Brunel's unsung contribution to medicine

Next Tuesday, 15 September 2009, is the 150th anniversary of the death of the engineer Isambard Kingdom Brunel.

Born in 1806 in Portsmouth, he was the son of a distinguished French engineer, Sir Marc Brunel, who had come to England at the time of the French Revolution. Unlike most engineers of the time, Isambard received a sound education and practical training, partly in France, before entering his father’s office and taking full charge of the Thames Tunnel at Rotherhithe at the age of 20.

At the age of 26, he was appointed engineer to the newly formed Great Western Railway. His engineering work on the route between London and Bristol is still used by high-speed trains today, and bears witness to his genius. He also built three vast steamships, each one representing a major step forward in naval architecture.

His other works included docks, viaducts, buildings, and bridges, the best known being the Clifton suspension bridge in Bristol. He became an engineering celebrity at a time when the public works of engineers were reshaping the landscape in large, visible ways, and sparking public imagination as never before.

Perhaps his most remarkable, yet little-known, project was the construction of a prefabricated, 1,000-bed hospital in present-day Turkey.

In February 1855, he was invited to design a hospital for use in the Crimean war that could be built in Britain and shipped out for speedy erection. The design took six days to complete and the parts reached Renkioi in the Dardanelles in May that year. As a civil hospital for military patients, it was staffed by experienced civilian doctors, and demonstrated the advantage of a hospital being run by a doctor rather than a military officer.

Renkioi also showed how infection rates could be reduced by able staff in a well administered, properly designed hospital. The hospital showed lower mortality rates than those of London hospitals.

There was scant recognition in the press that Brunel’s design was a major advance in hospital design, and a great improvement on the tented and hutted hospitals originally provided in the Crimea. However, Florence Nightingale commended its “magnificent huts” for their enhanced air circulation, which drastically reduced infection rates. And Brunel’s design was adopted by the federal forces during the American civil war (1861–65) and by the Prussians in the Franco-Prussian war (1870–71).