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Mildmay Mission Hospital: The history of a former cottage hospital delivering compassionate care one crisis at a time

Set up as a Christian mission in 1866, Mildmay Hospital has specialised in helping those facing the greatest stigmas in society, from cholera to HIV and homelessness. 

At the Mildmay Mission Hospital, in Bethnal Green, Sister Bernie has seen patients and visitors come and go, many suffering some of the most challenging and emotional times of their lives. Those who pass through the hospital’s in-house chapel come in search of spiritual guidance and counselling as part of their recovery from HIV and AIDs related illnesses. 

Ada, a patient at the Mildmay, was admitted after collapsing at Tower Bridge with HIV-related amnesia. She describes how Sister Bernie’s pastoral care was central to her recovery.

‘Bernie provided me with pencils, a pencil sharpener, and paper and I’ve been drawing ever since’ says Ada who, having lost so much of her past, is focusing on imagining a future. Despite the memory-ravaging effects of the disease, a calling to draw has helped Ada rediscover who she was before the illness took hold.  

The multi-faith chaplaincy at the Mildmay Mission Hospital, or Mildmay Hospital, in Bethnal Green, is just one of many forms of holistic care provided to cater to the vast and complex needs of those suffering from HIV and AIDs. 

For generations, staff and patients at the Mildmay Hospital have borne witness to some of the most intense healthcare needs in London’s history, from being on the frontlines of the emerging AIDs crisis in the 1980s to pioneering new care pathways for some of the most vulnerable Londoners today.

From a terrifying cholera outbreak in 1866 to the COVID-19 pandemic which swept across the city in 2020, the Mildmay Hospital has battled some of the worst crises in London’s public health. 

Today, as an international charity and through the associated NHS Mildmay Hospital, Mildmay continues on a legacy of compassionate care dating back over 150 years and placing it as a commemorated part of London’s LGBTQ+ and medical history.

From Cottage Hospital to NHS

Looking up at the entrance of the Mildmay Mission Hospital you will see a grand red clock, proudly embedded in the newly laid bricks of the 2015 build, just one of the few objects saved from the original hospital building of 1892. 

The modern hospital building, on Tabernacle Gardens just off Hackney Road, has twenty-eight single ensuite rooms and two wards with 26 beds named after founders William and Catherine Pennefather. The hospital also has communal lounges and kitchens, a physical rehabilitation centre, an occupational therapy assessment centre, laundry facilities, a courtyard garden and a digital services room.

Modern Mildmay Hospital building with old red clock in Bethnal Green.
Modern Mildmay Hospital building Bethnal Green © Mildmay UK

But the value of the hospital has not always been clear cut and Mildmay has faced threats of closure more than once in its history. In 1982, having been part of the NHS since it was founded in 1948, the 200-bed hospital was regarded as uneconomic and, along with many other ‘cottage hospitals’ (a name for small hospitals) was closed.​ After a tireless campaign from supporters and the Trustee Board, the Mildmay was reopened in 1985 as a voluntary charity hospital. 

Staff at the Mildmay Hospital in 1982 .
Staff at the Mildmay Hospital in 1982 © Mildmay UK

AIDS crisis and visits from Princess Diana

In the early 1980s, the term ‘AIDS’ was a terrifying unknown in the UK. At the time that Terrence Higgins, a 37-year-old schoolteacher from London, collapsed on the floor of the nightclub Heaven, he wasn’t aware that he would soon be the first person in the UK known to succumb to the disease, with a death toll which would continue to rise for the next 14 years. 

As the tragedy ensued, so did ignorance about the virus. Misinformation gave way to a pervasive and crippling stigma,  and fear surrounding HIV led to social isolation and discrimination towards patients.

In 1988, with no effective treatment and death tolls on the rise, the recently reopened Mildmay was commissioned by the government to operate as an AIDS hospice. The Broderip Ward at the Middlesex Hospital in west London had been opened as the first HIV and AIDs care ward a year prior. Just as they had during the cholera outbreak of 1866, the Mildmay Charity became a beacon of compassion for those left behind due to fear and stigma. 

One of the isolating misconceptions surrounding the disease was that it could be spread through skin-to-skin contact. Though debunked, the idea was pervasive and led to one of the most famous displays of solidarity in healthcare history when Princess Diana shook hands with a HIV patient at the Middlesex Hospital in west London 1987. Diana continued her London hospital visits coming to the East End and first visiting the Mildmay Hospital on 24 February 1989. She visited 16 more times both officially and unofficially, bringing media attention to both the hospital’s work and patients’ lives. 

Diana’s visits gave dignity to those so cruelly stigmatised including her visits to the Mildmay remain a huge part in changing how the world viewed HIV and AIDS. 

Diana shakes hands with staff and patients at Mildmay Hospital during a visit © Mildmay UK
Diana shakes hands with staff and patients at Mildmay Hospital during a visit.

In 1996, a new and effective antiretroviral therapy was introduced in the UK resulting in a greatly increased chance of survival for patients and the Mildmay Hospital evolved from an AIDS hospice to an internationally-renowned HIV rehabilitation centre.

