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Margaret and Rachel McMillan’s Open-air Nursery in the fight against disease

Updated: May 15, 2021

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Outside space for outdoor education

As we enter into the next phase of easing lock-down measures and the gradual re-opening of early years settings, it’s pretty obvious that although social distancing will not be fully possible with young children, we will be trying to limit transmission of Covid-19 by spending even more time outdoors where possible and in smaller groups. The Government Guidance that we have all become so familiar with during the last few weeks known as 'Coronavirus (COVID-19): implementing protective measures in education and childcare settings' Updated 1 June 2020, States that early years settings should,

'use outside space for outdoor education, where possible, as this can limit transmission and more easily allow for distance between children and staff.'

Reading this immediately got me thinking about the McMillan sisters and their ‘Open-Air Nursery’ that evolved during the early 1900s. During my Early Childhood Studies training, I remember reading about how important the ‘open air’ was to Margaret and Rachel McMillan’s nursery schools and how they used the ‘open-air’ in their fight against disease in the ‘slums’ of Deptford.

Adding to this, Boris Johnson's use of ‘wartime’ language during his daily updates in the fight against Coronavirus, got me thinking that this isn’t the first time the early years sector has been part of a wider national objective. In fact, nursery schools – particularly the original Open-Air Nursery established by the McMillan sisters provided a vital service during WW1.

The Open-Air Nursery was originally designed to provide the disadvantaged young children of Deptford (South East London) a chance to experience clean clothing, healthy food and space to learn in the 'fresh air', allowing them a better start in life. But just as the sisters established their first Open-Air Nursery, WW1 began. This meant that their objective became two-fold. As well as fighting to combat disease and poor developmental health in young children, they became a vital service to mothers who worked in munition’s factories, which of course was absolutely crucial to the war effort as this quote from the Imperial War Museum demonstrates:

'Of all the roles women took on during the First World War their work in munitions factories was probably the most vital. Without the bullets and shells they produced the British Army couldn't have carried on fighting.' [i]

I can’t help but draw comparisons between ‘then' and 'now’. The McMillan’s pioneering work is well documented and I’m sure you’re familiar with some of their contributions to children’s care and education such as free school meals and school medical inspections, but I feel particularly compelled to take a closer look at the development of their Open-Air Nursery, intrigued by how they used fresh air and hygiene measures to combat disease.

So, let’s start from the beginning,

(This post has several direct quotations - for the sake of maintaining the visuals, the precise references are provided at the end)

The McMillan Sisters, Margaret (1860-1931) and Rachel (1859-1917), made a commitment to improving the health and education of the most disadvantaged children in society during the late 19th and early 20th century. In 1905 the Education code stated that under-fives were no longer allowed in infant schools, meaning that all those very young children who had been going to school, ended up playing in the 'gutters', very often with no adult supervision because parents were working. Rachel wrote of her experience in the 'slums' of Deptford in the early 1900s,

'Children [were] creeping on the filthy pavement, half naked, unwashed and covered in sores...It became apparent that health had to come before education with these poor families.' [ii]

To this end, the sisters devoted their lives to improving the education of children through a holistic approach where health and hygiene was of paramount importance. Margaret opened a clinic to treat common health problems such as fleas. The clinic provided ear syringing, eye examinations and skin ointments. Margaret, however, soon realised that more proactive measures where needed to prevent these common conditions:

'Margaret was convinced that fresh air, exercise and good nutritious food would improve their health in a way that the clinic could not.' [iii]

So, she and her sister Rachel developed ‘Girls’ Night Camps’ where girls could escape the overcrowded, insanitary sleeping conditions of their homes. They would be bathed, fed and offered a bed in the open air. Following a Tuberculosis epidemic, the sisters opened a ‘Boys’ Night Camp’ to prevent the disease spreading further, followed by a ‘Baby Camp’ where,

'The children received training in breathing.' [iv]

The sisters believed that breathing training helped children to fight respiratory disease and develop their lungs. It was from the success and popularity of the ‘Baby Camps’ that the first Open-Air Nursery (later named the Rachel McMillan Open-Air Nursery) was born.

