Disease, conflict and nursing in the British Empire, 1880–1914
Transnational developments in biomedicine and technology together with broader social changes, not only reshaped disease prevention and healthcare policy, but facilitated mass migrations of people, creating new pathways for spreading disease, simultaneously helping form various conduits, including nursing, for the “new” medical knowledge required to combat this spread. Additionally, this period (1900-1914) was characterised by global crises, which provide important contexts for reappraising the history of nursing at local, national and transnational levels, while creating an important lens through which to study the changing profession. The geographical focus of this chapter is on three port cities: Cape Town, Melbourne and Hong Kong, selected as representing different types of colonial administration, and colonial histories, which naturally affected the implementation of healthcare systems. Traditional approaches to nursing’s history are enclavist in arguing that nursing practice, education and policy was established and solidified in the metropole before being exported to the colonies by British nurses. Consequently, professional nursing developed independently in each of the colonial outposts. The chapter argues that nursing practice is equally constituted on the peripheries of Empire, so that complex networks of nursing ideas existed within the British Empire, fuelled and expanded by mass migration of nurses.
Contextualising colonial and post-colonial nursing
Helen Sweet and Sue Hawkins
The introduction provides an overview of the book’s focus, structure and remit, outlining commonalities as well as differences between the experiences of colonial nurses discussed in the book. Drawing from their experience in researching and writing gender and racial social histories and in colonial and post-colonial nursing history respectively, the editors tease out emerging themes placing them within a clear chronological and historiographical framework. They examine how this field has developed in the history of medicine and identify questions which current research still leaves unanswered, but for which nursing’s history is uniquely placed. The chapters in this book reveal the presence (or absence) of underlying racial and cultural tensions between nurses and their patients, nurses and professional colleagues or their indigenous counterparts; and the editors question whether past histories have not been grossly oversimplified by projecting images of imperial collaboration/cooperation onto all forms of colonial nursing, by all countries, across a long timespan. We evaluate the difficulties of discussing and analysing the impact of colonial nursing from the indigenous population’s viewpoint to present balanced analyses, and explore different experiences of colonial/ post-colonial nursing over more than a century whilst considering the impact of peacetime or conflict on nurses and nursing.
The Indian Rebellion (1857) occupies a central position in the mythology of late nineteenth-century British history. The shock throughout British colonial society was expressed through a medium synonymous with the British experience in India, namely diaries or journals. Differing to accounts from other conflicts of the period, the prolonged and localised nature of fighting at Lucknow and Cawnpore meant that chroniclers represented a cross-section of gender, class and professional status in colonial society, including a range of medical practitioners but also women of various social ranks who had volunteered for medical service. Drawing on printed and manuscript sources from c.1857-c.1900, this chapter argues that the Indian Mutiny diary functions as both a vital record of women’s voices in the history of British colonial experience and a unique example of a nineteenth-century practitioner narrative told from a female perspective. The chapter largely focuses on journals published by participants of the Siege of Lucknow, and will explore the way in which a range of women eyewitnesses acting as nurses were able to participate in the defence of British interests in a time of national emergency thereby contributing to the culture of imperial myth-making that surrounds the Indian Rebellion.
Nursing and medical records in the Imperial War in Ethiopia (1935–36)
Anna La Torre, Giancarlo Celeri Bellotti, and Cecilia Sironi
The Ethiopian war (also known as the ‘Abyssinian War’) refers to the war waged by Italy during Mussolini's regime against the Empire of Ethiopia in 1935. It led to the proclamation of the AOI (Italian Oriental Africa) in 1936. Through analysis of primary and secondary sources the chapter explores how the Italian Army health care service was organised during the war, and the status of nursing in the Italian Army. From original reports, it was discovered that the male military nurse corps provided the majority of nursing care on the battlefield, in hospitals and clinics and in ambulances and radiological laboratories. Only 384 female Italian Red Cross volunteers participated in the war. They were called “Lady” nurses or Sisters because they belonged to the Italian nobility and to the upper class. These female nurses were joined by 200 missionary nuns of different religious orders. At the end of 1941, during the Second World War, the British Army freed Ethiopia. With reference to the data examined, the outcomes show that, in spite of what the official reports said, the real protagonists of nursing were male nurses.
At the commencement of the Second Anglo-Boer War the small cohort of nurses available for service in South Africa were insufficient to meet the demands inherent with the exigencies of modern warfare and ever-increasing numbers of sick and wounded. Around 1,400 civilian nurses from across the Empire served in varying capacities during the South African campaign, yet there was no defined overall control of those lay women and trained nurses who offered their services. From 1891 Nurse Registration in the Cape had been established in law, yet there was no demarcation over the role and responsibilities of British nurses serving in South Africa. Concerns were raised that some nurses were motivated for wartime service owing to a search for adventure in the colonies. Yet there were a number of motivators, including those of a humanitarian nature, combined with a patriotic sense of duty. This chapter will examine how accusations that nurses were ‘frivolling’ in South Africa, raised concerns over control and organization of nurses in future military campaigns and had an impact on discussions over levels of authority female nurses might be allowed in the new Queen Alexandra’s Imperial Military Nursing Service, established at the close of war in 1902.
