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Digital Timeline

Across the centuries, treatment provided for brain injuries has changed.

Explore the story and let us know what you think.

Explore the Timeline
1

How has the treatment for brain injury changed?

Across the centuries, the treatment provided for brain injuries has changed. From the early treatments of drilling holes into the skull to the cutting edge technology we use today to see inside the brain. As well as medical treatment, we also think differently about people with disabilities today and the support that should be provided for them.

Join us is exploring the hidden history of brain injury in Cambridgeshire...

Note on Terminology:

Through our timeline we have used the language of the time in order to be historically accurate.

'Feeble-mind' or 'idiot' could be used to describe a range of people, from individuals with a learning disability, physical disabilities, single mothers to those with a brain injury. We no longer use these words and today they are considered offensive.

2

Early treatment of brain injury (6500 BC – 1066AD)

The word brain appears for the first time in an ancient Egyptian papyrus known as the Edwin Smith Papyrus'. This describes the surgical treatments of brain injuries resulting from military battles. The ancient Egyptians were the first people to realise that damaging the brain could affect the whole body. 

The Edwin Smith papyrus (1600BC) is the
oldest surviving record of surgical treatments
for brain injury. 

The Edwin Smith papyrus (1600BC) is the oldest surviving record of surgical treatments for brain injury. 

The papyrus describes the structure of the brain. It notes the connection between the brain and...

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/assets/_timeline/Edwin_Smith_Papyrus_v2.jpg
By Jeff Dahl [Public domain], via Wikimedia Commons.
The Edwin Smith papyrus (1600BC) is the oldest surviving record of surgical treatments for brain injury. 

The papyrus describes the structure of the brain. It notes the connection between the brain and the body, suggesting that the location of the injury may affect different functions of the body.

“If thou examinest a man having a gaping wound in his head, penetrating to the bone, (and) splitting his skull, thou shouldst palpate his wound... Now when thou findest that the skull of that man is split, thou shouldst not bind him, (but) moor (him) at his mooring stakes until the period of injury passes by. His treatment is sitting.” 

A skull showing a drilled hole from trepanning. 

A skull showing a drilled hole from trepanning. 

Early treatments for brain injuries were rather brutal and often involve drilling into the skull....

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By Rama (Self-photographed) [CeCILL (http://www.cecill.info/licences/Licence_CeCILL_V2-en.html)
A skull showing a drilled hole from trepanning. 

Early treatments for brain injuries were rather brutal and often involve drilling into the skull. This is called trepanning. This skull is of a girl from 3500 BC and healing marks on the edges of the hole in her skull show she survived the operation. 

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An engraving of Hippocrates. 

An engraving of Hippocrates. 

Ancient Greeks often thought of the heart a controlling the body but Hippocrates (c.460 – c. 370...

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Engraving of Hippocrates by Peter Paul Rubens (1638).
An engraving of Hippocrates. 

Ancient Greeks often thought of the heart a controlling the body but Hippocrates (c.460 – c. 370 BC) understood the role the brain played in regulating the body and the mind.

Hippocrates said “Men ought to know that from nothing else but the brain come joys, delights, laughter and sports, and sorrows, griefs, despondency, and lamentations....” 

3

Treatment and care of people with a brain injury in the Middle Ages and Early Britain (1066-1800)

Little changed in how brain injury was treated between 1066 and 1800, the same surgical treatments were offered and trepanning was still in used. For those who survived their brain injury there was little aftercare as there were no state provisions for people with a disability, instead they were cared for by religious institutions. There was no distinction between types of disabilities and so people with a learning disability, mental health condition or a brain injury were all seen as the same. 

This painting by Hieronymus Bosch and shows
a Renaissance surgeon (1450-1516) using
trepanning to treat a patient. 

Hieronymus Bosch (circa 1450–1516) [Public domain], via Wikimedia Commons.

This painting by Hieronymus Bosch and shows a Renaissance surgeon (1450-1516) using trepanning to treat a patient. 

This Renaissance woodcut from 1525 shows
instruments being used to repair a depressed
skull fracture.

This Renaissance woodcut from 1525 shows instruments being used to repair a depressed skull fracture.

This Renaissance woodcut from 1525 shows instruments being used to repair a depressed skull...

