Nursing with the Grenfell Mission in Northern Newfoundland and Labrador, 1939-1981

Maria Heidi Coombs-Thorne

BA (Hons), Memorial University of Newfoundland, 1998 MA, Queen's University, 2001

A Dissertation Submitted in Partial Fulfillment of The Requirements for the Degree of

Doctor of Philosophy

In the Graduate Academic Unit of History

Supervisor: Linda Kealey, PhD (History)

Examining Board: Penny Ericson, Prof. Emeritus (Nursing), Chair David Frank, PhD (History) Sasha Mullaly, PhD (History)

External Examiner: Kathryn McPherson, PhD (History), York University

This dissertation is accepted by the Dean of Graduate Studies

UNIVERSITY OF NEW BRUNSWICK

August 2010

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ii ABSTRACT

The Grenfell Mission was a philanthropic social and medical aid organization in remote areas of northern Newfoundland and Labrador, 1893-1981. Nurses were an integral part of the organization and the health services it provided. This dissertation focuses on 498 nurses (primarily British) who worked with the Mission between 1939 and 1981. It applies gender and class analyses to archival material, print documents and oral histories to uncover the varied experiences of nursing with the Grenfell Mission. The nurses were considered to have attained an appropriate bourgeois character through their nurse training, and indeed many nurses assumed middle-class language, attitudes and behaviour in their interactions with the local people. In this sense, nursing with the

Grenfell Mission was a formative experience in terms of class identity. The nursing experience was also influenced by the messages of the official Grenfell discourse, especially as portrayed through the Mission's quarterly magazine, Among the Deep Sea

Fishers. Through this discourse, the Mission presented its singular image of the quintessential Grenfell nurse - a strong, independent woman who would have a greater chance of success on the Coast but who also understood the importance of their matemalist traits within the fibre of a middle-class, philanthropic health care organization. However, in providing health services to the people of northern

Newfoundland and Labrador, there was often a disconnect between the myth of the

Grenfell Mission as presented in the official Grenfell discourse and the realities of nursing in such unusual circumstances. Nursing activities on the Coast were sometimes at variance with the Grenfell Mission's official discourse and its middle-class matemalist message.

iii ACKNOWLEDGEMENTS

I sincerely thank my supervisor Linda Kealey, for providing continual support, encouragement and guidance; and my examining committee, Kathryn McPherson, Penny Ericson, David Frank and Sasha Mullaly, for providing constructive feedback and editorial expertise. I also thank Lianne McTavish for my field in the history of medicine.

For assisting with my primary research, I thank Greg Walsh, Elizabeth Fewer and the staff at the Provincial Archives of Newfoundland and Labrador, The Rooms; Bert Riggs and Linda White at Archives and Special Collections, Memorial University; Gary Newell at the International Grenfell Association Archives in St. Anthony; and those retired Grenfell nurses who shared their experiences with me through interviews.

For funding my various research trips and conference presentations, I thank the University of New Brunswick's School of Graduate Studies, the Department of History, the Graduate Student's Society, and the Canadian Association for the History of Nursing. And for overall financial support, I thank the Hannah Institute for the History of Medicine, the SSHRC/NSERC-funded project "Coasts Under Stress: The Impact of Social and Environmental Restructuring on Environmental and Human Health in Canada," and the Department of History at the University of New Brunswick.

Finally, I thank my husband, Blair Thorne and my family and friends.

iv TABLE OF CONTENTS

Dedication ii

Abstract iii

Acknowledgements iv

Table of Contents v

List of Tables vii

List of Figures vii

Map of the Coast viii

Chapter 1: Introduction 1 Historiography 3 History of Health Care in Newfoundland and Labrador 5 History of Medical Missions 14 Nursing History 20 Nursing with the Grenfell Mission 35

Chapter 2: History of the Grenfell Mission, 1892-1981 40 Philanthropic Origins and Secularization 52 Health Care Initiatives during Commission of Government 64 Increasing Medical Personnel 64 Increasing Medical Facilities 65 Tuberculosis 66 Improving Child Health 67 Dietary Reform 67 The Second World War 69 Confederation 1949 77 Summary 84

Chapter 3: Among the Deep Sea Fishers - A Promotional Vehicle for the 86 Grenfell Mission's Middle-Class Dominant Discourse Middle-Class Dominant Discourse 90 The People Poverty 92 Local Ignorance 100 Aboriginal Population 105 The Mission Social Guidance and Progress 111 Quality of Services 119

v Official Endorsement 122 The Nurses Characteristics 126 Activities 129 Summary 138

Chapter 4: "She seems a fairly venturesome girl" - Balancing Personal 141 Motivations with the Grenfell Agenda Personal Motivations 152 In Search of Adventure 153 Religion and Philanthropy 162 Career Experience and Advancement 170 Relationships, Marriages and Class 176 Marriage and the Grenfell Mission Response 184 Summary 196

Chapter 5: "There is no one to turn to for help" - The Work Experience of 199 Nursing With the Grenfell Mission Standard Nursing Duties 203 Midwifery/Obstetrics 207 Public Health 215 Dentistry 226 Domestic Chores 233 Administration 240 Supplementary Duties 247 Summary 251

Chapter 6: Challenging the "Truths" of the Grenfell Mission Discourse 254 Conflict with Members of the Community 255 Local Gratitude in the Fishers 256 Nurses' Relations with Members of the Community 261 Racial and Cultural Differences 268 Non-Medical Participation of Nurses in the Community 269 Conflict with Other Nurses 272 Nurses as Cooperative and Congenial in the Fishers 272 Conflict with other Nurses 273 Conflict with the Physicians 282 Nurses' Deference to Physicians in the Fishers 282 Conflict with Grenfell Physicians 288 Resistance to Paternalism 296 Summary 302

Conclusion 304

Bibliography 310 Appendix 337

vi LIST OF TABLES

Table 2.1: Relief for Labrador, 1936-47 48 Table 2.2: Household Amenities, Percentages 49 Table 2.3: Medical Superintendents of the Grenfell Mission, 1892-1981 51 Table 2.4: Hospital Construction Grants 78 Table 2.5: Grants to Support the Purchase of Equipment 79 Table 2.6: Cost Distribution of the Air Ambulance Service 81 Table 4.1: Most Common Training Schools, 1929-80 144

LIST OF FIGURES

Figure 2.1: "Labrador Feast" 63 Figure 2.2: A Dance in Goose Bay, 1959 73 Figure 3.1: Among the Deep Sea Fishers 87 Figure 3.2: "Mrs. Martin of Sandwich Bay, Labrador" 95 Figure 3.3: "Patchwork Patient" 97 Figure 3.4: Innu Women Netting Snowshoes 106 Figure 3.5: Girls of the St. Anthony Orphanage 113 Figure 3.6: Boys of the St. Anthony Orphanage 114 Figure 3.7: "Shakespeare at St. Anthony" 115 Figure 3.8: Nurse Barnard and a "Labrador Cradle" 137 Figure 4.1: British, Canadian and American Nurses, 1938-46 150 Figure 4.2: Travel by Dogsled 155 Figure 4.3: Marital Status upon Application, 1936-80 181 Figure 4.4: Marriage Status upon Application, Trends 1936-80 182 Figure 4.5: Grenfell Nurses by Age on Application, 1936-80 183 Figure 4.6: Traceable Marriages after Nursing with the Mission, 1936-80 190 Figure 4.7: Marriages Associated with the Grenfell Mission Experience, 192 1939-81

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viii CHAPTER ONE

Introduction

The Grenfell Mission was established in 1893 in response to the lack of basic health care and the difficult living conditions that Wilfred Thomason Grenfell witnessed on his visit to the Coast of Labrador a year earlier. Under Grenfell's direction, the

Mission became a paternalistic and philanthropic system of health care designed to reach people living in isolated coastal communities in northern Newfoundland and Labrador.

Grenfell arrived in Newfoundland and Labrador as a physician with the Mission to Deep

Sea Fishermen (and later the Royal National Mission to Deep Sea Fishermen), a British organization that provided spiritual guidance and medical aid to the fishermen of the

North Sea fleets. Although the Mission to Deep Sea Fishermen had intended its

Newfoundland venture to be a small extension of their North Sea project, in which a medically equipped vessel, complete with an onboard physician, accompanied the fleet to the fishing grounds, Grenfell established permanent facilities along "the Coast." These facilities became an extensive and enduring health and social welfare institution - the

Grenfell Mission, 1893-1981. The Mission included a network of hospitals and nursing stations, a hospital ship, and a variety of other social welfare programs and institutions.

Employees with the Mission came from diverse socio-economic backgrounds and from as far afield as Australia and Southeast Asia. However, founded as a philanthropic social and medical aid organization, the Grenfell establishment was steeped in middle-class mores, and every Grenfell employee was subject to these standards regardless of their background. As a colonial venture, the Grenfell Mission presumed its social and intellectual superiority over the local residents of the Coast, and nurses in particular were

1 expected to participate in the "civilizing" agenda of the Mission and its attempt to uplift the neglected corner of the British Empire.

This dissertation examines the nurses of the Grenfell Mission in northern

Newfoundland and Labrador from 1939 to 1981, focusing on 498 nurses (primarily

British) who corresponded with the London office of the Grenfell Association of Great

Britain and Ireland (hereafter "the Association"). These records are supplemented by

American and Canadian nurses who were represented in official Grenfell publications and who were available for personal interviews. The time frame for this study carries on from Jill Perry's MA thesis, "Nursing for the Grenfell Mission: matemalism and moral reform in Northern Newfoundland and Labrador, 1894-1938"' and concludes with the termination of the Mission as the region's health care provider in 1981. At that time, the provincial government assumed all health care responsibilities of the Grenfell Mission.

The Grenfell Mission in Newfoundland and Labrador consisted of a gender- and class-mixed social space based on the idea that nurses had attained a bourgeois

"character" through their training and thus were adequately prepared to partake of the

"civilizing" project of the Grenfell Mission, regardless of their own socio-economic backgrounds. The nurses who worked on the Coast during this period were, first and foremost, Grenfell nurses. Through their exposure to the Grenfell institution and the official Grenfell discourse, these nurses developed Grenfell-centred identities that shaped their experiences in the north, their attitudes towards the local people and their relationships with other members of Mission staff. Regardless of their personal motivations and their socio-economic backgrounds, nurses with the Grenfell Mission

1 Jill Samfya Perry, "Nursing for the Grenfell Mission: matemalism and moral reform in Northern Newfoundland and Labrador, 1894-1938," MA thesis, Memorial University of Newfoundland, 1997.

2 often adopted and replicated the mythology of the Mission. This dissertation argues that nursing with the Grenfell Mission provided women with the freedom to travel in a legitimate manner and in accordance with respectable feminine behaviour, and was a formative experience in terms of class and social identity. When stationed in a remote community in Newfoundland and Labrador, the Grenfell nurse found herself in a position of leadership which was shaped by the nurse's appropriation of the Grenfell Mission's middle-class maternalist agenda.

HISTORIOGRAPHY

This study contributes to several inter-connected fields of historical inquiry. First, this dissertation belongs within the history of health care in Newfoundland and Labrador.

Research in this field has focused mostly upon nutritional and deficiency diseases before

Confederation; infectious diseases, especially tuberculosis, and related public health initiatives; and historical biography. As the largest non-government health care organization in Newfoundland and Labrador, the Grenfell Mission itself has received some academic attention. However, this history is dominated by the life of Wilfred

Grenfell, to the neglect of the institution, the health care it provided, the patients' experience with the Mission, and the hundreds of individuals who were employed or volunteered with the organization. Grenfell nurses have been the subject of analysis in recent years in the form of an MA thesis in history and a PhD dissertation in English.

This dissertation builds upon those studies, carrying the research further into the twentieth century and situating the history within the context of the Second World War,

Confederation with Canada (1949), the increase in federal and provincial government

3 funding for health services, and the social changes that took place in the second half of the century.

Second, this dissertation contributes to the history of medical missions. Health care in the colonial world took three distinct forms: 1) colonial medicine, administered by colonial governments in order to protect Western interests in the territory; 2) missionary medicine, administered by Christian organizations in an attempt to provide what they perceived as physical and spiritual health to "uncivilized" or "less civilized" peoples; and

3) indigenous medicine, or traditional health care practices performed outside the realm of Western medicine. The Grenfell Mission can be categorized as missionary medicine, although it was unique in that the primary recipients of Grenfell philanthropy were

Christians of British and Irish descent. The Mission gradually reached Aboriginal communities through the twentieth century, although many Aboriginal people had already converted to Christianity through their contact with the Moravian Mission. Rather than proselytizing the people, the Grenfell Mission was interested in uplifting the people in terms of their social and moral values. Several themes in the historiography of medical missions are present in the history of the Grenfell Mission; specifically, the colonial gaze of viewing the locals as "other" was sometimes present, although veiled, on the Coast.

The institution of Western medical practices was frequently at variance with local customs and health practices. And Mission activities, like well-baby clinics and the clothing store, became arenas for the organization to evaluate and categorize the people.

These class-biased approaches sometimes took on the language of empire and were based on the middle-class stature of the Mission and the socio-economic disadvantage of the

4 local people, which assumed a racial bias as the Mission became increasingly involved in

Aboriginal affairs.

Third, this study is situated within the field of nursing history. Although nursing history has been traditionally dominated by research on professionalization and the pursuits of the nursing elite, the field has burgeoned into new directions under the influences of social history. Historians now employ critical theory to explore the many ways in which class, race, gender, ethnicity, and religion have affected nurses and the nursing experience. Several of these variables are present within this dissertation. The

Grenfell Mission recruited hospital trained, registered nurses to staff their hospitals and nursing stations. And nursing with a rural health organization, and often under extraordinary circumstances, provided an opportunity for them to hold positions of health-related responsibility that was uncommon in traditional hospital settings. This theme has received a significant amount of academic attention in the areas of rural,

"outpost," and Aboriginal nursing in North America and historians have emphasized that nurses in these situations often performed the duties of a physician. However, the more nuanced approach offered by this dissertation reveals a rural nursing experience in which the nurse's position of responsibility was balanced against the maternalist discourse and the middle-class moral code of the Grenfell Mission.

History of Health Care in Newfoundland and Labrador

In 1978, the Faculty of Medicine at Memorial University of Newfoundland created the John Clinch Professorship in the history of medicine. The first professor appointed to that position was Kenneth Bryson Roberts, who had been delivering lectures

5 and courses on the history of medicine since 1976 and was instrumental in establishing the library collection at the Medical School and incorporating the history of medicine into the curriculum. As John Clinch Professor, Roberts launched the Clinch lecture series,2 the

Historical Collection of the Health Sciences Centre Library, and the Canadian Bulletin of

Medical History (CBMH) as founding editor.3 These developments were in keeping with medical trends in Ontario universities during the period, and indeed the CBMH has become the principal forum for the academic study of medical history in Canada.

However, despite these early accomplishments at Memorial University, the history of medicine in Newfoundland and Labrador remains an underdeveloped area of academic inquiry. While Roberts encouraged the study of the province's medical history, his own academic contributions related to the history of medicine more generally, and the history of anatomical illustrations in particular, rather than the medical history of Newfoundland and Labrador.

Roberts was succeeded as John Clinch Professor by John K. Crellin, with an extensive academic background in medicine, science and pharmacy. Although Crellin's main professional focus was in the history of pharmaceuticals, he took an interest in publishing on the medical history of Newfoundland and Labrador, especially in the areas

: The lecture series included topics on historical understandings of health sciences: molecular biology, circulation, central nervous system; disease: bubonic plague, smallpox, tuberculosis, cancer; treatment: blood transfusions, antibiotics, chemotherapy. See The History of Medicine at the Medical School at Memorial University of Newfoundland from 1969-1988, assembled by B.W. Payton, (St. John's: B.W. Payton, 1988).

1 Roberts began editing biannual newsletters in 1979, assisted by Sylvio Leblond and Jacques Bernier. These newsletters contained scholarly articles, illustrations, news and announcements, regional reports, the programs and minutes of annual meetings, and financial reports. The Canadian Society for the History of Medicine encouraged Roberts et. al. to expand and formalize the newsletter, and in 1984 they published the first issue of the Canadian Bulletin of Medical History/Bulletin canadien de I'histoire de la medicine. See Jacalyn Duffin and Paul Potter, "History of the Canadian Society for the History of Medicine," Canadian Bulletin of Medical Histoiy, 2000 17(1-2): 292.

6 of nutritional diseases, alternative medicine, and traditional self-care.4 Home Remedies: the Newfoundland Experience is a fascinating collection of treatments that were known and/or used during the first half of the twentieth century. Crellin's sources for the book were primarily oral histories - data collected and stored by the Folklore and Language

Archives and supplemented by interviews conducted by the Medical Communications

Group at Memorial University and situated by Crellin into historical context. As such,

Home Remedies presents a patient's perspective of health care in Newfoundland.5 In his more recent publication, The Life of a Cottage Hospital: the Bonne Bay Experience,

Crellin again emphasized the patient perspective in interpreting medical history. Through examining oral histories, personal memoirs, and archival documents, Crellin found that the hospital was an integral part of the Bonne Bay community and that there was "a strong sense that the quality of patient care benefitted because staff and patients felt they were all part of a small community...."6 Crellin's research in this area is particularly timely, considering the current crisis in the provision of health care to rural and remote communities in Canada.

4 John K. Crellin, "Medical Books: for information or learning? Reflections on the books of three Newfoundland physicians, c. 1860 to c. 1970," Canadian Bulletin of Medical History, 1995, 12(2): 339- 350; "Early settlements in Newfoundland and the scourge of scurvy," Canadian Bulletin of Medical Histoiy, 2000, 17( 1-2): 127-136; "Presenting the past and understanding the present: health care in Newfoundland and Labrador museums," unpublished paper presented at the Symposium in Medicine in Newfoundland - its Heritage in Artifact and Word, Memorial University of Newfoundland, St. John's, 1990; and "Rural Medical Lives and Times," Newfoundland Studies, 2008 23(2): 231-243. See also, John K. Crellin, R.R. Andersen, and J.T.H. Connor (eds.), Alternative Health Care in Canada, (Toronto: Canadian Scholars Press, 1997).

5 John K. Crellin, Home Remedies: The Newfoundland Experience, (Montreal & Kingston: McGill-Queen's University Press, 1994).

'' John K.. Crellin, The Life of a Cottage Hospital: the Bonne Bay Experience, (St. John's: Flanker Press 2007), p. xvii.

7 While early developments in the history of medicine in Newfoundland and

Labrador centred on the John Clinch Professorship at the Faculty of Medicine, the broader academic community has become interested in exploring this long neglected field. Melvin Baker and Janet Miller Pitt produced a history of public health in

Newfoundland for the Encyclopedia of Newfoundland and Labrador, Volume 2 (1984), which highlighted historical references to nutritional and contagious diseases and traced relevant government policy related to public health.7 In terms of contagious diseases more specifically, tuberculosis was endemic in the country, and has been the subject of

g several treatises, including the eradication of tuberculosis through the twentieth century.

In another area of public health, historian Peter Neaiy has conducted several studies on public health during the 1930s and 1940s, particularly on venereal disease and American perspectives of health issues in Newfoundland during the Second World War.9 James

Overton has explored the health reform initiatives of the Commission of Government, especially its attempts to combat the widespread incidence of beriberi during the first half

7 Melvin Baker and Janet Miller Pitt, "A History of Health Services in Newfoundland and Labrador to 1982," huir/'wwu .ucs.iritin.ca/~mclbaker/PublicHeallh\L.pdf (September 2008).

8 Edgar House, Light at Last: Triumph over Tuberculosis 1900-1975, Newfoundland and Labrador, (St. John's: Jesperson Press, 1981); The White Plague in Newfoundland: Medical and Social Issues c. 1900 to 1970 and beyond, compiled by J.K. Crellin, (St. John's: [Faculty of Medicine, Memorial University of Newfoundland, with the Newfoundland Lung Association], 1990); and No One is a Stranger: reminescences in tuberculosis, traditional medicine and other matters / by Captain Peter Troake, formerly C aptain of the Christmas Seal, and the 'Pied Piper' of Newfoundland, compiled and edited by J.K. Crellin, (St. John's: Faculty of Medicine, Memorial University of Newfoundland, with the Newfoundland Lung Association, 1989), and William Ronald Knowling, '"Ignorant, Dirty, and Poor:" The Perception of Tuberculosis in Newfoundland, 1908-1912," MA Thesis, Memorial University of Newfoundland, 1996.

9 Peter Neary, "Venereal disease and public health administration in Newfoundland in the 1930s and 1940s," Canadian Bulletin of Medical History, 1998 15( 1): 129-151; "'And gave as much as they got': a 1941 American perspective on public health in Newfoundland," Newfoundland and Labrador Studies, 1998 14( I): 50-70; '"A grave problem which needs immediate attention': an American report on venereal disease and other health problems in Newfoundland, 1942," Newfoundland and Labrador Studies, 1999 15(1): 79-103.

8 of the twentieth century. Although the Commission provided fortified brown bread for poverty-stricken families, many refused to eat the bread because of the stigma that associated it with public relief. Overton's study is an interesting interpretation of the strength of social perception in determining the success of well-intentioned health care reform.10 Linda Kealey and Gail Lush have also contributed to the field in terms of the history of nutrition." In her thesis, "Nutrition, Health Education, and Dietary Reform:

Gendering the 'New Science' in Northern Newfoundland and Labrador, 1893-1928,"

Lush examines American nutrition workers with the Grenfell Mission who conducted surveys of children's diets and home conditions, advised mothers on preserving the health of their families, and worked with other Grenfell personnel to improve local children's health.12 From Crellin to Lush, the history of medicine in Newfoundland and

Labrador has tended to focus on nutritional and contagious diseases and public health initiatives by governing boards of health.

Texts that highlight the lives of individual physicians in the province are far less numerous in the field of medical history than those on diseases and public health. The few writers who have focused on historical biography include Nigel Rusted and Gary

Saunders: Rusted provides biographical sketches of notable doctors in Newfoundland

10 James Overton, "Brown Flour and Beriberi: the politics of dietary and health reform in Newfoundland in the first half of the twentieth century," Newfoundland Studies, 1998 14(1): 1-27.

11 Linda Kealey, "Historical Perspectives on Nutrition and Food Security in Newfoundland and Labrador," in Resetting the Kitchen Table: Food Security, Culture, Health and Resilience in Coastal Communities, Christopher C. Parrish, Nancy J. Turner, and Shirley M. Solberg (eds.). New York: Nova Science Publishers, 2007. pp. 177-190.

12 Lush focuses on the professionalizing strategies these nutrition workers employed for cooperating with the medical community. See Gail Lush, "Nutrition, Health Education, and Dietary Reform: Gendering the 'New Science' in Northern Newfoundland and Labrador, 1893-1928," MA Thesis, Memorial University of Newfoundland, 2008.

9 from 1497 to the twentieth century;13 and Saunders profiles John McKee Olds, an

American physician who practised at the Twillingate cottage hospital for over forty years.14 However, the physician who has earned the most historical attention for his life and accomplishments is Wilfred Grenfell. Grenfell has been the subject of extensive documentation, research and acclaim, both during his lifetime and posthumously. Many of the biographies of Grenfell were written by his contemporaries and tended towards laudation of the doctor and his legacy.15 At the level of academic inquiry, Ronald

Rompkey has dedicated himself to uncovering the history of Grenfell and of the extensive health care mission he established in northern Newfoundland and Labrador in the late nineteenth century. While Rompkey has edited and brought to publication the memoirs and personal correspondence of several individuals associated with the Grenfell

Mission,16 it is his book Grenfell of Labrador: A Biography that provides the most interesting interpretation of Grenfell and the early history of the Mission. Rompkey

'' Nigel Rusted, The Physicians and Surgeons: Biographical Gleanings, Occasional papers in the history of medicine, No. 14, (St. John's: Faculty of Medicine, Memorial University of Newfoundland, 1994); and "Dr. William Anderson, 1846-1897," unpublished paper, Memorial University of Newfoundland 1991. See also. It's Devil Deep Down There: 50 years ago on the M.V. Lady Anderson, a mobile clinic on the S.W. coast of Newfoundland Occasional papers in the history of medicine, No. 5, (St. John's: Creative Publishers, 1987).

14 J.T.H. Connor, the third and current John Clinch Professor in the History of Medicine at Memorial University, has recently published an account of the health care services offered at Twillingate and focuses on the socialized medicine offered there by Olds and Robert Skidmore Ecke, with the assistance of Wilfred Grenfell and funding from the United States. See J.T.H. Connor, "Twillingate: Socialized medicine, rural doctors and the CIA," Newfoundland Quarterly, 2007 100(1): 12-15, 30-35. See also, Gary L. Saunders, Dr. Olds of Twillingate, (St. John's: Breakwater Books, 1994).

15 See for example, James Lennox Kerr, Wilfred Grenfell: His Life and Work, (Harrap, 1959).

16 Eliot Cecil Curwen, Labrador Odyssey: the journal and photographs of Eliot Curwen on the second voyage of Wilfred Grenfell, 1893, Ronald Rompkey, ed., (Montreal & Kingston: McGill-Queen's University Press, 1996; Jessie Luther, Jessie Luther at the Grenfell Mission, Ronald Rompkey, ed., (Montreal & Kingston: McGill-Queen's University Press, 2001; Harry Paddon, The Labrador Memoir of Dr. Hany Paddon, 1912-1938, Ronald Rompkey, ed., (Montreal & Kingston: McGill-Queen's University Press. 2003).

10 argues that Grenfell is best understood as "a social reformer whose instruments were political and cultural' rather than 'a classical missionary bent on saving souls and healing bodies."17 He cleverly depicts Grenfell as a somewhat complicated product of social and religious movements in Victorian Britain and, later, of progressivism in twentieth-century

America, and these larger social ideologies influenced the direction of the Mission in administering health care to the people of the Coast.18

While Grenfell has been exalted in Newfoundland history and culture, and has received the majority of scholarly and popular attention, the nurses played an integral part in the functioning of the mission and the provision of health care. In fact, in many of the outports of Newfoundland and Labrador, nurses or nurse-midwives were the primary health care practitioners. The most comprehensive history of nursing in the province is

Joyce Nevitt's White Caps and Black Bands: Nursing in Newfoundland to 1934. The book is essentially a compilation of the major players and significant events in the history of nursing in Newfoundland. Nevitt traces the development of nursing from the health care work of religious organizations throughout the nineteenth century to the inauguration of the Commission of Government in 1934. Her use of archival material and personal interviews provides valued information on the history, but Nevitt does not delve into the material or explore the themes that emerge. The general theme of the text presents the congratulatory evolution of a health care practice from the "dark ages" to modern advancement common to this form of historical approach.19

17 Ronald Rompkey, Grenfell of Labrador: A Biography, (Toronto: University ofToronto Press, 1991), xiv.

18 See also, Ronald Rompkey, "Elements of a spiritual autobiography in Sir Wilfred Grenfell's 'A Labrador Doctor,'" Newfoundland Studies. 1985 1(1): 17-28.

19 Joyce Nevitt, White Caps and Black Bands: Nursing in Newfoundland to 1934, (St.

11 White Caps and Black Bands has proven to be a foundation stone for more critical

explorations of the history of nursing in the province. For example, Linda White's article,

"Who's in Charge Here? The General Hospital School of Nursing, St. John's,

Newfoundland, 1903-1930," addresses the power struggle that existed within the hospital

hierarchy through the early twentieth century, specifically between Mary Southcott as

Superintendent of Nurses and Lawrence Keegan as the hospital's Medical

Superintendent. While local physicians supported Southcott in her attempt to maintain

direction over the nurses, few were willing to criticize Keegan or oppose the medical

hierarchy. As a result, Southcott resigned as Superintendent of Nurses."70 The study

highlights the historically gendered position of nurses and nursing leadership associated

with the medical profession in Newfoundland - a position that resonates in this

dissertation regarding the nurses' professional conflicts with the medical hierarchy of the

Grenfell Mission.

More recently, White presents a history of outport nursing, focusing on the

Newfoundland Outport Nursing and Industrial Association (NONIA) - a nurse-

midwifery organization established in 1924 to employ British-trained midwives in the

outports of Newfoundland.21 And in a forthcoming publication, Linda Kealey focuses on

one particular outport nurse, Myra Grimsley Bennett, who nursed in Daniel's Harbour for

over sixty years, although she was not a NONIA nurse nor was she employed by any

John's: Jesperson Printing, 1978). For an argument detailing the problems inherent in this approach to nursing history see Celia Davies, "Introduction: The Contemporary Challenge in Nursing History," in Rewriting Nursing History, Celia Davies, ed., (London: Croom Helm), 1980.

:o Linda White, "Who's in Charge Here? The General Hospital School of Nursing, St. John's, Newfoundland, 1903-1930," Canadian Bulletin of Medical History, 1994 11(1):91 -118.

21 Linda White, "NONIA," Newfoundland Quarterly, 2007 100(1): 3-6. See also, Edgar House, The Way Out: the Stoty of NONIA in Newfoundland, 1920-1990, [St. John's: Creative Publishers, 1990].

12 agency between 1924 and 1936. Kealey defines her position as an outport nurse as one of

"occupational pluralism'' - Bennett performed a myriad of duties associated with medical treatment, shop-keeping, and home and community life.22 Such demanding and

"pluralistic" work-life patterns were common among nurses and midwives throughout rural Newfoundland and Labrador, whose experiences have received valuable attention at academic levels. Cecilia Benoit and Janet McNaughton both describe midwifery in the province as constituting various forms of practice, from the informally trained "granny midwives" to those formally trained in St. John's or abroad.23 Jill Perry and Iona Bulgin both examine the nurses with the Grenfell Mission, who experienced the same occupational pluralism as outlined by Kealey. Perry focuses her study on the Grenfell

Mission's emphasis on maternalism for its nurses, while Bulgin interprets the writings of four Grenfell nurses to highlight their experiences and perceptions of nursing with the

Mission.24 This dissertation builds on these studies of nursing and midwifery in the outports of Newfoundland and Labrador, exploring the provision of health care in extraordinary circumstances and the gendered tensions that became apparent in the process.

22 Linda Kealey, "On the Edge of Empire: The Working Life of Myra (Grimsley) Bennett," in Caregiving on the Periphery, Myra Rutherdale, ed., (Montreal & Kingston: McGill-Queen's University Press, 2010): 84-105.

Cecilia Benoit, Midwives in Passage: the Modernisation of Maternity Care, (St. John's: Institute of Social and Economic Research, 1991); and Janet McNaughton, "The role of the Newfoundland midwife in traditional health care, 1900 to 1970," PhD dissertation, Memorial University of Newfoundland, 1989.

24 Perry, "Nursing for the Grenfell Mission;" Iona Bulgin, "Mapping the self in the "utmost purple rim": published Labrador memoirs of four Grenfell nurses," PhD dissertation, Memorial University of Newfoundland, 2001.

13 History of Medical Missions

In her 1996 presidential address to the Society for the History of Medicine conference, "Medicine and the Colonies," Shula Marks pointed out that colonial medicine has a long history, beginning in the sixteenth and seventeenth centuries, although admittedly most of the research in the history of medicine and disease in the colonial world focuses on the late nineteenth- to early twentieth-centuries.25 Indeed, early

Christian missionaries who travelled throughout the world often sought to heal those individuals they tried to convert.26 However, the extent to which these practices constituted "colonial medicine" is a subject of debate. Some historians distinguish between formal colonial medicine, as administered by colonial governments, and missionary medicine, as administered by Christian missions. Megan Vaughan presented this distinction in her ground-breaking study, Curing Their Ills: Colonial Power and

African Illness. Vaughan argued that there were significant differences between secular colonial medicine and missionary medicine - secular medicine focused on society in general and attempted to eliminate the causes of (especially infectious) disease, while missionary medicine focused on individual healing and maternal and child health.27

Colonial governments maintained imperialist medical agendas that benefitted European interests first and foremost - their medical activities aimed at preserving the health of

White functionaries along with those indigenous workers employed in mining or

25 Shula Marks, "What is Colonial about Colonial Medicine? And What has Happened to Imperialism and Health?" Social Histoiy of Medicine 10.2(1997): 208.

26 For a detailed exploration of the significance of healing in Christianity, see Amanda Porterfield, Healing in the History of Christianity, (New York; Oxford: Oxford University Press, 2005).

21 Megan Vaughan, Caring Their Ills: Colonial Power and African Illness, (Cambridge: Polity Press, 1991), pp. 39-52.

14 ->8 agriculture.' They were less inclined to invest in expensive medical activities aimed at reaching indigenous populations, and as a result, missionaries became the main conduits of Western medicine at the local level.29 Michael Worboys distinguished the two this way: missionary medical personnel emphasized personal interaction and concentrated on individual patients and their care, while colonial medical personnel focused on disease agents, vectors, and populations.30

Researchers in the history of medicine and disease in the colonial world have traditionally taken a Eurocentric approach to the transfer and administration of Western medicine in colonial settings. The primary focus of early historians in the field was on the ways in which colonial governments promoted Western medicine, the initiatives taken to combat epidemic diseases that threatened White populations, and the general benefits of the unidirectional flow of scientific medicine from Europe to the colonies.31 Other historians focused on those individuals who were responsible for the administration of

28 "By the late nineteenth century the diseases which attracted most attention from British doctors in the tropics were—hardly surprisingly—those which took so large a toll of while lives in Africa and Asia, and it was the conquest of these diseases which of course made the penetration of the tropics a possibility: malaria, yellow fever, hook-worm." See Marks, p. 213. See also, John Farley, Bilharzia: A History of Imperial Tropical Medicine, (Cambridge: Cambridge University Press, 1991); Deepak Kumar (ed.), Science and Empire: Essays in Indian Context (1700-1947), (Delhi: Anamika Prakashan, 1991), p. 17.

"9 David Hardiman, "Introduction," in Healing Bodies, Saving Souls: Medical Missions in Asia and Africa, ed. David Hardiman, (Amsterdam; New York: Rodopi, 2006), p. 5.

10 Michael Worboys, "The Colonial World as Mission and Mandate: Leprosy and Empire," Osiris 15 (2001): 207-218.

31 See for example, E. Ford, "The malaria problem in Australia and the Australian Pacific Territories," Medical Journal of Australia, June 1950 (1): 749-60; John Duffy, Epidemics in Colonial America, (Baton Rouge: Louisiana State University Press, 1953); Leonard Rogers, Happy Toil: Fifty Years of Tropical Medicine, (London: Muller, 1950); Frantz Fanon, "Medicine and Colonialism," in The Cultural Crisis of Modern Medicine, ed. John Ehrenreich, (New York: Monthly Review Press, 1978): 229-52.

15 colonial medicine and the triumphs in the march against tropical disease,32 which celebrated the successes of Western medicine in different colonial contexts. In the 1960s,

historians began to explore the role of disease and medicine in imperial history and

produced case histories of tropical diseases, studied European confrontations with

disease, and explored the consequences of those diseases on the institutions that

established and administered Western medicine.33 Also during this period, scholarly

journals began to recognize "the political contingencies of medicine as pivotal aspects of

empire."34 However, the medicine in question was colonial rather than missionary and, as

Vaughan noted in Curing Their Ills, the large literature on colonial medicine in Africa

neglected the activities of mission doctors and nurses, even though "throughout most of

the colonial period and throughout most of Africa, Christian missions of one sort or

another provided vastly more medical care for African communities than did colonial

states.'"35

The social history of medicine, which has emerged since the 1960s, has had a

tremendous effect on the direction of the history of colonial medicine. Historians began

to take a more critical approach to the history and re-evaluate previous assumptions about

1: See J. Rowland. The Mosquito Man: The Story of Sir Ronald Ross, (London: Lutterworth Press, 1958); P.E.C. Manson-Bahr, "The march of tropical medicine during the last fifty years," Transactions of the Rovat Society of Tropical Medicine and Hygiene, 52 (1958): 483-99; and, M. Gelfand, Lakeside Pioneers: A Socio-Medical Study of Nyasaland, 1875-1920, (Oxford: Blackwell, 1964).

" See also, P.D. Curtin, '"The White Man's Grave': image and reality," Journal of British Studies, 1(1961): 94-110; The Image of Africa: British Ideas and Action, 1780-1850, (Madison: University of Wisconsin Press, 1964); J.N.P. Davies, "The cause of sleeping sickness," East African Medical Journal, 39( 1962): 81-99, 145-160; and R.E. Dumett, "The campaign against malaria and the expansion of scientific, medical and sanitary services in British West Africa, 1898-1920," African Historical Studies, 1 (1968): 153-99.

M Macleod. Roy and Milton Lewis, Disease, Medicine, and Empire: Perspectives on Western Medicine and the Experience of European Expansion, (London and New York: Routledge, 1988), p. 5.

35 Vaughan, Curing Their Ills, p. 56.

16 the positive effect Western medicine had on non-European peoples.36 Recent postcolonial historians approach medicine and disease in the colonial world from the perspective of the colonial setting, rather than the European imperial medical machine. Explorations of disease in colonial contexts illuminate the social, economic, and political processes that shaped the country's history.37 Some of these histories explore the interaction of local society and the colonial state or medical missions and attempt to determine the effect of that interaction on disease, health, and the structure of health services.38 Much of the recent research in the field concerns the responses of indigenous people to colonial medicine, including resistance to Western medicine, as well as the adaptation, manipulation, and incorporation of Western medicine by colonized peoples.39 For example, in Fractured States: Smallpox, Public Health and Vaccination Policy in British

India, 1800-1947, Sanjoy Bhattacharya, Mark Harrison and Michael Worboys provide a

36 The International Journal of Health Services, which began in 1970, became an academic critic of the traditional accounts of Western medicine and overseas expansion; and there followed a surge in revisionist history in terms of disease, medicine and empire.

17 Some of these histories are more often examinations of the colonizing process rather than an evaluation of colonial outcomes. In Black Death, White Medicine: Bubonic Plague and the Politics of Public Health in Colonial Senegal, 1914-1945, Myron Echenberg studies episodes of bubonic plague in an attempt to uncover the political and social realities of society in Senegal. Echenberg argues that outbreaks of plague, colonial interventions to combat the disease, and Senegalese responses to both the disease and the interventions were connected to local struggles for African political rights. Myron Echenberg, Black Death, White Mcdicine: Bubonic Plague and the Politics of Public Health in Colonial Senegal, 1914-1945, Social History of Africa, (Portsmouth, NH: Heinemann, 2001).

18 For example, Ceylon was considered a model colony in that administrators placed more emphasis on liberal governance and social welfare than other colonies. The health conditions of the people, the public health strategy, and the hospital and medical policies in Ceylon were similar to those of other colonies. However, Ceylon was unique in that the colonial government made efforts to accommodate indigenous medicine and by 1929, a college was established to provide training in Ayurveda, Unani, and Siddha medicine. The government also provided financial assistance for training in traditional medicine and provided grants-in-aid to Ayurvedic dispensaries. Ceylon was unique in accommodating different medical traditions for the needs of the populace. See Margaret Jones, Health Policy in Britain's Model Colony: Ceylon (1900-1948), New Perspectives in South Asian History, no. 10, (Hyderabad, India: Orient Longman, 2004).

39 Marks, "Colonial Medicine," p. 214.

17 political history of vaccination policy and its implementation in various regions of India.

They argue that colonial public health policies were not consistently administered and that they were continuously questioned and locally adaptable. As a result, both Indian public health officials and the local populace exercised considerable agency in terms of the administration of vaccines.40 Indeed, the postcolonial approach of exploring the role of indigenous people in the creation of colonial and missionary medicine is one of the most common approaches to the field today.41

The history of missionary nursing remains underdeveloped, despite some recent remarkable academic research. Histories of women involved with missionary societies often discuss gender-based power struggles but not necessarily in the context of nursing, since the women who joined foreign missions were wives, teachers and physicians as well as nurses.42 Conversely, histories of colonial medicine tend to neglect the role played by nurses in providing health care to the masses. However, several historians have attempted to remedy this gap in the historiography. Margaret Jones explores the presence of British nurses in Ceylon (1878-1948) and argues that "their presence in the colony

40 Bhattacharya, Harrison and Worboys focus on administrative, technological, and economic explanations for the development of vaccination policies and the manner in which these policies were put into practice. See Sanjoy Bhattacharya, Mark Harrison and Michael Worboys, Fractured States: Smallpox, Public Health and Vaccination Policy in British India, 1800-1947, New Perspectives in South Asian History 11, (London: Sangam Books, 2005).

41 See, for example, WalimaT. Kalusa, "Language, Medical Auxiliaries, and the Re-interpretation of Missionary Medicine in Colonial Mwinilunga, Zambia, 1922-51," Journal of Eastern African Studies, 1.1 (March 2007): 57-78; Timothy Man-kong Wong, "Local Voluntarism: The Medical Mission of the London Missionary Society in Hong Kong, 1842-1923," in Healing Bodies. Saving Souls: Medical Missions in Asia and Africa, David Hariman, ed., (Amsterdam; New York: Rodopi, 2006): 87-111; and Heather Bell, "Midwifery Training and Female Circumcision in the Inter-War Angle-Egyptian Sudan," Journal of African History, 39 (1998): 293-312.