Colonialism and Native Health nursing in New Zealand, 1900–40
Shortly after New Zealand’s Public Health Department was established in 1900, plans were initiated to launch a district nursing service for Maori, largely based on the Queen’s Institute nursing scheme in Britain. The Department regarded the proposal as a cheaper option than existing scheme which subsidised medical practitioners working in districts populated by Maori people. Initially the plan was to train Maori women as ‘Native Health Nurses’ who ‘by precept and example [would] help their countrymen to a good and healthy way of living’. This chapter discusses why it failed and why most the nurses working amongst Maori were European by origin, taking their Western nurse training into their new roles. The chapter focuses on their accounts, often written during epidemics, demonstrating how, to be effective, they had to grasp quickly the importance of compromise and the need to negotiate and interact with local communities. This is not a celebratory account of white nurses and colonial peoples, portraying nurses as fighting the ignorance and superstition of the native race, but does argue that historians should move beyond the victimisation model of history writing based on ‘tool of empire’ discourses to consider afresh the interactions between nurses and their patients.
Relatively few Indigenous Australians work as nurses, midwives, doctors or other health professionals yet they face the poorest health outcomes of any population group in Australia, with significantly reduced life expectancy. This paper places these two issues within their historical context tracing the history of nursing in Australia, from its earliest days when six nurses trained by Florence Nightingale arrived in the colony. It compares the training of non-Indigenous nurses and the emerging professionalisation of nursing with training received by ‘native nurses’ living on government-run settlements in Queensland. ‘Native nurses’ were trained to work under supervision of white nurses but confined to working with Indigenous patients on settlements and reserves rather than within the wider hospital system. This chapter argues that Australia differed from other British colonies in its treatment and recruitment of Indigenous nurses, by ignoring British recommendations to train them, and instead relying upon nurses brought in from overseas or recruited amongst the white settlers. This historical perspective helps to inform an understanding of the health issues that currently face Indigenous Australians.
Guerrilla nursing with the Friends Ambulance Unit, 1946–48
This chapter draws upon a rich collection of untapped private and public papers held in Canada, the USA, and Great Britain. With the promise to “go anywhere, do anything”, British surgical nurse Elizabeth Hughes and American public health nurse Margaret Stanley were cast into unexpected adventures punctuated by danger and unremitting demands to care. As part of ‘Medical Team 19’, they joined Mao Zedong’s Eighth Route Army when the International Peace Hospital evacuated after the fall of Yennan in 1947. They illuminate ‘complex entanglements of nursing as it was imagined and practiced on the liminal frontiers between war and peace’ that have characterised the post-colonial era. This article is attentive to how multi-faceted power relations intersect with faith, gender, race, place and nation to shape nursing imperial exchanges. Their experiences question post-colonialists’ prevailing portrait of Western nurses as cultural imperialists and reinforce the need for a multidisciplinary framework to critically analyse the agency, assimilation and accommodation of both Western nurses and their Chinese colleagues. Recovering their stories suggests there may be more continuity with the major contemporary challenges for collective humanitarian responses to conflict-ridden complex crises than previously acknowledged.
American colonial and missionary nurses in Puerto Rico, 1900–30
Winifred C. Connerton
This chapter explores intersections between nurse education and Americanisation in colonial Puerto Rico. It examines overlapping messages of Protestant missionaries and the U.S. colonial government, highlighting U.S. nurses’ active participation in those messages. Nurses’ letters to nursing journals, annual mission reports and colonial government’s annual reports to the Department of War, reveal strong connections between evangelical mission goals and the colonial government’s goals. Trained nursing, gradually became incorporated into ideas of proper American health care. Prior to the American occupation, there was no tradition of trained nursing in these colonies; rather, care was provided by family members, hired nurses with no formal training, or Roman Catholic nursing sisters. The U.S. government promoted the nursing profession as contributing towards successful self-governance for the territories because trained native nurses would minister to their countrymen and demonstrate proper sanitation and health practices. Similarly Protestant missions expected that nurses trained in the mission hospitals would offer health care to their communities, while also evangelising the Protestant understanding of Christianity in the predominantly Roman Catholic colonies. Nurses’ correspondence demonstrates they could not (and did not want to) separate the ‘American’ from the nursing, no matter whether in secular colonial or mission settings.
Women such as Julia Stimson and Helen Dore Boylston were motivated by both a desire for travel and adventure and a wish to prove themselves as professional women. They met the challenge of wartime nursing service, and the sometimes-chauvinistic responses of medical men to their presence in the ‘zone of the armies’, with a combination of diplomacy and indifference.