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Image reproduced from Treveris, P. (1973) English Woodcuts 1480-1535 by Edward Hodnett. Oxford University Press.
This Renaissance woodcut from 1525 shows instruments being used to repair a depressed skull fracture.

This Renaissance woodcut from 1525 shows instruments being used to repair a depressed skull fracture (a fracture where the bone is pushed inwards). The caption reads:

"This instrumente is for to worke upon the heed/whan the brayne pan is beten in/for to lyfte it up agayne."

During the 13th century the King had custody over the property and assets of people deemed to be 'natural fools' or 'idiots'. Special inquisitions were held to determine a person's mental status.

During the 13th century the King had custody over the property and assets of people deemed to be 'natural fools' or 'idiots'. Special inquisitions were held to determine a person's mental status.

During the 13th century the King had custody over the property and assets of people deemed to be...

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During the 13th century the King had custody over the property and assets of people deemed to be 'natural fools' or 'idiots'. Special inquisitions were held to determine a person's mental status.

During the 13th century the King had custody over the property and assets of people deemed to be 'natural fools' or 'idiots'. Special inquisitions were held to determine a person's mental status.

Emma de Beston lived in Ely, Cambridgeshire. In July 1383 she was examined and asked a series of questions including the days of the week and the names of men she had married. When was was not able to answer all the questions she was found “not of sound mind, having neither sense nor memory nor sufficient intelligence to manager herself, her lands and her goods. As appeared on inspection she had the face and countenance of an idiot.”

The Norfolk and Norwich Hospital was founded
in 1771 as a charitable institution for the care
of "the poor and the sick". 

The Norfolk and Norwich Hospital was founded in 1771 as a charitable institution for the care of "the poor and the sick". 

In the 1800s there was no state provision for people with disabilities. Most lived with support...

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/assets/_timeline/Original_Norfolk_and_Norwich_Hospital_-_geograph.org.uk_-_84361.jpg
By Katy Walters, CC BY-SA 2.0.
The Norfolk and Norwich Hospital was founded in 1771 as a charitable institution for the care of "the poor and the sick". 

In the 1800s there was no state provision for people with disabilities. Most lived with support from their family and friends, but some had to resort to begging.

Some were supported by monks or nuns who based their care on religious teaching and would provide food, clothes and housing for disabled people.

During this time hospitals for disabled people began to emerge, specialising in treatments for leprosy, physical disabilities or mental illnesses. 

4

Care and Control in the 19th Century

In 1845 the 'Lunacy and County Asylums Act' was passed. This meant that local authorities had to provide a public asylum which would provide care for people with disabilities. People at this time became increasingly interested in finding distinctions between the types of disabilities. 

Fulbourn Asylum. 

Fulbourn Asylum. 

Fulbourn Asylum was opened in 1858 and took in patients from Cambridgeshire. It housed 260 people...

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Fulbourn Asylum. 

Fulbourn Asylum was opened in 1858 and took in patients from Cambridgeshire. It housed 260 people when it opened. By 1870 the Asylum was full and building work took place from 1880-1910 to increased the number of patients who could stay there.

An inspection in 1898 reported “the rooms are still dull and cheerless... means of amusement in the wards are scanty... the staff of attendants is only barely sufficient when all are in duty.” 

An extract from the report Of The Royal
Commission On The Care And Control Of The
Feebleminded. 

An extract from the report Of The Royal Commission On The Care And Control Of The Feebleminded. 

In 1895 the 'National Association for Promoting the Welfare of the Feeble-Minded' was created with...

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Text reproduced from the Great Britain Commissions For The Care And Control Of The Feeble Minded. Published in 1908.
An extract from the report Of The Royal Commission On The Care And Control Of The Feebleminded. 

In 1895 the 'National Association for Promoting the Welfare of the Feeble-Minded' was created with the aim to provide permanent care for the 'feeble-minded' in residential homes or colonies.

In 1904 the 'Royal Commission for the Care and Control of the Feeble-Minded' was formed in order to consider 'the existing methods of dealing with idiots and epileptics, and with imbeciles, feeble-minded, or defective persons'. They published several recommendations on how to provide care.

The 1908 Report provided the first clear distinctions between people with a mental illness and people with a learning disability or brain injury.