What did the Open-Air Nursery look like?

Margaret was very particular about the best layout of the buildings so that

‘once inside the child comes under the influence of the great healers, earth, sun, air, sleep and joy.’ [v]

Set in the middle of the overcrowded streets of Deptford, the walled nursery garden provided a large space for children to experience the outdoors safely. The gardens were crucial, and, in Margaret’s opinion,

‘the buildings should face south or south east, and in order to have this, the line of the rooms or ‘shelters’ must be straight, the walls at either end shaped in butterfly form to catch all the sunshine possible.’ [vi]

Notice the use of the word ‘shelters.’ To this day, the Rachel McMillan Open-air Nursery still refers to their rooms as ‘shelters’. In the beginning, this is exactly what they were – the first ‘shelters’ consisted of a timber frame with a corrugated sheet roof and removable walls. They offered children protection from the elements in bad weather so they could still learn and play. In the depths of winter, the removable walls would be placed accordingly and a stove provided some much-needed heat. Another relevant fact about these shelters was that children were 'split' into smaller groups with at least one teacher and assistant per group (although they did mix in the gardens with children from the other 'shelters'). Of course, spending time in smaller groups is something that the current Covid-19 Guidance also recommends to reduce transmission but, as we already knew, the idea of grouping children is nothing new.

During the 1930s and after the deaths of the sisters, these rudimentary ‘shelters’ were modified to include a considerable amount of glass to resemble a greenhouse environment – utilising the healing elements of the sun. There were several shelters, each containing cupboards for sleeping equipment, tables and chairs. Each shelter had its own bathroom, cloakroom and sanitising station. The toddler’s shelter was fitted with several pot-baths. Each bath and sink had its own hot and cold-water taps – unlike the children’s homes where parents would have to heat the water in order to bathe their children.

The garden was an attractive area, with gym equipment, play areas and little pathways. Rabbits and guinea pigs were kept as pets, and there was an aviary and a dove cot. An abundance of flowers, trees and plants provided children with much-needed sensory input and gave them something to care for. This wonderful quote from Margaret McMillan highlights the special relationship she hoped the children would have with the garden:

‘A garden grown humanity cannot be as the humanity of the grime and of the street. It will have spent its first cycle in a place where living things are taken care of so that at least they spring up into things of beauty and colour and perfume. Those who do all this culture work will be cultured. The little gardeners themselves, not the flowers or the vegetables or the trees, will be the glory of the garden.’ [vii]

The children’s day would typically begin with a medical examination, followed by a bath, teeth-brushing and a hearty breakfast. The children would play and learn in their shelters and in the extensive gardens and eat a healthy lunch and tea outdoors where ever possible.

To get a real feel for the nursery, I strongly urge you to watch this absolutely adorable 2 minute video clip of the Rachel McMillan Open-Air Nursery from 1939 (quite a while after it was first established – but still very relevant.) You’ll notice the clear emphasis on personal hygiene and independence! If you haven’t quite met your quota for cuteness today – this should do the trick! (and the narrator is just brilliant!)

So here we have the perfect example of how inner city, urban settings can embrace outdoor learning despite the challenges of deprivation and over-crowded conditions.

She [Margaret] believed that an open-air environment is of paramount importance for promoting the mental and physical development of children, and she proved that it is practicable to provide it in the very midst of a poor and crowded neighbourhood’ [viii]

There is no doubt that this pioneering work of the McMillan sisters has shaped our early years care and education (particularly our approach to outdoor learning) as we now know it but let's take a closer look at the effectiveness of the Open-Air Nursery in terms of disease prevention. (I'm aware that Covid-19 is different to the diseases mentioned below and I in no way intend to minimise the seriousness of Covid-19 through this post but I do find the subject particularly fascinating given our current situation)

Disease prevention

It’s clear that Open-Air Nurseries played a vital role in combating the spread of disease – particularly influenza and tuberculosis as these spread through airborne bacteria. I find this quote from Margaret McMillan particularly poignant in relation to transmission of illness between children in the first Open-Air Nursery (or baby camp as it was first known),