42 Rosemary R. Gagan, A Sensitive Independence: Canadian Methodist Women Missionaries in Canada and the Orient, 1881-1925, (Montreal & Kingston: McGill-Queen's University Press, 1992); Myra Rutherdale, Women and the White Man s God: Gender and Race in the Canatlian Mission Field, (Vancouver; Toronto: UBC Press, 2002).

18 ultimately left an ambiguous legacy."43 Nurses furthered the spread of Western nursing and participated in the "civilizing mission" in Ceylon, but their dominance of the nursing profession in the colony discouraged local well-educated women from pursuing it as a career and "perpetuated the lowly status of nursing in the island."44

Sheryl Nestel also emphasizes the relationship between nursing and colonialism and how the activities of nurses contributed to the establishment of biomedicine as a "tool of empire." She focuses on colonial nurses' interventions into native women's reproductive practices, which was a common focal point for Christian medical authorities 45 By the 1930s, colonial governments were providing grants-in-aid to government and mission projects that targeted maternal and child health. These projects

"mimicked those of the metropole" in that they included prenatal and well-baby clinics in which babies were weighed and their growth/progress recorded. Nestel argues that "the clinic represented a particularly efficacious site for categorizing and monitoring the indigenous population."46 However, African women resisted this colonial regulation of motherhood.

Nestel considers "mission nursing and the nursing projects of state-run colonial medical services simultaneously despite the distinct histories which attach to these."47

Helen Sweet provides a specific comparison of mission nurses with colonial (Overseas

43 Margaret Jones, "Heroines of lonely outposts or tools of the empire? British nurses in Britain's model colony: Ceylon, 1878-1948," Nursing Inquiry 11.3 (2004): 148.

44 Jones, "Heroines," p. 159.

45 Shery! Nestel, "(Ad)ministering Angels: Colonial Nursing and the Extension of Empire in Africa," Journal of Medical Humanities, 19.4 (1998): 257.

46 Nestel, "(Ad)ministering Angels," p. 268.

47 Nestel, "(Ad)ministering Angels," p. 259.

19 Nursing Association) nurses in her article, '"Wanted: 16 nurses of the better educated type': provision of nurses to South Africa in the late nineteenth and early twentieth centuries." Sweet argues that both mission and colonial nurses were perceived as representing "civilized" Christian values. However, the colonial nurses did not work in

"such rural or materially disadvantaged settings" as the mission nurses, and "they did not establish, but were sent by formal request to supply an existing need."48 Colonial nurses tended to stay in South Africa for a relatively short time period, served mostly the White community in urban regions, and "remained firmly part of the colonial framework," whereas mission nurses tended to commit to longer terms and often either settled or transferred to where the health needs were greatest49

Nursing History

Traditional interpretations of nursing history address the processes of professionalization in terms of the struggle for legitimization and professional status.

These early histories purposely contributed to the ongoing professionalization of nursing by celebrating the pioneers in the nursing field and providing narratives that emphasized the courage and devotion of the heroic nurse. Three Centuries of Canadian Nursing, by

John Murray Gibbon and Mary S. Mathewson, is a classic in this genre. Beginning with the establishment of nursing sisterhoods in Quebec, Three Centuries provides a sweeping chronological account of significant events in the development of Canadian nursing until the Second World War. It provides little critical analysis of the purposes and

48 Helen Sweet, '"Wanted: 16 nurses of the better educated type': provision of nurses to South Africa in the late nineteenth and early twentieth centuries," Nursing Inquiry 11.3 (2004): 183.

49 Sweet, '"Wanted: 16 nurses of the better educated type,'" p. 183.

20 consequences of those events, but rather documents the contributions of individuals and associations in securing professional status.50 Other early studies in Canadian nursing history took the form of biography and focused on nursing leaders - those individuals

who established nursing associations across the country and fought for registration within

the profession.51 The focus on professionalization, the education system and the

leadership elite constitutes what nursing historian Kathryn McPherson labels the

"professionalization paradigm" within nursing historiography.52

The debate over whether or not nursing is a profession has been the subject of

infinite attention by nursing scholars. Standard interpretations of professionalism

emphasize the provision of a service to society, postsecondary education, certification

and self-regulation and assume that nursing "advanced" as a profession.53 Jo Ann

Whittaker and Mary Kinnear also rely on standard definitions of professionalism.

Whittaker defines the professionalization of nursing as "the struggle to obtain a

registration act, its enactment and, finally, the circumstances that added status and

50 John Murray Gibbon and Mary S. Mathewson, Three Centuries of Canadian Nursing, (Toronto: Macmillan Company of Canada. 1947).

51 See, for example, Margaret Street, Watch Fires on the Mountain: the Life and Writings of Ethel Johns, (Toronto: Toronto University Press, 1973); and Marion Royce, Eunice Dyke: Health Care Pioneer, (Toronto: Dundurn Press, 1983).

52 Kathryn McPherson, Bedside Matters: The Transformation of Canadian Nursing, 1900-1990, (Toronto: Oxford University Press, 1996), 9.

51 In her groundbreaking study, "The Physician's Hand": Work, Culture and Conflict in American Nursing, Barbara Meiosh argues that nursing is not a profession. Her rationale for this lies in the originating definition of "professionalism" as established by an elite, male population. Meiosh considers professions as "...particular expressions and vehicles of dominant class and culture," and since women are the "second sex," an occupation dominated by women can never be a profession. See. Barbara Meiosh, "The Physician s Hand": Work Culture and Conflict in American Nursing, (Philadelphia: Temple University Press, 1982), p. 20.

21 legitimized the profession of nursing."54 Kinnear engages more with the concept of professionalism in her study of the formation of nursing schools and state registration in

Manitoba. She concludes that nursing does contain "most of the components advanced as

'professional,'" and the failure of nursing to achieve autonomy "should not be seen as the test depriving nursing of any claim to be a profession, for other professions also were less than totally independent."55 More recent interpretations of professionalism in nursing history have deviated from the focus on educational and political processes and have instead highlighted social authority and workplace autonomy as important features of professional status. Meryn Stuart argues that many First World War nurses built on their experiences in the war to forge new career paths in public health nursing. University education for public health nursing developed after the war, but "...universities were unwilling to give degrees to nurses because of the status of nursing as a menial, if romanticized, occupation."56

Historians in Britain have been especially interested in the debates surrounding the professionalization of nursing. Celia Davies in particular has recognized the definitional and theoretical confusion surrounding the concept of professionalization. She divides the singular concept of "professionalization," the process of attaining the status of

54 Whittaker restricts her analysis to the three government acts that led to the creation of the Registered Nurses Association of British Columbia. Jo Ann Whittaker, "The Search for Legitimacy: Nurses' Registration in British Columbia, 1913-1935," Not Just Pin Money: Selected Essays on the History of Women's Work in British Columbia, Barbara K. Latham and Roberta J. Pazdro, eds., (Victoria: Camosun College, 1984), 315.

55 Mary Kinnear, "Nursing: 'One of the Truest and Noblest Callings," in In Subordination: Professional Women, 1870-1970, (Montreal & Kingston: MQUP, 1995), 99-101.

56 Meryn Stuart, "War and Peace: Professional Identities and Nurses' Training, 1914-1930," in Challenging Professions: Historical and Contemporary Perspectives on Women's Professional Work, Elizabeth Smyth, Sandra Acker, Paula Bourne and Alison Prentice, eds., (Toronto: UTP, 1999) 186.

22 a profession, into two distinct aspects: "professional ideology" - the language applied by leaders in reference to their shared activity; and "professionalizing strategy" - the accumulation of those actions proposed by leaders for the intention of directing the shared activity.57 Whether described as an ideology or a strategy, the concept of professionalization has provided historians with a useful vehicle for the discussion of change within occupational groups. Historians of nursing have used the concept to trace the events of the last two centuries, most often as a noble struggle, of middle class origins, for power and recognition from economic oppressors, as a fight against male/medical domination, or as a process of maturation.58 Recently, some have questioned this positive casting of events, and academic nurses now question whether or not professionalization has been a positive development for this "caring" occupation.59

Nursing as a profession has experienced problems of definition and identity, especially associated with its difficulty to establish definite boundaries. Historically, nurses have often accepted the "discarded" responsibilities of physicians, and have

57 Davies, "Professionalizing Strategies," pp. 47-63.

58 See for example, D. Coburn, "The development of Canadian nursing: professionalization and proletarianization," International Journal of Health Services, 18(3): 437-56, 1988; S. Nelson, "Reading nursing history," Nursing Inquiry, 4(4): 229-36, December 1997; M.O. Mosley, "Beginning at the beginning: a history of the professionalization of Black nurses in America, 1908-1951," Journal of Cultural Diversity, 2(4): 101-9, Fall 1995.

59 See for example, P.A. Parkin, "Nursing the future: a re-examination of the professionalization thesis in the light of some recent developments, " Journal of Advanced Nursing, 21(3): 561-7, March 1995; G.E. Tibbits, "The professionalization of nursing - an outdated goal," Australian Nurses Journal, 2(37): 2, 18, August 1974; J Salvage, "Professionalization-or struggle for survival? A consideration of current proposals for the reform of nursing in the United Kingdom," Journal of Advanced Nursing, 13(4): 515-9, July 1988; M.L. Campbell, "Nurses' professionalism in Canada: a labor process analysis," International Journal of Health Services, 22(4): 751-65, 1992; S. Porter, "The poverty of professionalization: a critical analysis of strategies for the occupational advancement of nursing,"Journal of Advanced Nursing, 17(6): 720-6, June 1992; S. Kermode, "The organization: a problem for the professionalization of nursing," Contemporaiy Nurse, 3(3): 110-7, September 1994, and "The power to be different: is professionalization the answer?," Contemporaiy Nurse, 2(3): 102-9, December 1993.

23 passed their own nursing responsibilities on to nursing assistants.60 The nursing profession sets its boundaries according to those set by the medical profession. Canadian historians have also found that technological developments in medicine affect the professional responsibilities of nurses as well as the relationship between physicians and nurses. As medicine became more complicated nurses inherited certain duties, such as taking blood pressure, previously performed by physicians only, and "what has evolved is a nursing practise that derives its professional identity almost entirely from controlling medical acts."61 Thus, nursing, like other professions dominated by women, is a reactive force and the boundaries that establish what nursing is are fluid. The fluidity of nursing's boundaries is an important theme in Kathryn McPherson's book, Bedside Matters: The

Transformation of Canadian Nursing, 1900-1990. McPherson examines five generations of nurses in Canada, beginning with the pioneer nurses of the late nineteenth century and concluding with the emergence of the politically aware nurse - the militant unionist. Each generation faced challenges associated with a gendered-construction of nursing unique to their period, and each generation had difficulties establishing the boundaries of their profession.62

While the debates surrounding professionalism and issues of professional boundaries continue to be explored, historians have also developed other avenues of interpreting nursing's past. Inspired by the advent of social history in the 1970s and

60 Janet Muff, "Of Images and Ideals: A Look at Socialization and Sexism in Nursing," in Images of Nurses: Perspectives from Histoiy, Art, and Literature, Anne Hudson Jones, ed., (Philadelphia: University of Pennsylvania Press, 1988), p. 202.

61 Sarah Jane Growe, Who Cares? The Crisis in Canadian Nursing, (Toronto: McClelland & Stewart, 1991), p. 103.

6: See McPherson, Bedside Matters.

24 1980s, scholars began to explore nursing history in terms of the analytical categories of class, race and gender. American historians have been particularly keen in addressing class in the history of nursing - defined by McPherson as constituting the

"proletarianization paradigm" of the historiography.63 In "The Physician's Hand": Work

Culture and Conflict in American Nursing, Barbara Melosh argues that there was a significant division within the nursing ranks between the vocal nursing "elite," who sought professional standards and public recognition, and those rank-and-file nurses whose positions were threatened by the proposals of those leaders. While the nursing elite focused on positioning the profession of nursing within the larger medical structure, they were not representative of all practicing nurses. Melosh points out that our interpretations of nursing history thus far have been shaped by the language and ideals of these select few.64 Conflict within the nursing profession resulted from the clash between the professional ideology of nursing leaders and the apprenticeship culture of rank-and-file nurses. Melosh concluded that the combined experience of professional ideology and apprenticeship culture allowed nurses to establish themselves as a "labor aristocracy among women" in the male public world of work. The theme of class conflict between nursing leadership and rank-and-file nurses is also developed by Susan Reverby in her acclaimed work, Ordered to Care: The Dilemma of American Nursing, 1850-1945, which examines national nursing reforms by focusing on trends in Massachusetts's hospitals.

61 McPherson, Bedside Matters, 8.

64 Melosh, "The Physician's Hand, " pp. 4-7.

25 Reverby argues that divisions within nursing were caused by the original gendered relation of "nursing" to "caring."65

While the nursing profession was often divided by class, Susan Rimby Leighow points out that it was also divided by generation. Leighow provides a feminist interpretation of the professionalization of nursing and the increasing importance of college education for nurses through the twentieth century in her book, Nurses' Questions

/ Women's Questions: The Impact of the Demographic Revolution and Feminism on

United States Working Women, 1946-1986. Leighow focuses her study on the evolution of nursing in the context of postwar demographic, economic, and social change. College education was central to nurses' changing beliefs in women's roles and nursing's place within the health care system - "[c]ollege attendance fostered a new career commitment among both graduate and beginning nursing students. College made R.N.s aware of nursing's second class status, contributed to their dissatisfaction, and gave them the tools to challenge their oppressors."66 College-educated and middle-class nurses also identified with the postwar women's movement and employed rhetoric and feminist tactics to

65 In a more recent article, '"Neither for the Drawing Room nor for the Kitchen': Private Duty Nursing in Boston, 1873-1920," Reverby explores private duty nursing in the United States, which was both included in, and isolated from, formal health care provision. The graduate nurses in private duty performed a range of functions from domestic to skilled nursing care and while it was isolated work and the private duty nurse was removed from the hospital and medical hierarchy, she was still dependent on the physician whose patient she cared for. Reverby argues that the role of the private duty nurse was complicated by several interconnected factors that affected her work, such as "...the pressure to prove the trained nurse; the ambiguity of her place in the household structure; the difficulty of the work; and the overcrowding in the field." Private duty nurses were limited in the control they could exercise over their profession because the nature of the work, the competition for cases, and the divisions within the nursing ranks discouraged collective action. Private duty nursing increasingly became "a nursing backwater" dominated by older graduates and non-trained nurses. See Susan Reverby, "'Neither for the Drawing Room nor for the Kitchen': Private Duty Nursing in Boston, 1873-1920," in Women and Health in America, Judith Walzer Leavitt, ed., (Madison: University of Wisconsin Press, 1999), p. 462.

66 Susan Rimby Leighow, \urses' Questions Women's Questions: The Impact of the Demographic Revolution and Feminism on United States Working Women. 1946-1986, (New York: Peter Lang Publishers, 1996), p. 45.

26 address work-related problems. They engaged in consciousness-raising and allied themselves with similarly-minded women's groups, connecting nursing with larger questions of female inequality and sexual discrimination. However, nurses were not a united group in terms of feminist ideas and expectations and became divided over the women's movement. The "traditionalist" nurses, those born before the Second World

War who were educated in hospital apprenticeship programs rather than college, identified with traditional gender roles and found feminism to be threatening and distasteful. In the postwar period, a large portion of nurses rejected feminism and refused to ally with the women's movement.67

Leighow also provides the most comprehensive examination of nurses and marriage in the postwar period. She discusses the transformation of the American nursing labour force as married women and mothers increasingly entered (or re-entered) the workforce. The expansion of the American health care system after the Second World

War led to a severe nursing shortage and employers turned to the pool of inactive nurses, those who had previously left their careers upon marriage, to deal with the shortage. By introducing part-time scheduling, refresher courses, child care facilities and better economic rewards, nursing employers accommodated to the needs of postwar RNs and presented them with the opportunity to balance their nursing careers with family.

67 During the 1960s, these women lobbied for the Equal Pay Act, while the younger feminists challenged the patriarchal family. Feminists and traditionalists represented opposite poles of thought - [f]rom the traditionalists' perspective feminism undermined the roles of wife, mother and caregiver. It both devalued their lifestyles and encouraged women to be selfish. Traditionalists saw no need for a women's movement because they wholeheartedly supported more conventional and conservative notions about gender." Leighow, p. 172. For a study of unionization among nurses in Canada, see Janet C. Ross-Kerr, "Emergence of Nursing Unions as a Social Force in Canada," in J.C. Ross-Kerr and Marilynn J. Woods, eds., Canadian Nursing: Issues and Perspectives, 4th ed. (Toronto: Mosby, 2003); and Linda Kealey, "No More 'Yes Girls': Labour Activism among New Brunswick Nurses, 1964-1981Acadi ens is XXXVII, no. 2 (Summer/Autumn 2008): 3-17.

27 However, Leighow emphasizes that changes in employer attitudes to hiring married nurses and the accommodations they introduced recognized rather than challenged the traditional beliefs of a wife and mother's family role. Health care agencies, professional associations and American society in general viewed married nurses as marginal workers supplementing the family income.68 Other historiography related to nursing and marriage is thin, which is surprising since the acceptance of married women into nursing careers was an important development of the postwar health care systems of Western societies.69

Unlike the history of nursing and marriage in the twentieth century, the history of nursing in rural and/or Aboriginal communities is receiving a significant amount of academic attention. In the American context, Emily Abel examines the provision of nursing care to native people in the United States in two recently published articles. Abel discusses the perspective of the field and hospital nurses in '"We Are Left So Much

Alone to Work out Our Own Problems': Nurses on American Indian Reservations during the 1930s." The nurses were unable to impose White medicine on the Sioux people because they lacked adequate resources and support. Some nurses were reluctant to be assertive with the Sioux because they were "[s]urrounded by a variety of both formal and

68 Susan Rimby Leighow, Nurses' Questions / Women's Questions: The Impact of the Demographic Revolution and Feminism on United States Working Women, 1946-1988. (New York: Peter Lang, 1996), p. 44.

69 Kathryn McPherson provides a solid analytical introduction to nurses and marriage in Bedside Matters: The Transformation of Canadian Nursing, 1900-1990. McPherson explains how nursing in Canada was "transformed from an occupation that proscribed against linking matrimony with work into a job that could easily accommodate large numbers of married women." McPherson, Bedside Matters, p. 218. In post-war Canada, hospitals and nursing leaders recognized the need to dramatically increase the nursing workforce. In order to encourage married nurses to re-enter and workforce, hospitals created the category of the part- time nurse and no longer required nurses to live in residence, the Canadian Nurses Association publicly criticized employers who discriminated against married nurses, and nursing leaders reconstructed nursing's image to emphasize its heterosexual nature and its appropriateness as a career for married women. As a result of these efforts, by 1961, 53% of active female nurses in Canada were married, widowed or divorced. Dominion Bureau of Statistics, Census of Canada 1961. quoted in McPherson, Bedside Matters, p. 214.

28 informal Indian practitioners, unsure of their own skills, and working in unfamiliar environments.. .."70 The nurses providing health care to the Sioux adapted their agendas, dispensed medicine, drove clients to hospitals, administered bedside care, allowed relatives to stay with patients, and accommodated traditional healers and old forms. They adjusted and negotiated their relationship with the Sioux.71

Laurie Meijer Drees and Lesley McBain provide an overview of outpost nursing in Aboriginal communities in Canada in their article, "Nursing and Native Peoples in

Northern Saskatchewan: 1930s-1950s." Drees and McBain argue that nurses on the stations would treat patients in need, whether or not they were Status Indian under the federal Department of Indian Affairs. This policy of health care "sharing" between the federal and provincial governments often created problems for the nurse who was unsure where treatment responsibilities lay and who was reimbursing the station for drugs and treatments. In addition to standard health care provision, the outpost nurse in northern

Saskatchewan engaged in public health education and nutrition counseling, and they attempted to instill conformity and discipline in their patients. Drees and McBain conclude that "[i]n Saskatchewan's north, health care was about more than individual

70 Emily K. Abel, '"We Are Left So Much Alone to Work Out Our Own Problems': Nurses on American Indian Reservations During the 1930s," Nursing History Review 4 (19%), p. 50.

71 While most studies focus on the perspective of the nurses in providing health care under challenging circumstances, Abel also explores the perspective of Aboriginal populations in receiving western health care. In an article co-authored with Nancy Reifel, Abel points out that the field nurses of the Office of Indian Affairs had hoped to educate the Sioux people on principles of scientific medicine and instill in them Euro-American values and attitudes. Their growing faith in medicine fostered disdain for native healing practices, and "[a]rmed with scientific 'truths,' the nurses cavalierly dismissed American Indian health beliefs as arbitrary and bizarre." As the Sioux had selectively appropriated white practices in an effort to maintain their culture through the eighteenth- and nineteenth-centuries, they adopted a similar strategy in their dealings with the field nurses - they were critical of the nurses' authority, challenged many recommendations, rejected educational advice, and "subjected the nurses to Sioux criteria of proper conduct.... When the Sioux accepted the nurses' services, they did so on their own terms." Emily K. Abel and Nancy Reifel, "Interactions Between Public Health Nurses and Clients on American Indian Reservations During the 1930s," in Women and Health in America, p. 492, 502.

29 health—it also involved attempts by nurses to alter local social behaviours, and change life-style patterns, from eating to leisure activities."72

The outpost nurses in Saskatchewan were part of a colonialist imposition of white, middle-class values on Aboriginal populations in the forms of structured Western medicine. This theme is also explored by Kathryn McPherson, in "Nursing and

Colonization: The Work of Indian Health Service Nurses in Manitoba, 1945-1970."

McPherson examines nursing in rural Manitoba between 1945 and 1970 and argues that the restructuring of the Indian Health Services in 1945 brought increased resources for meeting the health needs of Aboriginal peoples but did not separate IHS from its earlier colonizing functions. The system "reinforced Aboriginal people's dependent and

'uncivilized' status" and "...nurses sometimes found their professional abilities and obligations undermined by the racism of Canadian society, by the imperatives of northern economic development, or by the colonialist policies themselves."73

Jayne Elliott examines the importance of the physical space of the Red Cross outposts in determining the experience of nursing in rural Ontario between 1922 and

1945. These outpost buildings served as both professional and private arenas for the outpost nurse. The boundaries that distinguished the institutional and domestic spaces of the nursing stations were blurred, and Elliott outlines the "constant tension" between

72 According to the health care policies of the Departments of Indian Affairs and National Health and Welfare, the federal government accepted some temporary responsibility for the treatment of Status Indian patients but not for Aboriginal patients more generally. However, federal support for Status Indian health care was not clearly defined and Indian Health Services was anxious to devolve responsibility onto the provincial government. Laurie Meijer Drees and Lesley McBain, "Nursing and Native Peoples in Northern Saskatchewan: I930s-I950s," Canadian Bulletin of Medical History, vol. 18 (2001), 62.

73 Kathryn McPherson, "Nursing and Colonization: The Work of Indian Health Service Nurses in Manitoba, 1945-1970," Women Health and Nation: Canada and the United States since 1945, Georgina Feldberg, Molly Ladd-Taylor, Alison Li and Kathryn McPherson eds., (Montreal & Kingston: MQUP, 2003), 240.

30 these two areas - "[pjatients, physicians, visitors, local hospital committees and the nurses themselves had often competing claims on these different spaces..." 74 and public aspects of the nursing station often took precedence. Elliott also argues that the blurred boundaries of the nursing station also exposed the ambivalence of the nurses' status within rural communities - "[o]n the one hand, their professional training and the responsibility that they undertook as often the only medical people in their districts accorded them substantial authority and esteem;" on the other hand, they were

"...subjected to community surveillance and moral regulation."7S "

Nursing has featured twice as special issues of the Canadian Bulletin of Medical

History, first in 1994 and then again in 2004. In 1994, historians in Canada had begun to explore nursing from the perspectives of women's history, labour history, religious history, and the history of education; and the field's relationship to medical history was called into question. However, nursing history was still dominated by debates over professional ization, the category of "nurse" and the boundaries of nursing, the tensions between nursing as an art versus a science, and the influence of international linkages on

Canadian nursing leaders.76 By 2004, historians had become more interested in "re- conceptualizing and deconstructing nurses and nursing practice."77 Some contributions take more theoretical approaches to nursing history, such as James Wishart's study of

74 Jayne Elliott, "Blurring the Boundaries of Space: Shaping Nursing Lives at the Red Cross Outposts in Ontario, 1922-1945," CBMH 2004 21(2): 317.

75 Elliott, "Blurring the Boundaries," p. 318.

76 Kathryn McPherson and Meryn Stuart, "Writing Nursing History in Canada: Issues and Approaches," Canadian Bulletin of Medical History, 11 (1994): 3-22.

77 Cynthia Toman and Meryn Stuart, "Emerging Scholarship in Nursing History," Canadian Bulletin of Medical History. 21.2 (2004): 224.

31 nurses in training at the Kingston General Hospital Training School for Nurses. Wishart argues that the student nurses developed a "culture of mutuality" in reaction to the discipline imposed upon them by hospital administrators and were able to "subvert and/or ameliorate the effects of disciplinary technologies and to re-appropriate the spaces and discourses of nursing training."78 The themes of fluid boundaries and the changing definition of "nurse" are again present in the issue, although Judith Young's approach focuses on nursing as viable employment for working-class women,79 and Chris Dooley's approach focuses on psychiatric nursing in Manitoba during the Great Depression.

Dooley argues that psychiatric nurses were able to construct "mental nursing as a skilled craft based on proprietary knowledge, different from the work of both the general hospital nurse and the untrained ward attendant."80 The 2004 issue includes two articles

8 ] on psychiatric nursing in Canada, which is a growing area of historical inquiry.

Despite the recent interest in the history of psychiatric nursing, it is curiously absent from two recent collections on Canadian nursing history - On All Frontiers: Four

Centuries of Canadian Nursing (2005) and Place and Practice in Canadian Nursing

History (2008). Also absent from these collections is the histoid of Canadian-trained

78 James M. Wishart, '"We Have Worked while We Played and Played while We Worked': Discipline and Disobedience at the Kingston General Hospital Training School for Nurses, 1923-1939," Canadian Bulletin of Medical History, 21.2 (2004): 327.

7q Judith Young, "'Monthly' Nurses, 'Sick' Nurses, and Midwives in 19lh-Century Toronto, 1830-1891," Canadian Bulletin of Medical History, 21.2 (2004): 281-302.

80 Chris Dooley, '"They Gave Their Care, but We Gave Living Care': Defining and Defending Boundaries of Skill and Craft in the Nursing Service of a Manitoba Mental Hospital during the Great Depression," Canadian Bulletin of Medical History, 21.2 (2004): 229.

81 The other article was Very! Margaret Tipliski, "Parting at the Crossroads: The Emergence of Education for Psychiatric Nursing in Three Canadian Provinces, 1909-1955," Canadian Bulletin of Medical History, 21.2 (2004): 253-80. See also, Geertje Boshma, "A Family Point of View: Negotiating Asylum Care in Alberta, 1905-1930," Canadian Bulletin of Medical History 25.2 (2008): 367-389.

32 nurses who worked in international contexts, particularly in the mission field.82 On All

Frontiers is the third stage of a partnership between the Canadian Nurses Association, the

Canadian Museum of Civilization, the Canadian War Museum, and Library and Archives

Canada to make nursing history accessible to "a broad audience of interested

Canadians."83 Since it is based on this partnership and the editors had access to national

museum collections, the book contains numerous historical photographs, but most images

are not interpreted in a critical manner. On All Frontiers includes contributions by nurses,

nurse-historians, historians, and sociologists in a celebration of nurses as "pioneers,

educators, and leaders," and "innovators in the field of health care."84 This raison d'etre

does not preclude the presence of critical analyses in the topics covered; indeed, the

authors are experts in their fields and are well-versed in the historiography. However,

rather than delve into new ideas and new debates, the book presents a snapshot of the

current state of the historiography in Canada. And as such, it is a valuable synthesis of the

history which can encourage academics to think more critically about the history and

pursue further areas of research.

Place and Practice in Canadian Nursing Histoiy complements On All Frontiers

by presenting a collection of articles that expand on some of the themes presented in the

earlier text. The collection claims to "disrupt and decentre assumptions about the

relationship of nurses to hospitals and to the medical profession" by focusing on nursing

s2 Sonya Grypma, in particular, has been conducting research in this area. See Sonya Grypma, Healing Henan: Canadian Nurses at the North China Mission, 1888-1947, (Vancouver: University of British Columbia Press), 2008.

83 Christina Bates, Dianne Dodd and Nicole Rousseau, "Introduction," On All Frontiers: Four Centuries of Canadian Nursing, edited by Christina Bates, Dianne Dodd, and Nicole Rousseau, (Ottawa: University of Ottawa Press, 2005), p. 1.

84 Lucille Auffrey, "Forward," [.s/c] in On All Frontiers, p. v.

33 practice outside the hospital setting.85 Canadian nurses and Canadian nursing are

"broadly defined" and includes Canadian-born and trained nurses working outside

Canada - in Europe during the First World War - as well as foreign-born and trained nurses working inside (the political borders of) Canada. Although the editors allege that

"the idea of'place' provides an important heuristic device in organizing and situating the articles in this collection,"86 the articles themselves do not delve into the large literature on "place" but rather highlight (mostly) "identity," "context" and "nation-building."87

However, Place and Practice is a valuable contribution to the field of nursing history in

Canada and underscores the need for more research that engages with larger theoretical debates in academia.

85 Jayne Elliott, Meryn Stuart, and Cynthia Toman (eds.), Place and Practice in Canadian Nursing History (Vancouver: UBC Press, 2008), p. 2. Despite its claim to "decentre the strong connection between nursing and hospital work," two of the nine articles discuss nurses' experiences at military hospitals during the First World War, which were still highly disciplined, hierarchical, and masculine medical institutions, albeit located in unusual circumstances. See Cynthia Toman, "A Loyal Body of Empire Citizens": Military Nurses and Identity at Lemnos and Salonika, 1915-17," Meryn Stuart, "Social Sisters: A Feminist Analysis of the Discourses of Canadian Military Nurse Helen Fowlds, 1915-18," in Place and Practice.

86 Elliott et. al., Place and Practice, p. 3.

87 Much of the work on "place" has been conducted by feminist geographers, such as Doreen Massey, who considers place as a socio-cultural phenomenon, as "...particular moments in [...] intersecting social relations, nets of which have over time been constructed, laid down, interacted with one another, decayed and renewed. Some of these relations will be, as it were, contained within the place; others will stretch beyond it, tying any particular locality into wider relations and processes in which other places are implicated too." See Doreen Massey, "Spaces of Politics," Human Geography Today, edited by D. Massey, J. Allen and P. Sarre, (Cambridge: Polity Press, 1999): 279-94. See also "Places and their Pasts," History Workshop Journal 39 (April 1995): 182-192; and Linda McDowell, Gender, Identity and Place: Understanding Feminist Geographies, (Cambridge: Polity Press, 1999).

34 NURSING WITH THE GRENFELL MISSION

Nursing with the Grenfell Mission in northern Newfoundland and Labrador was a formative experience for women through the twentieth century. The 498 Grenfell nurses who came through the Grenfell Association of Great Britain and Ireland and those

American and Canadian nurses represented in the publications and interviews came from a variety of socio-economic backgrounds. Many were working-class women from various parts of the world who were expected to maintain positions of leadership on the Coast appropriate to the middle-class mores of the Grenfell institution. The Mission defined class according to the late nineteenth century bourgeois standards in which trained nursing developed and in which the organization itself was created. As graduates of nurse training programs, the Mission considered nurses to have attained a bourgeois character despite their personal backgrounds; and this bourgeois character could be employed on the Coast to propagate middle-class standards among the neglected people of northern

Newfoundland and Labrador. In short, regardless of the nurse's socio-economic background, her graduation from a nurse training program imbued her with an acceptable middle-class "character."88 In the hospitals and large medical centres of Britain, Canada and the United States, this bourgeois character was essential for adequately nursing the middle-class patients who paid for the health care they received and whose presence was valued by hospital boards for increasing the social status of the institutions. A bourgeois character was also considered essential to the moral uplift of the Anglo-Saxon stock of northern Newfoundland and Labrador.

88 For a discussion of the bourgeois "character" that rural and working-class nurses acquired through training, see McPherson, Bedside Matters, p. 34.

35 Nursing with the Mission provided a range of other challenges that nurses in the standard hospital environment did not have to contend with, namely: the isolation, the rural character of the district and the people, the hazardous travel and the level of independence. With this in mind, the Mission found value in all classes of women and those British working-class women who applied for service were often considered

"sensible" and "adaptable,"89 especially if they came from a fanning family. One candidate was described by her reference as "a homely person who understands and is understood by homely people" and concluded that "she would probably fit extremely well into an isolated community of fishermen and farmers."90 The Grenfell Mission expected nurses to be strong, independent women capable of handling difficult health care situations in unusual circumstances. At the same time, the Mission also expected nurses to be maternalist, accommodating, and submissive towards physicians in the performance of their duties. Grenfell nurses, especially those on the isolated stations, had to maintain a fine balance between meeting the health care needs of the people and deferring to physician authority whenever appropriate. This dissertation explores that history and the variables of work and life with the Grenfell Mission that shaped the nurses* values and opinions about themselves and the balance between the Grenfell ideal and the reality of the Coast.

Chapter 2 provides a general history of the Grenfell Mission prior to, and through the duration of, the period under examination. While the Mission had its roots in philanthropic Christianity, it became increasingly secularized through the twentieth

89 PANL, MG 63, Box 32, File 656, Note by Seabrook, 23 July 1963.

90 PANL, MG 63, Box 37, File 799, M.A. Bach to Seabrook, 12 April 1957.

36 century. The Second World War opened new employment opportunities for many local people: the construction of new Canadian and American military bases and radar installations required local labourers, and their maintenance required civilian personnel.

However, Newfoundland and Labrador's confederation with Canada in 1949 marked a watershed for the Coast and the Grenfell Mission. Federal and provincial funding was readily available throughout the 1950s to help finance the operation of the Mission, to construct new facilities, and to support Newfoundland men and women in pursuing medical and nursing education. The financial assistance provided by the various Grenfell associations gradually diminished, and in 1981 the Mission became a government health care institution, the Grenfell Regional Health Services.

Chapter 3 explores the official discourse of the Grenfell Mission which was propagated through the quarterly publication of Among the Deep Sea Fishers (hereafter

Fishers). The purpose of Fishers was to present the Grenfell Mission "truth" to its middle-class audience in order to maintain social and financial support for the Mission on a large scale. The Mission used the Fishers to justify its existence and continued presence in northern Newfoundland and Labrador, especially in light of the political, social and economic changes occurring on the Coast through the twentieth century. In each decade of the quarterly, the overarching message was that there was a great need for health and social services on the Coast and that the Grenfell Mission was well-qualified and well- positioned to provide these services.

Chapter 4 profiles the Grenfell nurses themselves, who they were, where they came from, and what their motivations were for joining the Mission. The Grenfell nurses were overwhelmingly single young women freed from immediate parental involvement

37 in their affairs. While the administration took efforts to assure the nurses' parents that the

Mission was a respectable institution which would safeguard their daughters' best interests, in reality it was often difficult to restrict the nurses' social activities or prevent them from forming relationships with other Mission personnel or with local individuals.

When relationships reached the point of marriage, the Grenfell administration reacted with disapproval, ambivalence, or enthusiasm depending on the socio-economic status of the husband in question, a response which demonstrated a class bias in evaluating the nurses and their success in marriage.

Chapter 5 details the range of nursing and non-nursing duties that nurses with the

Grenfell Mission performed on the Coast. Nurses performed standard nursing duties, midwifery/obstetrics, public health, dentistry, domestic chores, administration, and supplementary duties. However, their responsibilities were not uniform over the period or across the stations and hospitals. A nurse's professional experiences and level of responsibility depended on the characteristics of the building in which she worked and the size and constitution of the staff with whom she worked. Nursing with the Grenfell

Mission did represent an "exceptional female work experience," to quote Jill Perry;91 but it was an experience that was limited by established gendered parameters appropriate to the dictates of the paternalistic medical hierarchy of the Mission.

Finally, Chapter 6 balances some of the "truth" of the Grenfell Mission with the realities of nursing on the Coast through the twentieth century. With the Grenfell

Mission, the nurse was in a professional position of a contradictory nature. On the one hand, the Grenfell Mission sought women who would prove themselves capable of

91 Perry, "Nursing for the Grenfell Mission," p. 61.

38 handling emergencies in remote and isolated communities - which would include qualities of strength, judgment, adaptability and independence. On the other hand, the

Mission was concerned with its public image and worked to reassure its middle-class benefactors that neither the Mission's moral respectability (especially as represented by the nurses) nor its masculine male hierarchy was threatened by the independence of the nurses. The official Grenfell discourse portrayed the nurses as maternalist, accommodating, obedient and submissive, but the archival material illuminates episodes in which the Grenfell nurses navigated their positions and balanced their professional activities between what was appropriate and what was necessary.

39 CHAPTER TWO

History of the Grenfell Mission, 1892-1981

In 1892, Wilfred Thomason Grenfell traveled to the Coast with the Mission to

Deep Sea Fishers to provide medical care to fishermen and their families - people who were considered disadvantaged because they were geographically isolated, lived subsistence livelihoods, and lacked access to the social and medical infrastructure of urban centres. For the young medical graduate, the conditions he witnessed in Labrador provided him with the opportunity to combine "the aspirations of a young medical man.. .with.. .a desire for adventure and definite Christian work."' In fact, some of his first experiences on the Coast remained with him throughout his entire life and influenced

"all [his] subsequent actions."2 In his autobiography of 1920 he described one of his first experiences in a Labrador home in 1892:

.. .he led me to a tiny, sod-covered hovel, compared with which the Irish cabins were palaces. It had one window of odd fragments of glass. The floor was of pebbles from the beach; the earth walls were damp and chilly. There were half a dozen rude wooden bunks built in tiers around the single room, and a group of some six neglected children, frightened by our arrival, were huddled together in one corner. A very sick man was coughing his soul out in the darkness of a lower bunk, while a pitiable covered woman gave him cold water to sip out of a spoon. There was no furniture except a small stove with an iron pipe leading through a hole in the roof. My heart sank as I thought of the little I could do for the sufferer in such surroundings.3

1 Wilfred Grenfell, The Grenfell Association for Aiding Philanthropic Work, ([Ottawa: Grenfell Association of Ottawa], 1907), p. 3.

2 Wilfred Grenfell, The Stoiy of a Labrador Doctor, Abridged, (London: Hodder & Stoughton, [1920]), p. 52.

1 Grenfell, Labrador Doctor, p. 52.

40 Grenfell spent three months travelling the Coast and provided medical treatment to 900 people. The population on the Coast at that time consisted of approximately 30,000 stationers (people from the island part of Newfoundland who sailed to Labrador each summer to partake in the fishery), 3300 "livyers" (permanent settlers, including Anglo-

Saxon and Metis) and 1700 lnnu and lnuit. These people received only one visit from a government doctor each year.4 Grenfell was so affected by the poverty and hardship he witnessed on the Coast that he petitioned the Mission to Deep Sea Fishermen to support a medical missionary project in Labrador. Coastal Labrador was one of the most impoverished areas of the colony (and, after 1949, province) of Newfoundland through this period.5

4 R.J. Freebairn, "Presidential Address," Bulletin of the Newfoundland Medical Association, Annual Convention,(1931): 11-19.

5 Newfoundland's political status shifted several times through the twentieth century. However, during the time period of this dissertation, Newfoundland was a self-governing colony with a suspended legislature (1934-1949) and then a province of Canada (1949-1981). Therefore, I refer to Newfoundland before Confederation as a colony, and after Confederation as a province.

Newfoundland held responsible government from 1855 to 1933, when its legislature was temporarily suspended. Although the colony was included in the Statute of Westminster 1931, Newfoundland chose not to adopt the Statute. As a result, Newfoundland maintained its self-governing status but it was not a formal dominion, did not have a Governor General (but maintained a resident colonial Governor instead), and did not have control over its foreign affairs.

In 1933, Newfoundland appointed a Royal Commission "to examine into the future of Newfoundland, and in particular, to report on the financial situation and prospects therein." The Royal Commission, chaired by Lord Baron Amulree, recommended the temporary suspension of responsible government and tighter British controls over Newfoundland through the establishment of a Commission of Government. The Commission of Government would consist of six commissioners (three from Britain and three from Newfoundland) and would be led by a (British) Governor answerable to the Secretary of State for Dominion Affairs in London. The idea behind the Commission of Government was to give Newfoundland a "rest from politics."

