*With thanks to Cathy Wood and Carlton Publishing for their assistance with these pages.
Dr Ludwig Guttmann
Born into an Orthodox Jewish family in Tost, Upper Silesia, Germany in 1899 Ludwig Guttmann was the eldest of four children and the only boy. At the age of 18, he volunteered to be an orderly at the local Accident Hospital for Coalminers where he witnessed an incident which left a profound impression.
Guttmann became interested in a strong, young miner admitted with a broken back and paralysis below the waist only to discover the miner's outlook was so bleak that death was expected within weeks. Guttmann could hardly believe it but the miner was left encased in plaster and moved away from other patients, where he developed urinary tract infections and sepsis. Five weeks later he was dead. ‘Although I saw many more victims suffering the same fate,’ Guttmann said, ‘it was the picture of that young man which remained indelibly fixed in my memory.’ (‘Spirit of Stoke Mandeville’ by Susan Goodman, Collins, 1986).
In April 1918 Guttmann started medical studies at the University of Breslau, now Wroclaw, Poland, passing his finals five years later in 1923. Guttmann had intended to work in paediatrics but when his efforts to find work in this particular speciality failed he reluctantly took a job in Neurology and Neurosurgery - a decision that would affect the rest of his life, and those of countless others he came into contact with.
In January 1933 Adolph Hitler became Chancellor of Germany, but Guttmann, thanks to his growing international reputation, had a number of offers to work outside Germany.
Together with his wife, Else, and two young children, Dennis and Eva, the Guttmanns headed for England arriving in Dover on March 14 1939. Once in Britain the Guttmanns settled in Oxford where Guttmann busied himself with various research projects. (Goodman, Collins, 1986).
As time passed, and war progressed, the Government felt an influx of paralysed servicemen, as a result of a push on the second front planned for 1944, inevitable. In preparation they decided a special spinal ward to cater for casualties should be opened in readiness.
In September 1943 Guttmann was asked if he would like to take charge. He said he would provided he was free to implement his own theories on how best to treat patients who had paraplegia.There were two possible options for the new unit- Basingstoke or Stoke Mandeville.
Guttmann preferred Stoke Mandeville, Buckinghamshire and so, on February 1 1944, he took up his new post. The unit was called Ward X. There were just 26 beds.
Mann on a Mission
Dr Ludwig Guttmann started work at Stoke Mandeville Hospital in 1944, where he faced the possibility of receiving large numbers of wounded soldiers. But in many ways that was the least of his worries.
'"It is amazing to think that not that many years ago the treatment of paraplegics was generally regarded as a waste of time."' HRH Prince Charles writing in the foreword of ‘Spirit of Stoke Mandeville’ by Susan Goodman (Collins, 1986)
He could deal with the medical issues. A far bigger concern was how to overcome the widely held belief, both within the medical profession and among the public, that patients, once they had been paralysed, faced a pointless future and could never be reintegrated into society. And because of that his colleagues in the medical profession were baffled by Guttmann’s zeal for his new Stoke Mandeville job.
‘They could not understand how I could leave Oxford University to be engulfed in the hopeless and depressing task of looking after traumatic spinal paraplegics,’ he said. (‘Spirit of Stoke Mandeville’ by Susan Goodman, Collins, 1986).
Guttmann fundamentally disagreed with the commonly held medical view on a paraplegic patient's future and felt it essential to restore hope and self-belief in his patients as well practical re-training so when they were well enough to leave they could once more contribute to society.
He achieved this firstly by changing the way they were treated - he had them moved regularly to avoid the build up of pressure sores and the possibility of urinary tract infections developing - and secondly by engaging them in physical and skill-based activities. Sports like Archery improved their mental wellbeing while learning new skills, such as woodwork, clock and watch repair and typing, would ensure they would be employable. If staff, or patients, on Ward X thought they were going to have an easy time, they were in for a shock.
Guttmann demanded much of those who worked for him. But he gave in equal, or often greater, measure.
Bow and Arrow
Guttmann was fully aware of the positive and psychological benefits of physical activity; as a young man back in Germany he enjoyed Fencing and once at Stoke Mandeville insisted sport, including individual and team sports, became integral to the rehabilitation programme. And it was the sport of Archery that led to the very first competition between disabled athletes.
'"I foresaw the time when this sports event would be truly international and the Stoke Mandeville Games, would achieve world fame as the disabled person’s equivalent of the Olympic Games."'The Cord, 1949
Quite why Guttmann chose July 28,1948 to host an Archery event between two teams of disabled athletes, exactly the same day more than 4,000 non-disabled athletes from 59 countries took part in the Opening Ceremony of the XIV Olympic Games at Wembley, is unclear.
Whether it was coincidence, or a stroke of genius, hardly matters because July 28, 1948 became a moment in history; the day 16 former service personnel (14 men and two women) took to the lawns at Stoke Mandeville Hospital for an Archery contest.
On one side, the Star and Garter Home in Richmond, Surrey, on the other Stoke Mandeville. The Star and Garter won. A cup was presented and the first recorded competition between disabled athletes had taken place.
It may have been one event on one day with a tiny number of participants but it was from this other disabled competitions grew, the significance of which was not lost on Guttmann. ‘Small as it was, it was a demonstration to the public that competitive sport is not the prerogative of the able-bodied’ (Goodman, Collins, 1986).