Jason Reid was treated by the Mildmay for HIV-related dementia and seizures in 2005, following a dramatic onset of symptoms which saw him hospitalised at Royal London. Nearly two decades later and having survived an uncertain fate, the importance of compassion from those around him remains embedded in his memory of his journey.

Today the work of the Mildmay remains vital providing urgent shelter and pain management as well as psychological support and complex rehabilitation for those suffering from HIV Associated Neurological Disorders. The hospital also offers social worker support, counselling, speech and language therapy, substance misuse support, help with daily living and finances, HIV and healthy living education and art therapy, offering hope, dignity and world-renowned care across the capital. 

Deaconesses and Cholera 

Despite coming to international acclaim in the 80s, Mildmay’s history as a health service dates back to the 1860s. In 1864, respected vicar, William Pennefather was transferred to St Jude’s Church in the Mildmay Park area of Stoke Newington. It was here that Pennefather adopted the Mildmay name for his work, holding annual conferences on missionary work called Mildmay Conferences. In 1866, as cholera ravaged London’s East End, William’s wife and fellow missionary worker, Catherine Pennefeather began training Christian women to care for victims in what they named the Mildmay Mission, providing spiritual guidance and care for the sick.

Of notable bravery are the Mildmay Deaconesses who entered the notorious Old Nichol Slums, a site behind Shoreditch Church, neglected by authorities on account of its disease-ridden and poverty-stricken states. Their work for those in London’s most vulnerable conditions marked the beginning of Mildmay’s tradition of courageous and compassionate healthcare. 

The cholera epidemic subsided, but the work of the Deaconesses continued, as other nurses were trained and new facilities built. In 1877 the Mildmay Medical Mission began in a converted warehouse in Cabbage Court in the Old Nichol.

Cabbage Court.
Cabbage Court © Mildmay UK

When the dangerous Old Nichol slums were destroyed in the 1890s, so was the site of the Mildmay. But in an era before a national health service, demand for Mildmay’s care-giving services was high. And so, the first purpose-built Mildmay Mission Hospital was opened one street over, on Austin Street (off Hackney Road) in 1892 where it would remain for over 100 years. In May 1938, to accommodate rising patient numbers, Queen Mary opened an extension at the hospital, drawing national attention to Mildmay.

Beds in the women's ward at Mildmay Mission Hospital
Beds in the women’s ward at Mildmay Mission Hospital © Mildmay UK
The Mildmay Mission Hospital © Mildmay UK

Covid-19 and Homelessness

As healthcare challenges have grown and evolved, so too has Mildmay’s response. 

When the Covid-19 pandemic hit, the lives of those sleeping rough in London were thrust into an even more precarious and isolated state. With the virus sweeping through the city, homeless individuals were left vulnerable not only to the disease but to the unique challenges of sleeping rough.

Mildmay’s response was to launch a rehabilitative care service for people who were homeless, providing medical care but also the hope and stability rough sleepers needed in a time of unparalleled uncertainty. 

Mildmay’s Homelessness Rehabilitation pathway has continued post-pandemic and provides holistic care to reflect the complex realities of homelessness and the unique set of healthcare issues it presents. 

Mildmay’s services aim to prevent the ‘revolving door’ healthcare, by preventing patients from returning to life on the streets without first addressing their housing or underlying health problems. 

Continuing a legacy of change in the public health conversation the Mildmay also promotes positive recovery stories, leads anti-stigma campaigns and leads national conversation and pioneering services to combat the deeply entrenched links between homelessness and addiction. Much akin to their work with HIV they are continuing to make sure no one is left behind by social stigma and Mildmay has provided a vital haven for individuals struggling with homelessness and substance misuse.

But despite its legacy spanning three centuries and making an undeniable change to so many east Londoners, the Mildmay is still fighting to be able to continue its work. 

In 2024, the charity began publishing daily reports of unfilled beds to highlight their urgent need for funding. At a time when mainstream hospitals are facing severe bed shortages, Mildmay beds could provide care for those who no longer require urgent medical attention but have nowhere else to turn.

As a wider charity, the Mildmay is taking its care overseas and has reached 100,000 people affected by HIV and related health issues in other vulnerable parts of the world such as Kenya and Uganda. 

The Mildmay has most recently been memorialised by Transport for London’s new Mildmay Overground line, giving a modern tribute to the Mildmay’s deeply rooted legacy. The line will bring attention to what staff and patients like Ada and Sister Bernie have long known to be a life-changing public service, celebrating the compassion that Mildmay has shown east Londoners through some of the biggest public health crises of the past 150 years.


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One thought on “Mildmay Mission Hospital: The history of a former cottage hospital delivering compassionate care one crisis at a time

  • Victoria Cooper

    I really enjoyed this beautifully written and well researched piece. A paean to compassion coupled with action. Just the name “Mildmay Cottage Hospital” is therapeutic.

    Reply

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