Most historians agree that the Amulree Report's analysis and its conclusions about the financial crisis in Newfoundland were both flawed. The Report's criticisms of Newfoundland politicians and of the political system were unfair and exaggerated. In particular, the Report did not give enough credit to the impact of the First World War and the Great Depression on Newfoundland's financial situation. In addition, Britain's refusal to consider Newfoundland's default as a serious option was short-sighted. In the end, Britain did choose default for Newfoundland's debt. But that default was disguised in the suspension of responsible

41 Grenfell returned to Labrador in 1893 and opened the first of many Mission buildings along the Coast - the hospital in Battle Harbour - and marked the beginning of a long history of health care services in the area. Compounding the challenges created by geographic isolation was the very nature and structure of life in these areas of

Newfoundland and Labrador. The land was not conducive to agriculture, the climate was harsh, communities were isolated, and the northern coves and bays were blocked by ice through the winter and spring. Fishing was the primary industry in these outport settlements, and the household was the basic unit of production - all family members shared responsibilities with regard to producing salt fish and other goods to support the household economy.6 The fishing industry itself operated through a truck system: an arrangement in which merchants supplied local fish producers with goods and supplies on credit and then tabulated the cost of those supplies after setting the value of the fish.

Through this arrangement, the merchants could usually guarantee their own profit.

Historians have traditionally interpreted the truck system as exploitative towards the fishing population and detrimental to the local accumulation of capital and to the development and diversification of the economy. There was little exchange of currency, and fishing families often functioned at subsistence levels, vulnerable to merchant

government. See Government of Great Britain, "Newfoundland Royal Commission 1933, Report: Presented by the Secretary of State for Dominion Affairs to Parliament by command of His Majesty, November, 1933," (London, 1933), p.l. For a political history of Newfoundland and Labrador, see S.J.R. Noel, Politics in Newfoundland, (Toronto: University of Toronto Press, 1971); Peter Neary, Newfoundland in the North Atlantic World, 1929-1949, (Montreal: McGill-Queen's University Press, 1980); James K. Hiller, Confederation: Deciding Newfoundland's Future, 1934 to 1949, (St. John's: Newfoundland Historical Society, 1998), and "Newfoundland Confronts Canada, 1867-1949," in The Atlantic Provinces in Confederation, E.R. Forbes and D.A. Muise, eds., (Fredericton: Acadiensis Press, 1997).

6 Patricia Thornton, "The Transition from the Migratory to the Resident Fishery in the Strait of Belle Isle," in Rosemary E. Ommer, Merchant Credit and Labour Strategies in Historical Perspective, (Fredericton: Acadiensis Press, 1990), pp. 138-166.

42 prerogative. As a result, there was no accumulation of wealth among most fishing families and very limited resources for changing their socio-economic situation.7

While the truck system has traditionally been criticized for causing the impoverishment of the fishing population to the financial advantage of the merchants,

historians have recently reevaluated the system.8 Sean Cadigan argues that the truck system was a mutually-beneficial accommodation, that it "...was not something imposed

by the venality and avarice of merchants, but rather that it arose as a complex adaptation over time to mutual, if unequal, merchant-fishing-family dependence on salt-cod markets

in a region with few other resources to encourage much production outside of the

fishery."9 Due to the almost exclusive economic dependence on a single, unprofitable,

and sometimes unstable, resource sector which was highly susceptible to shifts in global

markets, the development of industrial-capitalist production in Newfoundland and

Labrador before the Second World War was limited. Fishing families usually focused

their energies on fish production supplemented by household garden cultivation - a

combination of subsistence and domestic commodity production, which "continued to be

7 See, for example, Gerald M. Sider, Culture and class in anthropology and history: a Newfoundland illustration, (Cambridge: Cambridge University Press, 1986), and Noel, Politics in Newfoundland, pp. 8-9.

8 The credit provided by merchants provided security against disruptions in the market, while merchants could offset losses in the fish trade by manipulating the prices of their goods. Sean Cadigan, "Truck, Paternalism and Ecology: The Struggle between Fishers and Merchants in the 19th and early 20th Centuries," in Garfield Fizzard, ed„ Amulree's Legacy: Truth, Lies and Consequences, (St. John's: Newfoundland Historical Society, 2001), pp. 30-37. See also Rosemary E. Ommer, "Introduction," in Ommer, ed., Merchant Credit and Labour Strategies in Historical Perspective, (Fredericton: Acadiensis Press, 1990); and Lawrence F. Felt and Peter Sinclair, "Introduction," in Living on the Edge: The Great Northern Peninsula of Newfoundland, Lawrence F. Felt and Peter R. Sinclair, eds., (St. John's: Institute of Social and Economic Research, 1995.

9 Sean Cadigan, Hope and Deception in Conception Bay: Merchant-Settler Relations in Newfoundland, 1785-1855, (Toronto: University of Toronto Press, 1995), p. viii.

43 the unchallenged base of the rural economy until about 1965."10 Nevertheless, the truck system was the foundation of an economy that maintained widespread poverty and a continual state of indebtedness in outport communities through the nineteenth and early twentieth centuries.

Within the Grenfell Mission, there were strong class-based assumptions of local inferiority underlying the institution and the services it provided. The people of northern

Newfoundland and Labrador were considered to be economically and socially disadvantaged according to British middle-class standards. The stationers were

Newfoundland fishermen and labourers, petty commodity producers. The livyers were

Metis, descended from Newfoundland fishermen and aboriginal women. While there were resident Innu and Inuit living in the territory as well, the Mission focused most of its efforts on the white Anglo-Saxon and Metis populations in southern Labrador, at least until it expanded its services throughout the north during the twentieth century. In its early days, the Grenfell Mission only occasionally came into contact with native peoples in throughout Labrador and Quebec." It is unique that the Mission focused so exclusively

10 Felt and Sinclair, "Introduction," p. 10.

" This is in contrast with many Canadian examples of outpost nursing in which health care establishments focused on white women nursing in Aboriginal communities. For example, in "Nursing and Native Peoples in Northern Saskatchewan: 1930s-1950s," by Laurie Meijer Drees and Lesley McBain, argue that federal support for Status Indian health care was not clearly defined and that a policy of health care "sharing" between the federal and provincial governments often created problems for the nurse, who was unsure where treatment responsibilities lay and who was reimbursing the station for drugs and treatments. In addition to standard health care provision, the outpost nurse in northern Saskatchewan engaged in public health education and nutrition counselling and attempted to instil conformity and discipline in their patients. The outpost nurses in Saskatchewan were part of a colonialist imposition of white, middle-class values on Aboriginal populations in the forms of structured Western medicine. See Laurie Meijer Drees and Lesley McBain, "Nursing and Native Peoples in Northern Saskatchewan: 1930s-1950s," Canadian Bulletin of Medical Hisloiy, vol. 18 (2001). Kathryn McPherson also explores the theme of colonizing functions in the provision of health care to Aboriginal communities in her article, "Nursing and Colonization: The Work of Indian Health Service Nurses in Manitoba, 1945-1970." McPherson found that the restructuring of the Indian Health Services in 1945 brought increased resources for meeting the health needs of Aboriginal peoples but did not separate IHS from its earlier colonizing functions. Nurses in rural

44 on the white population, and this is a theme that should be explored further in Grenfell historical research, which until recently has been primarily concerned with the history of

Grenfell himself.12 The Mission did not necessarily overlook the Aboriginal population; indeed, Grenfell took many opportunities to pose with Aboriginal children for publicity purposes. And the Mission became more concerned with health in Innu and Inuit communities through the mid-twentieth century. But the primary focus of their attention was the white population whom the Mission viewed as different, inferior, and requiring social and moral uplift.13 It displayed colonial attitudes of English cultural superiority based on class distinctions and a desire to "civilize" a socially deficient region. In her thesis, Jill Perry argues that Grenfell nurses were central to this reform agenda because they represented the female embodiment of the "superior" middle-class culture. Not only did they perform a myriad of essential medical and non-medical duties in isolated areas, but they also performed a range of social reform duties in an attempt to "civilize" local society. So, while nursing with the Grenfell Mission in Newfoundland and Labrador was

"an exceptional female work experience," it was rationalized by the institution according

areas of Manitoba sometimes found their professional obligations compromised by colonialist government policies. Kathryn McPherson, "Nursing and Colonization: The Work of Indian Health Service Nurses in Manitoba, 1945-1970," Women Health and Nation: Canada and the United States since 1945, Georgina Feldberg, Molly Ladd-Taylor, Alison Li and Kathryn McPherson eds., (Montreal & Kingston: MQUP, 2003).

See for example, Iona Bulgin, "Mapping the Self in the 'Utmost Purple Rim': Published Labrador Memoirs of Four Grenfell Nurses," PhD Dissertation, (Memorial University of Newfoundland, 2001), and Jill Samfya Perry, "Nursing for the Grenfell Mission: Maternalism and Moral Reform in Northern Newfoundland and Labrador, 1894-1938," MA Thesis, (Memorial University of Newfoundland, 1997).

13 Quoted in Perry, "Nursing for the Grenfell Mission," p. 18.

45 to a conservative gender ideology which emphasized the maternalist qualities that trained nurses could bring to the Coast.14

The Grenfell Mission recognized the necessity of bringing medical care to the people of northern Newfoundland and Labrador, but Grenfell and his successors considered it "impossible and impractical to have trained surgeons available on [the] coast."15 Therefore, they established nursing stations in the larger communities and hired nurses to provide health care services to the surrounding areas.16 The Mission relied heavily on nurses and recognized that "the main care and diagnosis of serious illness

[depended]...on the nurse in the outlying district in a small nursing station who [was] intimately connected with the people and [saw] a case early."17 This situation was not unique to the Grenfell Mission. Indeed, recent studies in Canadian nursing history have illuminated similar cases in other rural areas of the country where nurses performed medical duties due to the lack of a qualified physician.18 The reasons for the lack of physicians in areas of Newfoundland and Labrador were twofold: doctors did not want to practise in such remote areas, and the Mission could not justify increasing their expenses by stationing physicians in these regions, especially when there were so many trained

14 Perry, "Nursing for the Grenfell Mission," p. 61.

15 Charles S. Curtis, "Medical Work," in Among the Deep Sea Fishers, vol. 44, no. 3, October 1946, p. 81.

16 Similar circumstances inspired the creation of nursing stations throughout the Prairies and the Red Cross outposts throughout rural Ontario. See Jayne Elliott, "'Keep the Flag Flying': Medical Outposts and the Red Cross in Northern Ontario, 1922-1984," PhD Dissertation, Queen's University, 2004.

17 Curtis, "Medical Work," p. 81.

18 For example, Jayne Elliott discovered that nurses performed many nursing, medical and non-medical duties in her study of Red Cross outpost nurses in rural Ontario. See Jayne Elliott, "Blurring the Boundaries of Space: Shaping Nursing Lives at the Red Cross Outposts in Ontario, 1922-1945," CBMH 2004 21(2): 303-325.

46 nurses available. This is a major theme in the historiography of rural medicine, especially

in terms of the challenge that rural nursing presented to the traditional gendered division

of health care provision. Within the context of the Grenfell Mission, class and gender

intersected to create a situation in which nurses viewed themselves as socially superior to

the local petty commodity producing culture (their patients) but simultaneously

professionally secondary to male authority and the patriarchal institution.

With the exception of a brief period of booming employment during the Second

World War and post-war period, associated with the construction of military installations

in the area, the region and its people can be defined according to the dictates of a primary

resource-based economy:

Most Newfoundlanders live along the coast of their rocky, almost barren island, long known for its fishing grounds. Among the most isolated are the roughly 25,000 inhabitants of the Great Northern Peninsula, which ... suffers from a harsh climate, with long snowy winters and harbours closed by ice for months. The growing season is short and soils are poor. The region's forests have supported a timber industry, but the pulpwood was carried south to Corner Brook for processing in a pattern typical of underdeveloped regions.... Marine resources, especially cod and shrimp, are the main basis of the regional economy.19

In northern Newfoundland and Labrador, fishing was the only occupation and was

an unprofitable venture, not even as lucrative as those of the east and south coasts

of Newfoundland.20 The Commission of Government distributed relief to

19 Lawrence F. Felt and Peter R. Sinclair, "Introduction," Living on the Edge: The Great Northern Peninsula of Newfoundland, Lawrence F. Felt and Peter R. Sinclair, eds., (St. John's: Institute of Social arid Economic Research, 1995), p. 1.

20 The Labrador fishery began in the 1760s, by fishermen from the Conception Bay region of Newfoundland in search of less populated fishing grounds. Most of these planters initially participated in a "floater" fishery - they sailed to Labrador each summer, operated a fishery involving two-man dories launched from schooners, and returned to their homes in the fall. However, some families ("stationers") eventually established temporary residences on the shore for the summer, while others ("livyers" who were mostly Metis) established more permanent homes on the Coast. While the Labrador fishery did become important to the livelihoods of many Newfoundland families, it faced several challenges compared to the

47 individuals under a number of categories, including able-bodied relief ($4/month); casual sick, aged and infirm ($4.50/month); assistance to widows, orphans and infirm; old age pensions; child welfare; veterans' affairs; and labour affairs.21

Table 2.1 outlines the relief figures for Labrador, although Government data does not specify to which category of relief the recipients belonged. Note the sudden decline in persons on relief in 1942, when construction began on military installations, and the increase in 1946-47 after the Second World War.

TABLE 2.1: Relief for Labrador, 1936-47

Year Number of Persons Cost $ 1936-37 209 10,035.00 1937-38 152 7,318.00 1938-39 325 15,611.00 1939-40 509 24,466.00 1940-41 620 29,799.00 1941-42 675 32,521.00 1942-43 297 14,290.00 1943-44 174 8,373.00 1944-45 263 12,636.00 1945-46 373 17,938.00 1946-47 641 (5 months) 12,832.00

Source: Government of Newfoundland, "Report of the Committee on Public Health and Welfare," Public Welfare Section, (National Convention 1946-48), 1948.

There were also a number of individuals on relief in the Grenfell region of the

Northern Peninsula (the district of "White Bay") - in March 1946, there were 341 more southern fishing endeavours: it had a shorter fishing season, poorer curing conditions, and produced smaller fish. Merchants also bore the expense of supplying fish producers and their families with the necessities of life and with goods and services. See Cadigan, Hope and Deception, pp. 39, 43.

:i Government of Newfoundland, "Report of Committee on Public Health and Welfare," Public Welfare Section, (National Convention, 1946-1948), p. 1.

48 people receiving able-bodied relief and 291 receiving sick relief, for a total of 632 recipients." Generally speaking, residents had limited access to cash (except for temporary employment on American and Canadian military facilities), household amenities, or other modern conveniences and commodities. Table 2.2 demonstrates how the Northern Peninsula lagged behind Newfoundland as a whole (which lagged behind Canada as a whole) in terms of household amenities, even in the post-Confederation period.

TABLE 2.2: Household Amenities, Percentages

1951 1961 1971 1981 Northern Peninsula Stove Heating 99.2 80.1 77.4 31.3 Hot and Cold Water 5.4 10.9 33.5 Indoor Toilet and Bath 4.1 10.1 46.3 95.8 Freezer 3.1 34.4 Automobile 0 15.6 47.9

Newfoundland Stove Heating 91.2 73.9 48 20.1 Hot and Cold Water 17.5 38.3 62.7 Indoor Toilet and Bath 22.8 37.2 66.8 96 Freezer 4.6 28.9 Automobile 10.3 37.8 63

Canada Stove Heating 50.6 29.1 17.3 6.7 Hot and Cold Water 56.9 80.1 92.7 Indoor Toilet and Bath 64.1 77.1 91 98.6 Freezer 14.9 33.5 Automobile 42.3 68.4 77.7

Source; Census of Canada, 1951-1981.

22 Government of Newfoundland, "Report of Committee on Public Health and Welfare," Public Welfare Section, (National Convention, 1946-1948), p. 9.

49 The slow socio-economic development of the region had a long history, as it had "never been a centre of industry, commerce or technical innovation. It has always been isolated and economically marginal."23 In 1892, Grenfell recognized the challenges people faced in this region, and decided to devote his energies to helping improve the health care situation of northern Newfoundlanders and Labradorians.

Although the Grenfell Mission began in 1892 and the first hospital was built in

Battle Harbour in 1893, the organization remained a branch of the Mission to Deep Sea

Fishermen for over twenty years. Grenfell finally separated his enterprise from that organization in 1914, with the incorporation of the International Grenfell Association

(IGA) and the transfer of administrative authority to the new organization.24 The IGA hired staff and allocated funds, but depended on five independent organizations for financial support, including: the Newfoundland Grenfell Association in St. John's; the

Grenfell Association of America in New York; the New England Grenfell Association in

Boston; the Grenfell Labrador Medical Mission in Ottawa; and the Grenfell Association of Great Britain and Ireland in London. These organizations raised money by hosting lectures and other fund-raising events and by selling Christmas cards and goods from the

Industrial Department; they collected clothing and other necessities for the Coast; and they publicized and promoted the work of the Mission.25

Activities on the Coast were directed by the medical superintendent (see Table 2.3 below), the first of which was Grenfell himself (1914-37), followed by American

23 Felt and Sinclair, "Introduction," p. 7.

24 Theodore L. Badger, "A Brief History of the Board of Directors of the International Grenfell Association," Fishers 75.2 (1978): 1.

23 Rompkey, Grenfell of Labrador, p. 278.

50 physician Charles S. Curtis (1937-58), Canadian surgeon Gordon W. Thomas (1959-78), and Newfoundland physician Peter J. Roberts (1979-81), who guided the Mission through its transfer into a government health care institution in 1981.

TABLE 2.3: Medical Superintendents of the Grenfell Mission, 1892-1981

Medical Superintendents Years

Wilfred T. Grenfell [1892]-1914-37

Charles S. Curtis 1937-58

Gordon W. Thomas 1959-78

Peter J. Roberts 1979-81

Source: Rompkey, Grenfell of Labrador: A Biography, Fishers 57.1 (April 1959); Fishers 75.3 (October 1978); Fishers 76.2 (April 1979).

Under the guidance of these superintendents, the structure of the Mission steadily grew and adapted to the changing circumstances in northern Newfoundland and Labrador. By

1949 the establishment included four hospitals, five nursing stations, two hospital ships, a supply schooner, an orphanage and a school. [See Appendix A for details on the establishment of medical facilities by the Grenfell Mission from 1893 to 1975.] The hospitals contained up-to-date medical equipment and were considered the centres for medical knowledge on the Coast. Each was under the medical superintendence of a physician and operated in accordance with the standard medical hierarchy which was common in Western medical institutions. However, these four hospital centres could not adequately service the entire Coast of northern Newfoundland and Labrador. While the necessity of bringing medical care to the people was evident to Grenfell and his successors, they considered it "impossible and impractical to have trained surgeons

51 available on [the] coast."26 They found the solution in the establishment of nursing stations in the larger communities, and it was to these stations that many Grenfell nurses, especially British nurses with midwifery training, were posted.

PHILANTHROPIC ORIGINS AND SECULARIZATION

Grenfell began his medical career in Britain with the Mission to Deep Sea

Fishermen, a British evangelical organization that brought basic health care to fishermen stationed in the North Sea.27 In 1889, at the age of twenty-four, he became

Superintendent of the Mission to Deep Sea Fishermen with responsibility for control and maintenance of the mission's fleet. Although he maintained this position for several decades, Grenfell often came into conflict with the board of the Mission to Deep Sea

Fishermen, especially over his preference for the practical side of improving people's lives rather than the conventional approach of saving souls through preaching the Gospel and proselytization. Grenfell had been inspired by Christianity and it informed many of his decisions throughout his life, but his was a personal loyalty to Christ rather than a dogmatic endeavour. In her 1993 MA thesis, "Wilfred Grenfell and the Christ of

Culture," Barbara Robinson argues that Grenfell popularized a "culture-accommodating theological approach" to Christianity that "connected with the religious, or at least humanitarian aspirations of many, many people."28 Grenfell was influenced by liberalism

26 Charles S. Curtis, "Medical Work," in Among the Deep Sea Fishers, 44.3, October 1946, p. 81.

27 Neither Grenfell nor the Mission to Deep Sea Fishermen explained their meaning of the term "evangelical," and the Mission maintained a non-denominational character which, as Rompkey points out, seemed "a dangerously ambiguous theological position." See Rompkey, Grenfell of Labrador, p. 33.

28 Robinson also points out that the Grenfell Mission was "an anomaly in the story of Protestant endeavours in the north" - it did not suffer from the lack of personnel and funding that plagued other missionary societies, and it attracted "attracted scores of young, well-educated men and women who came prepared to

52 and by the protestant culture of the late nineteenth century, which "collaps[ed] theology into ethics."29 He focused on pragmatic activities that could be humanly accomplished in his personal aspiration to emulate Christ.

While religion was obviously important to Grenfell on a personal level, its importance in the early Grenfell Mission in Newfoundland and Labrador was based on

Grenfell's connection with the Mission to Deep Sea Fishermen and its evangelical agenda. However, the nineteenth-century cult of manliness also defined the early stage of

Grenfell's career in Newfoundland and Labrador. In her 1995 book, Manliness and

Civilization: A Cultural History of Gender and Race in the United States, 1880-1917,

Gail Bederman delves into the cultural meanings behind the term "manliness." She understands manhood as "a continual, dynamic process" in which "men claim certain kinds of authority, based upon their particular type of bodies."30 According to Bederman, ideals of manliness in the nineteenth century were central to the middle-class male identity and for the Victorian middle-class male this consisted of high-minded self- restraint. In addition, the process of "manhood" linked male anatomy to male identity and

"[linked] both anatomy and identity to particular arrangements of authority and power."31

The cult of manliness was a social phenomenon that emphasized the personal qualities of decency, honour and honesty as well as good health, personal hygiene, a healthy diet, the work without pay in any capacity of service. Association with Grenfell's work was perceived as glamorous and worthwhile." Barbara D. Robinson, "Wilfred Grenfell and the Christ of Culture," (MA thesis, University of Manitoba, 1993), pp. 1- 3.

Robinson, "Grenfell and the Christ of Culture," p. 17. See also, H. Richard Niebuhr, Christ and Culture, (New York : Harper & Row, 1975).

,n Gail Bederman, Manliness and Civilization: A Cultural History of Gender and Race in the United States, 1880-1917, (Chicago and London: University of Chicago Press, 1995), p. 7.

11 Bederman, Manliness and Civilization, pp. 7-8.

53 avoidance of alcohol and tobacco and the value of sport, outdoor pursuits and the frontier.32 As Bederman explains, manliness was not something intrinsic to all men, but rather "a standard to live up to, an ideal of male perfectibility to be achieved."33 Grenfell was driven by this mantra. As a young man he was deeply involved in sports and athletics and he encouraged physical exercise as a positive way to expend the energies of youth.

For example, while he was going to medical school in London Grenfell and his roommate established a boys' club in the ground floor of their house, complete with a gymnasium and boxing-ring in the dining room on Saturday nights. In accordance with the Victorian cult of manliness, Grenfell believed in the "good effects of the physical discipline provided by athletics."34 He also believed in the value of the countryside and the outdoors in contrast to urban industry and congestion. Perhaps the most obvious example of the cult of manliness in Grenfell's early career was his sense of adventure and his appreciation for the frontier - characteristics that drove him across the Atlantic and underlined his life-long commitment to Newfoundland and Labrador.

Throughout his career, Grenfell became increasingly interested in the practical side of improving the health and well-being of the people. Grenfell's Mission in

Newfoundland and Labrador was inter-denominational and made no obvious effort to proselytize the people and in this way Grenfell himself came into conflict with the Board of the Mission to Deep Sea Fishermen. Founder of the Mission's Industrial Department,

Rompkey, Grenfell of Labrador, pp. 10-11.

Vl Bederman, Manliness and Civilization, p. 27

34 Rompkey, Grenfell of Labrador, pp. 19-20.

54 Jessie Luther35 noted Grenfell's frustration with the Board's evangelical expectations: "It evidently troubles the Doctor that he is obliged during several months of the year, to go about 'with hat in hand' for Mission funds. Apparently the English Mission office wants him to give a year to evangelical work, but he wants to be doing instead of preaching, and seeing him, one can understand his point of view. I cannot imagine him an orthodox evangelist; his influence and appeal are through action, sincerity, and example rather than exhortation.'"36 At essence, Grenfell was a social reformer more so than a Christian missionary. But he gained a reputation as a Christian folk hero and was popularized in newspapers on both sides of the Atlantic as the "patron saint of Labrador."37 A plethora of biographies sanctified the man for his boundless devotion to the spiritual and physical health of disadvantaged people.38 The Mission took advantage of the strength and popularity of the myth of Christian service that surrounded Grenfell and it used this image in its fundraising efforts and in its recruitment messages. In fact, the ideal of

15 Jessie Luther was an artist and teacher from Providence, Rhode Island. In 1906, shejoined the Grenfell Mission and she established an Industrial Department, which included the local production of a variety of crafts throughout the region, including weaving, embroidery, and rug-hooking. See Ronald Rompkey (ed.), Jessie Luther at the Grenfell Mission, (Montreal & Kingston: McGill-Queen's University Press, 2001).

36 Rompkey, Grenfell of Labrador, p. 128.

37 Rompkey, Grenfell of Labrador, p. 151.

,8 Robinson divides the Grenfell Mission canon into five types of material: 1) hagiographic literature, intended to praise and publicize Grenfell's work on the Coast; 2) ediflcatory 'lives,' for the moral guidance of juvenile audiences; 3) fictional accounts, usually based on the adventures of Grenfell; 4) biographies, such as the officially sanctioned James Lennox Kerr, Wilfred Grenfell: His Life and Work, (Ryerson Press, 1959); and 5) Grenfell's own writing. See for example, James Johnston, Grenfell of Labrador, (S.W. Partridge, [1908]); Norman Duncan, Dr. Grenfell's Parish: The Deep Sea Fisherman, (New York; Chicago: Fleming H. Revell, 1905); Basil Joseph Mathews, Wilfred Grenfell: The Master-Mariner - A Life of Adventure on Sea and Ice, (New York: George H. Doran, [1924]); Ernest Henry Hayes, Forty years on the Labrador; the life-stoiy of Sir Wilfred Grenfell, K.C.M.G. (New York; Chicago: Fleming H. Revell, [1930]); Genevieve May Fox, Sir Wilfred Grenfell, (New York: Thomas Y. Crowell, 1942); Basil Miller, Wilfred Grenfell: Labrador's Dogsled Doctor, (Grand Rapids: Zondervan, 1948); Winifred M. Comber, Wilfred Grenfell: The Labrador Doctor, (London: Lutterworth Press, 1950); Henry Gordon, A Servant of Christ: A Study of the Religious Outlook of Sir Wilfred Grenfell, (Grenfell Association of Great Britain and Ireland, 1966); and most recently, Alex A. Smith, The Grenfell I Knew, (St. John's: Flanker Press, 2003).

55 Christian service was so strong within the Grenfell propaganda and had become so closely associated with the name of Wilfred Grenfell that by the 1950s some nurses were appropriating Grenfell's name in defence of evangelism.

The importance of Christianity to the Mission was strongest during Grenfell's tenure. One of the early basic principles of the Mission was the recruitment of medical and nursing staff who were evangelical Christians - this standard being a hangover from the Mission to Deep Sea Fishermen. Although Grenfell accepted Mission workers who were not inclined towards evangelism, he evidently had reservations about such individuals. In 1893, after spending several months in Labrador with two nursing sisters from Britain, he betrayed concern over one of the nurse's lack of religious zeal. Grenfell was satisfied with Sister Carwardine's medical work, but wrote to the Mission to Deep

Sea Fishermen: "'1 fear greatly nurse Carwardine is not a Christian. Oh it will be a pity.

We must make it a matter of earnest prayer that she may become one or she will be a terrible hindrance."'39 It is unclear what kind of a "hindrance" Carwardine would be, especially since Grenfell was pleased with her medical work. However, it should be emphasized that Grenfell was writing to the Spiritual Work Committee of the Mission to

Deep Sea Fishermen and perhaps embellished his reservations about Carwardine's spirituality for his intended audience. During these early years of the Mission in

Labrador, Grenfell's religious motivations were strongly based on his association with the

Mission to Deep Sea Fishermen.

However, it should be noted that Grenfell himself began drifting away from evangelism during this period. In the early twentieth century a gulf developed between

19 Quoted in Rompkey, Grenfell of Labrador, p. 63.

56 Grenfell and the Mission to Deep Sea Fishermen, who did not appreciate Grenfell's preference for practicality and action over sermonizing, which culminated with the creation of the IGA. Secularism was on the rise among mission societies on a global

level, especially during the interwar period, to such an extent that the International

Missionary Council (IMC) considered it "the most worrisome phenomenon in the

West."40 According to Rompkey, "Grenfell had felt constrained by the [Mission to Deep

Sea Fishermen's] theological position and less comfortable with it as time went on. He

was beginning to prefer the liberal theology of his New York committee ... to what he

referred to as 'the old stereotyped message of future salvation.'"41 In keeping with the development of the social gospel and secularized American reform philosophies of the

early twentieth century, an evolving agenda of social reform came to eclipse Grenfell's original spiritual agenda.

The Grenfell Mission itself also became increasingly distanced from its early

religious motives on an institutional level. This trend began relatively early in the

century: in 1907 John M. Little, a Boston surgeon, volunteered with the Mission at his own expense and was soon hired on by the organization and placed in charge of the St.

Anthony hospital. Little did not share Grenfell's characteristic Christian manliness, and in

fact he often became frustrated with Grenfell and disagreed with his methods. Little was

professionally ambitious - he transformed the St. Anthony hospital into a well-organized

medical institution and improved its medical reputation.42 Little was replaced at St.

40 Ruth Compton Brouwer, Modern Women Modernizing Men: The Changing Missions of Three Professional Women in Asia and Africa, 1902-69. (Vancouver: UBC Press, 2002). p. 15.

41 Quoted in Rompkey, Grenfell of Labrador, p. 167.

42 Little resigned from the Grenfell Mission in 1917. See Rompkey, Grenfell of Labrador, pp. 194-5.

57 Anthony by Charles Curtis, who arrived on the Coast in 1915 as a summer volunteer.

Like Little, Curtis did not share Grenfell's religious sensibilities and was more interested

in the quality of medical work being performed by the Mission. In fact, Rompkey described Curtis as "the complete antithesis of Grenfell: reserved and modest, with an

occasional display of crustiness, but quietly competent."43 Through the 1920s and 1930s,

Curtis provided confident leadership and exceptional surgical skill, and he effectively

administered the medical work at St. Anthony while Grenfell remained active in lecture

tours and fund-raising. Grenfell resigned from active management of the Grenfell

Mission in January 1936, although he maintained his salary and title as superintendent,

and appointed Curtis as medical supervisor on the Coast.44 Finally, in 1937 the board of

the Mission informed Grenfell that they were formally appointing Curtis as medical

superintendent and executive officer of the Mission; in November of that year, Grenfell

reluctantly relinquished his title to his successor and was thereafter referred to as the

"Founder'" of the Grenfell Mission.45

The myth of Christian service was strong in the Grenfell Mission; but it was

essentially a myth, or a particular truth - "a popular belief or story that has become

associated with a person, institution or occurrence, especially one considered to illustrate

a cultural idea."46 In reality, the Mission was not as spiritually motivated as the

propaganda surrounding Wilfred Grenfell and the Mission would have had people

43 Rompkey, Grenfell of Labrador, p. 184.

44 Cecil Ashdown became the executive director of the IGA and E.A.B. Willmer as business manager in New York. See Rompkey, Grenfell of Labrador, p. 277.

45 Rompkey, Grenfell of Labrador, pp. 282-283, 287.

46 wvvw.uiclionarv.comi -

58 believe, and it became even more secularized through the middle of the twentieth

century. By the early 1960s, the senior staff of the Grenfell Mission was trying to

maintain a distance between the Mission and religious affiliations. In fact, Gordon

Thomas even considered religion to be a distraction from the health work that the nurses

were hired to perform and that religion (or at least evangelical forms of Christianity) was

"not in the best interests of the Nursing Station."47

Secularization was also evident in the Grenfell Mission's recruitment of nurses,

which became driven by practicality rather than more lofty Christian ideals. The wording

of their application forms throughout the twentieth century reflected this shift towards

down-playing Christianity. The first application forms used by the Mission for the nurses

were "Applications for Medical Service" and they contained two sections designed to

gauge the applicant's religious affiliations: "Are you connected with any church?" and

"Name of denomination."48 In 1937 the application form had changed and assumed that

applicants were associated with a religious organization when it asked: "With what

church are you connected?"49 Until 1952, Grenfell applicants provided their religious

information, but after that date the form changed again and church affiliation was no

longer standard on every application. Instead, the forms indiscriminately asked for

"Religion," which was typed or hand-written on the page by the secretary of the Grenfell

Association of Great Britain and Ireland. In 1970 another form was created, an

47 PANL. MG 372 GTC, Box 35, File "Forteau - 1955-1962," Gordon Thomas to the Lord Bishop of Newfoundland, 12 July 1962.

48 See for example, PANL, MG 63 Grenfell Association of Great Britain and Ireland Collection, Box 53, File 1245 "Merrick (Austen), Kate Nurse: 1928-1930," Application for Medical Service, 4 April 1928.

49 See for example, PANL, MG 63, Box 56, File 1327 "Northorp (Robinson), Dorothy Nurse: 1937-1979," Application for Medical Service, 27 May 1927.

59 "Application for Nursing Service,"50 that again did not require religious information. So, on an official level, the Grenfell Mission did not require preliminary religious information on their application forms after 1952 - indicating that religion was not an important factor in considering and appointing nurses. However, it appears that the secretary of the Association, who was in charge of recruiting nurses for the Mission in

Britain, often took it upon herself to learn the applicants' religious affiliations either through the addition of "Religion" to the application form or by asking the nurse during her interview. The development of the application form for nurses interested in working with the Grenfell Mission evolved alongside the secularization of the Mission itself and the medical care it provided. However, religion as a category of significance was not completely eclipsed by secularism and remained an important factor in Grenfell nursing for many women, both in the office and in the field.

The Christian message was an important element of the Mission's fundraising and recruitment campaigns. Grenfell himself traveled around Britain, the United States and

Canada in order to raise money and to attract physicians, nurses and untrained volunteers to his operation. He spoke to audiences in schools, churches, halls and theatres; he wrote countless books, pamphlets and articles on life in Labrador and the work of the Grenfell

Mission. Not only did Grenfell himself inform thousands of people on the nature of his work in Newfoundland and Labrador by speaking to audiences, but those audiences themselves became agents of GrenfelTs pronouncements. The Grenfell message was spread through religious and educational institutions which exposed many children, future Grenfell employees such as Ivy Durley, to the work of the Grenfell Mission.

50 The "Application for Medical Service" was still used for some nurses after 1970.

60 Durley learned about Wilfred Grenfell in Sunday school at the age of eight and she was so drawn to the medical hero that she decided to become a nurse and to one day join the

Mission.51 In a series of oral interviews conducted with Grenfell nurses during the summer of 2004, it was found that some women, such as British nurse Agnes Warren and

American nurse Janet Stephens, recalled learning about Wilfred Grenfell as a child - either in school or from reading one of Grenfell's books - and they were consequently drawn to the organization as adults.52 Other nurses, like Louise Greenfield, decided to join the Grenfell Mission because an advertisement in a nursing journal, but she remembered learning about Grenfell as a child: "I obtained the Labrador post through the pages of the nursing journals - which one I can't recall, but everyone knows about the

GM. Most church-going children know Labrador. They told us something about it in my church group and...when you see an advertisement you feel you want to go. You feel you are needed."53 Newspapers like the New York Times and the Boston Herald and numerous Christian publications printed articles on the British doctor and his work among the poor fishermen of Newfoundland and Labrador. Grenfell was portrayed in the popular press as a saintly, selfless figure. He became a figure of legend, a publicly acknowledged hero of the modern day.54

51 Archives and Special Collections, Joyce Nevitt Collection COLL-177, Box 15, File 12.01.013 "Ivy Durley, Grenfell Assoc. nurse, c. 1947, includes essay 'Ready,..., c. 1976," Joyce Nevitt interview with Ivy Durley.

52 These are pseudonyms to protect the identities of the nurses who agreed to personal interviews in August 2004. See Agnes Warren, Personal Interview, August 2004 and Janet Stephens, Personal Interview, August 2004.

53 Archives and Special Collections (ASC), MG 177 JNC, Box 15, File 12.01.013 "Ivy Durley, Grenfell Assoc. nurse, c. 1947, includes essay 'Ready,..., c. 1976," A.W. Cockerill, "Ready, Aye Ready," (Port Hope, ON 1976), p. 12.

54 Rompkey, Grenfell of Labrador, p. 297.

61 Both the Mission to Deep Sea Fishermen and the Grenfell Mission were well

aware of Grenfell's popularity, and they used Grenfell's fame to their institutional

advantage. Even into the 1950s Charles Curtis, then Medical Superintendent of the

Mission, while negotiating with government agencies for public health care funding, still

promoted the myth of Grenfell as a "heroic, venturing Christian."55 It was a powerful

message and attracted many people to the cause - both in terms of financial donations

and in terms of medical staff and volunteers. Many nurses learned about the Grenfell

Mission through friends; for example, Mary Taylor learned about the Grenfell Mission

from a friend while she was working at the Ottawa Civic Hospital.56 Oral history also

supports the importance of personal connections in recruitment. In 1960, Elsie Davis

learned about the Grenfell Mission through her brother who learned about the Grenfell

Mission while at boarding school. He sent Elsie a Grenfell Christmas card; she quickly

read up on the Mission and left for Labrador that spring.57 The Christmas cards were a

major part of the Mission's fundraising campaign and effectively promoted the Grenfell

Mission beyond those already knowledgeable about the organization. Figure 2.1 was

States in 1948.

55 Rompkey, Grenfell of Labrador, p. 299.

56 Mary Taylor, Light on the Labrador, (E.M. Taylor, 2001), pp. 18-19.

57 This is a pseudonym to protect the identity of the nurse who agreed to a personal interview in August 2004. See Elsie Davis, Personal Interview, August 2004.

62 FIGURE 2.1: "Labrador Feast"

Source: Fishers 46.3 (October 1948): Ends piece.

Anne Thompson learned about the Grenfell Mission during her training at the Prince of

Wales Hospital in North London. Thompson nursed with a physician who had worked with the Grenfell Mission in Mary's Harbour (also sometimes called St. Mary's River) and he encouraged her to join after her training.58 The Mission recognized the importance of personal contacts and the power of word-of-mouth in spreading information about its work in Newfoundland and Labrador. It encouraged its medical and nursing staff to speak at local assemblies, church groups and medical and nursing schools after they retired or while they were on leave of absence.

58 This is a pseudonym to protect the identity of the nurse who agreed to a personal interview in August 2004. See Anne Thompson, Personal Interview, August 2004.

63 HEALTH CARE INITIATIVES DURING COMMISSION OF GOVERNMENT

While the Grenfell Mission was improving the provision of health care in northern Newfoundland and Labrador, the Government of Newfoundland began to improve health care throughout the colony in general. In the post-1934 era, the

Commission of Government took extensive measures towards improving the health of

Newfoundlanders and Labradorians and improving health care facilities. The government's five main initiatives included: 1) increasing medical personnel; 2) increasing medical facilities, particularly in rural areas; 3) improving the detection and treatment of tuberculosis; 4) improving child health; and, 5) promoting dietary reform.59

Many of these initiatives focused on areas outside of the Grenfell Mission area, especially increasing medical personnel and medical facilities. However, the government's tuberculosis program, its immunizations against smallpox, typhoid and diphtheria, its school health program, and its dietary reforms all reached the Grenfell region.

Increasing Medical Personnel

One of the first ways that the government tried to improve health and people's access to health care was by increasing the number of physicians and nurses within the population. The public health division of the Department of Public Health and Welfare appointed two permanent medical officers who would provide curative and preventive medicine and also oversee the nursing staff of St. John's. In rural areas, the government

59 The government also trained teachers to detect health problems in rural areas and created a national health insurance scheme in which $2.50/year provided a family with medical and/or hospital care. For those who could not afford the $2.50, the scheme allowed families to pay whatever they could afford in the form of cash or commodity, such as fish, firewood, or produce. In this way, the scheme was particularly sensitive to local traditions and created flexible means of access for people with limited resources. See Bishop, "Public Health and Welfare," pp. 86-7 and Government of Newfoundland, "Health Manual for Teachers," Department of Public Health and Welfare, 1934.

64 hired doctors as full-time employees. It also took over the nursing services of NONIA, hired nurses to fill vacancies, and opened centres that had not previously been served by a doctor or a nurse. The government also encouraged the quality of physicians and nurses by supporting specialized training. It encouraged medical and nursing leaders to attend

North American conferences on health care. And the government secured the financial support of the Rockefeller Foundation in sending local nurses to attend advanced nursing courses in Canada and the United States. Through such efforts, the Commission of

Government aimed to keep Newfoundland physicians and nurses up to date with continental education and health care practices.60

Increasing Medical Facilities

In order to increase the health care facilities for people in rural areas of the Island, the Commission of Government increased the number of nursing stations in rural areas and established a cottage hospital scheme in 1935. The scheme was based on a similar system in Scotland, although the first such program in Newfoundland was established by

Grenfell. A typical cottage hospital employed one or two physicians, a small staff of nurses, and had approximately ten to thirty beds. In addition to providing affordable medical services to the public, hospital employees offered public health education and midwifery training. By 1942 the government had established thirteen cottage hospitals across Newfoundland. The government also created a 'floating hospital' - the Lady

Anderson (1935) - in order to reach the more isolated communities on the Island. The

Lady Anderson began operation on the south coast, between Fortune Bay and Port aux

60 See Theresa Lynn Bishop, "Public Health and Welfare in Newfoundland, 1929-1939," MA Thesis, Queen's University, 1984).