In 1949, just a year later, more hospitals and participants took part in a summer sports festival which became known as the Stoke Mandeville Games. It was here Guttmann uttered the words for which he has forever been associated with: ‘I foresaw the time when this sports event would be truly international and the Stoke Mandeville Games would achieve world fame as the disabled person’s equivalent of the Olympic Games’ (The Cord, 1949).
It may have taken a while but Guttmann’s prophesy has come to pass. Today the Paralympic Games are the disabled person’s equivalent of the Olympic Games.
Year after year the number of participants at the Stoke Mandeville Games, and the sports on offer, grew as word spread among the different spinal hospitals around the country.
'"If ever I did one good thing in my medical career it was to introduce sport into the treatment and rehabilitation programme of spinal cord sufferers and other severely disabled."'Guttmann, in Scruton, ‘Stoke Mandeville, Road to Paralympics’. The Peterhouse Press, 1998
But Guttmann also wanted competitors from overseas and, in 1952, he got his wish. The Medical Director of the Military Rehabilitation Centre in Doorn, Holland, asked Guttmann if he could send a team of war veterans to compete at Stoke, and Guttmann agreed. In 1953 a team arrived from Canada. By 1954 there were Australians and Finns, Egyptians and Israelis. And so it went on. (Scruton, ‘Stoke Mandeville, Road to Paralympics’. The Peterhouse Press, 1998).
They came for the International Stoke Mandeville Games which would take place every July. They were the forerunner to today’s Paralympic Games.
By the late 1950s Guttmann, the Italian Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro (INAIL) and a spinal unit in Rome were already discussing the possibility of holding the 1960 Stoke Mandeville International Games outside Britain for the first time. As the Olympic Games were being held in Rome that year Guttmann saw no reason why the International Games couldn't be held there too. And the Italians supported him.
'"The action taken by the Stoke Mandeville Games Committee to hold the Games from time to time outside England is marvellous... It has made many people talk about, and follow up news of the Games - especially those paraplegics all over the world who are very depressed and of low morale"'Special Edition of The Cord, after the 1960 Games
The XVII Olympic Games ended on September 11, 1960 and just one week later, September 18, 400 disabled athletes, representing 21 nations assembled for the first overseas Stoke Mandeville Games for those with spinal cord injuries. Other impairment classes, such as those for athletes who were blind and visually impaired (BVI), amputees and had cerebral palsy were not added for many years.
There were glitches, of course, but the first overseas Games were a great success, not just for the organisers and athletes, but for the message of hope and possibility they sent to the disabled community around the world.
‘"The action taken by the Stoke Mandeville Games Committee to hold the Games from time to time outside England is marvellous," said Nizar Bissat of Lebanon. "It has made many people talk about, and follow up news of the Games - especially those paraplegics all over the world who are very depressed and of low morale"’ (Special Edition of The Cord, after the 1960 Games).
In Rome 1960, athletes shared the same city and accommodation as their Olympic counterparts. They came from every continent in the world and took part in nine events. Britain won 21 gold medals, 15 silver and 18 bronze. Rome would later become known as the first Paralympic Games. A precedent had been set.
Sports of the first Paralympiad/Rome 1960:
Athletics (Javelin, Precision Javelin, Putting the Shot, Throwing the Club)
Nations at the first Paralympiad/Rome 1960:
Broadening the Reach
Initially Guttmann was adamant the Games would only be open to those with spinal cord injuries and for 16 years (1960 -1976) this remained the case.
In 1976, though this changed with the addition of two new athlete classes; athletes with a visual impairment and athletes who were amputees. In 1980 athletes with cerebral palsy were added and in 1984 a fifth category, called 'les autres' which covers athletes who do not fit into the other categories already outlined. In 1996 the sixth, and to date, final impairment group was added for the first time, athletes with an intellectual disability (ID), known in the UK as learning disability.
Although athletes with an intellectual disability were admitted in 1996 not long after Sydney 2000 was over, the very next Games, they were out again. A Spanish journalist, Carlos Ribagorda, became part of the Spanish Basketball team with intellectual disabilities even though he had no impairment. At the Sydney Games he helped Spain take gold in an emphatic 87 to 63 point win over Russia. Barely had the medal been placed round his neck when he told his story claiming many of the team, not just himself, had not been checked for an impairment.
After an investigation found his story to be true, the Spanish team were ordered to return their medals and athletes with learning disability were banned from participation in future Games until a more robust, accurate way could be found to verify an athlete's disability within a particular sport.
In 2009 the IPC were satisfied of new testing methods ensuring athletes with learning disability could compete in three of the 20 sports at London - Athletics, Swimming and Table Tennis. The decision meant that for London 2012 the number of disability groups returned to six for the first time in more than a decade.
2012 and Beyond
The number of sports on the Paralympic programme and the number of athletes competing continues to grow as the Paralympic Movement embraces those wishing to be part of it.
In 1960, 400 athletes from 21 nations took part in nine events. In 2012, more than 4200 from 164 countries competed in 20 sports.
But it does not stop there.
In total seven new sports made submissions to the global governing body of the Paralympic Movement, the International Paralympic Committee (IPC), in 2010 in a bid to be added to the list of sports for the Rio de Janeiro Games from September 7-18, 2016. All were reviewed, along with existing sports, before it was announced that Para-Canoe and Para-Triathlon were the two sports chosen to make their debuts in 2016. This will take the number of sports from 20 to 22.
Para-Canoe will consist of eight events at Rio while Para-Triathlon (involving a 750m swim, followed by a 20km cycle and then a 5km run) will be open to athletes in six disability classes.