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 on a hospital bed, behind closed curtains and left there to perish,” tells BBC News Brazil Ian Brittain, a professor at the Coventry Business School in the UK and an expert in Paralympic sports.
Soldiers with spinal cord injuries died from pressure injuries that led to septic shock or kidney failure – a reflection of the little medical knowledge at the time.
Furthermore, before World War I, the UK was not prepared for the number of hospital beds it would need in a conflict of that caliber. With a high mortality, doctors also had no opportunity to learn how to treat these injuries.
A British doctor, however, gained experience during World War I. Along with other doctors, neurologist George Riddoch defended that soldiers with orthopedic or spinal injuries should receive specialized treatment in special units created just 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 treating patients during World War I and didn’t want to repeat them in World War II.”
With the advent of World War II, the world saw many soldiers and civilians wounded by bullets or shrapnel. But medical knowledge had advanced a little. The discovery of the antibiotics sulfanilamide and penicillin gave survival to those who, on other occasions, would have died.
In addition, this time, the UK has taken steps to prepare 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 of patients with spinal cord injuries – and the subsequent birth of the Paralympics.
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 emigrated to Oxford, UK, in 1939.
There he worked in an English military infirmary for head injuries.
The British team leaving London Heathrow Airport for the Stoke Mandeville International Games in Israel in 1968. Ludwig Guttmann, president and founder of the games, is pictured with 18-year-old Karen Hill of Mansfield — Photo: PETER STONE/MIRRORPIX /GETTY IMAGES/BBC
Guttmann accepted the invitation, but asked that he could play the center in any way he wanted. The hospital began as a place of treatment for British military personnel returning from World War II with injuries.
The neurologist first implemented the procedure of turning patients over every two hours so they no longer had pressure injuries. Then, it introduced physical activity as a fundamental way to rehabilitate patients.
He had three arguments for this: 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 patients’ physical and mental well-being.
“If it wasn’t fun, it wouldn’t go forward,” says Brittain.
Finally, sport was a path to social integration.
The first sport chosen by Guttmann illustrates this last idea well. It was archery. “If a patient went to Stoke Mandeville and practiced archery, they could go home and join a club for people without disabilities, competing at the same distance as they do,” 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 kind of injury. It was the Stoke Mandeville Games for athletes in wheelchairs. And the competition was organized to coincide with the opening ceremony of the 1948 Olympic Games in London.
At the time, says Brittain, what the neurologist was doing was fighting an establishment that wasn’t interested in disability.
Until then, the sport had already been used as a form of rehabilitation in small pockets. 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 United Kingdom.
“But none of these initiatives were a concentrated effort like Guttmann’s, which later turned into competitions that traveled beyond a single location,” says the expert.
The US basketball team scores against the Netherlands at the Stoke Mandeville International Games on July 30, 1955 — Photo: FRED RAMAGE/KEYSTONE/HULTON ARCHIVE/GETTY IMAGES/BBC
At the second Stoke Mandeville Games, in 1949, the number of athletes grew to 37. In addition to archery, the competition also included netball, a game similar to basketball.
“And I don’t 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 an amazing thing to say when there were only 37 people competing,” says Brittain.
He emphasizes, however, that none of this would be possible without the doctor’s dogmatic and even dictatorial personality.
“He was ambitious, he insisted on it,” he says.
And, of course, without the athletes’ commitment, effort and dedication. And also 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.
Guttmann’s vision, as we know, was realized.
Each year, new sports were added to the competition. The first outside team came from a rehabilitation center in the Netherlands in 1952, giving the competition an international character.
The neurologist, says Brittain, traveled the world to train doctors as neurosurgeons, and tried to publicize his activities where he was going.
It 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 the director of a rehabilitation center and convinced him to host the Games in Rome – where the Olympic Games would take place the following year.
And so, in 1960, the games for athletes with disabilities took place at the Olympics in Rome.
But there were problems. The athletes’ village was not fully wheelchair accessible, and military personnel had to carry athletes up and down stairs. As the movement grew, accessibility was also improved.
In any case, that had been the official start of the Paralympics – which, incidentally, was called that as a reference to “paraplegics” and because Guttmann constantly referred to the Olympic Games, explains Brittain.
In 1976, with the inclusion of other deficiencies, the prefix “para” came to symbolize “parallel”. Today, Paralympics means parallel Olympic games.
And it’s not the first time they’ve been headquartered in Japan.
A Japanese orthopedic surgeon named Yutaka Nakamura traveled to the UK in the 1950s to visit Guttmann and the Stoke Mandeville games. In Japan, the concept of rehabilitation had not yet taken hold.
Guttmann convinced Nakamura that he should try to host the games in Japan. Back home, Nakamura organized his own games, but was met with criticism from those who thought it was bad to expose people with disabilities.
He insisted on the idea. In 1962, Nakamura funded a trip by two 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 global press.
So, thanks to his efforts, in 1964 the Paralympic Games were held in Tokyo.
The competition expanded in the coming years, with more groups of the disabled and even Winter Games, held for the first time in 1976, in Sweden.
But in its early years, the Paralympics were very “medicalized,” Brittain describes.
“Doctors decided who was going to participate and how they would be ranked based on patients’ injuries. With more athletes participating in the 1970s and 1980s, there is pressure for less medical rankings. They claimed sports ranked more for their ability than for their level of disability .”
In 1976, at the Paralympic Games in Toronto, Canada, physical disabilities from amputations and visually impaired athletes participated for the first time – before that, the games were still for athletes who used wheelchairs.
More than 1,500 athletes from 40 countries participated in the games. It was in this championship that Brazil won its first medal, a silver in bocce on grass.
Guttmann, who died in 1980, continued his work at the hospital but remained a key figure for the Games as well. He became president of the Stoke Mandeville International Gaming Federation and years later was knighted by the Queen.
The games only grew, with more athletes, more modalities and more countries participating. The number of public at the competition venues also grew. Today, back in Tokyo, there are 22 sports, with two debuts: badminton and taekwondo, and 4.4 thousand athletes.
VIDEO: Brazilians arrive at the opening ceremony of the Paralympics
Representatives of the Brazilian delegation arrive at the opening ceremony of the Paralympics