65 Basques. A doctor and a nurse were onboard at all times to provide medical assistance to remote communities. The medical staff treated the sick, provided immunizations against contagious diseases, and conducted public health work. In 1936, during its sixth trip along the coast, the Lady Anderson stopped at fifty ports and the medical staff treated over nine hundred patients.61

Tuberculosis

During the 1930s, Newfoundland and Labrador's largest single health problem was tuberculosis. In a survey conducted in 1937, twenty thousand cases of tuberculosis were discovered, five thousand of which required strict isolation. In an attempt to deal with these staggering numbers, the Commission of Government added an extension to the

Tuberculosis Sanatorium in St. John's, which increased the number of beds to from 113 to 250, and built a sanatorium in Corner Brook. It also established the Avalon Health

Unit as a means to increase detection of the disease. The Avalon Health Unit was based in Harbour Grace but travelled throughout the Avalon Peninsula, taking x-rays of the population and isolating diagnosed cases. The government purchased another ship, the

Christmas Seal, for similar work in isolated coastal areas. However, despite this increased detection and preventive measures, tuberculosis remained a widespread health

61 See Bishop, "Public Health and Welfare"; John K. Crellin, The Life of a Cottage Hospital: the Bonne Bay Experience. St. John's: Flanker Press, 2007; Nigel Rusted, It's Devil Deep Down There: SO years ago on the M. V. Lady Anderson, a mobile clinic on the S.W. coast of Newfoundland. Occasional papers in the history of medicine. No. 5. St. John's: Creative Publishers, 1987.

66 problem. On the eve of Confederation, Newfoundland averaged one hundred tuberculosis-related deaths a year.62

Improving Child Health

The Commission of Government initiated a school health program in order to improve the health of children. This program included dietary reform in which the government distributed milk, coco-malt, cod liver oil, and whole-meal buns to school children. It included immunizations against diphtheria, typhoid, and smallpox. And it included public health initiatives - the government provided teachers with a health manual, so that they could teach healthy habits and learn to identify the symptoms of disease, and established the Junior Red Cross to instruct children in first aid, the prevention of accidents, and good health in general. The government also created a Child

Welfare Clinic in St. John's and a child welfare division within the Department of Public

Health and Welfare. It also passed important legislation, including the Adoption Act of

1940 and the Welfare of Children Act of 1944.63

Dietary Reform

The Commission of Government considered dietary reform as an affordable way to improve the colony's overall health and reduce the occurrence of nutritional diseases.

The traditional Newfoundland diet was not nutritionally diverse - many families lived off

62 See Edgar House. Light at Last: Triumph over Tuberculosis 1900-1975, Newfoundland and Labrador, (St. John's: Jesperson Press, 1980); and William Ronald Knowling, '"Ignorant, Dirty, and Poor:' The Perception of Tuberculosis in Newfoundland, 1908-1912," (MA Thesis, Memorial University of Newfoundland, 1996).

61 See Bishop, "Public Health and Welfare."

67 salt-fish, salt-beef, white flour, tea and molasses. And due to the poor quality of soil, fresh vegetables were often not available. White flour was a staple in many homes, but had very little nutritional value. Therefore, the government included vitamin-rich brown flour in its dole rations by the end of 1934. However, malnutrition rates remained high through the period, and there was significant public backlash about the "dole flour."64

However, the Department of Public Health and Welfare did not address the underlying problems of poverty and poor diet in the 1930s. John Puddester, Commissioner for the

Department, invited medical experts from the United States, Canada, and Britain to undertake a "Medical Survey of Nutrition in Newfoundland" in August 1944. The investigators found evidence of nutritional deficiencies directly related to the local subsistence diet, which was especially inadequate in terms of dairy products, meat and poultry, and eggs. The most widespread and severe vitamin and mineral deficiencies were calcium, ascorbic acid, vitamin A, thiamine, riboflavin and niacin.65 The department did not provide sufficient welfare support to complement the public health reforms, which served to limit the effectiveness of those reforms.66 As a result, poverty-related nutritional and deficiency diseases re-emerged, and were still common during the war.67

64 See Bishop, "Public Health and Welfare"; and James Overton, "Brown Flour and Beriberi: The Politics of Dietary and Health Reform in Newfoundland in the First Half of the Twentieth Century," Newfoundland Studies 14.1 (1998): 1-27.

65 See J.D. Adamson et a!., "Medical Survey of Nutrition in Newfoundland," Canadian Medical Association Journal, 52 (1945): 227-250.

66 Bishop, "Public Health and Welfare," p. 4.

67 Overton, "Brown Flour and Beriberi," p. 24.

68 THE SECOND WORLD WAR

Under the leadership of Charles Curtis, the Mission entered a new era, providing high standards of medical and surgical care to the people of northern Newfoundland and

Labrador. Curtis had been criticized by Grenfell, and by some of GrenfelPs peers, for his preference towards the medical work of the Mission over the social and religious work.68

And indeed, the start of his tenure as superintendent demonstrated this new direction as

Curtis refused to carry out the extensive fundraising ventures of his predecessor and turned towards increasing government support for the establishment.69 With this approach, Curtis discouraged any future endowment campaigns by the Mission, since, as

Rompkey explains, he recognized that the Commission of Government could shirk its financial responsibilities to the people of the north if it perceived an inexhaustible supply of funding from the United States.70 Through this period, Grenfell's influence in the affairs of the Mission declined, and it was Curtis who guided the Mission's activities on the Coast through the socially turbulent and financially difficult years of the Second

World War.

The war created both opportunities and challenges for the people of northern

Newfoundland and Labrador and for the Grenfell Mission. The colony was strategically situated in the north Atlantic and attracted the defence interests of Canada, Britain, and the United States. In particular, Newfoundland became an important stopover point for

68 Wilfred Grenfell Papers, Henry Richards to Wilfred Thomason Grenfell, 9 August 1938, referenced from Rompkey, p. 283.

69 Gordon W. Thomas, From Sled to Satellite: My Years with the Grenfell Mission, (Irwin Publishing, 1987), p. 105.

70 Rompkey, Grenfell of Labrador, p. 286.

69 transatlantic flights and shipping convoys between North America and Europe. To protect this valuable transportation link, Britain entered into arrangements with the Canadian and

American governments pertaining to the increased defense of the Island and Labrador. In

June 1940, the British Government turned over to Canada the airport at Gander and the seaplane base at Botwood, which had been built in Newfoundland in the late 1930s, and

Canada proceeded to construct air bases at Torbay (near St. John's) and at Goose Bay in

Labrador.71 And in September 1940, Britain signed a destroyers-for-bases agreement with the United States, according to which the United States provided Britain with fifty aged destroyers in exchange for permission to lease base sites and build military installations in Newfoundland and other territories in the western hemisphere.72

These developments ushered in a construction boom across Newfoundland and

Labrador and interrupted the established socio-economic order of the Coast. Local residents found waged employment in construction and later as civilian staff on the bases, and they began to turn from their traditional resource sector employment; writing from

North West River in 1941, Mary Barnard noted that "all the men [were] going to work there instead of trapping."73 At the peak of construction, in 1942, approximately 20,000

Newfoundlanders were employed on the Canadian and American bases.74 Waged employment led to the introduction of currency in communities that had previously

71 See Peter Neary, "'A Mortgaged Property': The Impact of the United States on Newfoundland, 1940- 49," in Twentieth-Century Newfoundland: Explorations, James Hiller and Peter Neary, eds., (St. John's: Breakwater, 1993), pp. 180-181.

72 Neary, '"A Mortgaged Property,'" p. 183.

73 PANL, MG 63, Box 23, File 428, "Barnard, Mary Penelope," Barnard to Spalding, 1 December 1941.

74 Steven High, "Working for Uncle Sam: The 'Comings' and 'Goings' of Newfoundland Base Construction Labour, 1940-1945," Acadiensis XXXI1.2 (Spring 2003): 84.

70 functioned on the credit system. According to Steven High, who explored Newfoundland

Ranger reports during the war in his article, "Working for Uncle Sam: The 'Comings' and 'Goings' of Newfoundland Base Construction Labour, 1940-1945":

[pjeople used their earnings to pay old debts, to make long-needed repairs to their homes and to purchase new fishing equipment. In fact, hundreds of homes in each district received badly needed repairs and a fresh coat of paint. Newfoundlanders also bought foodstuffs and consumer goods that had been beyond their means only a few months previously.75

Employment on the bases, combined with wartime improvements in the fishing economy, increased the standard of living for many families in Newfoundland and Labrador. The presence of American and Canadian military personnel on the Coast introduced

Newfoundlanders and Labradorians to North American culture and a consumer society.

The war substantially changed the economy and society on the Coast.

The establishment of North American radar installations in the 1950s had a similar impact on life in northern Newfoundland and Labrador. After the Second World

War, Canada and the United States became concerned with the threat of attack by Soviet bombers and nuclear weapons through the Arctic. To protect the continent from such threat, the two governments jointly constructed radar stations across Canada. The United

States Air Force constructed and maintained heavy radar facilities in St. Anthony, Goose

Bay, Cartwright and Hopedale as well as light-weight radars, or "Gap Fillers," in Fox

Harbour (St. Lewis), Cut Throat Island, Spotted Island, and Cape Makkovik. These facilities constituted a portion of the Canada-United States Radar Extension Plan, known

75 High, "Working for Uncle Sam," p. 90. High argues that there were high rates of labour turnover on the American bases and in primary industries at least partially because the activities of the Commission of Government: the Government urged fishers and loggers to return to their seasonal work and also attempted to keep base construction wages low. As a result, it "encouraged Newfoundlanders to combine base work with other traditional activities." (p. 107) He also points out that the majority of Newfoundlanders returned to the fishery when construction work ended, although the antiquated truck system was ruined and the fishery was now based on a cash economy.

71 as the "Pinetree" plan.76 They were built between 1951 and 1957, which created a construction boom for the communities, as the construction of military bases did during the Second World War. A local resident at Fox Harbour recalled: "Most of the men of the community went to work on the construction that fall and for the next couple of summers there was very little fishing from the community. The fishermen liked the good wages paid by Drake Merritt, the contractor, all in American currency."77

American Air Force personnel became a fixed presence in the region for over ten years. In his memoirs, Gordon Thomas recalled that "[t]his short period in the history of

St. Anthony completely reshaped the life of [the] community;"78 there was an influx of cheap liquor and lonely American servicemen on one-year tours of duty. There was also a related increase in socializing and interactions between local residents and military personnel, especially on the base where, "[e]very Saturday night the officers' mess, the non-commissioned officers* mess, and the private personnel mess were turned into clubs and opened to civilian employees and their friends. A large proportion of civilians in the area, including hospital staff, took advantage of this diversion from isolation and

76 There were seven heavy radars between Hopedale and St. John's. The facilities were constructed between 1951 and 1953, when they became operational, and they closed in 1968 (except for Goose Bay, which closed in 1988). In addition, six light-weight radars were constructed between each of these heavy radars, in order to increase low altitude coverage along the line and to provide back-up for these radars. These sites became operational in 1957 and closed in 1961. See Lydus H. Buss, "U.S. Air Defense in the Northeast, 1940-1957," Historical Reference Paper #1. hitpi/.'vvwvv.pinclrccline.oru/olhcr ncac.hinil (accessed 3 August 2009).

77 Calvin Poole, "Arrival of the Americans, 1955," htn>://ww\v.pindredinc.prg-'naiv'othcr/othcHha.html (accessed 2 August 2009).

78 Thomas, From Sled to Satellite, p. 75.

72 loneliness."79 Figure 2.2 shows a dance on the base at Goose Bay with a mixture of military and civilian personnel, and presumably people from the community.

FIGURE 2.2: A Dance in Goose Bay, 1959.

Source: The Pine Tree Line, http://www.pinctrcelme.org/ (accessed 3 August 2009).

Ches Lethbridge recalled that at Cartwright in 1967, "[t]here was some social activity on the base and the USAF would put on a special bus run on the week-ends for people from the village to come and visit their clubs."80 And in Fox Harbour, Calvin Poole remembered "going to the great Christmas parties on the site and also to the weekly movies."81 American and Canadian servicemen became an important part of the community in northern Newfoundland and Labrador, contributing to the work of the

79 Thomas, From Sled to Satellite, p. 77.

80 Ches Lethbridge, "Memories of Cartwright, 1967," hliir . ivu w .ninclrcelincA>i u. oihcivollier9/odicr9an.html (accessed 3 August 2009).

81 Poole, "Arrival of the Americans, 1955."

73 Mission and local churches and developing close friendships and sometimes marriages with residents and Grenfell staff.82

The outbreak of the Second World War had an immediate impact on the

Mission's work on the Coast. All voluntary workers at St. Anthony had left on the last boat by October 1939, 83 and the Mission's Industrial Department was forced to close down, and orders for raw materials from Britain were cancelled.84 The national emergency and shortage of nurses in Britain drew many nurses back home; Curtis had permitted all British nurses the opportunity to return home at the start of the war if they felt the need to help their country.85 The war also created a significant increase in the cost of food, fuel, medications, hospital equipment and supplies and the Mission could not afford to maintain its pre-war budget.86 As a cost-saving measure, the Mission introduced

"a campaign of rigid economy,"87 the Mission cancelled the printing of its annual report88 and Curtis introduced a 10% cut in all salaries for the duration of the war. In March 1941, he reported to the Board of Directors that the total running expenses of the Mission were down $25,000 from the previous year, most of the saving being in salaries ($9,000), food

82 Thomas, From Sled to Satellite, p. 78.

83 PANL, MG 63, Box 63, File 1496, Folder 1, "Rowbotham, Pansy Maude [Pam]," Rowbotham to Spalding, 19 October 1939.

84 PANL, MG 63, Box 27, File 520, "Bridge (Currant) Ethel," Spalding to Currant, 4 October 1939.

85 PANL, MG 63, Box 65, File 1552, "Shellam ([Johnson]), Patricia," Spalding to the Matron of Queen Alexandra's Imperial Nursing Service, 16 February 1942.

86 H.M. Richards, "The Grenfell Association of Great Britain and Ireland," Fishers, April 1943 41(1): 26.

87 PANL, MG 63, Box 8, File 100, Folder 2, "Forsyth," Forsyth to Spalding, 17 July 1942.

88 PANL, MG 63, Box 27, File 520, "Bridge (Currant) Ethel," Spalding to Currant, 4 October 1939.

74 ($5,000), freights ($2,000), fuel ($2,000), and travelling expenses ($2,000).89 Part of the savings in salaries resulted from the inability of the Mission to appoint physicians during the war, in which case both North West River and Mary's Harbour hospitals were turned into nursing stations.90

Recruiting staff for the Coast was one of the greatest challenges that the Mission faced during the Second World War. At the beginning of the war, the numbers of British staff available to work on the Coast immediately declined. There were no new contracts signed for nurses from Britain from the start of the war until 1944, when four nurses signed on. Only those British nurses who were already in North America in 1939 were able to contract for the Coast. The problem was not so much a lack of interest in the

Grenfell Mission, but rather the difficulties in gaining 1) official release from national service from the British Ministry of Labour, which would refuse permission for a nurse to work with the Mission due to their own nursing shortage in that country;91 2) an exit permit from the Passport Authorities;92 and 3) transatlantic transportation, a ban of which was imposed by the British Government in 1944.93 The Mission turned to nurses from the

United States to fill the void left by the British and, to a lesser degree, Canadian nurses.

89 PANL, MG 63, Box 9, File 113, Folder 2, "Report Submitted by Dr. Curtis to the I.G.A. Board of Directors, March 1941," March 1941.

90 Rompkey, Grenfell of Labrador, p. 293. See also, [Charles S. Curtis], "The Superintendent Reports," Fishers, April 1944 42(1): 16.

91 PANL, MG 63, Box 64, File 1543, "Seaman, Margaret Eleanor," Spalding to Seaman, 26 March 1945.

92 PANL, MG 63, Box 66, File 1585, Folder 3, "Smith, Jean Battinson," Mrs. Collins to Smith, 25 May 1944.

93 PANL, MG 63, Box 48, File 1081, Folder 1, "Kirby (Banyard) Helen Mabel," Spalding to Banyard, 25 May 1944.

75 In April 1941, Kathleen Young of the Staff Selection Committee published an appeal in the Fishers for workers on the Coast:

Since hostilities started we have only had two staff members come out from England and far fewer from Canada than normally. Consequently, for the past two years we had come to rely almost entirely on Americans to fill vacancies. This year Americans too are fast becoming absorbed into war work. Many of the doctors, dentists, and nurses of the type and age to whom our work makes the strongest appeal are now serving in the armed forces or Red Cross We appeal to all alumni, and other friends of the Mission, to remember and bring to the notice of their friends the opportunities for real service to humanity that exist in Labrador and Newfoundland.94

It is unclear what kind of effect this appeal had on recruitment numbers, although in a letter dated 26 May 1941, Spalding informed Ethel Currant that Young was still having difficulty recruiting North American staff.95 The presence of American nurses on the

Coast did increase for a short period, until the United States entered the war in 1941, when their numbers dropped from eleven to five.96 However, despite the financial and operational challenges the Mission faced during the Second World War, only one nursing station was closed from lack of personnel, while three of the hospitals that could not retain physicians were administered by nurses.97

94 Kathleen Young, "Labrador Calling," April 1942,40( I): 7.

95 PANL, MG 63, Box 27, File 520, "Bridge (Currant) Ethel Nurse: 1935-1974," Spalding to Currant, 26 May 1941.

96 According to the Fishers, there were 19 nurses from the United States on the Coast between 1939-1945, compared with 11 from Canada, 8 from Britain, 5 from Newfoundland, and one international. See the reports of the Staff Selection Committee, published annually in the Fishers.

97 PANL, MG 63, Box 9, File 113, Folder 2, "Curtis," Curtis to Spalding, 4 October 1943.

76 CONFEDERATION 1949

The Grenfell Mission was particularly supportive of Confederation with Canada,

go described by Gordon Thomas as Newfoundland and Labrador's "hope of deliverance."

In his memoirs, Thomas outlined the dramatic changes that took place on the Coast as a result of Confederation:

Family allowances, widow's allowances, old age pensions, and disability pensions brought a flow of new cash to a society founded on debt, where cash had been painfully scarce. Children ate better and wore better clothes. Rickets and beriberi disappeared. People built themselves new homes in all the outports. The provincial government placed welfare officers in communities to see to the needs of the indigent. Gradually our orphanage emptied, because widows who formerly had to give up their children could now afford to keep them at home."

It was certainly the prevailing view that the extensive Canadian social programs introduced to Newfoundland through Confederation had a long-term positive impact on the local standard of living, as they had in the other Canadian provinces. However, in this celebratory passage, Thomas ignored the impact that the Second World War had on the region, especially in terms of providing waged employment and initiating a consumer society. He also credited Confederation with solving widespread social and health problems that had been eradicated long before 1949 - namely, rickets and beriberi. Be that as it may, the Grenfell Mission was a primary beneficiary of Confederation, especially through increasing financial contributions from the federal and provincial governments. The Mission also took over the health of Aboriginal peoples in northern

Labrador, previously provided by the long-established Moravian Mission, and coordinated the construction of new nursing stations at Makkovik, Hopedale, Davis Inlet,

98 Thomas, From Sled to Satellite, p. 41.

99 Thomas, From Sled to Satellite, p. 41.

77 and Nain - all with federal funding. Under Confederation, the federal government also provided funding for the Grenfell Mission to treat Native tuberculosis patients, who had previously been sent to Canada for treatment; and in 1952, the Mission received $61,957 from the federal government to treat Innu and Inuit patients in Grenfell facilities.100 The

Mission also focused on expanding its network of nursing stations in remote communities, building new stations at Happy Valley and Englee in 1951, Roddickton in

1957, and Conche in 1960. Table 2.5 outlines the funding that the Grenfell Mission received through the Hospital Construction Grant of the Federal Health Grants, to support the construction and expansion of hospitals and nursing stations in the region.

TABLE 2.4: Hospital Construction Grants

Year Name of Project Amount

1952-53 St. Anthony Sanatorium 53,000.00 1952-53 Englee Nursing Station 3,040.00 1953-54 I.G.A. 44,845.00 1954-55 St. Anthony Sanatorium 22,422.50 1955-56 I.G.A. Hospital North West River 33,193.33 1955-56 I.G.A. Hospital Roddickton 10,040.00 1955-56 Hamilton Valley Village Nursing Station Extension 3,000.00 1961-62 Conche Nursing Station 18,394.07 1963-64 Happy Valley Hospital 75,210.00 1967-68 St. Anthony Hospital 356,280.00

Source: Government of Newfoundland, Annual Report of the Department of Health, Financial Report, 1953, 1954, 1955, 1956, 1962^ 1964, 1968.

100 Thomas, From Sled to Satellite, pp. 41-44.

78 The federal government also assisted the Province in purchasing medical equipment for several of the Grenfell hospitals. These funds were categorized under the General Public

Health Grant, the Laboratory and Radiological Services Grant, and the Tuberculosis

Grant.

TABLE 2.5: Grants to Support the Purchase of Equipment

Year Name of Project Amount

1951-52 I.G.A. 11,690.00 1952-53 I.G.A. 23,465.35 1952-53 I.G.A. 8,767.50 1953-54 I.G.A. 8,790.00 1954-55 X-Ray Equipment for St. Anthony Hospital 979.90 1955-56 Equipment for I.G.A. Hospital, Roddickton 1,613.70 1955-56 Equipment for North West River 8,288.76 1955-56 Assistance to North West River Hospital 7,535.16 1956-57 Equipment for I.G.A. Hospital, Roddickton 300.00 1956-57 Equipment for Nain Nursing Station, Nain Labrador 1,264.25 1956-57 Equipment for North West River 11,426.19 1956-57 Assistance to I.G.A. Hospital Roddickton 1,956.86 1957-58 Equipment for I.G.A. Hospital, Roddickton 300.00 1957-58 Equipment for North West River 9.90 1957-58 Happy Valley Village Hospital 2,990.16 1961-62 Equipment for St. Anthony Hospital 3,206.05 1963-64 Equipment for St. Anthony Sanatorium 393.25

Source: Government of Newfoundland, Annual Report of the Department of Health, Financial Report, 1952, 1953,1954, 1955, 1956, 1957, 1958, 1962, 1964.

79 While the federal government provided this financial assistance, the provincial government provided the bulk of funding for these constructions.101

The post-Confederation period also witnessed substantial developments in

transportation and communication on the Coast, which helped Grenfell staff to bridge the

long distances between their communities and facilities. Air travel became more

commercialized after the war, and in 1948, the first mail plane landed at St. Anthony.

Recognizing the potential of aircraft and the value in being able to reach patients in

outlying districts within hours of an emergency, rather than several days, Thomas

petitioned the provincial government for an air ambulance for the Mission and received a

de Havilland Beaver (and later, an Otter) for St. Anthony.102 The air ambulance services

began in Newfoundland and Labrador in 1949 as

an essential aspect in the [Department of Health's] policy of doing as much as possible to provide better health services to the isolated parts of the Province. The Department maintains an annual contract with the Eastern Provincial Airways, whereby that company must always have available a suitable airplane for the conveyance to hospital of emergency cases. Of the 163 flights made to various parts of Newfoundland and Labrador during 1951, there were 50 official flights, necessary for the maintenance of efficient health services, and 113 mercy flights, which, in many instances, meant the saving of a life.103

In 1950, the federal government provided the Province with a grant of $18,000 to support

its Air Ambulance Service which, by 1958, was located at St. Anthony, North West

River, and Gander. It was an important but expensive service which required funding

from several sources, as outlined in Table 2.6.

101 Thomas, From Sled to Satellite, p. 44.

102 Thomas, From Sled to Satellite, p. 51, 55.

101 Government of Newfoundland, "Annual Report of the Department of Health, 1951," (St. John's: Bowden & Co., 1953), pp. 13-14.

80 TABLE 2.6: Cost Distribution of the Air Ambulance Service

Year Total Cost Federal Provincial IGA

1958 240,000.00 18,000.00 222,000.00 n/a 1959 204,000.00 18,000.00 186,000.00 n/a 1960 189,000.00 30,000.00 150,000.00 9,000.00 1961 229,500.00 43,000.00 161,500.00 25,000.00 1962 229,500.00 43,000.00 161,500.00 25,000.00 1963 222,419.18 43,000.00 154,419.18 25,000.00 1968 287,946.62 59,480.08 203,629.16 24,837.38

Source: Government of Newfoundland, Annual Report of the Department of Health, Report on Air Ambulance Service, 1958, 1959, 1960, 1961, 1962, 1963 and 1968.

The federal government provided $10,786.50 between 1955 and 1958 for the purchase of snowmobiles and other equipment at St. Anthony. Snowmobiles were purchased for the

Grenfell Mission because of the lack of roads in the region, and they became indispensable in assisting with winter travel.104 These transportation services were developed along with a radio network, which combined to improve the timely provision of health care on the Coast.105 In the early 1950s, the provincial government contracted an electrical engineer from Montreal to design a radio-telephone system for St. Anthony, and the Mission obtained some war surplus radio equipment from military aircraft to link the nursing stations with St. Anthony. The Mission eventually replaced this military equipment with a more reliable radio-telephone system and hired a dispatcher at St.

104 "Annual Report of the Department of Health," 1956, 1957, 1958.

105 Again, the Federal Health Grants covered part of the cost of this radio network, providing $15,293.47 in 1957-58 and $2,593.17 in 1958-59. See "Annual Report of the Department of Health," 1958 and 1959.

81 Anthony to keep in regular communication with the stations. In this way, the radio telephone system became "the nerve centre of [the] regionalized health system."106

The construction of new facilities and improvements in transportation and communication continued through the 1950s and 1960s. In 1953, a 55-bed sanatorium was constructed at St. Anthony, with an operating room, staff quarters and a new heating and lighting plant. Funding for this project came from the endowment fund of the

Grenfeli Mission, while the operating room and clinical equipment was provided by government grants.107 In 1968, a new hospital was built at St. Anthony - funded by the provincial government but with the approval of the Board of Directors. This new facility contained departments of surgery, obstetrics, gynecology, pediatrics, pathology, radiology, laboratory services, social services, nursing, occupational therapy, physiotherapy, medical records, administration, and plant maintenance. It took on the character of a government institution much more than the previous St. Anthony hospitals, and the nursing staff alone increased to more than one hundred registered nurses plus certified nursing assistants.108 However, despite these many post-Confederation developments, there was more continuity than change on the isolated stations of the

Grenfeli Mission. The federal health grants provided a flood of funding for the construction of hospitals and nursing stations, the purchase of equipment for the hospitals, and the expansion of air ambulance services. But the services provided by

106 Thomas, From Sled to Satellite, p. 53.

107 Thomas, From Sled to Satellite, p. 65.

108 The construction of this hospital set Thomas against the Grenfeli Mission board, which was reluctant to approve such a large construction and did not welcome the increasing involvement of the provincial government in the Grenfeli Mission's work. Thomas, From Sled to Satellite, pp. 90, 87.

82 nurses on the stations were not directly or dramatically affected by these developments, except to a certain degree in terms of improved communications and transportation.

Notwithstanding the benefits provided by these improvements, throughout the 1960s and

1970s, nurses were still required to treat and assess every medical case that came to the station with whatever (sometimes ancient) tools and amenities they had on hand.

In a broader sense, the Second World War and Confederation with Canada brought fundamental changes to the quality of life on the Coast, the scope of the

Mission's social and medical services, and the sources of its funding. The Grenfell

Mission could no longer appeal to a philanthropic public to support the health care of

"disadvantaged" people who were now citizens of a wealthy country. Furthermore, the need for charity declined as the federal and provincial governments provided increasing funds for the health care facilities in the area. As a result, the fund-raising activities of the numerous Canadian and American branches ceased and the influence of the board on

Mission's activities on the Coast declined. In 1972, the province of Quebec took over the

Mission's health care services on the Lower North Shore (Harrington Harbour and

Mutton Bay). Thomas retired as Executive Director of the Mission on 31 December

1978, and was replaced by Newfoundlander Peter Roberts.109 And in 1981, the Mission turned over all health care assets to the Newfoundland government for $1. The provincial department of health established the Grenfell Regional Health Services Board to replace the Grenfell Mission.110

109 Gordon Thomas, "Executive Director's Report for 1978," Fishers 1978 75(3): 1.

110 Peter J. Roberts, "Executive Director's Report," Fishers 1981 78(1): 1.

83 SUMMARY

The Grenfell Mission provided health and social services to the people of northern

Newfoundland and Labrador from 1893 to 1981. The health needs of these people changed through the period, and the Mission adjusted its services to meet those changing needs. Initially established to provide medical and spiritual care to the petty commodity producing Anglo-Saxon residents, the organization increasingly shifted away from spiritual concerns to focus on quality medical care and practical social assistance for all residents including Aboriginal peoples. The Mission also geographically expanded, spreading from the tip of the Northern Peninsula and the southeast Coast of Labrador to include communities from Port Saunders in the south to Hebron in the north. At the same time, global economic and political events directly affected the Mission's operations on the Coast. The Second World War introduced waged labour and a North American consumer culture to local residents, including cheap liquor and socializing with American and Canadian military personnel - the consequences of which created both benefits and disadvantages for local residents. The war was followed shortly thereafter by

Newfoundland's "hope of deliverance" - confederation with Canada in 1949. An influx of funding from both federal and provincial governments marked a significant shift away from the philanthropic core of the Grenfell Mission ideology and its raison d'etre.

Government funding reduced the need for the Mission to solicit private financial support and, as a result, the fund-raising activities of the various branches ceased and the influence of the Mission's board of directors on the Coast declined. Finally, in 1981, the provincial government took over the health care services of the residents of northern

Newfoundland and Labrador.

84 As the Grenfell Mission met the changing health care needs of the people on the Coast, it presented a "truth" of its operation as a benevolent organization providing middle-class leadership to disadvantaged people. Chapter 3 explores the discourse of the Grenfell

Mission which was employed to demonstrate its middle-class values, to promote its activities to middle-class financial supporters, and to justify its existence in northern

Newfoundland and Labrador in light of changing political, social, and economic circumstances.

85 CHAPTER THREE

Among the Deep Sea Fishers - A Promotional Vehicle for The Grenfell Mission's Middle-Class Dominant Discourse

In 1903, the Grenfell Mission ventured into a new medium through which to reach those people in the United States, Canada, and Britain who were interested in the

Mission's activities: it began to publish and distribute a quarterly magazine called Among the Deep Sea Fishers (hereafter Fishers). The Fishers was a collection of thrilling, and sometimes heart-wrenching, stories based on life on "the Coast" and the experience of bringing medical care to the people in that region. These people comprised a mixed community of petty commodity producing white Anglo-Saxon and Aboriginal peoples.

They had been geographically and socially isolated from western developments in public health and medicine of the late nineteenth and early twentieth centuries and, before the establishment of the Grenfell Mission, had limited access to scientific medicine. The

Grenfell organization hoped that the information contained within the pages of the

Fishers would elicit in the readership a sympathy for the "folk" of northern

Newfoundland and Labrador and an admiration for the heroic Grenfell personnel who braved the isolation and the elements for the sake of their disadvantaged fellow man.

Ostensibly, the readership would be stirred into supporting the operation, either through monetary or material donations or through personal volunteer activities. With this agenda, the Fishers became an important marketing tool for the Grenfell Mission in its attempt to "sell" a romanticized version of medicine in the north to a global audience.

86 FIGURE 3.1: Among the Deep Sea Fishers

Source: Fishers 50.02 (July 1952): cover.

There were three main thematic phases to the Fishers between 1939 and 1981, which were defined by the intentions of the Grenfell Mission in relation to changing circumstances on the Coast. These phases are defined as: 1) the soliciting phase, 1939-

1948; 2) the progress phase, 1949-1964; and 3) the nostalgic phase, 1965-1981. In the soliciting phase, before Newfoundland joined confederation with Canada, the Mission used the Fishers to encourage its readership to become involved in fund-raising or to donate money, clothing, furniture or anything else that could contribute to life on the

Coast. As a result, the magazine presented the desperate need of the people, their poverty, their ignorance, and their social and medical disadvantage. In the progress phase, which

87 began with confederation in 1949, the Mission became preoccupied with justifying its existence in light of social and economic progress and increasing government involvement. The Fishers focussed on the ways in which the federal and provincial governments supported the organization and how the local people were benefitting from the presence of the Mission and its educated staff members. In the early 1960s, there was a surge of interest in Aboriginal health which lasted until 1965. A change in staff at the

Fishers in 1964 marked the beginning of the nostalgic phase of the magazine - Shirley

Smith retired as editor, and the new editor took the Fishers into a different direction. In the nostalgic phase, 1965-1981, the Fishers published numerous historical and nostalgic articles highlighting how much the Coast had changed. In this phase, the magazine became a more generic publication. It stopped publishing staff lists and financial reports of the Grenfell Mission and increased reprints of articles from other publications. This change in direction can, at least partially, be explained by a growing feeling within the

Grenfell administration that the Mission had become less accountable to the Fishers readership since it was now funded almost exclusively by governments.

Between 1892 and 1981, the Grenfell Mission was the most widespread and socially influential institution in northern Newfoundland and Labrador - both for the residents of the area and for the employees of the Mission, though in differing ways. For the local people, the Grenfell Mission provided a valuable health service and assisted with the improvement in health and living conditions in the region, often interfering with people's established cultures and traditions. For the foreign employees, the Mission provided an extraordinary opportunity for an international experience in which they were free from familial obligations and parental oversight and became exemplars of middle-

88 class mores. The text of the Fishers provides an opportunity to explore the influence of

the Grenfell Mission on the Coast, not necessarily in terms of accurate versus inaccurate

statements, but in terms of its characterization as dominant discourse; that is,

interpretations of the meanings behind Fishers statements, the impact of those statements

on the reader, and the effect of that impact on the reader's philanthropic actions. Ideally,

the readers would be so emotionally stirred and/or inspired by the articles of the Fishers

that they would donate their time or money to supporting the operation. Essentially, in all

these phases there was a terrible need for social and medical services in northern

Newfoundland and Labrador, the local people were worthy of assistance, and the Grenfell

Mission was well qualified and well placed to provide this service.

This chapter explores the pages of the Fishers in an attempt to highlight the

official Grenfell discourse used by the Mission to meet its institutional agenda. The

prominent themes of the Fishers changed through each decade, reflecting the socio

economic and political developments of the Coast and the changing needs and priorities

of the Grenfell Mission. However, there was a consistent purpose in portraying great

need on the Coast in terms of the people by highlighting the poverty of the people, local

ignorance, and the poor health of Aboriginal peoples. And there was an associated

consistent purpose in portraying the Mission as the best option for providing care to those

people by highlighting: progress and social uplift associated with the Mission, quality of

services, official endorsement, and nostalgia. These themes were interconnected within

the Fishers texts, contributed to the raison d'etre of the Mission, and formed the core of

the Grenfell Mission truth.

89 MIDDLE-CLASS DOMINANT DISCOURSE

For the Grenfell Mission, the Fishers became the vehicle through which to present its "truth," or dominant discourse, to a middle-class audience. "Truth" in this case is not necessarily the accurate representation of an actuality; it is not something inherent in a statement. Rather, "truth" is something that societies work to produce,' a "regime of truth," a "general politics" of truth, and the states of those who are charged with saying

"what counts as true."2 When Wilfred Grenfell landed at Battle Harbour in 1892, he arrived under the authority of the Mission to Deep Sea Fishers - an established philanthropic organization in Britain that was also a sanctioned medical institution.

Through his connection with this respectable, middle-class medical organization,

Grenfell was able to establish himself, his employees, and the Mission itself, as the social authority of the Coast. Considering the middle-class and colonial clout of Grenfell and his establishment, his narrative of the Grenfell Mission became the "truth" of the Grenfell

Mission. And according to this truth, the Grenfell Mission was a philanthropic health care organization that provided medical aid to poor and desperate people in a neglected corner of the British Empire. The people were apparently simple and ignorant but they were worthy of assistance and appreciative of the Mission's efforts on their behalf. The

Mission itself consisted of selfless individuals who sacrificed their own material comforts in order to serve the needy families of northern Newfoundland and Labrador. This, the official Grenfell discourse, was a product of the middle-class social context of Britain,

1 Sara Mills, Discourse: The New Critical Idiom, (London: Routledge, 2004), p. 16.

2 Michel Foucault, "Truth and Power: an interview with Alessandro Fontano and Pasquale Pasquino," in Meagan Morris and Paul Patton (eds), Michel Foucault: Power, Truth, Strategy, (Sydney: Feral Publications, 1979), p. 46.

90 the United States and Canada - from where the majority of Grenfell personnel came - but also of the petty commodity producing social context of the Coast. This discourse saturated the pages of the Fishers as the Grenfell Mission promoted its truth and reached out to its middle-class audience.

The Fishers was a promotional vehicle. Every article in the quarterly contributed to this vision and purposed to appeal to the hearts and pocket-books of a middle-class readership. It was edited and distributed through the Boston office of the New England

Grenfell Association, and the Grenfell secretaries functioned as censors to the content and language of the articles. No subject material was published without the approval and strict editorial eyes of these secretaries. As a result, the Grenfell administration had complete control over the material that was included and excluded from the magazine. In short, through the distribution of the Fishers and the censorship and editing prowess of the Grenfell secretaries, the administration was able to shape the truth of the Grenfell

Mission so that it was acceptable and appealing to the middle-class mores of the people they targeted as donors and participants. In distributing and promoting this truth, the main objectives of the Fishers were threefold: to justify its existence and continued presence on the Coast; to raise money for the Mission through subscriptions and by encouraging individual donations of money or material items; and to spread awareness of the Mission and its activities, which, it was hoped, would assist with the recruitment of new staff and encourage the participation of volunteers, both at home and on the Coast.

91 THE PEOPLE

Poverty

For most of its existence, the Fishers was primarily driven by a need to legitimize itself to its readership and to justify its existence and its continued presence in northern

Newfoundland and Labrador. The success of this approach, especially in the pre-

Confederation period, depended to a large extent upon the portrayal of the locals as poverty-stricken, ignorant, and desperately in need of the medical, social and even intellectual leadership of the Grenfell Mission. As outlined in Chapter 2, there were significant socio-economic disadvantages in northern Newfoundland and Labrador, and visitors to the Coast through the nineteenth century witnessed severe deprivation.3 In his

1897 book, The Tenth Island, Beckles Willson presented a promotional snapshot of

Newfoundland which contained a bleak description of life in Labrador: "If you want to know what the worst human poverty is like you should try not London, but Labrador."4

He proceeded to describe families with limited education and resources; families who neither needed nor expected luxuries; families who lived in one-room homes and slept on floors and wooden boards.5 Willson had met Grenfell while he was in Labrador, which may have influenced his perception of life on the Coast; and indeed, Willson quoted

1 Ron Rompkey outlines some of these reports in Grenfell of Labrador: A Biography. In 1867, Commander William Chimmo of the Royal Navy was astonished at the living conditions in Labrador and the unsafe passage of families to the fishing grounds. In 1880, Presbyterian clergyman Reverend Dr Moses Harvey reported that families in Labrador lived without administration, law and order, relief, medical care, or even "the ordinary necessaries of life." See Rompkey, Grenfell of Labrador: A Biography, (Toronto: University of Toronto Press, 1991). pp. 40-41.

4 Beckles Willson, The Tenth Island: Being some account of Newfoundland, its people, its politics, its problems, and its peculiarities, (London: Grant Richards, 1897), p. 199.

5 Willson. The Tenth Island, pp. 200-205.

92 Grenfell prolifically. However, regardless of the motivations of those reporting the widespread poverty in Labrador, there is evidence of fishing families along the Coast with very little in the way of material resources and amenities. In many cases, the most impoverished families were those in which the main "breadwinner" was sick, disabled, or deceased.

