After Nightingale sent a plea to The Times for a government solution to the poor condition of the facilities, the British Government commissioned Isambard Kingdom Brunel to design a prefabricated hospital that could be built in England and shipped to the Dardanelles. The result was Renkioi Hospital, a civilian facility that, under the management of Dr Edmund Alexander Parkes, had a death rate less than 1/10th that of Scutari.[18]
Stephen Paget in the Dictionary of National Biography asserted that Nightingale reduced the death rate from 42% to 2%, either by making improvements in hygiene herself, or by calling for the Sanitary Commission.[19] For example, Nightingale implemented handwashing and other hygiene practices in the war hospital in which she worked.