Black History and the Healthcare System: Separate and Unequal

Is it safe to say that Walter Clement Noel—the first individual to be described as having sickle cell disease—may also be considered the very first advocate for sickle cell patients?

I have a deep curiosity regarding the life experiences of those who suffered from sickle cell disease back in the early 1900s, especially given that this disease predominately affects people of color. It was a very different time, and the level of healthcare received by people of color was often not equal to the services provided to others.

I like to think that Walter Clement Noel played a role in advocating for sickle cell patients who would enter the healthcare system after his diagnosis and treatment.

By way of historical context, despite the abolition of slavery, racial segregation remained when it came to how health care services were provided.

Several discriminative codes and policies still prevented blacks from accessing proper health care services. In addition, many health care organizations were separated by race. Hospitals typically maintained separate hospital wings and employees to cater to blacks and whites, with blacks receiving a lower quality of care.

According to Tammy Joyner and Jasmine S. Lee 2020, those from each wing were not permitted to intermingle. The employees who served in black wings were rarely educated on the same level as those in white wings, causing blacks to receive subpar medical care. Knowing this, it is not surprising to learn that some deaths directly resulted from a lack of proper medical care. 

Poor Quality Living Conditions Led to Sick Blacks with Few Healthcare Options

In addition to the comparatively poor care received by blacks in hospitals over whites, they also faced various challenges in connection with their living environments. These issues led to a higher need for quality medical care, which was often impossible to obtain. For example, descendants of slaves often lived in unhealthy environments and faced more dangerous conditions.

Their living areas were often infected with contagious diseases, leading to poor health outcomes. Given the lack of highly educated medical practitioners treating black people, they mainly depended on traditional doctors and medicines.

While this could be effective for basic health issues, they rarely received specialized care when needed. Overall, very few physicians and scientists attended to black’s needs. Their hospitals—and hospital wings—were forced to function using fewer resources and were often understaffed and segregated.

The physicians who did provide treatment were typically only able to treat the most basic health conditions. In situations where the patient required specialized care, the death rates were quite high.

 Further, the infant mortality rate and childhood death rates were higher among blacks, which remains an issue today. Flaws in the health care system still exist, and racial disparities are still a threat to receiving equal health care, as illustrated by the many sickle cell warriors fighting the health care system. 

Walter Clement Noel, The First Sickle Cell Warrior

One of the most interesting aspects about Walter Clement Noel is that he was of an affluent background. According to Tod Savitt, a historian and sickle cell researcher, Noel’s mother married a wealthy man after the death of Noel’s father.

It is assumed that Noel’s father may have had sickle cell disease himself, which likely resulted in his death. This begs the question of how those facing sickle cell disease were able to live during this period. Traveling with sickle cell disease is extraordinarily difficult even today.

Walter Clement Noel was originally from the Caribbean island of Grenada, migrating to America to attend school. How did he take care of himself upon arrival and during his studies?

Sickle cell is generational, so it’s difficult to believe that people in the past were unaware that they had some defect in their bodies. People who encounter pain more frequently might be entuned with their intuition or even connected to their ancestors. 

I admire Noel’s ambition to move forward with his life, refusing to let sickle cell disease take over his life. However, I can’t help but think… if Dr. Herrick and Irons hadn’t found his blood cells so interesting, where might sickle cell be today?

According to the history of sickle cell disease, Dr. Herrick and his intern had no interest in Noel as a patient until they looked at his blood under a microscope.

It likely wasn’t until the sickle cells caught their attention that they began to give him any real medical attention. Even now, I can’t help but wonder whether it was partly because of his wealthy background or simply the fact that his blood is sickle that both doctors became interested in his case.

I still have many questions regarding Walter Clement Noel, his life, and his experience with sickle cell disease, diagnosis, and treatment.

Black Communities Faced Insurmountable Healthcare Challenges

As mentioned earlier, blacks had the cards stacked against them—but Walter Noel Clement made the best of his health and life situation, it seems.

Blacks did not have policies enacted in their communities to help ensure clean water supplies, control industrial and human waste, or handle contagious diseases appropriately.

Black students were rarely admitted to medical schools. Overall, they had worse health statuses and outcomes and experienced poor-quality healthcare services (“history of African Americans and organized medicine,” 2020).

Scientists and doctors were even used to spread falsehoods, myths, and stereotypes about blacks. The theories and stereotypes would even be taught in medical schools. These biased educational processes and medical and scientific abuse contributed to an even lower quality of care. 

Furthermore, blacks were often subjected to unethical experimentation processes to test new drugs, experimental medical procedures, and other experimental treatments.

Because of this, blacks mainly depended on home remedies and home surgeries to recover from their ailments. It was, in fact, probably safer for them. They would also purchase medicines that had not met the regulatory standards.

They were not allowed to become nurses or doctors to care for their own, let alone work in a hospital setting. 

Respect, Admiration, and Curiosity Regarding the Life of Walter Clement Noel

Even though I clearly never knew Walter Clement Noel, I consider him an ancestor—and one that I greatly admire.

Living with sickle cell isn’t easy today. It certainly wasn’t easy back then. Regardless of whether one is facing the disease while working or going to school, it is a constant challenge. However, Walter Clement Noel did make a name for himself.

During a challenging time for blacks in medicine, he even became a dentist! His story highlights that those facing sickle cell can still achieve their dreams and do what they desire.

Although sickle cell is the most common genetic disorder, it is still considered a rare disease. Also, while sickle cell disease is not solely a black disease, many people still believe that only black people can get it.

Countless other misconceptions still exist within the health care system and in the general population. Many even believe that patients with sickle cell are drug addicts. 

What I find most interesting about Walter Clement Noel’s story is that it weaves the threads of the very first sickle cell narrative together. It’s as if his story acts as the needle points that first started building the fabric of sickle cell awareness.

When it comes to sickle cell disease, everyone who faces it has a different experience. It’s a subjective disease, and no patient’s pain or story is the same—rarely are they ever even similar. 

Walter Clement Noel graduated from dental school, moved back to Grenada, and opened his own practice. However, he died in his early 30s from pneumonia.

Although sickle cell disease is not a black disease, it still plays a critical role in black history because of how hard blacks had to fight to receive adequate health care.

In all of the historical documents and literature in connection with sickle cell disease, the story of Walter Clement Noel might be my favorite story. It’s almost like he was the first advocate for sickle cell patients.

I will continue to be incredibly curious about how sickle cell was perceived back then. Unfortunately, all we have is history—and it often leaves out some of the most fascinating of stories!