ON THE FRONTLINE OF CARING: A HISTORY OF AFRICAN NURSES IN COLONIAL AND POSTCOLONIAL ZIMBABWE: 1940s -1996. A DISSERTATION SUBMITTED TO THE FACULTY OF THE GRADUATE SCHOOL OF THE UNIVERSITY OF MINNESOTA BY CLEMENT MASAKURE IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY ALLEN ISAACMAN AND HELENA POHLANDT-McCORMICK. Advisers. JULY 2012 © CLEMENT MASAKURE 2012 Acknowledgements This dissertation would not have been possible without the help, support and encouragement of friends, family, colleagues and mentors in Zimbabwe and Minnesota. First and foremost, I wish to thank my advisers, Allen Isaacman and Helena Pohlandt- McCormick for their support, encouragement, patience, and whose expertise have guided me throughout my graduate studies. They provided a model of patience and commitment to one‟s work that will continue to inspire my own intellectual and professional development. I will forever be grateful. In addition, I am grateful to members of my committee, Malinda Lindquist, Keith Mayes and Elizabeth Boyle. To them I say thank you. In Zimbabwe, I thank my mentors and friends at the University of Zimbabwe, Economic History Department, Dr. J.P Mtisi and Dr. P. S. Nyambara who gave me intellectual support. Your support was much appreciated. Financially, I am grateful to the History Department and the ICGC a scholarship that brought me to the University of Minnesota. The History Department provided assistantships and travel grants that made it possible for me to purse my academic. The ICGC offered me the Compton Peace Fellowship and the McArthur travel grant to conduct my research in Zimbabwe. The ICGC and the Institute of Global Studies also offered me assistantships that made it possible for me to continue working on this dissertation. I thank you. I want to thank the staff at the National Archives of Zimbabwe who made it possible for me to access archival documents. I also want to thank the women who gave up their valuable time to share their knowledge on nurses and nursing with me. Their i willingness to talk and share information despite the tense political and harsh economic environment prevailing in Zimbabwe left me humbled. Several colleagues: Terrence Mashingaidze, Munya Munochiveyi, Ireen Mudeka, Jones Sichali, Oswald Masebo, Jesse Bucher, Julie Weiskopf, Drew Thompson, Elliot James, Puthego Molosia, Frank Murphy, Dave Morton, Eleusio Phillipe, Virgil Slade, Paul Vig, Gabrielle Payne and the ICGC community were sources of intellectual and social support throughout my studies. I thank you. Patience Mukwambo-Nyamunda, Tinashe Nyamunda and Paul Svongoro were extremely helpful with some interviews. I thank you. Admire Mutsa Nyamwanza and Kelvin Chikonzo, thank you for your support during my time in Harare. I am also grateful to my family for their love and support. To my wife Tarisai and daughter Anashe Chido, words cannot express my gratitude. I appreciate you. My parents who have been extremely supportive in all my endeavors, my brothers and sisters and their families, thank you for your support and encouragement throughout this project and others before it. Finally, I take responsibility for the errors of omission and commissions that remain in this dissertation. ii Dedication This dissertation is dedicated to my parents. Thank you for the gift of life. iii Abstract This dissertation puts into focus African women who day and night toiled in hospitals, taking care of the infirm and healing the sick. I examine their hopes and aspirations, their daily work, their struggles and resilience in racialized and oppressive clinical spaces. In this dissertation, I argue that when African women entered colonial healing spaces as State Registered Nurses in the post Second World War period, they used the opportunity to showcase their potential, their expertise, and to contribute to the wellbeing of their people. Using a variety of strategies to adapt to their racial and subaltern positions within clinical spaces, African women played a pivotal role in not only nursing sick bodies, but also nursing the nation, and their struggles within and outside hospitals were part of the larger struggles by ordinary Zimbabweans for self- determination and equality in colonial and postcolonial Zimbabwe. iv Table of Contents Acknowledgements i Dedication iii Abstract iv List of Tables vi List of Images vii Abbreviations viii Chapter 1 Introduction 1 Chapter 2 African women‟s varied motives for choosing nursing as a profession: 1950s-1980. 58 Chapter 3 An anatomy of African nurses‟ work within Rhodesia‟s clinical spaces: 1950s to 1970. 95 Chapter 4 Hospitals and nurses from the 1970s to the 1980s. 144 Chapter 5 Neoliberalism, nurses and health in post-colonial Zimbabwe: 1990-1996. 192 Chapter 6 Conclusion. 234 Bibliography 243 Appendix 1 262 Appendix 2 263 Appendix 3 264 v List of Tables Table 1: Salaries per month: African Student Orderlies (1958). 84 Table 2: Salaries: Trainee Nurses (1958). 