What does World War II have to do with the Paralympic Games? Well, in essence, everything.
Before World War II, when soldiers returned wounded from war, their fate was bleak. People with spinal cord injuries often died within a year of suffering the damage, with no hope of recovery.
“People were put in a hospital bed, behind closed curtains and left there to die”, Ian Brittain, a professor at the Coventry Business School in the UK and an expert in Paralympic sports, tells BBC News Brazil.
Soldiers with spinal cord injuries died from bedsores -or pressure ulcers- that led to septic shock or kidney failure, a reflection of poor medical knowledge at the time. Furthermore, prior to World War I, the UK was unprepared for the number of hospital beds it would need in such a conflict. With high mortality, doctors also did not have the opportunity to learn how to treat these injuries.
Increase of medical knowledge
However, a British doctor did gain experience during the First World War. Along with other doctors, neurologist George Riddoch stated that soldiers with spinal or orthopedic injuries should receive specialized treatment in units created especially for them.
“World War II played a huge role in creating the Paralympic Games,” says sports historian Cobus Rademeyer of Sol Plaatje University in South Africa. “But indirectly, World War I was also important. Raddoch identified problems in the treatment of patients during World War I and did not want to repeat them in World War II”. With the advent of World War II, the world saw many soldiers and civilians injured by bullets or shrapnel.
But medical knowledge had advanced a bit. The discovery of the antibiotics sulfanilamide and penicillin achieved the survival of those who, on other occasions, would have died. Furthermore, this time the UK had taken steps to prepare not only militarily, but also medically, by freeing up beds to treat the wounded.
Meanwhile, Riddoch was trying to establish specialized units. He is credited with a decision that would change the course of rehabilitation for patients with spinal cord injuries and the subsequent birth of the Paralympic Games.
In 1943, Riddoch appointed an experienced neurologist named Ludwig Guttmann to head a new national center for spinal injuries in the UK, Stoke Mandeville Hospital, in the town of Aylesbury, 100 km from London.
Born in Germany in 1899, Guttmann had fled Nazi oppression against the Jewish community and immigrated to Oxford, UK, in 1939. There he worked in an English military head injury clinic. Guttmann accepted the invitation, but asked to handle the center in any way he wanted. The hospital began as a place of treatment for British military personnel returning from WWII with injuries.
The neurologist first implemented the procedure of turning patients every 2 hours so that they no longer suffered from pressure ulcers. Later, he introduced physical activity as a fundamental way to rehabilitate patients.
In this regard, Guttmann had 3 arguments for that therapy:
In the first place, physical activity through sport was a natural way to strengthen the trunk and upper limbs of a paraplegic person, for example, who would need to be strong to move their wheelchairs.
Second, sport was good for the physical and mental well-being of the patients.
Finally, sport was a form of social integration. Guttmann’s first sport of choice illustrates this last idea well. This was archery.
“If a patient went to Stoke Mandeville and practiced archery, he could go home and join a club for people without disabilities, competing at the same distance as them,” says Brittain. People were also encouraged to try activities such as wheelchair polo and wheelchair basketball.
In 1948, Guttmann organized a competition for 16 men and women with some type of injury. It was the Stoke Mandeville Games for wheelchair athletes. And the competition was organized to coincide with the opening ceremony of the 1948 Olympic Games in London. At the time, Brittain says, what the neurologist was doing was fighting an established culture that was not interested in disability.
Until then, sport had already been used as a form of rehabilitation in small groups. In World War I, a rehabilitation center in England focused on the use of physical activity for visually impaired veterans.
In 1932, the Society of Golfers with One Arm was also born in the UK. “But none of these initiatives was a concentrated effort like Guttmann’s, which later turned into competitions that traveled beyond a single location”, says the expert.
The Stoke Mandeville International Games in 1955. At the second Stoke Mandeville Games, in 1949, the number of athletes increased to 37. In addition to archery, the competition also included netball, a game similar to basketball.
“And I do not know if he was a madman or a visionary. But in those games, Guttmann said that one day there would be an Olympic Games for people with disabilities. It’s amazing that he said it when there were only 37 people competing”, Brittain says.
However, he emphasizes that none of this would have been possible without the dogmatic and even dictatorial personality of the doctor. “He was ambitious; he insisted on it”, he assures.
Of course, it would not be possible without the commitment, effort, and dedication of the athletes. And also from a very important woman: Joan Scruton, who started out as Guttmann’s assistant, but became his right-hand man and, eventually, general secretary of the games between 1975 and 1982.
Going to the Games in Rome
Guttmann’s vision, as we know, came true. Every year, new sports were added to the competition. The first foreign team came from a rehabilitation center in Holland in 1952, which gave the competition an international character.
The neurologist, says Brittain, traveled the world to train doctors as neurosurgeons and tried to make his activities known where he was going. He also challenged countries to bring their own teams of athletes with disabilities to the games in Stoke Mandeville.
In 1959, while at a conference in Italy, he met with the director of a rehabilitation center and convinced him to host the Games in Rome, where the Olympics would be held the following year.
And so, in 1960, the games for athletes with disabilities took place at the Olympic Games in Rome. But there were problems. The athletes’ village was not fully wheelchair accessible, and military personnel had to carry the athletes down the stairs. As the movement grew, so did accessibility.
Anyway, that had been the official start of the Paralympic Games – which, incidentally, was dubbed as a reference to “paraplegics” and because Guttmann was constantly referring to the Olympics, Brittain explains.
In 1976, with the inclusion of other shortcomings, the prefix “para-” was changed to symbolize “parallel”. Today, Paralympics means parallel Olympic Games. And it is not the first time that they are based in Japan.
A Japanese orthopedic surgeon named Yutaka Nakamura traveled to the UK in the 1950s to visit the Guttmann and Stoke Mandeville games. In Japan, the concept of rehabilitation had not yet taken hold.
Guttmann convinced Nakamura that he should try to organize the games in Japan. At home, Nakamura organized his own games, but received criticism from those who thought it was wrong to expose people with disabilities.
He insisted on the idea. In 1962, Nakamura financed a trip for 2 Japanese athletes to participate in the Stoke Mandeville Games. The news that participants from Japan had traveled so far to participate in the games electrified the British press and eventually the world press. Then, thanks to his efforts, in 1964 the Paralympic Games were held in Tokyo. The competition expanded in the following years, with more groups of the disabled and even the Winter Games, held for the first time in 1976, in Sweden.
But in its early years, the Paralympic Games were very ‘medicalized’, Brittain describes. “Doctors decided who was going to participate and how they would be classified based on the patients’ injuries.” “With more athletes participating in the 1970s and 1980s, there was pressure for fewer medical classifications. They said that athletes should be classified more by ability than by level of disability.”
In 1976, at the Paralympic Games in Toronto, Canada, athletes with physical disabilities due to amputations and with visual impairment participated for the first time; before that, the games were still for athletes using wheelchairs. More than 1,500 athletes from 40 countries participated in the games. It was in this championship where Brazil won its first medal, a silver bowling on grass.
Guttmann, who died in 1980, continued his work at the hospital, but he also remained a key figure for the Games. He became president of the Stoke Mandeville International Gaming Federation and, years later, was knighted by the Queen.
The games only grew, with the participation of more athletes, more modalities and more countries. The number of public in the competition venues also grew. Today, back in Tokyo, there are 22 sports, with 2 debuts: badminton and taekwondo, plus 4,400 athletes.