It [the nursery] was a pleasant and a renewing world. They [the children] came back eager and wide-eyed. The camp grew lovelier and the children more resistant. There were thirty of them…ranging in age from eighteen months to seven years. In six months, from March to August, there was only one case of illness. [ix]

I can really sense Margaret McMillan's pride here - she clearly viewed the Open-Air Nursery as a success in preventing illness in young children. Even more poignant than this, is an intriguing book, written by Superintendent Stephenson (yes, the manager was referred to as ‘superintendent’) of the Rachel-McMillan Open-air Nursery during the 1920s. I must share with you, some of her captivating passages:

‘The winter of 1920-21 was a difficult one. In Dec 1920 an epidemic of influenza raged in South-East London, and many children fell victim to the disease during the Christmas Holidays....Outside the nursery school the children died in great numbers.’ [x]

I feel this passage, although chilling, shows the seriousness of the situation for those children who did not attend the nursery. The superintendent goes on to explain that the nursery at this time had expanded to include a brand new 3rd 'department' to meet demand. Despite the influenza epidemic, the 2 more established departments of the nursery had

‘no deaths and no cases of serious illness amongst the children...the children’s power of resistance had been built up by the good plain food and fresh air they had enjoyed for months, in some cases for years’.[xi]

The superintendent goes on to explain that shortly after the Christmas influenza outbreak, they were further hit by an epidemic of measles in Feb 1921.

Measles is the one infectious disease we dread in the nursery school. We have of course isolated cases of scarlet fever, diphtheria and whooping cough. These diseases we do not fear, for they do not spread in the open air. Measles is our bugbear.’[xii]

She goes on to explain,

‘But we have never closed our school for any epidemic and it was not our intention to do so now’ [xiii]

Bearing in mind that all the children in attendance would have been regarded as ‘vulnerable’ I feel we can liken it to our current situation in which settings remain open for ‘vulnerable’ children across the country.

The superintendent quotes Dr. Margaret Hogarth who took care of the medical needs of the children during these outbreaks and who also objected to closing:

‘Feed the children well, Watch most carefully for the first symptoms of the disease. Then isolate at once. Visit the parents and see that if possible, the child is put to bed at once and kept warm.’ [xiv]

The superintendent goes on to explain that the measles epidemic spread in the neighbourhood and as expected the 3rd newly opened department which had the ‘weakest’ children, suffered the most. Unlike their peers in the more established departments of the school who had developed their strength and resistance through months and years of attendance at the nursery, 41 of the 100 children who attended the new department were isolated at home and regularly monitored by the nursery staff and Dr Hogarth. The superintendent explains that due to the medical care and attention that these children received,

‘we had only one instance of running ears attributable to the disease – there were no other after effects...This is proof that little ones who came under the care of the open-air nursery were better off than those left to play on the streets.’[xv]

Of course, nowadays the children would most likely be isolated in cleaner, dryer, less crowded homes and not left to play on the streets, but I can't help but feel inspired and heartened by the the superintendent's passion and belief in the open-air nursery's fight against these diseases.

I hope these extracts offer some sort of solace to our early years workforce as we plan our return to a 'new normal' and try to implement the measures outlined in the Covid-19 Guidance. I know I feel really quite moved by these chilling (yet charming) extracts that are so relevant right now and hope I can share with you a huge sense of pride and admiration for our early years workforce both now and then, amidst the current crisis.




[ii] Trueman, H et al. (1999) ‘The Children Can’t Wait: The McMillan Sisters and the Birth of Nursery Education’ London: Deptford Forum Publishing

[v -viii] Liebovich, B. (2018). The MacMillan sisters, the roots of the open-nursery, and breaking the cycle of poverty. Social and Education History, 7(1), 78-96. doi:10.17583/hse.2018.2925

[ix] McMillan M (1919), The Nursery School, London: Dent and Sons

[x-xv] Stevenson, E (1923) ’The Open Air Nursery School’ London: JM Dent and Sons.

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