85 vi List of Images Image 1: The first cohort of African Sate Registered Nurses to train at Harari Hospital. 104 Image 2: The whole class watches Sister Tutor demonstrate how to prepare a bed for a patient. 118 Image 3: Nurses in the maternity section at Harari Hospital. 122 vii Abbreviations AFH Andrew Fleming Hospital NAZ National Archives of Zimbabwe PTS Primary Training School RAF Royal Air Force SRN State Registered Nurse ZANLA Zimbabwe African National Liberation Army ZANU (PF) Zimbabwe African National Union (Patriotic Front) ZINA Zimbabwe Nurses Association viii Chapter 1: Introduction. Section A: The argument This dissertation explores the history of African nurses working in government hospitals in colonial and postcolonial Zimbabwe from the late 1940s to 1996.1 I examine their hopes and aspirations, their daily work, their struggles and resilience in racialized and oppressive clinical spaces. In this dissertation, I argue that when African women entered colonial healing spaces as State Registered Nurses (SRNs) in the post Second World War period in colonial Zimbabwe, they grabbed this rare opportunity to showcase their potential, their expertise, and to contribute to the wellbeing of their people. Using a variety of strategies to adapt to their racial and subaltern positions within clinical spaces, African women played a pivotal role in not only healing sick bodies, but also nursing the nation, and their struggles within and outside hospitals were part of the larger struggles by ordinary Zimbabweans for self-determination and equality in colonial and post- colonial Zimbabwe. The dissertation begins with the premise that, from the introduction of the hospital system at the inception of colonial rule, white women were the principle health care workers in hospitals.2 By the Second World War however, a constellation of interrelated factors led to a crisis in government hospitals. The problems included inter alia shortages 1 For this dissertation, I use the term “African” to refer to black people of African descent. This usage is not used in any way to deny any group of people the right to belong to Africa but is only selecting among the peoples of Africa a specific group that shall be used as case study in this project. I have to emphasize that white Zimbabweans are not treated as Africans in this study because the various archival records even those written by colonial officials and the day-to-day usage of the term “African” clearly outlined Blacks as Africans and not any other group of people. It is from this semantic context that the term is used. 2 See this Chapter, Section B: Historical Background. 1 of nursing personnel, government‟s failure to attract enough white nurses to ease the staffing situation, increased workloads and the subsequent failure of hospitals in Rhodesia to cope with the surge of African patients. The crisis forced authorities to rethink and adjust nursing service policies in the process, setting in motion new health policies that were to change the structures of clinical services in post Second World War era. Specifically, the crisis gave impetus to the Africanization of the hospital system, in the process transferring the burden of nursing African patients from white nurses to African nurses. Towards this end, in 1947 the first group of African women successfully completed the State Registered Midwifery program at Umtali Government Hospital. The graduation of this first African group of government trained midwifery nurses coincided with the expansion of the African wing at the hospital.3 Within few years, the government expanded and extended the program to Bulawayo and Salisbury. In 1950, Rhodesian authorities began offering bursaries to African students to study nursing in South Africa. These students were expected to return and work in African hospitals. In the meantime, in 1953, the government started training Colored and Asian nursing students.4 This was the first cohort of non-European State Registered Nurses (SRNs) in colonial Zimbabwe. The opening of Impilo and Harari Central Hospitals in 1958 set into full gear the Africanization of clinical spaces in colonial Zimbabwe.5 Thus, in 1962, the leading African magazine, The African Parade noted that: “Each year a number of nurses complete their training course (SRN) and are 3 Michael Gelfand, A Service to the Sick: A History Of The Health Services For Africans in Southern Rhodesia (1890-1953) (Gwelo: Mambo Press, 1976) 151. 4 For this dissertation the term Colored refers to people of mixed race. This is a popular term that is used throughout Southern Africa. 5 See Chapter 3: Section A. 2 ready to go out in the world to take part in the healing of the sick men and women.”6 By 1981, the newly independent Zimbabwe had approximately 4 000 nurses practicing their craft in various hospitals and clinics nationwide. In 1996, almost fifty years after the pilot midwifery scheme, Zimbabwe had approximately 8 000 nurses.7 The following propositions undergird the study.