In the context of this dissertation, 'poverty' refers to subsistence living with pervasive limits on capital accumulation. In northern Newfoundland and Labrador, poverty continued well into the twentieth century. Fishing families were susceptible to the vagaries of the fishing economy and their relationships with local merchants; and their health problems were often shaped by limited access to nutritional foodstuffs improved lifestyle commodities. The widespread nutritionally inadequate staple diet was linked to numerous deficiency diseases, which became the subject of a variety of nutritional surveys in Newfoundland and Labrador during the first half of the twentieth century. These academic studies and government reports found compelling evidence relating deficiency diseases to the poor local diet.6 Reporting in 1915, Nurse Godden from the Newfoundland Tuberculosis Public Service stated her observations of the local diet: '"Bread and tea' seemed to be the only diet. ... They seldom see or taste fresh meat,

6 See for example. J.M. Little, "Beriberi Caused by Fine White Flour "Journal of the American Medical Association, 58.26 (1912): 2029-30; V.B. Appleton, "Observations on Deficiency Diseases in Labrador," American Journal of Public Health, II (1921): 617-21; H.S. Mitchell, "Nutrition Survey in Labrador and Northern Newfoundland," The Journal of the American Dietetic Association, 6(1930-31): 29-35; M. Vaughn and H.S. Mitchell, "A Continuation of the Nutrition Project in Northern Newfoundland," The Journal of the American Dietetic Association, 8 (1933): 526-31; W.R. Aykroyd, "Beriberi and Other Food- Deficiency Diseases in Newfoundland and Labrador," The Journal of Hygiene, August 30.3 (1930): 357- 86; D. Steven and G. Wald, "Vitamin A Deficiency: A Field Study in Newfoundland and Labrador," Journal of Nutrition, 21.5 (1941): 461 -76. Several studies were conducted by Grenfell Mission personnel, including M.R. Mosely, "The Third Year of Health Work," Fishers 24.4 (January 1923): 106-9; M.D. Lynon, "The Summer's Health Work at Poverty Cove," Fishers 29.4 (January 1928): 74-75; W. Murdock, "Fighting Famine at Forteau," Fishers 36.4 (January 1935); H.S. Mitchell, "Food Problems in the Labrador," Fishers 31.3 (October 1929): 99-103.

93 very little milk, or any of the principal necessities."7 In 1930, W.R. Aykroyd investigated the dietary habits of families along the Northern Peninsula and in Labrador and directly associated the seasonal and annual incidence of beriberi with poverty. Aykroyd found that outbreaks of beriberi followed bad fishing years and seasonal beriberi occurred in late spring and early summer, when the nutritional level diets were particularly low because the families' supplies were becoming exhausted.8

In the pre-Confederation period, there were areas of widespread poverty in the outports, especially along the Northern Peninsula and coastal Labrador. In Them Days magazine, residents of Labrador recollect their experiences during the Depression. An article by Elizabeth Goudie at Happy Valley describes her experience as a trapper's wife in the Labrador interior:

Now, we as trappers were only managin' from hand to mouth, there was no extra money, none in the bank, none even in your money box. We'd always have to depend on the Hudson Bay Company to supply us with a fit-out, a supply of food, for three months. ... When we'd want extra milk or a few pounds of raisins, we'd go out in the field, one year we cut nine hundred pounds of hay, me and my two children. I cut and they dried. That was to get extra milk or raisins or something for the children. The times we lived was like a depression all through. We didn't know about the Depression in the cities and those places, so it didn't affect us because we was already livin' that life. The way the HBC runned it was that you got a supply of food and you had to try and pay that off when you come back from trappin', and if you wasn't able to pay it off completely, it was added on to the bill next year, and then you wouldn't get as much supplies as you did the year before. We would only get butter, sugar, flour, pork, beef, dried beans and dried peas and rolled oats, tea and a couple of pounds of coffee and some molasses. We had lard for fryin' our fish and pork for stewin' it. My

7 "Report of the Tuberculosis Public Service for the Year 1915," Journal of the House of Assembly of Newfoundland, (St. John's: Government of Newfoundland, 1916), pp. 650-51.

8 Aykroyd, "Beriberi," p. 365.

94 children didn't know what it was to have an apple or an orange. There was no fresh fruit of any kind.9

According to Goudie, the trapper's financial arrangement with the Hudson Bay Company was similar to the credit system between fishers and merchants. The passage also describes the limited resources available to residents of Labrador, especially in terms of foodstuffs.

The Fishers published photographs of local housing and living conditions as a means of displaying this poverty. Figure 3.2, showed the interior of a local home with a

ladder to the "bunk" room and the walls covered with "the London and New York Sports and Society pages;"10 evidence of the austere living conditions on the Coast.

FIGURE 3.2: "Mrs. Martin of Sandwich Bay, Labrador"

Source: Fishers 37.02 (July 1939): 52.

9 Elizabeth Goudie, "We Lived From Hand to Mouth," Them Days 5.1 (1979): 53-54.

10 "Excerpts from the Notes and Pictures of a Medical WOP: Answering Calls," Fishers 37.02 (July 1939): 52.

95 The same article proceeded to describe the austere living conditions of a Labrador home

where a woman had recently given birth to twins; her sleeping arrangements consisted of

a "straw mattress and quilting upon the floor."11 Nurse Ella Hewitt described local homes

as "tiny and poorly furnished but always clean and tidy. Just inside the door of every

home is the bare, wooden sofa or 'settle".... Limited space decrees that beds be built

within the three walls of a tiny cubbyhole which serves as a room. Stairs to the attic are

always very narrow and very steep, and one must go up with bowed head and shoulders

to the little place under the eaves where the boys usually sleep."12 From the same period,

Figure 3.3 showed a man in a boat, presumably heading to the station to visit the Grenfell

nurse or physician. The man was smoking a pipe, looking rustic and relaxed as he

travelled on the water; and the several patches mending his shirt earned him the caption,

"Patchwork Patient."13

11 "Excerpts from the Notes and Pictures of a Medical WOP," 52.

12 Ella E. Hewitt, "Eight Months at Forteau," Fishers 43.1 (April 1945): 20.

13 "Patchwork Patient," from Notes and Pictures of a Medical WOP, Fishers 37.02 (July 1939): 58.

96 FIGURE 3.3: "Patchwork Patient"

Source: Fishers 37.02 (July 1939): 58.

Although the Second World War brought about a local economic boom in certain areas of the Coast, this boom was "strictly comparative. The standard of living

[remained] sternly Spartan."14 There was a significant disparity between poverty levels at the large Grenfell centres compared to the smaller, isolated communities.15 The people often lived a day's journey from the nearest physician, and "[could] never afford to pay more than a few dollars for the visit."16 Writing in 1942, Morgan Berthrong described his

14 C. Garth Forsyth, "Cartwright Today," 41.1 (April 1943): 14.

15 "St. Anthony and its hospital [were] modern, but twenty miles away the small settlements [were] scarcely better off than they were fifty years ago. People [were] still starving in the long cold winters, tuberculosis [was] still rampant." See Morgan Berthrong, "St. Anthony Hospital," Fishers 39.4 (January 1942): 109.

16 Berthrong, "St. Anthony Hospital," p. 108.

97 trip to the Coast in terms of regressing back in time and with housing and infrastructure dwindling from "cities" to "shacks":

As we passed to the north, going to summer service for the Grenfell Mission, the cities dwindled into towns, and towns into villages, the villages into settlements, mere outposts of humanity where several frame shacks were huddled about a tiny sheltered cove. From Boston to the top of the northern Peninsula of Newfoundland one passes back years in time, as well as from riches to comparative poverty.17

Despite the changing circumstances brought about from the war, the economic need in northern Newfoundland remained, according to the Fishers, "as desperate as ever."18 In fact, right up to the eve of Confederation, there were reports of poverty, malnutrition, and even starvation on some parts of the Coast. In the spring of 1949, Nurse

Dorothy Jupp reported a serious food shortage in her community, an event which garnered considerable public attention since it coincided with Newfoundland's confederation with Canada. Jupp wired an urgent appeal for food to the new province's premier, J.R. Smallwood, stating: "There is a serious shortage of food on this coast. To

17 Berthrong juxtaposed the poverty of the inhabitants of the Coast with the spectacular presence of the Grenfell Mission as an "oasis" of health and security. He also equated the plebeian character of the people coinciding with their strong connection to nature; they were "a people who [eked] out with their hands their living from nature." See Morgan Berthrong, "St. Anthony Hospital," pp. 108-109. This observation is reminiscent of hierarchies of racial and class difference in colonial contexts. In her study, "Race, Culture, and the Colonization of Childbirth in Northern Canada," Patricia Jasen found that a myth of painless childbirth for Aboriginal women was common among representatives of Euro-Canadian culture in the North, based on perceptions that European civilization was more highly developed than "primitive" or less enlightened peoples. According to this theory, less developed peoples were closer to nature than those more "civilized" and as a result, were more accepting of their circumstances and suffered less physical pain - both observations were common in the Grenfell literature in reference to the petty commodity producing residents of northern Newfoundland and Labrador. See Patricia Jasen, "Race, Culture, and the Colonialization of Childbirth in Northern Canada," Social History of Medicine, 10(3): 383-400.

18 C. Hogarth Forsyth, "Cartwright Today," Fishers 41.1 (April 1943): 14. In 1946, there were still reports of starvation and lack of proper food on the Coast. A Fishers article on the medical trip of the "Maraval," presented a heart-breaking story of a local baby who was "in a state of complete starvation and despite every effort, died the same day. The poor little creature looked like a 'Belsen Baby' and at 7 months weighed but six pounds." "Log of'Maraval' - Summer 1946," Fishers 44.4 (January 1948): 104. This was likely a reference to the Bergen-Belsen Displaced Person's Camp which was established by the Allies in July 1945, to house survivors of the Bergen-Belsen Concentration Camp. See Suzanne Bardgett and David Cesarani (eds.) Belsen 1945: New Historical Perspectives, (Portland OR: Vallentine Mitchell, 2006).

98 avert starvation of the people food much be got here somehow. Babies are being fed on flour, water and molasses water as there is no milk or rolled oats. At the time of wiring only seven bags of flour were left on the coast. No milk, no meat, no vegetables, no butter and no tea."19 Newspapers across Canada became consumed with the critical situation in Labrador. However, Jupp had been reporting incidents of starvation in her area for some time. In June 1948, she informed Seabrook that the local lumber company

"crashed" and "people were left without food. Two thirds of the population of the District had to go on the 'dole' ($5.00 per month). Dogs died in scores.... People look very thin and haggard, and the children seem to be listless. Several horses, belonging to the Co. were brought to St. Mary's for shelter and food—two of them dropped dead from starvation."20 Evidently, despite the proximity and the promises of confederation with

Canada, poverty, malnutrition, and even starvation were harsh realities for many families in northern Newfoundland and Labrador in the late 1940s which wartime stringencies and post-war recovery had worsened.

The emphasis on the poverty and the social and educational disadvantage of the people of northern Newfoundland and Labrador was more common in the Fishers articles of the 1940s than in succeeding decades, perhaps because poverty was genuinely more prominent on the Coast during that decade compared to the postwar period. However, politics may have also been a factor in the decrease of poverty themes after 1949 since

19 "Starvation in Labrador," The Evening Telegram, 7 April 1949, p. 3. For an insightful interpretation of the political nature of this incident and the tension between Jupp and the Grenfell Mission over her assertiveness in calling public attention to the matter, see lona Loreen Bulgin, "Mapping the Self in the 'Utmost Purple Rim': Published Labrador Memoirs of Four Grenfell Nurses," (PhD Dissertation, Memorial University of Newfoundland, 2001). See also, Gordon W. Thomas, "Winter Plane Trips," Fishers 47.2 (July 1949): 35-36.

20 PANL, MG 63, File 1057, "Dorothy Jupp," Jupp to Seabrook, 17 June 1948.

99 Newfoundland's "progress" and its status as a Canadian province was decidedly celebrated in the Fishers. The administrators may not have considered it politically acceptable to highlight the poverty of a Canadian province in the 1950s while it also emphasized progress and development and assured the readership that their donations and participation with the Grenfell Mission was still having a significant positive impact on the people of the Coast.

Local Ignorance

In addition to the comparatively poor economic situation of people in the 1940s, the Fishers also emphasized the comparative poor social and intellectual situation of those people on the Coast. Some contributors to the Fishers associated the economic hardships of the people with a perceived lower potential intelligence. Canadian Nurse

Ella Hewitt described people at Forteau in 1945 as "...hardy and wiry. They live a hand- to-mouth existence, depending mainly on the fish for the bare necessities of life. Their diet is such that they are ready subjects for all types of infections. Tuberculosis takes its toll; their minds cannot grasp the significance of precautions or treatment."21 There was a common perception among Grenfell staff members that the people of the Coast were less

"developed" than more formally educated and middle-class city folk. For example, contributor H.T.R. Mount provided an overview of Curtis's work on the Coast, and when discussing an orthopaedic patient at the St. Anthony Hospital he made an elitist judgement of the man's intellect based on his physical bone pathology: "One young man aged twenty years was brought in, whose lower extremities were fixed in a position of

21 Ella E. Hewitt, "Eight Months at Forteau," Fishers 43.1 (April 1945): 20.

100 extreme flexion. The feet were shapeless with softened, malformed bones. As might be

expected, his mind was as warped as his body. This man's legs were straightened, and as

they took shape under sympathetic professional and nursing care his mind began to

develop."22 Mount pointed out the age of the patient, and "twenty years" would doubtless

indicate a body at the prime of life; but, according to Mount, on the Coast this twenty-

year-old was physically and intellectually inferior; however, significantly, according to

Mount, both "conditions" diminished under the spectacular care of the Grenfell Mission.

During the early 1940s, the Fishers also reprinted letters of gratitude from local

residents to Grenfell staff members. One letter in 1943 was written from a woman in the

community of Fleur de Lys to an individual who had donated clothing to the Grenfell

Mission's Clothing Store. The woman found a name and address on a tag in the bag of

clothing she received and wrote to the donor, presumably encouraged to do so by the staff

member in charge of the Clothing Store:

I am a Newfoundlander. I live in the north of Newfoundland in Whit bay districk I am a married woman have 7 children 1 boy and 6 girls their ages are from 14 down to 14 months My husband is a fisherman He fishes all summer and winter time he spens most of his time in the woods logging or getting fire wood for our home for you know we peopl in those out ports are unable to by cole if we had to by our firing we would never do it. You know Nfld is a poor country to live in thats the norts parth especily those little places There is a place 60 miles north from us it is call St. Anthony there is a hospital there and there is a clothing store there they have lots of clothing come in from others contrys it called secon hand clothing and we people find it a great help We can exchange vegetables of any kind or fish and mats for clothing but they will not take any cash So last month i exchanged a mat for some clothing for my little

" H.T.R. Mount, "Charles S. Curtis, M.D., Superintendent," Fishers 40.3 (October 1942): 80. Similar "ignorance" was highlighted by Paddon in 1947, when he noted that "a full-blown diphtheria case [was] stumbling around, happily unaware of his condition." See WM. Anthony Paddon, "Log of the 'Maraval,"' Fishers 45.2 (July 1947): 51.

101 children and among it was a bag with a ticket on it bearing this name .. . So I am just writing to see if i will get a answer.23

The letter was titled "Fan Mail" and was reprinted with spelling, grammar and

punctuation mistakes included, emphasizing the woman's (people's) simplicity and lack of basic formal education and the potential for social uplift in the region. This portrayal was likely purposeful on the part of the Fishers because on the one hand the medical and

Mission staff clearly felt a genuine desire to serve others, but on the other hand this service was filtered through their largely paternalistic middle-class outlook. By either means through these types of publications the Fishers were able to demonstrate the need

for public sympathies and donations, reinforcing the dominant middle-class dogma about rural communities/people in northern Newfoundland and Labrador.

This ideology is further demonstrated by the way the Fishers sometimes

portrayed local residents as child-like or requiring the parental guidance of the Grenfell

Mission. In 1945, Curtis praised Nurse Ethel Currant for being "firm but just with the

local people,"24 ostensibly because they were not mature or intelligent enough to make responsible decisions for themselves. This theme was reiterated in 1947 when the death of a baby at Forteau was somewhat blamed on the parents. In this case Curtis reported:

->5 "Lack of proper food and lack of knowledge had contributed equally to its death."*"

Local ignorance was a common theme in the Fishers, and was considered a serious justification for the Grenfell presence. Even non-medical incidents amplified the

2i "Fan Mail," Fishers 41.1 (April 1943): 5. There was no indication of how this letter came to be published in the magazine, but most likely the recipient of the letter submitted it to the editor of the Fishers.

24 Charles S. Curtis, "Heroines," Fishers 43.2 (July 1945): 46.

:s Charles S. Curtis, "Louie Hall Nursing Station - Forteau," Fishers 44.4 (January 1947): 104.

102 intellectual and educational need of the Coast. In January 1943, on reflecting on the career of Donald Hodd at Harrington Harbour, "H.F.L." presented the story of a local man who disagreed with Hodd after the latter instituted summer daylight saving time by advancing the Mission clocks by one hour to reduce the use of the hospital's power plant.

Some of the residents were not prepared to abide by daylight saving in the community, and H.F.L. referred to one such individual as "some wag" because he '"preferred God's time to Hodd's time!'"26 H.F.L. proceeded to praise the work of Hodd among the less civilized residents of Harrington Harbour and stated that: "life in that part of the world

[was] so different from life in more highly developed regions" and that Hodd was

"[elevating] a large and varied population a degree or two in their manner of living.. ,."27

In the 1940s, the Fishers published ample examples of the Grenfell Mission providing enlightenment to the local residents, especially in the form of health education and the

"growing health consciousness" of the people.28 Curtis noted in 1944 that the people's health was improving over time in association with their growing realization of the

"necessity for a healthy population."29 These improvements were presumably the result of the Grenfell presence and the health and educational guidance provided by high quality Grenfell personnel.

Associated with this depiction of the local residents as child-like was the tendency in the Fishers to view locals as simple, uncritical, uncomplaining, and resigned to their

26 H.F.L. "Dr. Hodd of the Canadian Labrador," Fishers 40.4 (January 1943): 105.

27 H.F.L. "Dr. Hodd of the Canadian Labrador," p. 105.

28 Verna Loomis, "Keep-Well Work," Fishers 39.3 (October 1941): 73.

29 [Charles S. Curtis], "The Superintendent Reports," Fishers 42.1 (April 1944): 17.

103 fate. The cooperation of mothers and children was particularly notable. In conducting

public health at St. Anthony, nurse Verna Loom is "found the younger generation and

mothers most cooperative and cordial."30 She also implied that the children were not

educated enough to realize that their eye-sight could be substantially improved; but she

presented this naTvete as an attribute.31 The patients' acceptance or resignation to their

fate was considered to be, and was portrayed as, a local virtue that could inspire Grenfell

staff to have strength in the face of life and death situations; "the habitual cheerfulness

and often passive resignation of the people in facing hardships has been a great

inducement to hard work."32 Similarly, when describing a treacherous trip with a sick

patient across the Straits of Belle Isle, Bessie Banfill described her patient as having

"accepted his fate without complaints against the weather or the sea. His was an inner

calm, practically unknown to the average city person, as he lay there and awaited his

fate."33 By referencing her patient's "inner calm" Banfill's example implied that, as a

simple small coastal village man, he possessed an extraordinary inner spiritual strength;

she also made the distinction between her patient and "the average city person," implying

that the local man did not possess the same expectations of life as city-folk. Banfill's

example is telling in terms of illustrating a representation of unconsciously ingrained

middle-class attitudes toward those of the deserving poor, to which her description of this

10 Verna Loomis, "Public Health Report," Fishers 39.4 (January 1942): 125.

31 Verna Loomis, "Keep-Well Work," Fishers 39.3 (October 1941): 73.

32 Winifred Burgess, "Flowers Cove Household and Social Work, 1947-1948," Fishers 46.4 (January 1949): 104.

13 B. Banfill, "Night Watch," (reprinted from the Canadian Nurse, February 1949), Fishers 47.2 (July 1949): 44.

104 man's simplicity and demeanour suggests he belonged. By portraying the residents as child-like, simple, and intellectually unsophisticated, the Fishers attempted to emphasize the Grenfell Mission's paternalistic position on the Coast; as important as a father's presence was to the well-being and development of his family, so was the presence of the

Grenfell Mission to the folk of northern Newfoundland and Labrador.

Aboriginal Population

Considering the socio-economic changes during the 1950s, along with the influx of federal and provincial funding for health care activities in the region, it became less attractive for the Fishers to promote the poverty and lack of "civilization" of the white residents of the Coast. However, the Mission was able to maintain its truth of providing an essential service to disadvantaged people by turning their promotional focus towards the Innu and Inuit in Labrador. During the 1940s, the Grenfell health services described in the articles of the Fishers had focused on the people of the Coast of white Anglo-

Saxon descent. Aboriginal peoples were only briefly referenced in the Fishers', there were some images of Aboriginal patients, but no articles focusing specifically on their health, communities, or lifestyle. Contributors to the Fishers sometimes photographed Innu or

Inuit families that they encountered on their travels through Labrador. Figure 3.4 below was from an article by Kate M. Keddie, Industrial Supervisor at Cartwright during late-

1930s and 1940s, "Here and There as 1 Go Along," which consisted of photos taken during a recent dog-team trip in the area.

105 FIGURE 3.4: Innu Women Netting Snowshoes

Source: Fishers 37.01 (April 1939): 15.

The Innu women shown were netting snowshoes, with the children huddled in the doorway of the tent observing the process, in what looks to be a deliberate pose produced by the photographer.34 One of the earliest references to Aboriginal health during this period was in a report on the Grenfell activities at Harrington Harbour and Mutton Bay in

1944, in which Donald Hodd described the condition of Aboriginal residents of the north shore of Quebec as "only fair," with infant mortality being particularly high.35

Paddon was especially interested in pushing Grenfell services to northern Inuit communities - he began winter dog-team trips and summer boat cruises along the Coast.

And with the establishment of the Canadian base at Goose Bay, the Royal Canadian Air

Force began flying Paddon to Nain, where he would charter a dog-team to head north

34 Kate M. Keddie, "Here and There as I Go Along," Fishers 37.01 (April 1939): 13-17.

33 D.G. Hodd, "The Canadian Shore," Fishers 41.4 (January 1944): 111.

106 towards Hebron and then south back to North West River.36 Following Confederation, the

Grenfell Mission became increasingly involved in Aboriginal health care. In 1954, the

Government of Canada began a formal arrangement with the province of Newfoundland

which consisted of federal funding towards Aboriginal health and welfare.37 The province

itself increasingly supported expansion projects of the Grenfell Mission in northern

settlements, funded the construction of the Nain nursing station in 1956,38 and cooperated

with the Tuberculosis Association of Newfoundland to conduct a meticulous x-ray survey

of Aboriginal populations. This increase in Grenfell activities in Innu and Inuit

communities was reflected in the plethora of references, articles, and photographs of

Aboriginal people in the Fishers, especially between 1955 and 1975.

In the magazine's post-Confederation expose on the plight of Aboriginal

communities in Labrador, Curtis pointed out that the Inuit had recently become

dependent on financial assistance from the provincial government. Curtis explained that

the Inuit had depended on resource sectors for their livelihoods, particularly sealing and

cod fishing, both of which industries had declined. During the war, the Inuit found

employment on the construction sites of American military installations but these projects

had ended, leaving the people reliant on government relief.39 By underlining the Inuit's

social and economic disadvantage, Curtis positioned them as needy beneficiaries of

M' Paddon's 1948 article, "Northern 'Cruise,' Winter 1947-48," was a significant treatment of Inuit communities in the Fishers and contained a picture of two "Eskimo" children at Makkovik. However, the article focused more on Paddon's trip itself - the adventure - rather than the people and their lifestyle. See Wm. Anthony Paddon, "Northern 'Cruise,' Winter 1947-48," Fishers 46.3 (October 1948): 78-83. See also, W.A. Paddon, "North West River at the Cross-roads," Fishers 49.02 (July 1951): 50-53.

37 Gordon W. Thomas, "New Era: A Radio Talk over CBC," Fishers 53.3 (October 1955): 77.

38 Dorothy Jupp, "The New Nain," Fishers 55.1 (April 1957): 9-11.

19 Charles S. Curtis, "Eskimos and Nain," Fishers 54.3 (October 1956): 67.

107 Grenfell health services. However, while the Inuit lifestyle did not measure up to Grenfell white middle-class standards, the Innu at North West River and Davis Inlet were highlighted as being particularly "primitive" - sleeping on beds of spruce boughs, living in government-issued canvas tents, travelling by canoe, and pursuing their migratory lifestyle.40 To Shirley Smith, writing in 1965, "...modern white 'civilization' [had] for the most part let them alone;"41 this ostensibly explained the "quaint" Aboriginal lifestyle while it also provided a "civilizing" agenda for the Mission, which was reflective of the colonial/colonially racist and classist perspectives represented by Grenfell Mission and its staff.42 In the meantime, the Inuit on the Coast usually had more permanent lodgings in their communities; however in 1961, presumably to prevent the misconception that the

Inuit lived more advanced livelihoods, the Fishers pointed out that the people at Nain still made igloos.43 Depicting the exotic living arrangements of Aboriginal communities in

Labrador was an important means by which the Fishers demonstrated "difference" and, by Western middle-class standards, appealed to the readership to assist with the uplift of those "disadvantaged."

40 According to nurse Marjory K. Stevens, there were only two houses in Davis Inlet in 1964 - one for the priest and one for the Innu Chief and his family. See Marjory K. Stevens, "There's Always Davis Inlet," Fishers 61.4 (January 1964): 101. See also Arthur W. Bingham Jr. and Andrew Y. Rogers, "Two Directors Report - continued," Fishers 56.4 (January 1959): 106; Alika Webber and Ray Webber, "The Naskapi Child," Fishers 62.3 (October 1963):96-97; and Patricia Elkington, "House Call at the Indian Village," Fishers 63.1 (April 1965): 9-11.

41 Shirley Smith, "The Nascapi Indians of Davis Inlet," Fishers 63.1 (April 1965): 21. However, though one should note that because the modern, white, 'civilization' was distinctly colonial, which Smith herself represents, her comments are thus inaccurate and implicitly racist because white colonialism directly impacted the different Aboriginal nations, even as some attempted to maintain some of their lifestyle heritage and traditions.

4" There were multilayered issues that the Innu and Inuit faced as a consequence of contact with the Grenfell Mission which are beyond the scope of this dissertation.

41 "Of Igloos and Kayaks," Fishers 59.2 (July 1961).

108 Innu and Inuit participation in western cultural activities was a popular feature of the Fishers during the 1960s, as it was considered an example of Grenfell progress on the

Coast. Most of these references pertained to the Inuit along the Coast, who had long been exposed to European colonial culture through the presence of the Moravian Mission.

Christmas in particular was the epitome of colonialists' Aboriginal "civilizing" endeavours since it combined both western and Christian activities. At Nain in 1960,

Christmas involved a children's candle service, a church service, the distribution of toys, a "Children's Day," and a Scout and Guide party.44 Several articles described the nursing station at Nain, with its complement of local Inuit girls employed as ward aides assisting with patient care and station maintenance, complete with numerous photographs of

Aboriginal staff and patients. The girls were described as "capable" aides, one of which had a "merry twinkle" in her eyes 45 The Innu and Inuit were frequently described as having "bright eyes," being "sunny," "cheerful,"46 "full of vim and vigor - eager to sing, talk and play,"47 characteristically happy with a good sense of humour and a light-hearted approach to life. Yet, they were also described as composed and benefitting from "native stoicism."48 Again, while the human connections can be seen in this evidence, these descriptions nevertheless illustrate the integrated racism and classism inherent in the white perspectives of Innu and Inuit peoples.

44 Joan Stedman, "Christmas From the Sky," Fishers 59.1 (April 1961).

45 Dorothy A. Plant, "Lasting Lure," Fishers 58.4 (January 1961): 102.

46 W. Anthony Paddon, "Northern Medical Patrol," Fishers 69.1 (April 1971): 7. 47 Alice Mae Zenike," A Visit to the Nursery," Fishers 54.4 (January 1957): 111-112.

48 Theodore L. Badger, "The Era of Ships and Dog Teams is Past," Fishers 59.1 (April 1961): 10; and Betty Seabrook, "North Again," Fishers 59.3 (October 1961). See also Webber, "The Naskapi Child," pp. 96-97; Smith, "The Nascapi Indians of Davis Inlet," pp. 21-23.

109 The Fishers often took a reductionist approach to Aboriginal characteristics, describing the Innu and Inuit as nonchalant about mistakes or problems, steady and stoic about crises.49 However, the colonialist discourse presented in the Fishers in the 1960s and 1970s differed from the earlier discourse surrounding the poverty and ignorance of the local Anglo-Saxon population. In those earlier Fishers articles, the Mission overtly depicted the desperate state of people who often did not have the education or initiative to improve their situation - people who could easily be blamed for their perceived social deficiency according to middle-class Grenfell Mission standards. In contrast, the Innu and Inuit were more often depicted as blameless in their plight. Several Fishers articles made reference to the disruption in the Innu lifestyle brought about by the introduction of government housing and welfare - the imposition of a sedentary lifestyle and the decline of a traditional migrant way of life. In terms of its portrayal of Aboriginal peoples, the

Fishers made more use of photography in demonstrating "difference" and in one instance the photographer admitted that she was interested in photographing the people "not because they were oddities but because they seemed to be a beautiful group of people."50

49 And the abundance of photographs during this period in the Fishers highlighted these characteristics - one issue of the magazine contained two full-page photographs of Aboriginal men at work, with the caption: "Indians... work hard, have lighter moments." See "Indians... work hard, have lighter moments," Fishers 59.2 (July 1961): 49-50. Most of the articles about Innu or Inuit communities included photographs documenting various aspects of Aboriginal life - children in the hospital, children at play, mothers with children, men at work, the elderly, their domestic arrangements, their villages. See for example, Joan Stedman, "These for Their Comfort," Fishers 57.4 (January 1960): 110-114; Stedman, "Christmas from the Sky," pp. 5-7; Warren D. Haley, "Excerpts from a Summer Journal," Fishers 59.1 (April 1961): 13-14; Stevens, "There's Always Davis Inlet," Fishers 61.4 (January 1964): 100-103; Elkingston, "House Call at the Indian Village," pp. 9-11; Webber, "The Naskapi Child," pp. 96-97; Smith, "TheNascapi Indians of Davis Inlet," pp. 20-23; W.A. Paddon, "Origins of the Northern Nursing Stations," Fishers 67.4 (January 1970): 110-121; Paddon, "Northern Medical Patrol," 2-9; Candy Cochrane, "Northern Portfolio," Fishers 69.1 (April 1971): 10-13; Anne Keiser, "Hopedale Summer," Fishers 69.3 (October 1971): 56-59; John M. Darte, "The Delivery of Health Care to Children of Newfoundland," Fishers 70.4 (January 1973). 2-8; Theodore L. Badger, "Labrador Profile: The Montagnais," Fishers 72.1 (January 1975): 9-14; R. Ann Brister, "Summer with the Eskimos on the North Labrador Coast," Fishers 73.2 (April 1976): 3-7.

50 Candy Cochrane, "Northern Portfolio," Fishers 69.1 (April 1971): 7.

110 Thus, despite the absence of overt colonialist language, the undercurrents of difference and inferiority continued. By profiling the Innu and Inuit in the Fishers, highlighting their primitive lifestyles, their need for assistance, and their quality of character, the Grenfell

Mission presented a noble health and social services agenda that would appeal to their white middle-class readership.

THE MISSION

Social Guidance and Progress

In the pages of the Fishers, the Grenfell Mission constantly attempted to prove to its readership that it was highly qualified and well-positioned to provide the necessary medical and social care to the people of northern Newfoundland and Labrador; this often involved references to progress on the Coast. For example, as proof of the Mission's success in advancing health care on the Coast, the Fishers published articles comparing recruitment levels for local men during the Second World War to those of the First World

War. The increased numbers of recruits that were accepted for the Second World War was offered as proof of the population's improved health between the two wars.51

Progress was also underlined in reference to the institution in general and its expanding facilities and services on the Coast. An article about the St. Anthony Hospital in 1942 reminded readers that the hospital at St. Anthony began as a '"glorified cupboard' in a trader's cottage," and emphasized the development or progress of the Mission in that community:

51 D.G. Hodd, "The Canadian Labrador," Fishers 41.4 (January 1944): 110.

Ill In the short ride from the wide Mission wharf, past the Industrial building, the towering coal bin, and the large new store, through freshly painted gates into fenced green fields, on well-kept gravel roads lighted by street lights, and up to the large grey-brown building of concrete blocks that is the Grenfell Hospital, my imagination was more than punished. It was incredible that a few men and their faithful backers had built an idea until it came to this.52

Discussing progress over time required a fine balance because if there was too much "progress," the continued necessity of the Grenfell Mission in northern

Newfoundland and Labrador could be called into question. Perhaps to qualify the

Grenfell presence in light of progress, the most frequent theme that appeared in the

Fishers related to social progress, rather than health or medical progress. Social progress and local initiative was always portrayed as stemming from the leadership and enlightenment techniques of Grenfell staff.53 In many cases, staff members were praised in the Fishers for providing practical guidance to the people and helping them "[live] useful lives."54 Grenfell nurses often taught and encouraged local residents to grow gardens and bottle preserves for the winter, and provided "remarkable service in stimulating the people in the preservation of local produce."55 Ethel Currant held

"canning classes, women's clubs, cooperative study clubs..." and, according to Curtis, she was "firm but just with the local people. She [had] made them realize that they have a responsibility and if they could not pay for their medical attention in cash, they paid in

52 Morgan Berthrong, "St. Anthony Hospital," Fishers 39.4 (January 1942): 108.

51 "Newfoundland Now," Fishers 44.4 (January 1947): 111.

54 H.T.R. Mount, "Charles S. Curtis, M.D. Superintendent," Fishers 40.3 (October 1942): 79.

55 Charles S. Curtis, "The Mission's Fiftieth Year," Fishers 40.2 (July 1942):47.

112 wood or other supplies that the station could use."56 The fact that Curtis pointed out that

Currant was "firm but just" with the people implied that it was important to portray locals as simple and less responsibly-minded than adults should be and, therefore, in need of a strict leader to keep their priorities in order - much the same way as a mother with her children.

The local children were also frequent targets of Grenfell social guidance.57 The orphanage at St. Anthony provided an opportunity for the Mission to provide this guidance to children with the intention of instilling valuable traits in them from an early age. Figures 3.5 and 3.6 portrayed girls and boys at the orphanage participating in gender appropriate behaviour.

FIGURE 3.5: Girls of the St. Anthony Orphanage

Source: Fishers 37.03 (October 1939): 115.

56 Charles S. Curtis, "Heroines," Fishers 43.2 (July 1945): 46.

57 In 1942, Berthrong reflected upon the valuable interaction of staff members with the children of St. Anthony: "the staff often gathered at the near-by field for a baseball game with the Children's Home team or, on rainy cold evenings, around the fire in the large cozy living room for discussions of politics or for a radio program or a photograph recital of Sibelius or Brahms." Morgan Berthrong, "St. Anthony Hospital," Fishers 39.4 (January 1942): 109.

113 The girls prepared a meal in the orphanage kitchen (above), while the boys sawed firewood in the yard (below).

FIGURE 3.6: Boys of the St. Anthony Orphanage

Source: Fishers 37.03 (October 1939): 115.

From sporting events to political debate and classical music, the children of northern Newfoundland and Labrador were, according to the Grenfell middle-class standards/ideology, depicted as deficient in "culture;" they apparently were not exposed to "appropriate" cultural activities at home, and so it was the Grenfell Mission's mission to provide the opportunity for enlightenment and to broaden the people's social horizons.

In 1940, Grenfell teacher, Ruth Blackburn, introduced some children of the Coast to

Shakespeare, when she organized a production of A Midsummer Night's Dream. Figure

3.7 appeared in a Fishers article describing the production, complete with children dressed in costumes and standing on the stage. Highlighting the significance of the event

114 to the children, Blackburn noted the innocence of their reactions: "'Miss,' said Fred,

"Who made up that play? Well, he did a pretty good job.' I said he was usually regarded as being pretty good. 'Oh, did you know him, Miss? Did he write any more like that?"58

FIGURE 3.7: "Shakespeare at St. Anthony"

Source: Fishers 38.03 (October 1940): 78.

In a similar fashion, Dr. Hogarth Forsyth apparently made a priority of socializing with the school children of Cartwright. In reference to Forsyth, one contributor to the Fishers pronounced:

Anyone who has been to Cartwright and seen him out chopping wood with the boys of Lockwood School before breakfast, playing football with them in recess time, or conducting the simple church services in the schoolroom of a Sunday evening, cannot fail to be impressed with the fact that to him

58 Ruth Blackburn, "Shakespeare at St. Anthony," Fishers 38.03 (October 1940): 78.

115 the school children are his family, and mean individually just as much to him as if they were his very own.59

Forsyth was praised in paternal terms as the devoted father of the local children, and his associations with them clearly prescribed to appropriate male gender roles - chopping wood was a useful and practical pursuit and playing football was a healthy and acceptable release of competitive male energy. Physical activity was an important part of the British (thus colonial) middle-class model of education, and the Grenfell Mission transferred these values onto the local population as part of its intention to uplift the community. Not only did Forsyth provide valuable leadership to the children in terms of physical activity, but he also provided leadership by promoting intellectual activities.

According to the Fishers, he and his wife Clayre would "eat their meals with the children, each heading separate tables. They encourage[d] the children to take an interest in and discuss current events of the world, and books, as well as their own little world.

There [was] keen competition between the children as to which table [could] carry on the most intelligent conversation at meal times."60 The article highlighted the important cultural leadership that the Forsyths provided to the children and also depicted the children in patronizing terms, especially by referring to the children's "own little world."

Such language could serve to endear the Fishers readership towards the children and families of the Coast.

In the post-Confederation period, the Fishers published articles emphasizing progress, the increasing demand for Grenfell services, the continued isolated distribution of communities in northern Newfoundland and Labrador, and the endemic presence of

59 "Meet Dr. Forsyth," Fishers 41.3 (October 1943): 70.

60 "Meet Dr. Forsyth," p. 70.

116 tuberculosis among the populace. To garner the economic and sympathetic support for the Grenfell Mission's activities the Fishers used these examples to repeatedly inform readers that the Canadian and Newfoundland governments supported the Grenfell

Mission. Simultaneously, to cultivate continued government patronage, the Fishers also revealed how these governments - working 'together' in a new post-Confederation union

- were doing their parts to assist the Mission in its vitally important work. One advantage that the Grenfell Mission could claim, and that the Fishers articles reflect in their post-

Confederation focus, is that the Grenfell Mission was best positioned to continue to offer care to rural Coastal communities because of the longstanding ties they built with these people which no other health care provider could comparatively offer. The Grenfell

Mission and its staff members were portrayed as beacons of light, spreading quality health care, education and 'civilization' to a neglected corner of the British Empire.

Directly related to the progressive improvement of coastal peoples' health during the 1950s was the genuine and actual increased demand for Grenfell services. During this decade, the Fishers placed obvious emphasis of the rising appeal for the health care offered by the Grenfell staff and the hospital and nursing station facilities. In 1951, Jupp

"reportjed] a full hospital with fifteen patients"61 and Paddon reported an increase in responsibilities at the hospital at North West River, due primarily to an influx of aboriginal patients "...who [were] increasingly willing to accept the White Man's medicines, and even to stay in his hospitals."62 The reasons for the increasing demand on

61 C.S.C., "Winter Chronicle 1950-51: From Letters From Staff Members - St. Mary's River, Labrador," Fishers 49.1 (April 1951): 4.

62 W.A. Paddon, "North West River at the Cross-Roads," Fishers 49.2 (July 1951). Although this is not the focus of this section, again, this evidence reveals that the racial and classist colonialist mentality and

117 Grenfell services were primarily related to the initiation of federal and provincial health plans after confederation. The Mission became responsible for providing health services to aboriginal communities in Labrador, for taking a leadership role in combating tuberculosis in the region, and for increasing public health services in terms of immunizing local children against infectious diseases.63 Nutritional diseases were considered to be "under control and tuberculosis of the bones and joints [had] decreased remarkably,"64 although pulmonary tuberculosis was still a problem and remained so through the 1940s.

By 1949, tuberculosis was highlighted as "the disease most prevalent among the people, and the one most difficult to handle. But in those areas where the Mission influence was directed through hospitals and nursing stations, the incidence of the tuberculosis was at its lowest."65 Thus, the Fishers presented a picture of northern

Newfoundland and Labrador in which the people's health and well-being was improving, and although tuberculosis was still widespread in many communities, the Grenfell

Mission was a positive presence in combating this fearful disease and worked steadily to reduce tuberculosis along the Coast. Tuberculosis was a distinct problem in Labrador, and "[t]here [were] areas where the tuberculosis rate [was] almost of epidemic behaviour, as well as social institutional structures, continued to impact the lives and health of Aboriginal peoples.

63 "Log of the Star. 1957 Season - Log-keeper: Hughlett Acreman, Narrator: Lesley M. Diack, S.R.N.," Fishers 56.1 (April 1958): 18.

64 [Charles S. Curtis], "The Superintendent Reports," Fishers 42.1 (April 1944): 16.

65 Theodore L. Badger, "Medical Planning," Fishers 47.3 (October 1949): 67. At the time of Confederation (1949) tuberculosis was higher in Newfoundland than in any other Canadian province. See Edgar House, Light at Last: Triumph Over Tuberculosis in Newfoundland and Labrador, 1900-1975, (St. John's: Jesperson Press, 1980); and Leonard A. Miller, "The Newfoundland Department of Health," Canadian Journal of Public Health 50 (June 1959): 228-239.