Ida Darwin 

Ida Darwin 

Ida Darwin, with Florence Ada Keyes, founded the 'Cambridge Association for the Feeble-Minded' in...

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Ida Darwin 

Ida Darwin, with Florence Ada Keyes, founded the 'Cambridge Association for the Feeble-Minded' in 1908 to put the recommendations of the Royal Commission into action. 

5

The Mental Deficiency Act of 1913

In 1913 the government passed the 'The Mental Deficiency Act of 1913'. This required local authorities to maintain institutions and supervise community care. This was the first legislation by the British government that specifically related to services for people with a learning disability.

Francis Galton 

Francis Galton 

Francis Galton (16.02.1822 – 17.01.1911) was the cousin of Charles Darwin. He was very interested...

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Image reproduced from Karl Pearson's ‘The Life, Letters, and Labors of Francis Galton’. [Public Domain].
Francis Galton 

Francis Galton (16.02.1822 – 17.01.1911) was the cousin of Charles Darwin. He was very interested in Darwin's book, 'The Origin of the Species', which discussed how animals could survive and adapt to their environment and pass these adaptions on to their offspring. He was interested to know if the same was true to people. Galton invented the term 'eugenics'.

Eugenics is a set of beliefs and practices that aims to improve the genetic quality of the human population. Galton believed that 'feeble-minded' people should not have families as they might pass on a genetic disability.

Eugenics poster from 1932. 

Eugenics poster from 1932. 

Eugenics emphasised preventing people with a learning disability, brain injury or mental illness...

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Image from Scientific papers of the Third International Congress of Eugenics held at American Museum of Natural History, New York, August 21-23, 1932. ©Wellcome Library London
Eugenics poster from 1932. 

Eugenics emphasised preventing people with a learning disability, brain injury or mental illness from having children. Some people wanted this done by sterilisation but writer G.K. Chesterton led a successful campaign to defeat this as a clause in the 1913 Mental Deficiency Act. Ida Darwin also campaigned against including sterilisation in the Act. 

Two young men from Dartford who were
labelled as ‘feeble-minded cretins’. 

Two young men from Dartford who were labelled as ‘feeble-minded cretins’. 

A person deemed to be an 'idiot' or 'imbecile' might be placed in an institution or under...

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/assets/_timeline/Two_Cretins-_from_Heredity_in_Man_R._Ruggles_Gates_1929_Wellcome_L0013872.jpg
"Two cretins" early 20th Century image from ‘Herefity in Man’ by R.R. Gates (1929) ©Wellcome Library London.
Two young men from Dartford who were labelled as ‘feeble-minded cretins’. 

A person deemed to be an 'idiot' or 'imbecile' might be placed in an institution or under guardianship of the state, as could a person who had been 'abandoned', 'neglected', was guilty of a crime, was 'habitually drunk' or 'unable to be schooled'.

At the height of the Act around 65,000 people were placed in institutions. 

6

Ida Darwin (7th November 1854 - 5th July 1946)

Ida Darwin, along with other wives of Cambridge University dons, helped to found the 'Association for the Care of Girls' which offered support for women drawn into sex work or abuse. Here she first met women who were 'feeble-minded' and she campaigned for legislation, such as the Mental Deficiency Act of 1913. 

Illustration from Hans-Christian Andersen's
‘Little Ida's Flowers’. 

Illustration from Hans-Christian Andersen's ‘Little Ida's Flowers’. 

Ida Darwin was born on 7th November 1854. Originally christened Emma Cecilia Farrer, she changed...

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Illustration from Hans-Christian Andersen's ‘Little Ida's Flowers’ by the artist Vilhelm Pedersen. Image from katrinahaney.com.
Illustration from Hans-Christian Andersen's ‘Little Ida's Flowers’. 

Ida Darwin was born on 7th November 1854. Originally christened Emma Cecilia Farrer, she changed her name after reading the Hans Christian Anderson story 'Little Ida's Flowers'. 

Ida Darwin 

Ida Darwin 

Ida was born in Surry and later moved to Cambridge. Ida was an active member of many associations...

