spring cart, but the paupers were always taken to hospital on a litter constructed like a stretcher on wheels (Katalett tar-Roti).
The “bed” of the litter was stretched between two horizontal shafts ending in a handle at both ends. Each of the two shafts was supported fore and aft, on two elliptical steel springs. The two front springs rested on the axle of the two front wheels, and the other two springs on the axle of the rear wheels. The springs reduced the jolting, and to ensure smooth running as much as possible, the rise of the wheels was covered by solid rubber tyres.
A barrel shaped hood made of canvas stretched on an iron frame, covered the “bed” and protected the patient from the inclemency of the weather and from the indiscreet gaze of passers by. On one side of the hood near the head end, there was a little aperture, about six inches square, through which the carrier of the litter or some other person, could peep at the patient and talk to him.
Every town and village had its Katalett, which was considered to be a very useful object of public utility and was always kept ready for emergencies at the local Police Station. A hefty individual, very often the local barber, was entrusted with the transport of the patients, whilst some meddlesome and officious woman of middle age, always volunteered to accompany the patient to the hospital and look after his needs on the way. In the long run both these worthies become adept, and acquired some experience in the handling of patients and attending to his needs during the long trek from home to hospital.
There were two general hospitals in Malta and one in Gozo: the Central Hospital in Floriana and Santo Spirito Hospital in Rabat, and the hospital in Victoria, Gozo. Each hospital admitted patients from its area as well as from outlying districts. Patients from nearby towns and villages did not take long to reach hospital, but those from distant villages and hamlets suffered great hardships. Their trip to hospital was a grim ordeal which very often produced an adverse influence on the course of the disease. From distant villages it might have required three, sometimes even four, hours pushing and dragging the “Katalett” along bad roads and lanes full of potholes, to reach hospital, and when the patient was admitted into the ward he was not only exhausted but in a grave condition after his painful and distressing trip. No wonder that many patients were afraid to go to hospital and preferred to remain languishing at home.
The woman accompanying the patient provided herself with a jugful of a brew consisting of water into which a lemon, and some laurel leaves were boiled, and to which a stiff dose of brandy was added. Along the road she gave several sips of that concoction to the patient to stimulate his flagging spirits, but she herself and the carrier and the relatives of the patient, took frequent swigs to keep good company! In the case of a maternity patient, the woman attendant carried with her a bottle of water to baptize the new born child should delivery occur on the way to hospital.
When the carrier and the attendant returned to the village they visited the partient’s family and gave a flowering account of the trip and, hopeful news about the patient; after receiving the thanks and some remuneration for their pains (One Scudo — twenty pence, to the carrier and Disgħa Rbagħajja — fifteen pence to the woman) they prepared themselves for the next trip to hospital.
In order to prevent the spread of infection, contagious cases were not conveyed on the “Katalett” to the hospital for infectious diseases (Lazzaretto); instead, patients suffering from infectious diseases were driven in a horse drawn van, painted black which was not unlike a “Black Maria” and which produced a sobering effect wherever it appeared and made the children fly in terror away from it. The patient was laid on a straw mattress on the floor of the van and his personal effects were tucked in a corner. The members of the patient’s family used to be taken for isolation or disinfection in the same van doing another trip. The van and its horse and driver were stationed at the Lazzaretto where they remained on call during all the hours of the day and night.
Cases of sudden dearh, fatal accidents or suicide were remitted to the mortuary of the hospital for post mortem examination; the corpses were carried on a bier supported on four legs (Katalett ta’ l-Istrippi). Unlike the litter on wheels which was pushed along or dragged by the handles, at the ends of the shafts, the bier for corpses was carried by two bearers, one in front, another behind, each wearing a harness consisting of two shoulder straps into which fitted the anterior and posterior ends of the two shafts. The bier, like the litter, was covered by a hood.
When he corpse came from outlying districts, the bearers halted several times to rest, and the “Katalett” was laid by the roadside until the two toughs refreshed themselves from a bottle tucked beside the corpse inside the bier!
During epidemic outbreaks, like the Plague epidemic of 1813 when several patients died every day, their corpses were removed for burial on a large barrow which was really a wooden box on four wheels; in front it had a long shaft ending in a cross-bar. A gang of hoodlums pulled and heaved at the cross-bar and dragged the hearse, collecting corpses from infected houses and piling them into the box, and when it was filled to the brim, the gang dragged the gruesome load to the local cemetary for burial. It was not unusual to see one of the gang of ruffians sitting on top of the pile of human remains and grinning for all he was worth!
Those were hard times, but perhaps they were made hardier because of the primitive means available. Technical development and progressive methods have brought with them comforts and amenities, which were unknown to our forefathers and which rendered our life easier and more gracious, but we must not forget those hardships suffered by our forebears, if only to thank Providence for the good things we enjoy in our days.
WATSON, S.B. “The Cholera at Malta,” London, 1848, p. 17.
BRITTAIN, V. “Testament of Youth,” London, 1933, p. 301.
CASSAR, P. “The Medical History of Malta,” London, 1964. Page 76. Plate vi.
CASTAGNA, P.P. “Storia Ta Malta,” Malta, 1888, p. 420 and picture.