118 proportion, especially in the northern section, and there are a large number of patients, particularly Eskimos, requiring active treatment."66 Thomas also stated that the Mission's commitment to treating pulmonary, bone and joint tuberculosis at St. Anthony had been proven worthwhile, since, according to vital statistics, the death rate from tuberculosis in

White Bay was "one of the lowest in this province."67 By 1957, the number of in-patients in Grenfell hospitals and stations had reached an all-time high and the number of outpatients was also increasing.68 The Tuberculosis Sanatorium at St. Anthony was full to capacity all summer and the incidence of tuberculosis among Aboriginal patients was especially high.69 The Grenfell Mission received funding from the federal government to assist with the treatment of tuberculosis among Innu and Inuit, and funding from the provincial government to increase and improve treatment facilities at St. Anthony. And the Fishers made extensive use of images of Aboriginal residents and patients to emphasize the important health work among 'less advantaged' people.

Quality of Services

The Grenfell institution, the physicians, and the nurses were all subjects of praise in the Fishers for providing a level of medical and social care comparable with that of larger cities and "any large general hospital."70 On the eve of Confederation, Cecily M.

66 Gordon W. Thomas, "The New Tuberculosis Sanitoriuni [.v/c], St. Anthony," Fishers 50.2 (July 1952): 37.

67 Thomas, "The New Tuberculosis Sanitarium," p. 37.

68 Charles S. Curtis, "Air Era: Report of the Superintendent for 1956," Fishers 54.4 (January 1957): 100.

69 Charles S. Curtis, "Consolidation: Annual Report of the Superintendent," Fishers 55.4 (January 1958): 102.

70 H.T.R. Mount, "Charles S. Curtis, M.D. Superintendent," Fishers 40.3 (October 1942): 80.

119 Ingram reported on the tuberculosis annex at St. Anthony: "Here the treatment includes the latest scientific discoveries, with highly skilled doctors, surgeons, nurses, research workers and also the latest drugs, particularly streptomycin, and all under constant supervision, so that all reactions can be carefully watched and noted."71 The tendency to publish articles emphasizing the quality of care provided by the Grenfell Mission increased in the post-confederation period, and indeed was a recurring theme of the

Fishers in the 1950s. Curtis frequently praised the medical staff of the Grenfell Mission for being experts in their fields. His 1950 superintendent's report singled out the return to the Grenfell staff of Gordon Thomas, who had spent eight months studying thoracic surgery in the United States with Dr. John Steele. Thomas, referred to as a skilful surgeon and a devoted physician, "...returned to the coast well-equipped to undertake the surgery of pulmonary tuberculosis and apply the latest technique in treatment."72 Other contributors to the Fishers also commented on "the skills and ability of Dr. Thomas and his staff of doctors and nurses. Dr. Thomas [was] doing general surgery from brain tumors to crushed feet but [had] particular interest in thoracic surgery."73 By promoting the return and expertise of Dr. Thomas, the Fishers demonstrated that the Grenfell

Mission was equipped with high-quality equipment and had a resident surgeon who performed the latest advances in chest surgery at the hospital at St. Anthony.74 This

71 Cecily M. Ingram, "In the T.B. Annex," Fishers 46.4 (January 1949): 112.

72 Charles S. Curtis, "The Superintendent Reports," Fishers 48.3 (October 1950): 68.

71 Frank L. Babbott, "A Director's Eye View," Fishers 51.3 (October 1953).

74 Gordon W. Thomas, "New Era," Fishers 53.3 (October 1955): 77.

120 information likely contributed to creating both private and government donor confidence in the health work of Grenfell Mission.

Through the 1960s and 1970s, the Fishers regularly published articles about

Grenfell Mission quality, progress, and success. The magazine noted the presence of eminent physicians or surgeons associated with the Mission, their exceptional qualifications, and any Newfoundland medical "firsts" conducted by these individuals.

Apparently, the first corneal transplants at St. Anthony were conducted by an eminent

New York eye physician, Eleanor Faye.75 In 1962, Thomas outlined three major accomplishments of the Mission through the previous year, including the construction of two new nursing stations (bringing the total up to fifteen), the establishment of the air- ambulance service, and the eradication of tuberculosis.76 There were also articles on

"revisiting" the Coast, written by individuals who had worked with the Mission in the past and were sharing their observations about change and progress.77 With numerous articles profiling advancements in health care and the extension of services through new constructions, the post-Confederation Mission promoted itself as a progressive high quality establishment performing advanced medical services to the people of the Coast and meeting with great success in their endeavours.78

75 Eleanor Faye worked with the Mission in 1959-60 and "performed four corneal transplants, the first operations of this kind done in Newfoundland." See "Highlights," Fishers 58.2 (July 1960): 34.

76 Gordon W. Thomas, "The Decline and Fall of Pulmonary Tuberculosis in Northern Newfoundland and Labrador." Fishers 60.1 (April 1962): 3-4.

:1 See for example, James M, Dunning, "A Grenfell Dentist Revisits Labrador," Fishers 63.4 (January 1966): 97-100; Theodore L. Badger, "The Mission Revisited - Summer of 1972," Fishers 70.3 (October 1972): 9-12.

78 For example, see "Dedication of the New Hospital at St. Anthony," Fishers 66.2 (July 1969); Robert H. Wilkinson, "Pediatric Care in St. Anthony," Fishers 68.3 (October 1970). 64-65; Robina Salter, "The Growth of the Grenfell Mission," Fishers 70.3 (October 1972): 1-4; J.M. Darte, "Delivery of Child Health

121 Official Endorsement

Perhaps the most prominent theme in the Fishers during the 1950s related to the fact that the Canadian and Newfoundland governments supported the institution, both financially and legally. In the immediate post-Confederation period, the Fishers highlighted the relationship that had developed between the Grenfell Mission and the federal and provincial governments. In a statement of acknowledgement in 1951, Curtis wrote:

The Department of Health of the provincial government.. .has always been most co-operative and understanding and the generous financial assistance provided by this most progressive department augmented by large donations of penicillin, streptomycin, insulin, liver extract, vaccines, x-ray films, orange juice and cod liver oil. I want to publicly acknowledge the debt we owe to them for all they do for the people of this coast through their assistance to the International Grenfell Association.79

Curtis was aware of the importance of maintaining a positive working relationship with the government, expressing gratitude for their assistance in financing certain medical activities on the Coast. With this language, the Fishers tried to justify its presence in northern Newfoundland and Labrador to its readership (and donors) - the federal and provincial governments had such faith in the Grenfell establishment that they were willing to financially contribute to the endeavour, which obviously increased the professional credibility of the Grenfell Mission. The provincial government funded the

Care to Children of Newfoundland," Fishers 70.4 (January 1973): 3-8; Bruce A. Wright and James M. Dunning, "Increased Dental Services for Labrador and Northern Newfoundland," Fishers 71.1 (April 1974): 12-13;Val Perrin and Madge Applin, "Port Saunders Community Health Centre," Fishers 72.1 (April 1975): 10-15; Gordon Thomas, "The Grenfell Mission - Past, Present and Future," Fishers 72.2 (July 1975): 1-7; J.H. Williams, "Health Care Delivery in Remote Areas: A Medical Symposium at St. Anthony, June 12-14 1975," Fishers 72.3 (October 1975): 1-6; "Indian Alcohol Program, North West River - to November 1976," Fishers 74.1 (April 1977): 10-11; J.H. Williams, "The Expanding Role of the University in Community Programmes," Fishers 75.4 (January 1978): 10-13; Peter J. Roberts, "The Process of Change," Fishers 78.2 (July 1981): 1-4.

79 Charles S. Curtis, "The Superintendent Reports," Fishers 49.3 (October 1951): 73.

122 construction of new nursing stations at Englee, Happy Valley,80 Roddickton,81 and

Nain,82 and also contributed to the construction of a new tuberculosis sanatorium at St.

Anthony.83

In addition to the construction of physical structures, the governments also supported other health care initiatives in the region. For example, in 1955, the federal government's Department of Indian Affairs cooperated with the provincial government's

Department of Health, the Tuberculosis Association, and the Grenfell Mission to conduct an x-ray survey of aboriginal inhabitants in northern Labrador. The survey helped health care workers uncover cases of tuberculosis among aboriginal groups and arrangements

were made to send those patients to the sanatorium for treatment.84 Moreover, the

Newfoundland Government also supported the Grenfell Mission by donating automobiles, snowmobiles and airplanes, to assist with transportation for the provision of health care in such remote and isolated communities.85 Again, this support gave the

Grenfell Mission a monopoly position in the health care of the region which, in turn,

substantiated further applications and claims to government funding. This reciprocity is

80 Charles S. Curtis, "Summer Resume," Fishers 49.4 (January 1952): 99, 101.

Sl Curtis, "The Superintendent Tells About 1955," p. 104.

82 Dorothy M. Jupp, "The New Nain," Fishers 55.1 (April 1957): 9.

83 Gordon W. Thomas, "The New Tuberculosis Sanitorium [.vie], St. Anthony," Fishers 50.2 (July 1952): 37.

84 Gordon W. Thomas, "New Era," Fishers 53.3 (October 1955): 77.

85 Curtis, "The Superintendent Tells About 1955," p. 106; Charles S. Curtis, "Air Era," Fishers 54.4 (January 1957): 99,100; Charles S. Curtis, "Summer Season Facts: 1958 Season," Fishers 56.4 (January 1959): 99. The Newfoundland Government also provided the pilots and mechanics for the airplanes. See Arthur W. Bingham and Andrew Y. Rogers, "Two Directors Report: Part I," Fishers 56.3 (October 1958): 74.

123 revealed in the Fishers articles; according to the Fishers, the federal and provincial governments became the Grenfell Mission's "most sincere and co-operative friends.. .in giving valuable financial assistance in the increasing expenses of this medical service to the people in northern Newfoundland and Labrador" and the Grenfell Mission expressed its "sincere thanks."86 The financial support for the Grenfell Mission that the federal and provincial governments provided, particularly in terms of the donations of pharmaceuticals, equipment, funding for construction projects, administration of health surveys, and vehicles for improved transportation, not only provided practical assistance to the Grenfell operation, but also strengthened the Grenfell Mission's credibility as the preeminent health care provider for northern Newfoundland and Labrador.

In the 1950s, the Fishers frequently published articles addressing the concern that the Grenfell Mission might prove unnecessary in northern Newfoundland during the post-

Confederation period. These articles acknowledged that great progress had taken place on the Coast to establish and maintain local peoples' health, but that the Mission still provided an essential service to a region typically isolated and dependent on these services. Indeed, post-Confederation Newfoundland was in a period of social and economic transition in which "the Grenfell Mission must play its part,"87 not only as a matter of morals or values but as a matter of fact resulting from actual national and provincial structural changes. Although the Grenfell Mission's financial situation was better in the post-Confederation period than it had been previously, and although progress had been made in the region since the days of Wilfred Grenfell, still the Fishers reiterated

86 Curtis, "Summer Season Facts: 1958 Season," p. 100.

87 Curtis, "Air Era," p. 105.

124 the vital need for the Mission on the Coast because of the indispensible services and

"fundamental [social] work" it continued to provide.88

In the post-Confederation period, the Fishers began to realize that it could no longer rely on stories of poverty-stricken and ignorant locals to maintain Grenfell

Mission's credibility as the region's health establishment. During the 1950s, the Fishers agenda of justifying its presence and maintaining support for the Grenfell Mission in light of tremendous economic and social developments in the province was best summed up by a statement from Curtis: "Some of our readers might say, in view of this, 'Is the

Grenfell Mission needed on the coast now?' Our answer is a definite Yes. The federal and provincial governments realize that the Grenfell Association, with its reputation, is able to secure staff which a government might not be able to secure, and, in the words of one of the Deputy Ministers of Health, 'The Department of Health will do everything possible to enable the International Grenfell Association to continue the so well developed and economically operated health services' in northern Newfoundland and

Labrador."89 Adjusting its discourse to fit a post-Confederation climate, the Fishers thus turned to cultivating and reflecting/portraying the valuable relationships the Mission was developing with the Canadian and Newfoundland governments; likewise, the governments recognized the strategic position of the already established Grenfell Mission in providing health care to the people of the Coast and they assisted the Mission with its important work.

88 Curtis, "Consolidation," p. 99.

8" C.S.C., "Sixty Years Forward," Fishers 51.1 (April 1953).

125 THE NURSES

Characteristics

In its news and articles throughout the period, the Fishers was careful to present a strong and appropriate (according to middle-class mores) association between the

Grenfell nurse and maternalism, domesticity, nursing/midwifery, and proper deference to physician authority. Yet, the Grenfell nurses were called upon to hold a level of responsibility on the Coast, particularly in the nursing stations, that was atypical of their responsibilities within the traditional paternalistic medical hierarchy. Through the

Fishers, the Grenfell Mission sought to attract strong women to their nursing stations; hence the numerous references to their nurses "carrying the brunt of the medical work for the Grenfell Mission."90 This corresponded with the maternal, domestic, nurturing gender model of femininity that was prescribed for women in middle-class society. The endless articles and references to adventurous nurses travelling around the Coast by boat, dogsled, and (later) snowmobile and plane, risking their lives for the sake of their patients, were intended to attract a particular sort of woman to nurse with the Grenfell Mission.

However, at the same time, the Mission sought to attract the financial and social- networking support of its middle-class readership, which included an emphasis on the nurturing femininity of its nurses.

As a result, in order to avoid informing the readership that nurses were performing the duties of physicians, the Grenfell Mission, through the pages of the

Fishers, attempted to maintain a balance between promoting the work experience it offered to nurses with sensitivity to middle-class understandings of appropriate female

90 Charles S. Curtis, "Heroines," Fishers 43.1 (April 1945).

126 behaviour. Jill Perry presents an extensive study of this balance in her thesis, "Nursing for the Grenfell Mission: Matemalism and Moral Reform in Northern Newfoundland and

Labrador, 1894-1938," and argues that "...the official Grenfell discourse rooted an extraordinary female work opportunity in a traditional gender ideology. The Grenfell nursing opportunity was based on the social reform agenda of a Mission which viewed itself as a culturally-superior 'civilizing' force in a 'backwards' corner of the British

Empire. The matemalism of this discourse argued that as women, nurses were ideally suited to the 'civilizing" task...."91 The succeeding period of 1939-1981 witnessed similar trends in this balance with the official Grenfell discourse, especially that contained within the Fishers.

Nurses with the Grenfell Mission were expected to possess and exhibit maternal characteristics towards the people of the Coast. The most commonly referenced character traits of the ideal Grenfell nurse included: devotion, self-sacrifice, compassion, composure, adaptability, perseverance, strength and courage. Curtis was particularly laudatory of nurses in his contributions to the Fishers, perhaps because he was directly involved in the hiring of nurses for the Coast and would have been aware of the usefulness of the Fishers in promoting a Grenfell nursing career to the readership. For example, in his 1948 superintendent report in the Fishers, Curtis acknowledged the role of the English nurses in staffing the remote nursing stations: "1 cannot praise highly enough the devotion and courage which these nurses show, isolated as they are along

91 Jill Samfya Perry, "Nursing for the Grenfell Mission: Matemalism and Moral Reform in Northern Newfoundland and Labrador, 1894-1938," MA Thesis, Memorial University of Newfoundland, 1997, p. 25.

127 these shores."92 He continued to describe the two nurses at Flowers Cove as "tireless in their devotion to the people" and that Dorothy Jupp at St. Mary's had been constant in

"her devoted service" and was well known to all Fishers readers "for her skill as a nurse and her devotion to the people."93 Perhaps the most exemplary Grenfell nurse (according to the pages of the Fishers) was Selma Carlson, and upon her retirement Curtis wrote:

As a nurse Miss Carlson was superb: strong and tireless, sympathetic yet firm, untiring in her efforts on behalf of the patients. Scores of patients along the coast owe their lives to her ceaseless vigilance and able nursing. Many times after a long, busy day (and she was always on duty at seven o'clock in the morning) 1 have seen her sit by the bedside of some seriously ill patient for into the night nursing the patient through a crisis.94

Carlson was the quintessential "nurse" - she was devoted, tireless, compassionate, selfless, thrifty and efficient. But Carlson was exemplary in another manner on the Coast

- she was described as an inspirational leader and "mother" of fellow Grenfell staff: "She mothers the hospital workers, discusses good music, literature and the philosophy of life with all; gives confidence to the uncertain and makes the lonesome one feel wanted and at home. ... She is always thinking about her hospital family, both staff and patients."95

With such important maternalist characteristics plastered throughout the Fishers, and so prominent in descriptions of admirable Grenfell nurses, there was little chance that a potential candidate for the Coast would not be aware of the character traits that the

Grenfell Mission valued in its nurses.

92 Charles S. Curtis, "The Superintendent Reports," Fishers 45.4 (January 1948): 108.

93 Curtis, "The Superintendent Reports," Fishers 45.4 (January 1948): 108.

94 Charles S. Curtis, "Miss Carlson Has Left the Coast," Fishers 45.4 (January 1948).

95 E.H., "Selma Carlson, Head Nurse," Fishers 40.4 (January 1943): 109.

128 Activities

Ironically, while many contributions to the Fishers emphasized the exceptional medical skills of the nurses and praised their ability to cope with traditional medical situations, there were rarely any examples given of nurses actually performing "medical" duties. While nurses were occasionally called upon to challenge themselves in non- nursing capacities, those situations were rarely mentioned in the Fishers. For example, the opening line of Curtis* seminal 1945 article, "Heroines," (written as a promotional piece to encourage nurse recruitment for the Coast during the difficult war time period) stated that nurses were "carrying the brunt of the medical work for the Grenfell Mission," but the article did not qualify that statement. Instead, the article focused on maternal leadership. One paragraph in particular is worth quoting in full:

Not only are they continually in demand to take care of their districts medically, but in all other aspects of the life of the people they take a very prominent part. They conduct classes for mothers, give instruction in public health nursing. They are all active in the patriotic societies where the local women meet to knit for the boys overseas. In summer each of these nurses conducts a community garden and preserves a large quantity of local produce for the use of the station during the time when navigation is closed. In some of our stations the nurses have been instrumental in stimulating the efforts of the local women to preserve food for their own use. The nurses have helped them secure seeds to plant gardens, encouraged them through the growing season, offered prizes and sponsored local agriculture shows for the best home-grown vegetables, fresh or tinned. They have also encouraged the local families to procure hens and goats, for eggs and milk.96

Significantly, the article did not deviate from highlighting acceptable female, maternalist, and nursing behaviour. The nurses provided "care" to their patients and leadership to local women. They were modest in performing their duties, courageous in the face of danger, anxious over the health of their patients, and selfless in putting the comfort of

96 Curtis, "Heroines," p. 3.

129 their patients first. Dorothy Jupp, for example, accompanied a patient to the St. Anthony hospital - "they placed him on their komatik and hauled him to the hospital, the nurse bringing up the rear - cold, wet and tired, dragging herself through the heavy, wet snow at almost thigh depth."97 Jupp's discomfort and self-sacrifice was rewarded when her patient recovered after a long illness. These characteristics were also highlighted in the

Fishers during the 1950s. Nurses were modest (as Curtis reported, "[Nurse Durley] modestly avoids mention of the hard work in this extensive district but her medical report speaks for itself."98 Post-Confederation Grenfell nurses were still "devoted,"99

"unselfish,"100 "self-sacrificing,"101 and "very heroic."102

The promotion of local gardening and the bottling of preserves as an acceptable and useful female occupation was a common theme during the 1940s in the Fishers, and all of the nursing stations supplemented their Mission supplies with extensive gardens.

The nurses were often praised for leading by example with their gardening programs in the community, and they encouraged local families to grow gardens and bottle their own preserves. Ethel Currant, Dorothy Jupp, and Selma Carlson were particularly applauded in the Fishers for their efforts on behalf of gardening. Despite the fact that Currant "was always on the move, traveling many miles on foot, by dog-team in winter and by boat in

97 Curtis, "Heroines," p. 6.

98 Charles S. Curtis, "The Superintendent Reports," Fishers 47.4 (January 1950): 103.

99 Curtis, "The Superintendent Reports," Fishers 47.4 (January 1950): 99,103,104; Charles S. Curtis, "The Superintendent Reports Fishers 48.3 (October 1950): 68.

100 Curtis, "The Superintendent Reports," Fishers 47.4 (January 1950): 104.

101 [Charles S. Curtis], "The Superintendent Reports," Fishers 49.3 (October 1951): 69.

102 Charles S. Curtis, "Nurse Rhodes," Fishers 48.1 (April 1950): 12.

130 summer, she still found time to develop and cultivate extensive and productive gardens and to preserve great quantities of food - fish products, vegetables and berries, keeping her own station well supplied with very palatable food and providing an 'export surplus' for St. Anthony."103 Jupp kept her station "in flourishing condition. The goats were furnishing an adequate milk supply for the patients; there was an extensive and flourishing garden with potatoes, cabbage, lettuce and spinach growing, and the storehouse was filled with canned salmon and canned berries which Miss Jupp had preserved for the winter."104 And Carlson "saved [the] Mission thousands of dollars by putting up local produce. She was an expert in using the fish, berries, and other produce of this country."105 By managing the gardens and bottling preserves for the winter, these

Grenfell nurses exhibited several qualities valued by the western white colonial middle- class: care, by supplying quality food for their patients; devotion, by making time in their busy schedules to focus their energies on promoting healthy eating; and economy, by saving the Mission thousands of dollars in importing large quantities of food. By adhering to the colonial, class, and gender models prescribed for them, these women's maternalist leadership, in turn, illustrated the Fishers discourse of the integral value the

Grenfell Mission brought to these regional communities beyond medical specific health issues to healthy social "civilized" relationships.

In terms of authorship, content, and even language, the articles of the Fishers must be read with caution. The articles, regardless of their authorship, inform readers

103 H.H.C., "Ethel Currant," Fishers 44.3 (October 1946): 85.

104 Curtis, "Heroines," p. 4.

105 Curtis, "Miss Carlson Has Left the Coast."

131 more on the Grenfell ideal than on the author's perspective on a topic. Helen R. Hosmer's

1941 article, "St. Mary's River," exemplifies the difficulty ascertaining an author's actual point of view in the Fishers. Hosmer was a female American physician posted to St.

Mary's River in 1938. In "St. Mary's River," she presented a particularly gendered version of Grenfell work at the station. She praised Margaret Seaman for arriving to take over the nursing duties, and implied, but did not outright acknowledge, that Seaman was a skilled nurse. Instead, she wrote that Seaman "proved herself indefatigable in other ways too" and proceeded to describe her gardening activities.106 She and Seaman apparently donned "veils" tucked into their outside clothing, to "close so far as possible all openings leading to the inner person."107 The veils in question contained "a transparent cellulose window" and were actually meant to ward off the swarms of black flies that inhabited the gardens during summer. However, the choice of describing the headpieces as a "veils" suggested a parallel between their work with the Mission and the quintessential western female vocation that veils signify. Of course, Hosmer was dealing with her own gendered parameters being a female physician in the Grenfell Mission.

Perhaps she was sensitive to down-playing her own exceptional role on the Coast and, therefore, focused on a seemingly innocuous story of herself and Seaman wearing veils and growing vegetables. Of course, the question remains as to how much of Hosmer's original article made it to publication. Her article would have been censored and edited by the Mission; therefore, one must read the content with caution, as with other Fishers articles which promoted the Grenfell mandated discourse.

106 Helen R. Hosmer, "At St. Mary's River," Fishers 39.1 (April 1941): 10.

107 Hosmer, "At St. Mary's River," p. 10.

132 Maternalism and domesticity were closely connected in reference to nurses in the

Fishers. In the same article, Hosmer (or perhaps the Mission) emphasized the domestic abilities of the nurse she had met at Forteau. Again, the sensitivity towards equating nursing with maternal and domestic values is evident and persuasive: the nurse at Forteau

(Jean Smith), "always maintained] such a homelike atmosphere."108 Smith was singled- out at again when she was at Flowers Cove, this time for providing hospitality, including

"a magnificent lobster dinner" to the medical staff from St. Anthony, and apparently was

"almost as good a cook as she [was] a nurse."109 Similarly, at Mary's Harbour during the summer of 1946, Canadian nurses Margaret Darby and Edith Miller apparently commented on having "the weighty problem of what to have for a meal" and qualified the position of nurses-in-charge with "Domestics-in-General."110 Nurses were also called upon to assist with the hospitality of individuals outside the medical sphere. For example, when the new nursing station was being built at Flowers Cove in 1948, the station nurses,

Ivy Durley and Winifred Burgess, looked to the needs of the men who were building the new station; they "[took] care of the men and [made] them comfortable."111 These examples demonstrate the importance of maternalist imagery and leadership within the

Grenfell discourse to further its cause of recruiting nurses and maintaining philanthropic financial contributions.

108 Hosmer, "At St. Mary's River," p. 10.

109 "Log of 'Maraval,' - Summer 1946," Fishers 44.4 (January 1947): 104.

110 Margaret E. Darby and Edith O. Miller, "Ringed With Fire," Fishers 44.4 (January 1947): 108.

111 Charles S. Curtis, "New Nursing Station at Flowers Cove," Fishers 46.4 (January 1949): 103.

133 In addition to domestic chores and/or management and hospitality to other

Grenfell staff, the nurses on the stations were also responsible for maintaining the

Clothing Store for the community, which sometimes was a demanding occupation. Upon her retirement from the Grenfell Mission, an American nurse, Laura N. Thompson, was credited for providing "the care and management of food and the feeding of patients and staff' at the hospital at Harrington Harbour and also for "running the Clothing Store, checking all those big bales and boxes of used and new clothing, toys and magazines as well as other supplies, and then acknowledging all of the donations and the keeping in touch with the many donors from all over Canada."112 The Fishers made reference to the

Clothing Store during the early 1950s as well. Nurse Ella Hewitt detailed the events of a

Clothing Store Day close to Christmas, in which she had to unpack the bales of clothing, organize it for sale, and then manage the event.113

Most of the nurses profiled in the Fishers possessed all of the maternal and domestic qualities valued by the Grenfell Mission (or at least, they were portrayed that way). And Thompson was particularly exemplary when, after providing fourteen years of nursing service to the people of Harrington Harbour, she "[laid] down her work on the coast for what we hope will be many happy years as a good American-Canadian housewife..14 Again, these themes continued well into the Fishers articles of the

112 D.G.H., "Mrs. Thompson Leaves," Fishers 43.3 (October 1945): 78. For another Fishers example of Clothing Store work, see Winifred Burgess, "Flowers Cove Household and Social Work, 1947-1948," Fishers 46.4 (January 1949): 104.

113 Ella E. Hewitt, "Work and Play - at Mutton Bay: Christmas, 1949," Fishers 48.3 (October 1950): 85.

'14 D.G.H., "Mrs. Thompson Leaves," p. 104.

134 1950s, where nurses were praised for being "dietician"115 and "housekeeper,"116 and for conducting their duties "efficiently"117 and for exhibiting "fortitude and skill,"118

"courage and wisdom"119 and "assisting"120 the physicians "without complaint" in carrying out their work.121 Upholding this maternal-domestic image of a woman's role, even as a career woman, coincided with (and simultaneously reinforced) the re-fashioned emergence of a well-worn model of femininity pervasive throughout 1950s popular culture based on the middle-class consumer breadwinner-domestic nuclear family model throughout this period in Canada (and the U.S). This model of femininity was not isolated to the women with the Grenfell Mission, but the Fishers discourse shifted to capture this domesticity alongside appropriately-careered women. The discourse reflected the larger social phenomenon that was occurring during the 1950s: that of the housewife- domestically feminine model to the male breadwinner model within socially prescribed family dynamics.122

115 Curtis, "The Superintendent Reports," Fishers 48.3 (October 1950): 68.

116 Curtis, "The Superintendent Reports," Fishers 48.3 (October 1950): 68; Curtis, "The Superintendent Tells About 1955," p. 99.

117 Charles S. Curtis, "Summer Resume," Fishers 49.4 (January 1952): 101.

'18 Gordon W. Thomas, "Coast Chronicle, Fall 1952," Fishers 50.4 (January 1953): 104.

110 Charles S. Curtis, "The Superintendent Tells About 1955," Fishers 53.4 (January 1956): 104.

1:0 Curtis, "The Superintendent Tells About 1955," p. 103.

Curtis, "The Superintendent Reports," Fishers 47.4 (January 1950): 103; C.S.C., "Coast Chronicle," Fishers 50.1 (April 1952): 5; Curtis, "The Superintendent Tells About 1955," 104.

1:2 See Lesley Johnson and Justine Lloyd, Sentenced to Eveiyday Life: Feminism and the Housewife, (Oxford; New York: Berg, 2004).

135 While the experience of nursing on the Coast, especially in isolated nursing stations, was unique and filled with the potential for extended medical responsibilities, the Fishers focused on occupational duties that were positioned within the traditional comfort zone of female practice - specifically, maternity and women's health. It was acceptable and appropriate for nurses/midwives to attend women in childbirth in the absence of a physician. The nurses at the stations were required to have midwifery training (hence, the dominance of British nurses staffing the stations), and/or extensive training in obstetrics and pre- and post-natal health. A Canadian nurse, Ella E. Hewitt, did not have midwifery training, but had gained "wide experience among the Indians in the

Canadian Northwest."123 She was therefore qualified through experience to attend women in labour. Curtis reported to the Fishers that while she was at Forteau, Hewitt "had been called to a very complicated obstetrical case" and that the complications that confronted her "would defy the skill of any obstetrician in any obstetrical hospital with plenty of nurses and assistants and means for blood transfusions. Miss Hewitt was alone and had no chance to get a doctor's aid in this emergency. Alone in a fishing house, with no one to help her but a local midwife." Of course, two days later, "the mother and baby were doing well."124 In a similar situation, Tony Paddon credited Dorothy Jupp as having saved the life of both mother and child in a difficult labour, although the details of the

125 nurse's abilities or her specific life-saving actions were not disclosed.

1:1 Curtis, "Heroines," p. 6.

1-4 Curtis, "Heroines," p. 6.

125 Wm. Amthony Paddon, "Log of 'Maraval,' (continued)," Fishers 45.1 (April 1947): 20.

136 In the 1950s, the Fishers also published numerous accounts of nurses attending women in childbirth or treating sick babies and children. Midwifery was an acceptable area for the Grenfell nurses to practice, especially those with midwifery training, and was highlighted in the official Grenfell discourse. Dorothy Jupp reported on attending to five births in six days at St. Mary's River, although the article did not provide any medical aspects of the births. Rather, after referring to the "speculation as to who would happen to

'fall sick' first," Jupp mentioned the speed with which the babies arrived, the need to have the birthing room "washed and cleaned up" in time for the next labour, and the challenge of finding bed room for all the babies.126 Figure 3.8 shows a Grenfell nurse tucking in "Baby Bunting" in a "Labrador cradle" - a wooden barrel. The caption implies that barrels were commonly used as cradles in Labrador, and suggests a local thrift and practicality in making use of the items at hand.

FIGURE 3.8: Nurse Barnard and a "Labrador cradle"

Source: Fishers 38.01 (April 1940): 34.

1:6 Dorothy M. Jupp, "Five Babies in Six Days." Fishers 47.4 (January 1950): 115-116.

137 Nurses were also appropriately in attendance when examining and treating children, depending on the severity of their condition. Iris Mitchener saved the life of a baby when she brought him to the nursing station at Forteau and administered injections of penicillin.127 In the Fishers, a nurse was praised for exercising the appropriate level of responsibility depending on the circumstances or the medical emergency in which she found herself.

SUMMARY

With its early association with the Royal National Mission to Deep Sea Fishers - an established philanthropic organization in Britain that was also a medical institution - the Grenfell Mission was able to establish itself as the social and medical authority on the

Coast. Considering the middle-class and colonial clout of Grenfell and his enterprise in northern Newfoundland and Labrador, his narrative of the Mission became the "truth" of the organization. According to this truth, there was a desperate need for middle-class leadership on the Coast in the form of medical and social services and the Grenfell

Mission and its nurses were well qualified and well positioned to provide that leadership.

The Mission used its quarterly magazine, the Fishers, as a vehicle through which to present this truth, to justify its presence on the Coast, and to encourage support for the

Mission among its middle-class readership. There were three main thematic phases to the

Fishers between 1939 and 1981: 1) the soliciting phase, 1939-1948; 2) the progress phase, 1949-1964; and 3) the nostalgic phase, 1965-1981. And in each of these phases,

1:7 Iris F. Mitchener, "Forteau in Retrospect," Fishers 47.4 (January 1950): 108.

138 nurses were presented as maternalist, adventurous, and well-qualified purveyors of middle-class Grenfell leadership.

Through each of these three phases, the Grenfell Mission attempted to maintain a balance between promoting the work experience it offered to nurses with sensitivity to middle-class understandings of appropriate female behaviour. Grenfell nursing was an

"exceptional female work experience" - one in which an appropriately trained hospital nurse could find herself performing health-related duties outside of her traditional purview. The Mission sought a number of characteristics in their nurses that would ensure her success on the Coast, especially in terms of independence - courage, adaptability, the ability to use judgement, and a sense of adventure, since she would have to travel over difficult terrain and in challenging circumstances to reach her patients. At the same time, this independence was balanced against maternal characteristics - devotion, self-sacrifice, compassion, composure, perseverance and strength. By presenting these differing qualities within the singular image of the quintessential

Grenfell nurse, the Mission attempted to attract strong, independent women who would have a greater chance of success on the Coast but who also understood the importance of their maternalist traits within the fibre of a middle-class, philanthropic health care organization.

The work of the Grenfell Mission, especially as presented through its quarterly publication Among the Deep Sea Fishers, attracted hundreds of women from Britain,

Canada, the United States, and other countries around the world who wished to participate in the meaningful and adventurous work. Chapter 4 examines some of those

139 nurses, particularly those who applied through the office of the Grenfell Association of

Great Britain and Ireland in London. Nursing with the Grenfell Mission was a personal experience for these women, and the Mission was often required to balance personal motivations against the public face of the organization.

140 CHAPTER FOUR

"She Seems a Fairly Venturesome Girl": Balancing Personal Motivations with the Grenfell Agenda

The Grenfell Mission enjoyed an international reputation for respectability and moral leadership; and the nurses, as representatives of the Grenfell image, were expected to adhere to its middle-class moral code. Women chose to nurse with the Grenfell

Mission from 1939 to 1981 for three main reasons: they wanted travel and adventure; they wanted to perform a Christian duty and "serve" less fortunate people; and they wanted a unique work experience. These three motivations are categorized as: 1) "In

Search of Adventure;" 2) "Religion and Philanthropy;" and 3) "Career Experience and

Advancement."1 However, the nurses cannot be situated easily within a single motivational category; they did not join the Mission for either adventure, religion, or career purposes, but rather had a combination of two or three of these motivations. The fact that these women applied to an international health care organization suggests that they were driven by a desire for travel and adventure; otherwise they would have remained in their home country. The nurses were distinguished more by the degree of their secondary motivating factor - religion and/or career. Within the context of the

Grenfell Mission, the nurses' personal motivations and individual life choices were balanced against the public face of the institution. Although they nursed in challenging circumstances that were unusual for women of their generation and they often exercised a

1 In her recent study, Myra Rutherdale found similar motivations among nurses who worked with Aboriginal peoples in the Canadian North. She identifies three types of nurses in the North - "cleansers" who were often wives of missionaries and were interested in intervening in Aboriginal peoples' lives; "cautious caregivers" who were interested in learning from the people and sometimes questioned the use of southern medicine; and "optimistic adventurers" who embraced the challenges of their situation and often accepted established community practices. See Myra Rutherdale, "Cleansers, Cautious Caregivers and Optimistic Adventurers: A Proposed Typology of Arctic Canadian Nurses, 1945-70," Place and Practice.

141 high degree of professional independence, their personal lives and individual behaviours sometimes came under the scrutiny, and even the condemnation, of the Grenfell

administrators.

This chapter discusses the personal aspects of nursing with the Grenfell Mission

and the balance between personal motivations and the institutional public image. It is

based on the personnel records of the Grenfell Association of Great Britain and Ireland.

Most nurses (outside Canada and the United States)2 applied through this office, and in

many instances the nurses kept correspondence with the Association through their tenure

with the Mission and afterwards. These personnel records contained the nurses'

applications for service, letters of reference, copies of contracts, staff suitability reports,

interview notes, and correspondence. In addition, the three successive Association secretaries, Kate Spalding, Betty Seabrook, and Shirley Yates, maintained interview

notes which detailed their impressions of the applicants and why those nurses wanted to

work with the Mission. These secretaries were particularly involved in evaluating

candidates and choosing suitable nurses to work with the Mission in Newfoundland and

Labrador. An examination of the correspondence between the nurses and the secretaries

provides useful indications as to motivations; for example, letters often reveal the degree

to which nurses were involved with the local church or other good will groups. Through

an analysis of these records and the discourse contained within the letters it is possible to

hypothesize as to the motivations of the nurses who joined the Grenfell Mission.

2 Canadian nurses applied for the Grenfell Mission through the Grenfell Labrador Medical Mission while American nurses applied through the New England Grenfell Association.

142 Although the organization itself was steeped in middle-class mores, a range of social classes were represented within the nursing staff of the Grenfell Mission. Many of

the nurses were clearly middle-class, especially those being the daughters of physicians and ministers. In the early years of the Mission, nurses often joined for religious and

philanthropic reasons or for personal reasons - for example, to travel. And before the

Second World War many nurses volunteered for service during the summer months -

they received no salary and were expected to provide a "donation" of about £40 to cover

their expenses. When Anne Thompson3 decided to volunteer with the Mission in the

summer of 1949, her father insisted that his daughter travel first-class and he paid her fare

from Liverpool to St. John's himself.4 However, not all Grenfell volunteers had financial

resources or parents who were in a position to help them. The socio-economic

background of a nurse was sometimes evident in the archival material, especially through

correspondence, letters of reference, and notes that the secretaries made about candidates

after their interviews. For example, a reference for one applicant explained that the nurse

had been an orphan since she was a child; she had no family ties, no resources, no

money.5 These challenges aside, the nurse went on to have a successful Grenfell and

post-Grenfell career.

Nurses were considered to have attained bourgeois values through their

completion of a hospital nurse training program. Over two hundred nurse training schools

were represented by the nurses who applied to the Grenfell Mission through the Grenfell

3 Pseudonym.

4 PANL, MG 63, Box 37, File 805, [Anne Thompson] to Betty Seabrook, 30 May 1949.

5 PANL, MG 63, Box 49, File 1099, Folder 2, Agnes W.R. Mair to Betty Seabrook, 6 April 1952; and Note by Seabrook, 2 August 1951.

143 Association of Great Britain and Ireland. Of 466 nurses (466 nurses' files, out of the total

498 files, contained data on their school and year of graduation), 26% attended one of the following ten nurse training programs in London, Glasgow, and Edinburgh:

TABLE 4.1: Most Common Training Schools, 1929-80

Training School Nurses

St Thomas Hospital London 19 St Bartholomew's Hospital London 17 Royal Infirmary Edinburgh 14 Royal Infirmary Glasgow 14 Guy's Hospital London 12 University College Hospital London 12 Victoria Infirmary Glasgow 10 Westminster Hospital London 9 Hammersmith Hospital London 8 St George's Hospital London 7

Source: PANL, MG 63, Box 22, File 376 - Box 77, File 1842, Applications for Medical Service and Applications for Nursing Service, 1929-81.

These training programs were based on the Nightingale system, which included a period of probationary training within acute general hospitals. The training emphasized discipline and obedience under a supervisory matron, purity of character, a devotion to patient welfare, and assistance to the physician.6

When nurses applied to work with the Mission, they were required to provide professional references from recent employers or supervisors. The Mission was certainly

6 See Monica E. Baly. Florence Nightingale and the Nursing Legacy, (London: Routledge, 1986); "The Influence of Florence Nightingale," in Nursing and Social Change, 3rd ed., (London and New York: Routledge, 1995), pp. 111-122.

144 interested in the middle-class values inherent in the Nightingale system, especially in terms of the bourgeois character that they would bring with them to the Coast. However, the Grenfell Mission was also particularly interested in the practical qualities of candidates which could help predict a nurse's chance of success in the demanding environment of northern Newfoundland and Labrador. In their reference letters, the

Mission asked referees to answer the following standard questions:

- Do you consider her to be a person of poise and good judgment? - Is she adaptable and easy to work with? - Is she energetic and capable? - Strong, healthy with endurance? - Do you consider her qualifications as a nurse suitable for being in charge of an isolated settlement with only an occasional visit from a doctor during the long winter months? - If this applicant applied to you for such a position would you appoint her?7

The Grenfell Mission did not ask for referees to comment on the candidate's religious philosophies or specific attributes of moral leadership. The Mission wanted nurses who could improvise, make their own judgments and handle the independent nature of the work. They also wanted nurses who were strong, healthy and energetic to meet the demands of nursing in a northern climate where they brought health care to scattered coastal communities by walking, boating or dog-sledding. These were practical qualities rather than ideological qualities.

Recruitment for nurses was handled through the Mission's three main branch centres located in London, Boston and Ottawa.8 From these three headquarters, the

7 PANL, MG 63 Grenfell Association of Great Britain and Ireland Collection, Box 35, File 738 "Durley, Ivy Constance Nurse: 1947-1981Seabrook to The Matron, General Infirmary Salisbury, 25 April 1947.