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Darwin Archive Add 8904.4: 1254: image reproduced with the permission of Cambridge University Library
Ida Darwin 

Ida was born in Surry and later moved to Cambridge. Ida was an active member of many associations including the 'Association for the Care of Girls'. It was here that Ida first came into contact with people considered to be 'feeble-minded'. Ida's daughter said of her that she 'realised the injustices they suffered in an ignorant and careless world. She suffered with them and there was awakened in her the deep convictions of the need for social and legislative reforms that guided her future course'.

Ida wanted to offer a more human approach to care in the community. She was interested in the 'talking cure' and helped to found the 'Central Association for Mental Welfare' which later became the leading mental health charity MIND. She helped to fund the post of the first psychiatric social work in the 1920s who helped people make the transition from hospital to home. 

Ida Darwin

Ida Darwin

Ida married Horace, the son of Charles Darwin. They had three children, Erasmus, Rut and Emma....

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Darwin Archive Add 8904.4: 1282: image reproduced with the permission of Cambridge University Library
Ida Darwin

Ida married Horace, the son of Charles Darwin. They had three children, Erasmus, Rut and Emma. Erasmus was killed in 1915 in the First World War.

Ida died on 5th July 1946 and is buried in Cambridge. Her obituary in The Times described her as 'one of the pioneers in this country in the field of social work'.

The Ida Darwin Hospital site, in the village of Fulbourn near Cambridge, is named after her in recognition of her pioneering work. 

7

Brain Injury in the 20th Century

Until the 20th Century, there was a high mortality rate for people who sustained a brain injury. As medical care improved more and more people survived their brain injury and there were more thoughts about rehabilitation and aftercare. The biggest advances came with technology which allowed faster diagnosis and better treatment options. 

Unknown group of Cambridgeshire
Regiment Soldiers during World War 1 

Unknown group of Cambridgeshire Regiment Soldiers during World War 1 

Many soldiers were hospitalised with brain injuries from blast injuries and injuries on the...

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/assets/_timeline/CambridgeshireRegtGroupWW1.jpg
Image reproduced with permission from: http://www.roll-ofhonour.com/Regiments/cambregt.html
Unknown group of Cambridgeshire Regiment Soldiers during World War 1 

Many soldiers were hospitalised with brain injuries from blast injuries and injuries on the battlefields. The First and Second World War brought many advances in trauma medicine with increasing numbers of people surviving. Following the Second World War the first rehabilitation centres for brain injuries were set up in the UK. 

Patients in the kitchen at Fulbourn Hospital. 

Patients in the kitchen at Fulbourn Hospital. 

While more people survived a brain injury, there were not resources in the community to support...

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Patients in the kitchen at Fulbourn Hospital. 

While more people survived a brain injury, there were not resources in the community to support them to live at home or provide care in the community. Many people were discharged from hospitals to families who were not equip to look after them or placed in institutions.

F.T. Unwin worked in Fulbourn Hospital as a student nurse 1960s. He wrote about this in 'Dew on My Feet' and gave several accounts of people with a brain injury in Fulbourn Hospital.

"Harold Gimbert had been the head porters of a famous college. He was loved and respected by students and academic staff alike... Whilst cycling in the town, Harold was knocked over by a car. Having been rushed to hospital, the head porter was found to be suffering from irremedial brain damage. In Fenton Ward, where he was eventually admitted, Harold would often sit childishly chanting over and over again the children’s rhyme, ‘Pussy’s in the well’... Fenton Ward, with its great spectrum of patients, ranging from subnormality, epilepsy, brain damage, dementias, schizophrenics, to psychopaths... "

An MRI scan of a brain. 

An MRI scan of a brain. 

Wilhelm Conrad Rontgen invented the x-ray in 1895, for many years this was the only way to see...

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An MRI scan of a brain. 

Wilhelm Conrad Rontgen invented the x-ray in 1895, for many years this was the only way to see inside the body without opening it up. In DATE Egas Moniz discovered you could inject special dye into the blood stream which you could see using an x-ray. This allowed doctors to detect bleeds in the brain.

In 1972 Godfrey Hounsfield and Allan Cormack invented Computerized Tomography (or CT scans) which use x-rays to create an image of the whole brain in cross sections.