8 International Grenfell Association (IGA) Archives, St. Anthony, File "General Correspondence (1965- 1968)," J.R. Kelly, Acting Director of Nursing Services, to Mrs. Angeles M. Miranda, Manager, Cebu Branch House of Travel, Manila, Philippine Islands, 23 February 1967.

145 Mission advertised positions in nursing and medical journals and through affiliation with associations like the Queen's Nursing Institute in Britain. In fact, many of the British nurses who worked with the Grenfell Mission were originally Queen's district nurses. But without a doubt, the best way to find staff was through direct contact. In 1967, Maijorie

Nichols at the Boston Office informed June Kelly in St. Anthony that advertisements just did not work; she had no reply at all from an ad placed in the American Medical

Association Journal; "on the other hand, previous alumni and Directors [turned] up really good sources."9

Who were these women who left their families and the comfort of their homes to fill the isolated nursing stations of the Grenfell Mission? There were common attributes among the nurses, the most obvious being the fact that the vast majority of them were foreigners. Fortunately for demographic history, the official Grenfell quarterly, Among the Deep Sea Fishers, published the "Reports of the Staff Selection Committee" from

1914 onwards. Until 1967, these reports detailed the nationalities of each new nurse on staff with the Grenfell Mission. From these reports it is possible to gauge national demographic trends and speculate on shifts that occurred in terms of which countries supplied nurses. For example, in her thesis Perry argues that the overwhelming majority of nurses who worked with the Mission before the Second World War came from the

United States. According to Perry's data, Grenfell nurses from 1894 to 1938 were approximately 68.8% American, 12.5% Canadian, 7.5% British and Irish, 4.9%

9IGA Archives, St. Anthony, File "Director of Nursing Services 1967 -"Marjorie G. Nichols (Boston Office) to June Kelly (Acting Director of Nursing Services, IGA St Anthony), 5 April 1967.

146 Newfoundlander, and 4.9% unknown/other.10 These figures are in stark contrast to post-

1945 data, where American numbers fell and British women became the majority of

Grenfell nurses. American numbers started to decline through the 1930s, dropped to 24% after the Second World War and as low as 8.4% in the mid-1960s, while British numbers steadily increased to peak at 59.3% in the mid-1950s. Canadian numbers also increased and peaked at 30.8% in the immediate post-1945 period, while Newfoundland numbers were the most erratic - rising to 14.9% during the Second World War, dropping to 1.3% in the mid-1950s and then peaking at 22.3% in the mid-1960s.11

There are several explanations for the shifting demographics of Grenfell nurses through the twentieth century. As a multi-national philanthropic organization, the

Grenfell Mission was sensitive to the economic and political events of the twentieth century, especially: 1) the Depression, 2) the Second World War, and 3) Newfoundland's

Confederation with Canada. These events directly affected the Mission's nursing numbers. Before the Depression, in 1924-28, 79.8% of the Grenfell nurses were

American.12 It is not surprising that there were such high numbers of American nurses during this period because New England was the focus of Grenfell's early recruitment and fundraising campaigns. Grenfell traveled extensively throughout the United States teaching wealthy Americans about the deplorable medical conditions in northern

10 Jill Samfya Perry, "Nursing for the Grenfell Mission: Maternalism and Moral Reform in Northern Newfoundland and Labrador, 1894-1938," MA Thesis (Memorial University ofNewfoundland, 1997), p. 10.

11 These figures have been obtained by compiling names found in the "Reports of the Staff Selection Committee" published in Among the Deep Sea Fishers between 1939 and 1967, excluding the years 1952 and 1966 for which the "Reports" could not be found. 1967 was the last year in which the "Reports" included the nationalities of the nurses.

12 See Perry, "Nursing for the Grenfell Mission," pp. 10-11.

147 Newfoundland and Labrador and in the first three decades of the century.13 Furthermore, during the financial boom of the 1920s, when American numbers peaked, more and more nurses were perhaps financially able to volunteer with the Grenfell Mission. However, during the Depression, the proportion of American nurses employed by the Mission dropped from 79.8% in 1924-28 to 66.7% in 1929-33 and 52.9% in 1934-38.14 These figures reflect the financial realities of the Depression, when fewer people could afford to leave their families and volunteer in another country.

The Second World War had a similar impact on British numbers. Initially a project of the Mission to Deep Sea Fishermen, the Mission's work in Labrador became increasingly independent of its British base and more closely associated with the name of

Wilfred Grenfell. In 1922, Grenfell began directing funds from his British lectures into his own special account for Newfoundland and Labrador and was gathering supporters to create his own organization in Britain separate from the Mission to Deep Sea Fishermen.

This committee became incorporated as the Grenfell Association of Great Britain and

Ireland (the Association) and in 1934 officially ended its connection with the Mission to

Deep Sea Fishermen.15 With an office in London and Kate Spalding as Secretary, the

Association set about on the beginnings of a recruitment campaign. While the proportion of British nurses with the Grenfell Mission climbed to 20.6% after the establishment of the Association (1934), the figure dropped to as low as 8.3% in 1942-43. At the start of

13 In 1919 Grenfell published his autobiography, A Labrador Doctor: The Autobiography of Wilfred Thomason Grenfell, with Houghton Mifflin Company of Boston and New York and Rompkey points out that "as Grenfell turned his attention more exclusively to lecturing throughout the 1920s, the book would become one of his principal instruments." Rompkey, Grenfell of Labrador, p. 203.

14 Perry, "Nursing for the Grenfell Mission," pp. 10-11.

15 Rompkey, Grenfell of Labrador, pp. 229-233.

148 the war, the Grenfell Mission gave all British subjects permission to return home for its duration, and several nurses felt the need to return home during the national crisis in

England.16 In addition, the logistical demands on Britain during the war made it sometimes impossible to send a nurse from England to Newfoundland - the nursing shortage in Britain meant that nurses who wished to work with the Grenfell Mission could not acquire a permit to leave the country, since their skills were in such demand at home and on the front.17 By the spring of 1944, the British government had instituted a

i g ban on overseas travel, and in the rare instances when a nurse was granted an exit permit (i.e. for Newfoundland women who finished nurse training in England during the war and wished to return home), it was difficult and time-consuming to attain trans-

Atlantic passage.'9 To accommodate the shortage of British staff during the war, the

Mission appealed to North American nurses to fill the void, and throughout the war the

American and Canadian nurse numbers increased (see Figure 4.1).

16 For example. Nurse Pam Rowbotham returned home (with another nursing colleague) in October 1939 after having gone to Labrador in May of the same year. See Archives and Special Collections, Joyce Nevitt Collection #177, Box 15, File 12.01.023 "Pam Rowbotham, IGA."

17 PANL, MG 63, Box 63, File 1496, Folder 1, "Rowbotham, Pansy Maude," Rowbotham to Kate Spalding, 19 October 1939.

18 PANL, MG 63, Box 66, File 1585, Folder 3, "Smith, Jean Battinson," Mrs. Collins to Jean Smith, 25 May 1944.

19 PANL, MG 63, Box 65, File 1552, "Johnston, Patricia," Kate Spalding to Patricia Johnston, 30 April 1941. The Mission sent two of their British nurses back to England in 1941, and the trans-Atlantic crossing took 15 days. See PANL. MG 63, Box 8, File 100, Folder 2, Kate Spalding to Garth Forsyth, 3 November 1941.

149 FIGURE 4.1: British, Canadian and American Nurses, 1938-46

B British • Canadian 13 American

1938 1939 1940 1941 1942 1943 1944 1945 1946

Source: "Report of the Staff Selection Committee," Fishers, 1938-46.

The American figures peaked in 1941-42, and then declined for the duration of the war. This perhaps corresponds with the entrance of the United States into the Second

World War and the sudden demand of nurses for American war service. But why did the

American figures drop off so decidedly after the Second World War? Perry suggests that the American majority fell in the late-1930s "largely due to an influx of nurses from the

British Isles."20 However, did the American numbers fall because there were increasing numbers of British nurses vying for nursing positions, or did the British numbers increase because there were declining numbers of American nurses? Perhaps the Grenfell Mission felt it was exhausting its nursing resources in the United States and turned to Britain to

"° Perry, "Nursing for the Grenfell Mission," p. 11.

150 supplement falling recruitment. Although the proportion of British nurses in the post-

1934 period increased from 9.8% (1929-33) to 20.6% (1934-1938),21 the actual increase

of British nurses was only two. Therefore this figure is perhaps more reflective of the

serious decline in American nurses rather than a sudden "influx" from Britain. Although

in the postwar period, the Grenfell Mission also discovered the value of British nurses

trained in midwifery for staffing their remote nursing stations [see Chapter 5],

The numbers of Newfoundland and Labrador nurses with the Grenfell Mission

remained in the single digits until the 1960s, when the figure dramatically increased. In

1954-1958, the Mission had two Newfoundland nurses on staff, in 1959-1963 they had

fourteen, and in 1964-1968 they had forty. Perhaps these numbers reflect the greater

educational opportunities for women after Confederation and the introduction of federal

financial support for nursing and medical services, especially in the form of Federal

Health Grants. In 1949, fifteen Newfoundland men and women received financial

assistance in the form of Federal Health Grants for post-graduate study in public health -

nine of which went to nurses. The Federal Health Grants were conferred annually to each

province and were based on population. During 1951-1952, Newfoundland was entitled

to $1,033,899 in nine categories of assistance.22 The Federal Health Grants assisted in the

expansion of existing provincial health projects and helped local women attend post

graduate nursing education on the continent. Within this system of financial assistance

for education, more and more Newfoundland and Labrador women could consider a

career in nursing with the Mission. In any event, at any given period with the Grenfell

:| Perry, "Nursing for the Grenfell Mission," p. 11.

" Canadian Journal of Public Health, 40.12 (December 1949): 523.

151 Mission the nursing staff consisted of a mixture of British, Irish, American, Canadian,

Newfoundland, and other nationalities of women who were personally motivated to work in the remote physical environment and challenging work environment of northern

Newfoundland and Labrador.

PERSONAL MOTIVATIONS

There was something about nursing with the Grenfell Mission in northern

Newfoundland and Labrador that appealed to hundreds of women in Britain, the United

States, Canada, and the world. The Mission offered nurses, in the words of Jill Perry, "an exceptional female work experience."23 In her thesis on nursing with the Grenfell

Mission, Perry uncovered the early history of nursing with the Grenfell Mission and argued that the Mission rationalized the independent nature of their nurses' work by emphasizing the need for "essential" female virtues, such as domesticity, sympathy and selflessness, as part of its localized reform agenda. Women were the backbone of the

Grenfell Mission, and nurses in particular were central to the organization in two important ways: "[fjirst, they performed a wide range of duties, both medical and non medical, which kept the Mission running smoothly. Second, they were strategically central to the Mission's objectives of'improving' the local people."24 Clearly, the employment of nurses to provide health and social services to such a dispersed population was advantageous to the Grenfell Mission. But what were the advantages to the nurses who chose this career path? What induced so many women to leave the

23 Perry, "Nursing for the Grenfell Mission," p. 61.

24 Perry, "Nursing for the Grenfell Mission," p. i.

152 comfort of their homes and the company of friends and family to practise in a strange country and in such a remote area? Certain clues in this area can be discerned from recent historiography on the experiences of other female missionaries in North America. In her book, Women and the White Man's God: Gender and Race in the Canadian Mission

Field, Myra Rutherdale examines the experiences of Anglican women missionaries in northern Canada from 1860 to 1940. She moves beyond the standard dichotomy of colonizer/colonized and instead focuses on the contact zone. She argues that the mission field in Canada's north was fluid and there was no typical pattern of experience for missionary women, especially regarding their relations with Aboriginal women. In terms of their motivational patterns, Rutherdale found that "[f]or many women, mission work offered an empowering opportunity to work, see the world, and be independent. Many were enthralled by the chance to travel. Others, who dedicated their lives to mission work, no doubt had the calling, and others still were anxious to marry missionaries and go into the field as partners."25 Similar motivational patterns emerge in the history of

Grenfell nursing.

In Search of Adventure

The most common reason nurses gave for joining the Grenfell Mission was to travel. Indeed, due to its self-identification as a guardian of middle-class morality, the

Grenfell Mission was an ideal career choice for women who wanted travel: it provided an opportunity for adventure that was acceptable to parental and middle-class standards.

References to travel and adventure appear in oral histories, in the archival material (the

25 Myra Rutherdale, Women and the White Man's God: Gender and Race in the Canadian Mission Field, (Vancouver and Toronto: UBC Press, 2002), p. 155.

153 secretaries" interview notes, applications for employment, termination of employment, and general correspondence), and also within the pages of the Fishers, supporting the theory that travel and adventure was the most common motivation for nurses joining the

Grenfell Mission. In order to gauge adventure as a motivating factor for joining the

Mission, three themes evident in the oral histories and archival material were analyzed: 1) the nurses* propensity to travel before they joined the Grenfell Mission; 2) their admission of a desire to travel, either during their interviews or through correspondence; and 3) the direction of their post-Grenfell Mission careers/lives. In addition, the official

Grenfell discourse promoted the idea of adventure in northern Newfoundland and

Labrador, especially in its attempts to fundraise and to recruit nurses to the area. Images of travel by dogsled were common in the Fishers before the late 1950s. Figure 4.2 portrays an outfitted dogsled trip, complete with a local driver, snowshoes, and other necessities.26

26 Jack Buckle of Forteau was often hired to drive Grenfell nurses throughout the region — "I used to take nurses and Industrial workers as far as Mary's Harbour. I used to go once a month, leavin' Forteau and go to Red Bay one day and the next day, if'twas fine, we'd go to Green Bay. You'd get back around eight or nine o'clock. T wo dollars a day for yourself and your dogs, that was your pay. If 'twas dirty weather and you were caught in Red Bay, you got nothing. If you didn't harness your dogs, you'd get n'are dollars. I was drivin' nurses for six or seven winters." Jack Buckle, "A rough trip," Them Days 5.3 (1980): 24-25.

154 FIGURE 4.2: Travel by Dogsled

Source: Fishers 37.01 (April 1939): 14.

The Mission recognized that it offered an experience vastly different from that of standard hospitals or city clinics, and it tried to capitalize on this difference by emphasizing the adventurous nature of the work. Travel and adventure permeated the

Grenfell discourse and was a strong motivating factor for many nurses who joined the

Mission. [For an in depth discussion of the Grenfell Mission discourse, see Chapter 3].

Oral history in particular suggests that travel was an important motivating factor for many women. One British nurse, Kate Mackenzie, joined the Grenfell Mission because she wanted adventure; she wanted to travel. She looked through advertisements in the Nursing Mirror and sent applications to missionary associations all over the world.

155 The Grenfell Mission was the first to respond and became her employer of choice.27 Elsie

Davis, whose brother sent her the Grenfell Christmas card (see Chapter 2), had always

wanted to travel. As a child she loved reading books about other countries and was

especially interested in seeing Canada.28 Not only Newfoundland, but Canada in general

was a popular destination for the British nurses - in fact, some nurses joined the Grenfell

Mission (post-confederation 1949) specifically because they wanted to go to Canada.

Anita Robinson was interested in joining the Mission because it was "somewhere

different."29 And when Elaine Fullard finished her midwifery training in 1970 she

immediately wrote to the Canadian Department of Immigration enquiring about nursing

positions in Canada. Although the Department told her that there were no vacancies in

Canada, Fullard contacted the London office of the Association and was accepted for

service in Newfoundland and Labrador. She had already known about the Grenfell

Mission through her mother, who purchased the Christmas cards each year.30

Every nurse who applied through the London office completed an "Application

for Medical Service" (which became, more specifically, an "Application for Nursing

Service" in 1972) which contained a section on previous work experience. This section

often revealed the nurses' past history of international travel. At least sixty-eight nurses

out of 468 (468 nurses' files, out of the total 498 files), contained data on previous work

27 This is a pseudonym to protect the identity of the nurse who agreed to a personal interview in August 2004. See Kate Mackenzie, Personal Interview, August 2004.

28 Davis, Personal Interview, August 2004.

29 PANL, Mg 63, Box 62, File 1473 "Robinson, Anita Mary," Robinson to the Grenfell Mission, [24 August 1956].

10 PANL, MG 63, Box 38, File 824 "Fullard, Elaine Margaret," note on Fullard by Seabrook, 22 October 1970.

156 experience, including overseas experience), or 14.5% who applied for the Grenfell

Mission between 1935 and 1981, had previous experience nursing in a foreign country.31

The most common destinations were Canada (especially Ontario, Alberta and British

Columbia; as well as Newfoundland both before and after confederation), the United

States, Australia and New Zealand, Zambia, Kenya, South Africa and Rhodesia.

However, nurses had also worked in countries in Southeast Asia, the Middle East,

Europe, the Caribbean and Central America. During the 1930s and 1940s, four Grenfell nurses began their second overseas appointment in Newfoundland; Ethel Currant,

Margaret Seaman, Mabel Hainsworth and Mary Weir originally came to the country with the Newfoundland Outport Nursing and Industrial Association (NONIA) - an organization established originally as the Outport Nursing Scheme (ONS) in 1920 to bring health care services to people in rural communities of Newfoundland.32 NONIA recruited their nurses through the Overseas Nursing Association (ONA) in London which, while independent of religious affiliations, certainly encouraged the promulgation of British middle-class standards to the neglected corners of the empire. Currant, Seaman,

Hainsworth and Weir were attracted to NONIA for the chance to practise nursing

" See PANL. MG 63. Personnel Files.

NONIA was organized such that the nurses' salaries would be partially supported by the industry of women in the communities. The women produced such products as knitted goods for sale, the idea being that the scheme would encourage industrious work among the people and give them a sense of having earned the services of the nurse rather than receiving charity. For somewhat celebratory account of the history of NONIA see Joyce Nevitt, White Caps and Black Bands: Nursing in Newfoundland to 1934, (St. John's: Jesperson Printing, 1978), pp. 127-145, 224-231.

157 overseas and in an outport situation. After the nursing endeavours of NONIA ended in

1934, these four women applied to work with the Grenfell Mission in the outports.33

Many nurses also admitted their desire for travel and adventure to the Mission itself, either through correspondence or during their interviews with the Association secretaries. Joan Smith could not contain her excitement at being accepted for the

Grenfell Mission, and in August 1947 (almost a year before her appointment to the

Coast), she wrote to Seabrook ..1 am getting so thrilled at the prospect of the adventure in the spring."34 Nurses who had a more extensive history of overseas nursing experience usually made a point of informing the secretaries of their qualifications, such as Muriel

Ingalls, who told Dorothy Plant: "During the last war I was in the British Army, and since, I have completed a tour with the British Overseas Nursing Service in Northern

Rhodesia, worked with the Rio Taite Company in Spain and spent five years in Canada -

7 months in Vancouver and the remainder of the time in Toronto."35 At the time of her

33 For example, Currant applied to the Grenfell Mission in October 1935 and Seaman in December 1938. See PANL, MG 63, Box 27, File 520, "Currant, Ethel," Application for Medical Service, October 1935, and Box 64, File 1543, "Seaman, Margaret," Application for Medical Service," 4 December 1938.

In 1934 Responsible Government in Newfoundland was suspended and a "Commission of Government" was established to govern the Island. Through an absence of partisan politics, the Commission, in principle, was intended to eliminate political corruption and efficiently establish Newfoundland's economy onto a firm footing. This was a controversial move on the part of the British and Newfoundland governments and has been the subject of much historical debate. See for example, Garfield Fizzard, (ed.), Amulree's Legacy: Truth, Lies and Consequences - Symposium March 2000, (St. John's: Newfoundland Historical Society, 2001); Gene Long, Suspended State: Newfoundland Before Canada, (St. John's Breakwater Books, 1999); Patrick O'Flaherty, '"Holding the Baby': Parliamentary Responses in Britain and Newfoundland to the Crisis of 1931," Newfoundland Quarterly 32:2 (Summer/Fall 1997): 23-32; James Overton, "Economic Crisis and the End of Democracy: Politics in Newfoundland during the Great Depression," Labour/Le Travail 26 (Fall 1990):85-124; Frederick W. Rowe, A History of Newfoundland and Labrador, (Toronto: McGraw-Hill Ryerson, 1980). For the purposes of this paper, the Commission of Government terminated NONIA and instituted a new system of health care on the Island based on the establishment of Cottage Hospitals and community health subsidies.

34 PANL, MG 63, Box 66, File 1586 "Smith, Joan Mary," Smith to Seabrook, 18 August 1947.

35 PANL, MG 63, Box 46, File 1026 "Ingalls, Muriel Jane MacDonald," Ingalls to Dorothy Plant, 30 May 1960.

158 letter, Ingalls was nursing in Bermuda. Her vast foreign experience made an impression on Seabrook, who noted that Ingalls was "[n]ot afraid of responsibility, as she had lived and worked in isolation.'*36

The secretaries were impressed by a candidate who had nursed in a foreign country because it suggested to them that she was adaptable and prepared to live in circumstances different from home, characteristics that they believed would lead to a successful placement with the Grenfell Mission. Seabrook and Yates often commented on the nurse's previous international experience and the likelihood that she would be a successful employee in northern Newfoundland and Labrador. They often made note if a candidate (with foreign work experience) "[seemed] to adapt quite well away from home,"37 could "adapt herself and enjoy whatever she [was] doing,"38 and "enjoyed the work in Zambia and did not mind the isolation."39 The secretaries also noted the eagerness of many Grenfell applicants to travel. For example, with regards to one candidate, Seabrook noted: "She seems a fairly venturesome girl."40 A similar note on

Muriel McConnell states: "She does not seem to have any idea what she would like to do in the future, but just said that she would like to travel."41 Evidently, her nursing career came second compared to the opportunity to travel, otherwise she may have given more

36 PANL, MG 63, Box 46, File 1926 "ingalls,Muriel Jane MacDonald," note by Seabrook, 11 August 1960.

37 PANL, MG 63, Box 29, File 574 "Campbell, Jean Mary," note by Yates, 12 October 1972.

38 PANL, MG 63, Box 63, File 1506 "Tarratt, Alison Laura," note by Seabrook, 8 April 1968.

39 PANL, MG 63, Box 35, File 725 "Doyle, Madeline," note by Yates, 21 June 1971.

40 PANL, MG 63, Box 49, File 1119 "Lennox, Christina Ann," note on Lennox by Seabrook, 5 March 1973.

41 PANL, MG 63, Box 52, File 1209 "McConnell, Muriel," note on McConnell by Yates, 26 September 1974.

159 thought to what kind of position she wanted with the Mission, whether station or hospital, and if hospital, which department.

Other applicants were more delicate in balancing their eagerness to travel with the work opportunity the Grenfell Mission presented. When she first contacted the Mission,

Leela Nambiar stated, "I am single, free, and very interested in travelling and gaining more experience."42 Again, the impetus was on the travel aspect of Grenfell nursing, although Nambiar did acknowledge the importance of the work experience. Some candidates had even exhibited the desire for extreme travel during their student days. The

Matron of St Olave's Hospital in London described Jane Johannesson as "a quiet, well- mannered young lady for whom nursing alone was not sufficient for her complete fulfillment. To me she had an adventurous nature which required an outlet from time to time. For example, she would go on Safari for her annual leave."43

For many Grenfell nurses, previous international experience was tied directly to global political events, especially related to colonial and military service during the

Second World War. Before their contracts with the Grenfell Mission, nurses could be found working with the Colonial Nursing Service in British East Africa, and with major military establishments: Princess Mary's Royal Air Force Nursing Service, Queen

Alexandra's Royal Naval Nursing Service, and the Territorial Army Nursing Service and

Queen Alexandra's Imperial Military Nursing Service.44 The fact that British nurses took

42 PANL, MG 63, Box 55, File 1305 "Nambiar, Leela," Nambiar to Yates, 9 October 1979.

41 PANL, MG 63, Box 46, File 1039 "Johannesson, Jane," reference letter from Ann Miller to Yates, 24 July 1974.

44 For example, see PANL, MG 63, Box 41, File 913 "Hainsworth, Mabel Lilian," Application for Medical Service, 19 January 1949; and Box 46 File 1026 "Ingalls, Muriel Jane MacDonald," Application for Medical Service, August 1960.

160 advantage of the plethora of international nursing opportunities associated with the war is also evident in the significant dip in Grenfell Mission recruitment numbers during the period [see above]. Many nurses continued their globe-trotting after the war as well, some with the military, such as Susan O'Hanlon who nursed with Queen Alexandra's

Royal Naval Nursing Service (1965-69),45 and some in relief work, such as Ena Hadfield who nursed with the Society of Friends in Poland and China (1947-50).46 And along with military opportunities, commercial interests increasingly provided nurses with the chance for travel. For example, in 1964, May Foster nursed with the Kuwait Oil Company for the purposes of starting a health visiting service in that country.47 One of the most popular destinations during the 1960s and 1970s was Zambia, where nurses contracted with mining companies, such as the Roan Consolidated Mines in Mufulira.48

During their careers after the Grenfell Mission, nurses could be found throughout the world, especially in northern Canada, Africa and Southeast Asia. Several nurses traveled further north after their tenure with the Grenfell Mission, including Kathleen

Lutly, Sheila Rawlings, Philippa Dixon and Jean McRobert, who all worked on Canadian

The Territorial Army Nursing Service and Queen Alexandra's Imperial Military Nursing Service amalgamated in 1939, and became Queen Alexandra's Royal Army Nursing Corps in 1949. See The National Archives, "War Office: Directorate of Army Medical Services and Territorial Force: Nursing Service Records, First World War," Administrative / biographical background, http://vvww.iiationalarchives.ttov.uk (accessed 27 April 2008).

45 PANL, MG 63, Box 57, File 1337 "O'Hanlon, Susan Mary Josephine," Application for Medical Service, 27 January 1975.

46 PANL, MG 63, Box 41, File 910 "Hadfield, Ena," Application for Medical Service, 7 September 1952.

47 PANL, MG 63, Box 38, File 809 "Foster, May," Foster to the Association, 22 August 1966.

48 See PANL, MG 63, Box 57, File 1337 "O'Hanlon, Susan Mary Josephine," Application for Nursing Service, 27 January 1975; Box 63, File 1514 "Sands, Catherine Elizabeth," Application for Nursing Service, 30 March 1974; and Box 34, File 725 "Doyle, Madeline," Application for Nursing Service, 19 May 1972.

161 government nursing stations in the Northwest Territories. Nurses in Africa and Southeast

Asia were usually on contracts with philanthropic organizations, such as the London

Missionary Society in Rhodesia, the Friends Service Council in Algeria, and the

International Union of Child Welfare in the Sudan. While she was with the Baptist

Missionary Society in Bangladesh, Susan Headlam compared her experience with the

Grenfell Mission and informed Yates: "I have now been here in Bangladesh 6 months and am really enjoying the challenge. Of course it is vastly different from Labrador in every respect and so much is pathetic. Nursing is challenging with very little equipment

& drugs & people so malnourished, but I'm spending a lot of time teaching Bengali student nurses."49 And in 1979, Mary Fancott commented to Yates on her personal attraction to travel: "Itchy feet again! This time I've come East for a change."50 She was working with Save the Children Fund at a Mother and Child Clinic in Kathmandu, Nepal.

Perhaps the most notable post-Grenfell story is that of Helen Fraser, who was awarded the Florence Nightingale Medal for nursing in Cambodia in 1975: "Despite repeated opportunities to be airlifted to safety, they refused to leave the sick and dying victims of the fighting as Phnom Penh fell to the Khmer Rouge."51

Religion and Philanthropy

Religion and philanthropy were important motivating factors to many nurses who considered a career with the Grenfell Mission in northern Newfoundland and Labrador.

49 PANL, MG 63, Box 43, File 960 "Headlam, Susan," Headlam to Yates, 25 April 1976.

50 PANL, MG 63, Box 37, File 780 "Fancott, Mary Jane," Fancott to Yates, 27 November 1979.

51 PANL, MG 63, Box 38, File 813 "Fraser, Helen Clare," The Lady, 28 July 1977.

162 However, there was never one standard level of religious interest or spiritual involvement among those nurses who possessed religious motivations. In fact, as there were different degrees of interest between travel, career and religion among the Grenfell nurses, so too were there different degrees of religious activity among those religiously motivated. This section discusses the religious and philanthropic motivations of the nurses who worked with the Grenfell Mission in Newfoundland and Labrador from 1939 to 1981, during a period of increasing secularization of western society. The Grenfell Mission originated during the apex of the late-nineteenth century Christian missionary movement, and under the personal leadership of Wilfred Grenfell possessed strong undertones of Christian duty. However, the Mission was never wholly evangelical in the sense of converting local people to a particular brand of faith, and by 1939, more secular concerns had infiltrated the organization (see Chapter 2). The Grenfell executive became increasingly concerned with its professional image and the quality of health care it provided. For the board of the

Mission, and for many of the nurses who worked with the Mission in Newfoundland and

Labrador, Christianity was an inspirational element of the official Grenfell discourse rather than a reality of the daily work. However, religious or philanthropic factors remained important to many nurses throughout the twentieth century to varying degrees.

Between 1939 and 1981, approximately 38% of applicants expressed a direct interest in missionary work and/or informed the Grenfell secretaries about their active involvement with a local church. In terms of gauging the nurses' Christianity as a motivating factors for joining the Grenfell Mission, five aspects of their correspondence with the Grenfell

Association of Great Britain and Ireland were analyzed: 1) the nurses' admission of their

Christian devotion; 2) the content of their reference letters, including their pre-Grenfell

163 religious activities; 3) the comments of secretaries or other Grenfell personnel who interviewed them; 4) their religious activities during their tenure with the Mission; and 5) their post-Grenfell Mission careers/lives.

Sometimes upon first contacting the offices to inquire about the work of the

Grenfell Mission, a nurse would profess her long-standing desire to contribute in an extraordinary way to the health of less-fortunate people. In fact, several nurses felt they were "called by God"52 to work with the Grenfell Mission, and referred to "God's will,"53

"God's guidance," and "His plan"54 as leading them to pursue a career with the Mission.

In 1944, Lydia Veitch applied to the Grenfell Mission because, as she informed Spalding,

"1 long so much to use my Life in the service of God for others. My Christian Faith is a vital part of my Life. I know that there is an Evangelical feeling & spirit permeating your

Hospitals."55 Even though the Mission was not evangelical, Veitch had developed a pre conceived notion that it was, perhaps from the religious discourse surrounding the myth of Wilfred Grenfell, as discussed in Chapter 2. In any event, Veitch felt that the Grenfell

Mission would provide her with an excellent opportunity to practice her faith and profession in unison. In the meantime, the Mission often discouraged their staff members from becoming too involved with the local denominations in Newfoundland and

Labrador, especially in terms of attempts to proselytize the people.56 And a nurse could

5: PANL, MG 63, Box 65, File 1550 "Selwood, Eveline Mary," Selwood to Somerset, 11 October 1961.

51 PANL, MG 63, Box 34, File 712 "Dickson, Lindsay Ann," Dickson to Seabrook, 22 May 1969.

54 PANL, MG 63, Box 37, File 799 "Fooks, Dorothea May," Fooks to Seabrook, 6 March 1957.

55 PANL, MG 63, Box 72, File 1710 "Veitch, Lydia," Veitch to Spalding, 3 March [1944].

56 For example, a conflict developed between Nurse Mary Taylor and the Anglican Church in Newfoundland because she had been apparently holding Gospel meetings on Grenfell Mission property.

164 damage her chances of employment with the Mission if she appeared too eager to convert the local population.57 While the Mission was mythically associated with Christianity and philanthropy, in reality the Grenfell administration preferred employees who were moral but not zealous - employees like Kathleen Williams, who admitted: "1 have not an evangelical disposition but I sincerely wish to serve a needy community of people...." 58

Williams impressed Seabrook as being "missionary minded in a practical way."59

Many nurses had personal references from one or two clergymen when they applied to the Mission, and these references usually verified her Christian qualities and her membership in a particular church. At least forty nurses who applied through the

London Office presented reference letters from clergy or other individuals who commented on the nurse's Christian ethic. Such letters usually described the nurse as "a keen Christian,"60 "a good living Christian girl,"61 "a deeply committed Christian,"62 "a

This conflict is discussed in more detail in Chapter 6. See also, PANL, MG 63, Box 9, File 113, Folder 3 "Curtis, Charles," Seabrook to Curtis, 12 March 1962.

57 A Grenfell candidate was refused an offer of employment with the Mission because she expressed had interest in doing "a little missionary work" on the side and holding "evening prayer meetings with the local people" at St. Anthony. Shirley Smith, with the New England Grenfell Association, found the candidate's religious enthusiasm "a bit alarming" and Dorothy Plant, with the Grenfell Labrador Medical Mission, found her to be "a bit of a crack pot" who would not likely fit in at the Mission. See PANL, MG 372, Box 1, File "NEGA 1953-62," letters from Shirley Smith to Gordon Thomas, 16 March 1956 and 2 April 1956.

5S PANL, MG 63, Box 75, File 1798 "Williams, Kathleen," Williams to Seabrook, 25 August 1962.

59 PANL, MG 63, Box 75, File 1798 "Williams, Kathleen," note by Seabrook, 13 September 1962.

M PANL, MG 63, Box 69, File 1641 "Susen (Mitchener), Iris Florence," reference letter from Reverend Father A. Wheatley, 1 May 1945; and Box 68, File 1613 "Steele, Agnes," reference letter from Mrs. J. Metcalfe, 8 March 1961.

61 PANL, MG 63, Box 30, File 619 "Clark, Jean May Deller," reference letter from Reverend R.G. Hyland, 15 May [1958].

6: PANL, MG 63, Box 27, File 524 "Broadbent, Heather," reference from Reverend Kenneth H. Pillar, 30 April 1968.

165 devout Christian,"63 "an earnest Christian" and "a true witness for her Master."64 Many references also commented explicitly on the applicant's "background & upbringing as being that of a happy Christian home"65 and Olive Baines provided the Grenfell Mission with two personal references who verified her excellent family background and "sound

Christian upbringing."66 While the individuals who provided these references for nurses may have felt inclined to confirm the applicant's Christian ethics in accordance with the missionary myth surrounding the Grenfell organization, it is likely that most of these nurses were genuinely active in church activities before they joined the Mission. Several reference letters illuminate some of those pre-Grenfell activities: for example, Meryl

Taylor was a teacher at the Eastgate Baptist Church67 and Doreen Dick was involved with the Nurses' Christian Movement at her nursing school.68 Sheila Chree's pre-Grenfell

Christian activities were even more impressive, as her reference stated: "Her chief interests outside her work were directed towards her Church and with the help of her

Colleague, who had like interests, they organized a Sunday School Class for young children and held Children's Working Parties in their own home."69 It should also be

63 PANL, MG 63, Box 65, File 1550 "Selwood, Eveline Mary," reference from the Matron of Guys Hospital, 30 November 1961.

64 PANL, MG 63, Box 31, File 628 "Coe, Elsie," reference from Mrs. Dorothy Simpson, 4 May 1959.

65 PANL, MG 63, Box 33, File 682 "Dale, Louisa May," reference letter from Margaret Emmott (Elder of Society of Friends), 4 June 1966.

66 PANL, MG 63, Box 32, File 658 "Cox (Baines), Olive Gwendolyn," reference letter from Mr. Ford, 9 July 1970; and reference letter from C.T. Butler to Seabrook, 13 July 1970.

67 PANL, MG 63, Box 29, File 579 "Carpenter (Taylor), Meryl Gladys," reference letter from Mrs. W.M. Buzzwell, 1 May 64.

68 PANL, MG 63, Box 25, File 475 "Bier (Dick), Doreen Elizabeth," reference letter from D.I. Whiteley, 11 November 1963.

166 noted that during her time with the Grenfell Mission in Cartwright, Chree was heavily involved with the local church and community.70

The comments of Grenfell personnel who interviewed the nursing candidates also provide insight into the religious motivations of nurses, although Christian ethics seemed less important to the secretaries than a woman's general adaptability. When she interviewed Mary Selwood, Seabrook noted that her father was a Baptist minister, but she was Church of England and had "the right kind of missionary spirit" and was, "I am sure, adaptable."71 Lesley Diack sometimes met and interviewed candidates for the Coast on behalf of Seabrook, after she retired from the Grenfell Mission. Diack, who was herself especially spiritual, found Sadie Baldwin "to have been 'led' to [service with the Grenfell

Mission] in the right sort of way - with a nudge here and there from the Holy Spirit!" She concluded: "I think Sadie Baldwin will do - in fact I am sure she will...."72 Diack also recognized the difference between religious and evangelical nurses when she warned

Baldwin "that if she was very missionary minded that she might be in for some disappointment (because I do think that is the case sometimes). ... She expressed herself to be a devout Anglican, but not Evangelical, at least not the awkward, emotional, mixed- up kind."73 Again the question of degree is important: not all religiously motivated nurses

69 PANL, MG 63, Box 30, File 611 "Chree, Sheila Margaret," W.M. Williams to Seabrook, 3 April 1959.

70 For example, in 1965, Chree helped the Women's Community Club raise money for the building of a Community Hall with a library. See PANL, MG 63, Box 30, File 611, "Chree, Sheila Margaret," Chree to Seabrook, 23 April 1965.

71 PANL, MG 63, Box 65, File 1550 "Selwood, Eveline Mary," note by Seabrook, 9 November 1961.

72 PANL, MG 63, Box 24, File 469 "Bethell (Baldwin), Sadie Melford," Lesley Diack to Seabrook, 7 April 1962.

7,1 PANL, MG 63, Box 24, File 469 "Bethell (Baldwin), Sadie Melford," Lesley Diack to Seabrook, 7 April 1962.

167 favoured a personal/individual approach to religion and spirituality, but certainly not all were driven by evangelism. Indeed, nurses' religious motivations ranged the spectrum from non-religious to Christian-evangelical.

The religious activities of nurses during their tenure with the Mission also reflected the degree to which Christianity was fundamental to their lives, and thus a motivating factor for joining the Grenfell organization. Many of the Grenfell nurses attended church services in the community where they were posted or met regularly with the visiting minister or priest. However, some nurses took their religious involvement a step further. Margaret Fromow established a Sunday school on her ward at St. Anthony, which was one of the few communities in northern Newfoundland and Labrador that contained several denominations.74 Winifred Burgess and Ivy Durley also expressed interest in the religious instruction of their patients. While she was at Flowers Cove,

Burgess noted the lack of religious literature at the station and requested "some copies of the Bible for ward use by the patients."75 Durley acquired religious recordings which she played each morning and evening for her patients as part of devotions, as she explained to

Seabrook: "We have morning devotions here, play records which are getting very well used for morning hymns. So, if anyone wants to contribute another record, we could use it - morning Praise. The evening one is very well received, because all the patients love

Beverly Shea, so we are really enjoying it, and have played it a lot already."76 While

Fromow, Burgess and Durley participated in religious activities aimed at their patients,

74 PANL, MG 63, Box 38, File 823 "Fromow, Margaret Ruth," Fromow to Seabrook, 10 September 1969.

75 PANL, MG 63, Box 45, File 1008 "Hughes, Winifred Helena Rose, nee Burgess," Burgess to Seabrook, 26 January 1952.

76 PANL, MG 63, Box 35, File 738 "Durley, Ivy Constance," Durley to Seabrook, 14 June 1956.

168 other nurses demonstrated a more personal spirituality, such as Louise Greenfield, who took a short holiday at Forteau, attended a Christian Conference and recalled, "Ah! I had such a good time -1 returned feeling just great."77 Dorothy Jupp and Lesley Diack sometimes spent their holidays at convents;78 and in 1963, Jupp informed Seabrook that she was planning her second pilgrimage to the Holy Land.79

A nurse's level of religious motivation can also be somewhat gauged by examining the direction of her life after her tenure with the Grenfell Mission. Many nurses pursued opportunities with other missionary organizations after their Grenfell careers, which testified to religious motivations, although adventure motivations would have played a strong role in this direction as well. For example, Gwendoline Bloomfield worked with the London Missionary Society in Africa;80 Susan Headlam worked with the

O I Baptist Missionary Society in Bangladesh; and Doreen Dick became a proselytizing missionary with her husband in South Africa.82 Some nurses took new directions with their careers after leaving the Grenfell Mission, such as Shan Elizabeth Davies who became part of the Community of the True Vine with her husband and converted an old farmhouse into a retreat centre for clergy and missionaries.83 Elizabeth Bailey joined a

77 PANL, MG 63, Box 41, File 891 "Greenfield, Louisa," Greenfield to Seabrook, 14 April 1962.

78 PANL, MG 63, Box 47, File 1057, Folder 2 "Jupp, Dorothy," Seabrook to Curtis, 24 June 1952; and Box 34, File 710 "Diack, Lesley," Diack to Seabrook, 6 July 1957.