The MRI was invented in 1977 by Raymond Damadian. It is currently the most widely- used form of neuroimaging technology. Magnetic Resonance Imaging scans are commonly used in hospitals to determine specific activity within the brain, as well as many other tissues and organs throughout the body. 

8

The Ida Darwin Site: 1965 - 1990

During the 1950s, the local authority decided to build an institution for people with a learning disability in Cambridge. They chose a site behind Fulbourn Hospital for this project. By 1965 the project was completed and the first patients were admitted. The site was named 'The Ida Darwin Hospital' to honour the work of Ida Darwin. 

Patients in the occupational therapy
department in the Ida Darwin Hospital. 

Patients in the occupational therapy department in the Ida Darwin Hospital. 

The Ida Darwin hospital was purpose built for people with a learning disability. The hospital...

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Patients in the occupational therapy department in the Ida Darwin Hospital. 

The Ida Darwin hospital was purpose built for people with a learning disability. The hospital took people of all ages and had a school on site. People could stay in the hospital their whole lives.

Patients were seen by occupational therapists, arts therapists, psychologists and physiotherapists. There was also a laboratory on site which tested newborn babies for genetic disorders and carried out research in the causes of a learning disability. 

Psychiatrist Gwyn Roberts

Psychiatrist Gwyn Roberts

Gwyn Roberts, a Psychiatrist, was in charge of the Ida Darwin Hospital. He helped to change...

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Psychiatrist Gwyn Roberts

Gwyn Roberts, a Psychiatrist, was in charge of the Ida Darwin Hospital. He helped to change attitudes and set new standards of care for people with a learning disability. He contributed to government legislation to provide better services for people with a learning disability.

This photograph is of the test kit used on the Ida Darwin Site.

This photograph is of the test kit used on the Ida Darwin Site.

To establish whether someone had a learning disability they might see a Psychologist and take a...

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This photograph is of the test kit used on the Ida Darwin Site.

To establish whether someone had a learning disability they might see a Psychologist and take a Wechsler Adult Intelligence Scale test or WAIS to determine their ‘intelligent’ (IQ). This is an IQ test designed to measure intelligence and cognitive ability in adults. The test included asking someone to copy patterns, remember numbers and solve puzzles.

Neil Baker remembers the time he spent in
the Ida Darwin Hospital. 

Neil Baker remembers the time he spent in the Ida Darwin Hospital. 

Neil Baker remembers the time he spent in the Ida Darwin Hospital. “I went to the Ida Darwin...

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Image reproduced with permission from The Edmund Trust.
Neil Baker remembers the time he spent in the Ida Darwin Hospital. 

Neil Baker remembers the time he spent in the Ida Darwin Hospital.

“I went to the Ida Darwin Hospital in Fulbourn, near Cambridge. I was there a long time too. I went to school there - the Windmill School and I had lots of jobs as well - you name it, I've done it. I used to help to wash the other patients, and I used to make the beds on some of the other wards. I was on Lapwing Ward. I got on alright with the staff there - it was OK. I was on Mallard Ward as well and I had my 21st birthday in there. Dr. Roberts helped me a lot to get out of Ida Darwin. He was very nice and very helpful. So I came out of the Ida Darwin in 1970 and moved into Edmund House (a residential home owned and run by Cambridge Mencap).”

You can read more about Neil's story here: http://www7.open.ac.uk/shsw/reclaimingthep ast/neilbakerstory.htm 

The Ida Darwin Hospital is no longer a long stay institution for people with a learning disability. It houses many health and social care organisations today.

Headway Cambridgeshire moved to the site in 2012 and we currently run our Cambridge Hub from Block 10.

9

Care In The Community

In 1961 Enoch Powell, the Health Minister, announced that the government would not spend any more money on long stay hospitals, instead focusing on community care. There was a fifteen year plan to move people from hospitals into the community. It was a new era of residential and group homes, day-care facilities and independent living within mainstream communities. 

The social model of disability says that disability is caused by the way society is organised, rather than by a person's impairment or differences. It looks at ways of removing barriers that restrict life choices for disabled people. 

In the 1970s, disabled campaigners advocated the 'social model of disability'. Within this, disabled people were in control of their own lives and challenged the assumptions of non- disabled society. 

Pauline, Margaret and Florence were amongst
some of the first people to move out of the
Ida Darwin site and into a house together.

Pauline, Margaret and Florence were amongst some of the first people to move out of the Ida Darwin site and into a house together.

When interviewed in 1981, Florence said she would not leave their new house even if she was paid....

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Pauline, Margaret and Florence were amongst some of the first people to move out of the Ida Darwin site and into a house together.

When interviewed in 1981, Florence said she would not leave their new house even if she was paid.

“I go out shopping on my own sometimes now, but before I came here I could not do numbers above eight. Now I can do up to 50 or 60. I did not go out before, but I can now. We have a kitty so we can get the shopping. We all pay in £6 and go to Sainsbury's.” 

Newspaper clipping about the fostering
scheme. 

Newspaper clipping about the fostering scheme. 

As well as providing group homes, social worker Peter Durrant, led a scheme to encourage local...

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Article reproduced from ‘Town Crier’, 20th June 1981 edition.
Newspaper clipping about the fostering scheme. 

As well as providing group homes, social worker Peter Durrant, led a scheme to encourage local families to 'foster' children with a learning disability to give their families a short break from their caring responsibilities. 

The logo for Headway UK. 

The logo for Headway UK. 

In 1979 Sir Neville Butterworth put an advert in a national newspaper. He was looking for holiday...

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Image reproduced from Headway UK.
The logo for Headway UK. 

In 1979 Sir Neville Butterworth put an advert in a national newspaper. He was looking for holiday accommodation for his son who had a brain injury. Dinah and Barry Minton, who were carers, responded to the advert. This led to a conversation about the support networks that existed.

Shortly after this two social workers called Philip Lockhart and Reg Talbot contacted Sir Neville. The five people decided to call a meeting to discuss the care for people with a brain injury and from this Headway was formed. 

10

Headway Cambridgeshire (1989 to present day)

Headway Cambridgeshire began with one family in 1989. Sarah Durrant and her husband Peter, lived and worked in Cambridge when Peter sustained a brain injury as a result of a car accident. Sarah looked around for support in the community and when she was not able to find something that matched Peter's needs, she decided she would have to create it. 

Sarah and Peter Durrant 

Sarah and Peter Durrant 

Sarah’s aim was to improve local support for people with a brain injury, together with her friend...

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Image reproduced with permission from Peter Durrant.
Sarah and Peter Durrant 

Sarah’s aim was to improve local support for people with a brain injury, together with her friend Maurice Reynolds, she founded Headway Cambridgeshire. In 1991 they were able to secure an old ward on the Brookfields Hospital site, off Mill Road in Cambridge, for minimal rent to use as a meeting place. The building was named ‘Headway House’. 

Renovating Headway House

Renovating Headway House

The picture shows staff and volunteers decorating the new Hub on the Ida Darwin Hospital Site. In...

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Image reproduced with permission from Headway Cambridgeshire.
Renovating Headway House

The picture shows staff and volunteers decorating the new Hub on the Ida Darwin Hospital Site.

In 1999, Headway House was subjected to an arson attack which gutted part of the building.Support from the local community helped Headway Cambridgeshire rebuild and raise over £20,000 to repair the building.

Not long after the building was repaired, the owners of the site increased the rent, making it unaffordable. Headway Cambridgeshire and their supporters lobbied Cambridge City Primary Care Trust until they agreed to reduce the rent and cap it at an affordable rate.

After Brookfields Hospital Site, Headway Cambridgeshire moved its Cambridge Hub to the Ida Darwin Hospital Site in December 2012. 

Photograph of research group 

Photograph of research group 

When we celebrated our 25th birthday we became more interested in thinking about our own history....

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Photograph of research group 

When we celebrated our 25th birthday we became more interested in thinking about our own history. Some of the people who come to the Hub have been here since Headway Cambridgeshire was founded. We decided it was time for us to write down and record our history.

The Research Group took on the task of finding out about our history and the wider history of brain injury in Cambridgeshire.

Our research group are Glen, Richard, Nick, Stephen, Sonia, Wendy and Lesley. 

Thank you for joining us on this journey through the history of brain injury.

If you would like to learn more about brain injury in modern times then you can watch some short histories of people in Cambridgeshire living with a brain injury today.

Oral Histories

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