79 PANL, MG 63, Box 47, File 1057, Folder 2 "Jupp, Dorothy," Jupp to Seabrook, 3 March 1963.

80 PANL, MG 63, Box 26, File 493 "Bloomfield, Gwendoline," Bloomfield to Spalding, 14 April 1955.

81 PANL, MG 63, Box 43, File 960 "Headlam, Susan," Headlam to Yates, 25 April 1976.

83 PANL, MG 63, Box 25, File 475 "Bier (Dick) Doreen Elizabeth," Bier to Seabrook, 11 July 1969.

83 PANL, MG 63, Box 27, File 536 "Brown (Davies), Shan Elizabeth Lloyd," Brown to Yates, 16 August 1978.

169 Roman Catholic convent;84 and Lesley Diack joined an Anglican convent later in life.

Diack, in fact, is an example of a Grenfell nurse who easily belongs in all three motivational categories. Diack was born into a British military family in Simla, India and during the course of her pre-Grenfell career she nursed overseas in France, Iceland, North

Africa, Italy and India. She stated in her autobiography that she "enjoyed the roving life" and specifically looked for positions in overseas nursing service.85 However, she was also one of the most vocal advocates for improving the employment conditions of nurses, especially those posted to the nursing stations. Before she retired from the Mission Diack composed a list of recommendations for the executive of the Grenfell Mission pointing out the constant strain of nursing on a station and arguing for higher salaries, holidays and equality of contracts for all Grenfell nurses.86 Diack was career-oriented and enjoyed travel, but she was also tremendously spiritual and devoted much of her life to the work of God.

Career Experience and Advancement

Evidence of adventure and religious motivations were more common in the archival material, perhaps because these two motivations fit comfortably within the official Grenfell discourse, whereas career motivations were more problematic for the image of the ideal, selfless nurse. However, the Grenfell Mission certainly offered nurses the opportunity for a unique work experience, and a work environment quite different

84 PANL, MG 63, Box 59, File 1398 "Plint, Audrey Robson," Seabrook to Plint, 28 January 1965.

85 Lesley Diack, Labrador Nurse, (London: Victor Gollancz, 1963), p. 9.

86 PANL, MG 63, Box 34, File 710 "Diack, Lesley Molloy," Diack to Seabrook, 26 April 1956.

170 from a standard hospital or urban clinic. It was the independent nature of the work combined with a challenging work environment that attracted many nurses to the Mission

- many women sought the opportunity to challenge themselves professionally and to expand the boundaries of their strict hospital training. This was an important motivation for Anne Thompson who went to Labrador because it was "something to do with proving yourself to oneself."87 Some nurses had learned of the Grenfell Mission from doctors and nurses who had already worked in northern Newfoundland and Labrador and it was usually through these connections that candidates learned of the extraordinary work opportunities on the stations. For example, during her interview with Yates, Susan Lewis expressed an interest in working on a nursing station because she had heard a lot about the Mission from various people at St Bartholomew's Hospital during her training.88 In discerning the nurses' interest in the professional experience as motivating factors for joining the Grenfell Mission, two aspects of their correspondence are examined: 1) the nurses' initial interest in being posted to a station, which they communicated to the

Association secretaries through correspondence or during their interviews; and 2) their frustrations working at Grenfell hospitals and their requests for transfer to a station. In addition, a particular sub-group of the nurses recruited through the Association were specifically driven by career motivations - the nurses of Newfoundland and Labrador who saw Grenfell nursing as a chance to make a livelihood in their home communities.

The nurses' initial interest in being posted to a station was usually communicated to the secretaries through early correspondence with the London office or during their

87 Thompson, Personal Interview, August 2004.

88 PANL, MG 63, Box 49, File 1121 "Lewis, Susan Ann," note on Lewis by Yates, 8 February 1971.

171 interviews. When Mary Stephens contacted the Association in 1959, she was specifically interested in a vacancy at a nursing station and would consider a position at Harrington

Hospital only on condition that she could transfer to a station after one year.89 Also through correspondence, Isobel Muir informed Yates that she was "looking for something a little bit different"90 and during her interview admitted that, "[s]he would be interested in working on a station."91 In the nurses' files, the secretaries kept note of those applicants interested in a nursing station, as well as those who did not feel comfortable with the thought of so much responsibility. For example, Suzanne Service was interested in working at a small hospital, but "seemed a bit nervous about a nursing station."92 The secretaries noted whether or not she thought the applicant was suitable for a nursing station. In the case of Juliet Murgatroyd, Seabrook noted that "a nursing station

[appealed] to her" and that "she [was] the right material."93 Through the 1970s, Yates was particularly thorough in noting a candidate's interest in a nursing station, which suggests that she asked nurses directly if they wanted to be posted to a station. This would account for the high proportion of nurses during Yates' tenure who desired a nursing station. However, if Yates did prompt candidates about employment on a station, she may have also inadvertently given them the (false) impression that they would be posted to a station, if they accepted an offer of employment. In 1973, Nurse Heather

89 PANL, MG 63, Box 68, File 1616 "Stephens, Mary Kiese Jean," Stephens to Seabrook, 1 February 1959.

90 PANL, MG 63, Box 63, File 1505 "Muir, Isobel Anne," Muir to Yates, 18 June 1972.

91 PANL, MG 63, Box 63, File 1505 "Muir, Isobel Anne," note by Yates, 12 February 1973.

92 PANL, MG 63, Box 65, File 1551 "Service, Suzanne," note by Yates, 26 April 1973.

91 PANL, MG 63, Box 55, File 1296 "Murgatroyd, Juliet Claire Nurse: 1970-1973," note on Murgatroyd by Seabrook, 15 September 1970.

172 Young threatened to break her contract because there was little likelihood of her posting to a station, and she accused Yates of raising her expectations for a nursing station:

I cannot say that I have not enjoyed working with the I.G.A., as I have. But the impression from yourself, I got when I came out here, was that I would have the opportunity to work in a Nursing Station, which was the reason I came out here. After only being here a short time as I have, I have learnt the situation about Nursing Stations. The vacancies are few and far between, and there is no possibility of me going to a station for some time, if at all, as there are lots of girls here who also were under the impression, they could work in a Nursing Station, and these have been here far longer than myself.94

Indeed, Young was one of many nurses who joined the Mission with the hopes of working in a station, but who spent the majority of their contracts working at Grenfell hospitals.

Many Grenfell nurses joined the Mission specifically to have charge of a health care facility, and they were attracted to the responsibility involved in district nursing.

These nurses often became unhappy if they were posted to a Grenfell Hospital, where they had to take direct orders from the physician in charge and where they were required to follow formal medical procedure and requested transfers to the stations. In 1938,

British nurses Phyllis Wenyon and Gwendoline Bloomfield complained to Spalding about their posting at St. Anthony; they complained that they did not have much responsibility, "certainly not as much as [they] had in [their] last year at St. Mary's

Hospital, before [they] finished [their] training."95 They felt themselves to be "rather

94 PANL, MG 63, Box 77, File 1842 "Young, Heather Joan," Young to Yates, 11 August 1973.

"5 PANL, MG 63, Box 74, File 1768 "Wenyon, Winifred Phyllis," Wenyon and Bloomfield to Spalding, 19 July 1938.

173 superfluous members of staff' and requested transfer to a nursing station.96 Similarly,

Margaret Rose became frustrated at her post of Harrington Harbour because she had been promised a nursing station which failed to materialize. In a letter to Gordon Thomas,

Rose stated "there is no place for an experienced nurse with post-graduate qualifications here"97 and she proceeded to resign her post when the Mission could not secure for her a nursing station.98 Sheila Rawlings also petitioned the Mission for a nursing station while she was posted to the hospital at North West River. Writing to Betty Seabrook, Rawlings confessed that she regretted accepting the post: "It was rather rash of me ever to say I would come here - knowing it was a hospital.... [I] beg of you (on bended knee) to let me know if, when, and where a vacancy is likely to occur in a Nursing Station."99 Four months later, Rawlings was still at North West River and again petitioned Seabrook: "I am really fed up at the moment and have been since I arrived here. There is not enough work for two nurses and I am sick and tired of trailing around day after day wondering what to do to pass the time ... after fourteen years of nursing I want to be doing something worth while and not trailing around here just in case we have a few emergencies where a second nurse is required (these occasions are very rare since I arrived)."100 Rawlings found her position as second nurse at North West River to be

% PANL, MG 63, Box 74, File 1768 "Wenyon, Winifred Phyllis," Wenyon and Bloomfield to Spalding, I June 1938.

07 PANL, MG 372 GTC, Box 35, File "Harrington - 1958-1962," Margaret Rose to Gordon Thomas, 27 July 1960.

98 PANL, MG 372 GTC, Box 35, File "Harrington - 1958-1962," D.G. Hodd to Jean DuMont, 1 July 1960. w PANL, MG 63, Box 51, File 1174 "MacQuiens (Rawlings), Sheila," Rawlings to Seabrook, 30 April 1958.

100 PANL, MG 63, Box 51, File 1174 "MacQuiens (Rawlings), Sheila," Rawlings to Seabrook, 18 August 1958.

174 professionally frustrating. She did not feel that she was using her training and experience

to the best of her ability and she threatened to return to England unless she was

transferred to a station, "where there [was] a job worth doing."101

One more type of Grenfell nurse was driven primarily by career motivations: the

Newfoundland and Labrador nurse. Before confederation with Canada, few local women

worked with the Grenfell Mission as trained nurses. Many were employed as aides and

domestics, but there were no nurse training facilities in northern Newfoundland and

Labrador, and few local women could afford the cost of travelling to a larger centre for

training. In the spirit of philanthropy, Grenfell supporters through the 1930s and 1940s

sponsored the education of Newfoundland girls from the orphanage in St. Anthony. Hazel

Compton was sponsored to train at Brightlook Hospital in Vermont and later studied

midwifery at the Liverpool Maternity Hospital in Britain. Upon graduating, she returned

to Newfoundland to work at the Grenfell Hospital at St. Anthony.102 Violet Learning was

sponsored to train at the Liverpool Maternity, and in a letter to Spalding she emphasized

her desire to work in Newfoundland with the Grenfell Mission: "My one ambition is the

same today as it was when I left the coast. That is to get my training and return to do my

101 PANL, MG 63, Box 51, File 1174 "MacQuiens (Rawlings), Sheila, Nurse: 1953-1975," Rawlings to Seabrook, 18 August 1958. Rawlings did not return to England. Seabrook carefully attempted to pacify her in a letter, stating: "1 do hope that by now you are feeling happier and have more to do. I am sure Dr. Thomas understands and will not forget you when the time comes. As you know, it is not always easy to fit Staff into ideal posts, but 1 think you so know how very much the work you all do is appreciated and valued wherever you may be. One can only do one's best, and your generous wish to serve the Mission and the people is known and understood." Rawlings remained at North West River through the winter and spring, and was transferred to the nursing station at Mary's Harbour in October 1959. See PANL, MG 63, Box 51, File 1174, "MacQuiens (Rawlings), Sheila, Nurse: 1953-1975," Seabrook to Rawlings, 2 October 1958.

,o: Judith Power, Hazel C ompton-Hart: Angel from the North - A Story of Courage, Devotion and Humamtarianism, (St. John's: Jesperson Publishing, 1995), p. 66.

175 best for my people & country."103 Learning did extremely well through her training and won the silver medal for her graduating class.104 Nora Noseworthy also proved to be an exceptional nurse and through her tenure with the Grenfell Mission she advanced to Head

Nurse at the St. Anthony Hospital. She earned rave reviews from the Matron of the West

Middlesex Hospital where she trained and also from the Grenfell staff in Newfoundland and Labrador.105 Druscilla Hope from North West River was also supported in her pursuit of nursing education; she graduated with honours from the New England Baptist Hospital

Training School and joined the staff of the Grenfell Mission in 1950.106 According to the

Staff Selection Reports published in the Fishers, twenty-five other women from

Newfoundland and Labrador nursed with the Mission between 1939 and 1969, most in the post-Confederation period. Only eight of those women were from a community outside the Grenfell district. For each of these women, the Grenfell Mission provided an opportunity to pursue a nursing career and earn a livelihood close to home.

RELATIONSHIPS, MARRIAGES AND CLASS

On 12 November 1963, Grenfell nurse Marion Fay107 was relieved of duties by the Medical Officer in Charge of the Grenfell Mission and was not recommended for re-

l<" PANL, MG 63, Box 49, File 1110 "Learning, Violet Maria," Learning to Spalding, 1 October 1936.

104 PANL, MG 63, Box 49, File 1110 "Learning," Learning to Spalding, 5 April 1939.

105 PANL, MG 63, Box 56, File 1329 "Noseworthy, Nora Frances AmeliaNurse: 1940-1948," reference letter from E.K. Wilson to Spalding, 13 April 1943.

106 "Druscilla Hope, R.N.," Fishers July 1949 47(2): 47.

107 This is a pseudonym, to protect the identity of the nurse.

176 employment.108 Fay had been nursing for almost two years in Roddickton, a small community on the Northern Peninsula of Newfoundland, and she had apparently become romantically involved with a local married man. When the Mission learned of the relationship they requested Fay's resignation and sent her back to England before the completion of her contract. In the meantime, Fay and the man from Roddickton maintained their relationship over time and distance. In August 1964, Fay informed

Seabrook: "Now I am soon to be on my way to Canada to join my beloved [Alex].109

Yes we have kept up & our love has grown the stronger for our parting so have decided to make our lives together. Many will & have criticised us but there it is. I want now to make him happy and try to build a new life."110 Fay left her family and friends in

England, Alex left his own wife and family in Roddickton, and together they settled in southern Ontario.

The importance of the moral regulation of nurses, as public figures and representatives of the Grenfell Mission middle-class morality, was evident from the moment nurses were recruited by the secretaries of the Association, when those secretaries tried to discern the nurses* personal motivations. Since the Grenfell Mission originated as a middle-class philanthropic organization that brought medical and social

"uplift" to an underprivileged corner of the British Empire, the administrators of the

Mission considered the institution to be the moral leader of northern Newfoundland and

Labrador and its staff members to be exemplars of a middle-class moral code. As

108 PANL, MG 63, Box 73, File 1742, Staff Suitability Report, 12 November 1963.

109 Pseudonym.

110 PANL, MG 63, Box 73, File 1742, "[Fay, Marion]," [Fay] to Seabrook, 25 August 1964.

177 contributing guardians of this middle-class morality, the secretaries often took note of a candidate's socio-economic background and the activities and/or accomplishments of her family members. The Mission took the personal relationships of their nurses seriously, especially when those relationships involved local Newfoundland and Labrador men. The case of Marion Fay was perhaps exceptional, in that her relationship was with a local married man who left his wife for her. However, socializing with local men in general was very much discouraged and when marriages between Grenfell nurses and local men did take place the nurse's wisdom or her character was often called into question. At the same time, marriages between Grenfell nurses and physicians or dentists were almost always celebrated. In terms of the Fay affair, the disapproval of the Mission and others was evident in Fay's immediate dismissal as well as her statement that "[m]any will & have criticized us." And it is significant that while Fay confided her personal information to Seabrook because she "had...always been so kind and understanding,"111 there is no evidence that Seabrook offered any advice or well wishes to her or even responded to the confidential letter. From the perspective of the Grenfell Mission, one of their nurses, sent to Roddickton to provide medical care and moral/social leadership to the people, had led a respectable married man astray and had caused the destruction of a Newfoundland family - the very people she was sent there to assist and "improve."112 This was not a moment of which the Grenfell Mission could be proud. In fact, it was instances such as this that the Mission sought to avoid.

PANL, MG 63, Box 73, File 1742, "[Fay, Marion]," [Fay] to Seabrook, 25 August 1964.

112 Perry, "Nursing for the Grenfell Mission."

178 As women trained through hospital nursing programs based on the ideals of middle-class morality and femininity, the Mission considered nurses ideal for directing the "'moral reform" of the local people."3 Along with their alleged qualities of selflessness, sympathy and domesticity, the Mission also valued the tradition of virtue and the "nurse as angel-of-mercy" ideology that had been closely associated with nursing since the Nightingale era. Ideally, Grenfell nurses were expected to have joined the

Mission for the "right" reasons and to display a combination of both middle-class moral behaviour and the ability to cope with the extraordinary physical and social circumstances in northern Newfoundland and Labrador. The ideal Grenfell nurse provided moral leadership in the communities, displayed asexual behaviour, and maintained a professional distance from the local people. Realistically, Grenfell nurses were often single young women who could not be isolated from potential marriage partners and relationships were bound to develop. The Mission responded to those relationships with class-based assumptions based on the socio-economic background of the nurses and the men they married. The responses were positive or negative depending on whether the husband in question was a Grenfell physician (on one end of the spectrum) or a local labourer or fisherman (on the other end of the spectrum); and were tied to the Mission's concern for preserving its perceived moral superiority in the communities it served. This class-based response to marriages remained fairly consistent throughout the period in question. However, the Grenfell Mission was not completely immune to larger social changes, especially in terms of the increase of married women remaining in the workforce in the postwar period. The Mission did accommodate to the

m See Perry, "Nursing for the Grenfell Mission."

179 social acceptance of married women in the workforce, although this occurred later with the Grenfell Mission than in other parts of Canada.

In Western health care institutions, nurses were traditionally encouraged to leave work upon marriage - a "social taboo" which, Kathryn McPherson argues, was

"formalized by hospitals which would employ only married women who were divorced or widowed."114 As a result, nursing remained a profession dominated by single women until the second half of the twentieth century. And while the trend in nursing across

Canada through the mid-twentieth century was towards hiring increasing numbers of married nurses, the Grenfell Mission nursing staff did not fit that pattern. For example, in

1961,47% of nurses in Canada were married and 6% were widowed or divorced.115

However, that same year, according to staff figures in the Fishers, the Grenfell Mission had only one married nurse employed within a nursing staff totalling thirty-four (or

2.9%), a Canadian nurse who accompanied her physician husband to St. Anthony."6

Grenfell nurses were overwhelmingly single women. Through the entire period of 1936 to 1981, approximately 94.8%, or 436 of 460 nurses (460 nurses' files, out of the total

498 files, contained data on marital status), were single women (see Figure 4.3).'17

114 Kathryn Mae McPherson, "Skilled Service and Women's Work: Canadian Nursing, 1920-1939," PhD Dissertation, Simon Fraser University 1989, p. 105.

115 Dominion Bureau of Statistics, Census of Canada, 1961, quoted in McPherson, p. 214.

116 "Our Staff," Fishers, July 1961 59(2): 46. Married nurses who were listed on staff with the Mission were usually either the wives of physicians or they were widowed or divorced. This is perhaps a reflection of the international and transient nature of working with the Mission.

11' This figure includes two women who were divorced, one who was separated, and one who was a widow. Numbers are based on the nurses' marital status at the time of their initial application to the Association. It does not represent those nurses who became married during or after their appointment with the Grenfell Mission. See PANL, MG 63, "Personnel Files."

180 FIGURE 4.3: Marital Status upon Application, 1936-80

• M arried £3 Single • Divorced/Widowed

95%

Source: PANL, MG 63, Files 371 - 1842, Applications for Medical Service, Applications for Nursing Service and Contracts, 1939-1981.

As this figure demonstrates, nurses who were married at the time of their application represented only 4.3% of the 460 candidates throughout the period (460 nurses' files, out of the total 498 files, contained data on marital status at the times of application). And of those 4.3%, the vast majority applied to the Mission in the 1970s, after the acceptance of married women into the workplace had been firmly established throughout North

|| ^ America (see Figure 4.4 below).

118 Susan Rimby Leighow discusses the transformation in the American nursing labour force through the 1950s as married women and mothers increasingly entered (or re-entered) the workforce. With the severe nursing shortage during the postwar period, employers began to turn to the pool of inactive nurses who had previously left their careers upon marriage. By introducing part-time scheduling, refresher courses, child care facilities and better economic rewards, nursing employers accommodated to the needs of postwar RNs and presented them with the opportunity to balance their nursing careers with family. See Susan Rimby Leighow, "An 'Obligation to Participate': Married Nurses' Labor Force Participation in the 1950s," in Not

181 FIGURE 4.4: Marriage Status upon Application Trends, 1936-80

140 i 130 120 110 100 90 80 • Single 70 0 Married 60 50 40 30 20 10 0 • • • • I 1936- 1941- 1946- 1951- 1956- 1961- 1966- 1971- 1976- 40 45 50 55 60 65 70 75 80

Source: PANL, MG 63, Files 371 - 1842, Applications for Medical Service, Applications for Nursing Service, and Contracts, 1939-1981. Not only were the vast majority of Grenfell nurses single women, but they were also young women. The average age of the Grenfell nurses who applied through the

Association was 23 years. The opportunity for adventure and freedom from parental restrictions that the Grenfell Mission offered made its appeal to single young women very strong. In this regard, recruitment patterns of the Association often focused on young women just out of nursing school. Figure 4.5 outlines the ages of nurses at the time of the application with the Grenfell Mission. According to the data, approximately 76% of the nurses were under the age of 30.

June Cleaver: Women and Gender in Postwar America. 1945-1960, Joanne Meyerowitz, ed., (Philadelphia: Temple University Press, 1994).

182 FIGURE 4.5: Grenfell Nurses by Age on Application, 1936-80

200

180

160

140

120

100

0 20-24 25-29 30-34 35-39 40-44 45-49 50+

Source: PANL, MG 63, Files 371 - 1842, Applications for Medical Service and Applications for Nursing Service, 1936-80.

In an attempt to assure the parents of these young nurses that the Grenfell Mission was a respectable career option for their daughters, the secretaries often maintained correspondence with the parents of their nurses. These letters contained words of gratitude to the parents for "giving up" their daughters and allowing them to work with the Mission. For example in one letter to a parent Seabrook wrote, "We owe a great deal to the parents of our nurses serving on the Coast for sparking [s/c] their daughters, who are doing such a great work."119 Seabrook also held tea parties at the office in London as an opportunity for the parents to get together and learn about the work their daughters

119 PANL, MG 63, Box 37, File 817, "Fredman, Ray Isabel," Seabrook to Mrs. Fredman, 23 September 1954.

183 were doing in the service of the Mission. Seabrook's approach to the parents of Grenfell nurses and her hosting of tea parties for the mothers suggests that elements of class mitigated the recruitment process of the Grenfell Association of Great Britain and

Ireland.

MARRIAGE AND THE GRENFELL MISSION RESPONSE

For single young women trained in nursing, working with the Grenfell Mission was a great adventure and a chance to meet new people. And in the case of middle-class candidates, the secretaries of the Association were often eager to reassure the parents of the nurse that their daughter was in good hands, nursing with an organization of high moral fibre. The Mission itself provided chaperoned opportunities for their staff members to mingle in appropriate settings and Seabrook often recommended to nurses that they take out "one or two afternoon frocks for special occasions."120 In most cases, Grenfell socializing consisted of organized staff events, like picnics and dances held on Mission property. But socializing with non-Grenfell members also took place, especially in places like St. Anthony, North West River, and Happy Valley, which were close to military installations and mining operations. Some of the most informative references to the flirtatious relations that could develop between the nurses and the men they came into contact with came from Pansy Rowbotham, nurse at North West River in 1957.

Rowbotham obviously felt comfortable enough with Seabrook to indulge in social gossip.

She playfully described a Grenfell pilot as "definitely one of God's Gifts to women" and proceeded to relate his attributes and charms. "At the moment he doesn't look interested

120 PANL, MG 63, Box 66, File 1586, "Smith, Joan Mary," Seabrook to Smith, 5 April 1951.

184 in anyone in particular which is keeping everyone happy! I feel my chances are ruined by his visit to Nain as he came back with cracks from Dorothy about my tall boy-friend; found out that in 1939 Mr. Peacock & I spent 19 days on the 'Newfoundland' walking round the decks in the black-out, etc. etc."121 One month later, Rowbotham had lost her interest in the "charming" pilot and wrote that she and a fellow nurse

...have each collected an admirer connected with Brinco, and get letters from 'the bush.' Hers is an Australian with a hideous beard - a helicopter mechanic. Mine is a Canadian who uses a toothpick in public - a geologist. Geoff the pilot is beginning to pall at times although he hasn't grown a beard yet and doesn't pick his teeth. He is awfully arty and we get great amusement reading his literary works which include a strange play about the beginning of the world and the fall of man, and some poetry, some of which is rather pornographic. Andrew McAdam is simply charming and works so hard. The dentist is all right but very ordinary.1*2

For her part, Seabrook seems to have taken Rowbotham's gossip in good humour. But unfortunately such correspondence is rare in the archival material. Most of the nurses were not so forthcoming with their personal relations and flirtatious behaviour to

Seabrook - the woman who recommended them to the Grenfell Mission based on a character assessment. However, the example of Rowbotham suggests that flirtations between Grenfell nurses and the men of the region were part of the Mission experience to varying degrees.

The moral and social behaviour of nurses was not always easy for the Grenfell

Mission to regulate. In 1967, the Mission received a worrisome letter from a local resident who was concerned about a relationship that had developed between her brother-

1:1 PANL, MG 63, Box 63, File 1496, Folder 2, "Rowbotham, Pansy Maude," Rowbotham to Seabrook, 30 June 1957.

1:2 PANL, MG 63, Box 63, File 1496, Folder 2, "Rowbotham, Pansy Maude," Rowbotham to Seabrook, 1 August 1957.

185 in-law and a Grenfell nurse. Apparently, the brother-in-law was having an affair with the

nurse, had asked his wife for a divorce, and was planning to leave his wife and four

children to move to England with the nurse.123 The Grenfell Mission's Director of

Nursing Services, June Kelly, investigated the situation and concluded that the Mission

had no authority over the nurse's personal affairs. The nurse was "functioning adequately

on the job," although "her behaviour off duty [was] highly questionable."124 Kelly

continued: "I do feel she is over 21 and that her personal life is her own. True as this is,

'extra curricular' activities such as hers do reflect upon the hospital."125 Thomas

contacted the concerned sister-in-law, and informed her: "...it is difficult to legislate with

regard to the private lives of our staff. ....the International Grenfell Association has no

authority, nor right, to interfere in the personal and private lives of its staff. However, we

will do all we can to help in this unfortunate situation."126 Despite the reassurances that

the Mission provided to the parents of their nurses in England, the organization could not

regulate the nurse's socializing activities or prevent relationships from occurring.

The nature of the Grenfell Mission as an international organization of temporary

employment made its appeal to married women somewhat limited. In fact, before the

1970s the Mission rarely attracted nurses who were married and the earliest married

121 IGA Archives, File "Director of Nursing Services 1967," J.H. to the Director of the Grenfell Mission, 7 February 1967.

124 IGA Archives, File "Director of Nursing Services 1967," June Kelly to Gordon Thomas, 22 February 1967.

125 There were two nurses at Happy Valley that year that were having relationships with married men. In the same letter, Kelly informed Thomas that the other nurse had resigned, although she had had an "involved social life" and that "the married man concerned has recently left Goose Bay." See IGA Archives, File "Director of Nursing Services 1967," June Kelly to Gordon Thomas, 22 February 1967.

126 IGA Archives, File "Director of Nursing Services 1967," Thomas to J.H., 4 March 1967.

186 nurses were women accompanying their husbands who were physicians or teachers with the Mission.127 There were slightly more married nurses recorded in the staff reports of the Fishers, which published the names of all nurses on staff including American and

Canadian nurses, and married nurses who accompanied their husbands to the Coast.1 28

Many nurses presumed that they could not have both a nursing career and a family, and that they would retire from nursing upon marriage. In 1958, Helen Leeson retired from nursing upon getting married, but felt that her two years with the Grenfell Mission justified her training and meant that her training was not "wasted."129 The idea of a nurse having "wasted" her training upon marriage emerged in reference to several nurses who chose marriage over nursing. Millicent Blake's marriage in 1942 was considered "a great pity after all her training."130 There was a continuing notion among the British Grenfell staff that a nurse could not have both a family and a career with the Mission. However, for nurses who were married to Grenfell physicians, pregnancy and motherhood often marked the end of their nursing career in the postwar period rather than marriage. Nurse

127 For example, in 1957, Barbara Watson accompanied her husband, Dr. James F. Lumsden, whom she had met while nursing with the Grenfell Mission. In 1956 Mrs. Geoffrey C. Stacey and her husband volunteered at North West River. And in 1969, Judith Carter accompanied her husband to St. Anthony. See "Our Staff," Fishers October 1957, 55(3): 72; July 1956, 54(2): 49; and PANL, MG 63, Box 29, File 587, "Carter, Judith Ann," Application for Medical Service, December 1968; and Contract, August 1969.

128 Including, Mrs. Verna Hartranft Loomis in 1939, Mrs. Gordon E. Gray in 1952, Mrs. Richard KimofTin 1954, and Mrs. Homer N. Showman in 1955. See "Report of the Staff Selection Committee," Fishers July 1939, 37(2): 53, July 1952, 50(2): 48, July 1954, 52(2): 47, and October 1955, 53(3): 79. Other married nurses were listed throughout the Fishers staff reports, although their precise status (i.e. married, divorced, widowed) was not specified. For example, Mrs. J. Melvina Bergsagel was a summer volunteer at Harrington Harbour in 1947 ("Our Staff," Fishers July 1947, 45(2): 87); Mrs. Ardella L. Clench nursed at St. Augustine PQ in 1948 ("Our Staff," Fishers October 1948,46(3): 81); Mrs. Donald Iversen volunteered at St. Anthony in 1951 ("Our Staff," Fishers July 1951,49(2): 45); Mrs. Anna A. Kliene nursed at Cartwright in 1954 ("Our Staff," Fishers July 1954, 52(2): 49).

129 PANL, MG 63, Box 25, File 480, "Leeson, Helen Gillian," Leeson to Seabrook, 4 March [1958].

130 PANL, MG 63, Box 23, File 428, "Barnard, Mary Penelope," Banard to Spalding, 29 September 1942.

187 Barbara Watson remained on staff at St. Anthony after she had married Grenfell dentist

James Lumsden in 1957, but did not appear on staff lists after the birth of their first child in 1958.131 In terms of its British nurses, the Mission clearly lagged behind the general trend of post-war North American nursing in which married women remained in the workforce. However, through the 1960s and 1970s, married women increasingly began applying to serve with the Grenfell Mission - and in almost all of these cases the nurses were accompanying their husbands on a medical appointment.

While nurses through the 1940s and 1950s usually retired from the Grenfell

Mission upon marriage, by the 1970s an increasing number of nurses were choosing to remain in the work force. Many of the nurses who married local men settled permanently, or semi-permanently, in their husband's community; and by the 1970s, the Grenfell

Mission was accepting these married nurses as practitioners in those communities. In

1973, nurse Annemarie Graham informed Shirley Yates that she was enjoying St

Anthony so much that she had decided to get married and live there permanently.132 After her marriage she continued to work for the Mission.133 In that same year, Barbara Long, who had married a local man from Paradise River, wrote that she had been working in the

Cartwright nursing station that summer and used to bring her son to the station with her.

She was also able to secure a position as Community Health Worker at Cartwright

1,1 "Our Staff," Fishers 55.3 (October 1975): 72; and PANL, MG 63, Box 50, File 1145, "Lumsden (Watson) Barbara," Lumsden to Seabrook, 3 August 1958.

I,: PANL, MG 63, Box 58, File 1387, "Graham, Annemarie Margaretha," Graham to Shirley Yates, 8 April 1973.

PANL, MG 63, Box 58, File 1387, "Graham, Annemarie Margaretha," Graham to Yates, 3 August 1973.

188 through the winter.134 The Grenfell Mission soon recognized the advantage to them of their nurses marrying and settling in Newfoundland, and in 1976, when Alison Gardner married a local man from Mary's Harbour, the Director of Nurses for the Grenfell

Mission suggested that because of her marriage, Gardner would likely be available for

future employment. This was confirmed in a 1979 letter from Gardner's mother to

Shirley Yates, who stated that her daughter had been married for three years, was living

permanently in Mary's Harbour where she was still employed part-time by the Mission

and was the happy mother of two children.135

Since the majority of nurses were single women, it is not surprising that

relationships and marriages developed between them and the men with whom they came

into contact - either in the work environment or the community in general. Exact figures

of how many Grenfell nurses became married are difficult to determine, since most of

these marriages occurred after the nurses' contracts had expired. Tracing nurses'

marriages and marriage partners after their Grenfell contracts also depends on their

disclosure of this information to the Association or other Grenfell personnel. However,

approximately 82 of the 498 nurses (16.4%) who corresponded with the Association

became married at some point during their correspondence, although in most cases these

marriages took place many years after their contracts with the Grenfell Mission, and thus

were (presumably) unconnected with their Grenfell experience.136 Forty-six (46)

114 PANL, MG 63, Box 49, File 1120, "Long, Barbara Fay," Long to Yates, 4 October 1973.

115 PANL, MG 63, Box 39, File 833, "Gardner, Alison Elizabeth," Hilda Gardner to Yates, 25 April 1979.

1,6 This figure was compiled using information from the nurses' original application for service, Staff Suitability Reports, and the personal correspondence of the nurses contained within the personnel files of the Grenfell Association of Great Britain and Ireland. See PANL, MG 63 IGA Collection.

189 marriages of these 82 can be traced through the correspondence between the nurses and the Association secretaries, the Grenfell Mission's Staff Suitability Reports which were completed upon retirement from the Mission, and the "Alumni News" of the Fishers. As

Figure 4.6 demonstrates, most of these marriages occurred in the 1960s and 1970s, the period that also saw an increase in the number of married nurses applying to the Mission.

FIGURE 4.6: Traceable Marriages after Nursing with the Mission, 1936-80

1936-40 1941-45 1946-50 1951-55 1956-60 1961-65 1966-70 1971-75 1976-80

Source: PANL, MG 63, Files 371 - 1842, Staff Suitability Reports and Correspondence, 1939-81; and Fishers, "Alumni News," 1939-81.

As the British nurses broadened their horizons by serving with the Grenfell

Mission in Newfoundland and Labrador, they also broadened their marriage market.

These nine nurses in particular exemplified how increased contacts between social classes, along with freedom from parental controls, could lead to increased social

190 exogamy.137 Within the Grenfell Mission, a nurse's social status could be raised or lowered (as perceived by the Grenfell administration) depending on whom she chose as a marriage partner. According to the traceable marriages (Figure 4.7), twenty-two nurses married physicians or dentists who were also working on the Coast; two married the minister of the church in the community where she was stationed; four married teachers, either local or associated with the Mission; four married men in the military; one married a Canadian RCMP Officer; and one married a wealthy Englishman who volunteered for a summer and who went on to attend Cambridge University. Twelve nurses married local men whose occupations were not identified, but who likely were fishermen, loggers or other labourers. While the vast majority of marriages occurred between the nurses and other members of Grenfell staff - especially physicians and dentists (47.8%), it should be noted that the Grenfell documents would have been biased towards recording these marriages. Grenfell nurses would have been eager to share the news of their marriage to another member of the Mission, especially since the London office would have known, or at least known of, the husband. Thirty-six (36) of the 82 known marriages could not be traced in detail, and these would have included marriages with non-Grenfell staff and non-medical partners. In such cases, nurses would have been less inclined to inform the

Association of their husband's details when the office would not know the individual.

137 Exogamy is marriage outside similar social groups; whereas endogamy is marriage within similar social groups. See Marco H.D. van Leeuwen and Ineke Maas explain in "Endogamy and Social Class in History: An Overview," InternationaI Review of Social History 50, Supplement 13 (2005): 1-23.

191 FIGURE 4.7: Marriages Associated with the Grenfell Mission Experience, 1939-81

IGA Physicians Local Workers IGA Dentists Teachers Military/RCMP IGA Others Ministers

Source: PANL, MG 63, Files 371 - 1842, Staff Suitability Reports and Correspondence, 1939-81; and Fishers, "Alumni News," 1939-81.

Marriages between the British Grenfell nurses and other members of staff were usually celebrated by Grenfell personnel, especially when those marriages involved physicians and dentists. Such weddings affectionately called "IGA weddings" by other

Grenfell staff.138 Sometimes the nurse credited the Mission for her upcoming marriage, such as Marilyn Cade, who thanked Yates in 1942: "...John and I became engaged two weeks ago - and it's all thanks to you and the I.G.A."139 In 1961, the engagement of

Nurse Wendy Clegg to a physician was greeted with enthusiasm by other Grenfell staff members and Seabrook wrote to Morgan's mother, "...I am sure you will like her fiance

1,8 PANL, MG 63, Box 30, File 605, "Cheetham, Annette Mary," Seabrook to Cheetham, 4 March 1968.

1,0 PANL, MG 63, Box 38, File 808, "Cade, Marilyn Fiona, Helen," Cade to Yates, 30 November 1974.

192 very much indeed. He is a dear and everyone was very happy about the engagement."140

Perhaps the most excitement expressed by the Association was on the occasion of

Barbara Watson's marriage to a Grenfell Mission dentist. Seabrook wrote to Watson:

"What lovely news - it was such a joy to read your happy letter and you know you have all my very best wishes... fancy being a dentist's wife. Rather nice and you will be a great success."141 Seabrook romanticized the idea of being a dentist's wife and implied

that Richards was embarking on a new career-like challenge - that of being a respectable

housewife. The acceptance of marriages between nurses and physicians was not only a

Grenfell phenomenon. In her chapter, '"The Case of the Kissing Nurse': Femininity,

Sociability, and Sexuality, 1920-1968," Kathryn McPherson points out that while some hospitals discouraged flirtations between nurses and male members of hospital staff, and

indeed some training institutions set rules to explicitly prevent romances between nurses and orderlies, nursing leaders were more relaxed about nurses having relationships with doctors.142 Evidently, there was a class-based bias among nursing leaders concerning the appropriate relationships and marriages of active nurses. In the Grenfell Mission, every

marriage between a nurse and physician or dentist was celebrated with the exception of one - the marriage of a British nurse with one of the only Newfoundland physicians on staff during the period. The Grenfell Mission secretaries on both sides of the Atlantic apparently did not think very highly of this physician and Seabrook actually referred to

140 PANL, MG 63, Box 32, File 667, "Ciegg, Wendy Nadine," Seabrook to Mrs. Clegg, 5 May 1961.

141 PANL, MG 63, Box 50, File 1145, "Watson, Barbara," Seabrook to Watson, 19 November 1956.

142 McPherson, Bedside Matters, p. 165.

193 him as a "laughing stock"143 in a letter to the Canadian office. The Canadian secretary expressed concern over the nurse's decision: "She seemed to me such a fine sort and I

hope she is taking a wise step."144 The secretaries refered positively to the character of

the British nurse but questioned her decision to marry a local man, even though he was a physician.

In almost every instance of marriage between a nurse and a local man, other

Mission members questioned the nurse's decision and implied that she was behaving in

an irrational or irresponsible manner. The best example of this comes from nurse

Penelope Barnard, who wrote to the Association in 1940:

Mrs. Tilley had a very hasty wedding! She had been engaged to the medical wop145 who was out last summer first, but broke that off when she met [George]. He is a nice enough fellow - a regular clown, but not at all of her social standing. They only decided to get married at 4:30 pm & it was all over by 9 pm the same evening.... they had five days of so-called honeymoon, & then parted for goodness knows how long.... 1 hope it will be a successful match, but I don't know. She is very impulsive & childish in some ways....146

Seabrook had been in communication with Tilley's mother who had been very anxious

about Jean because, "she must know how impulsive her daughter is. I had not heard about

her previous engagement; she certainly does things quickly. I hope on his side, I mean

[George] Tilley, that her money did not influence him."147 It is significant here that while

141 PANL, MG 63, Box 10, File 133, Seabrook to Ethel Graham, 9 April 1952.

144 PANL, MG 63, Box 10, File 133, Graham to Seabrook, 4 July 1952.

145 A "wop" was an informal term that referred to the American volunteers who arrived on the Coast each summer. They were workers without pay, as opposed to other Grenfell salaried staff.

146 PANL, MG 63, Box 23, File 428, "Barnard, Mary Penelope," Barnard to Spalding, 4 September 1940.

147 PANL, MG 63, Box 23, File 428, "Barnard, Mary Penelope," Seabrook to Barnard, 9 September 1940.

194 Barnard and Seabrook both voiced concern over Tilley's alleged impulsiveness and intimated that she made a poor decision not reflective of her upbringing and education, they both characterized [George] Tilley as socially beneath her and potentially interested

in her money. Another hasty and questionable wedding was Mabel Clarke's.148 Clarke was actually a local girl who was raised at the Grenfell orphanage in St. Anthony and was sponsored by the Mission to attend nursing school in the United States and midwifery training in England. After graduation she returned to Newfoundland and worked as a

nurse with the Mission. But her sudden marriage in 1942 elicited this reaction from a

fellow nurse: . .[Mabel Clarke] got married all on the spur of the moment, while on

board the Kyle, to the Mailman, of all people. Mrs. Keddie was rather distressed, as she

felt sure it was a mistake. I did not know [Mabel] myself, but she sounds a very

determined person!'"149 Clarke was a Grenfell nurse with humble beginnings, whose

social standing improved through bourgeois nurse training and exemplifies the

transformative nature of nursing in terms of class. Her colleagues' reaction to her

engagement to a local man implied that by attending nursing school she had transcended

her inferior social background, but was lowering herself by marrying the local mailman.

Furthermore, in the same way that Tilley's impulsiveness led her to a perceived

unfavourable marriage, Clarke's determination was implied to be the root cause of her

perceived unfavourable choice of marriage partner.

In all instances where the Grenfell Mission disapproved of a marriage, from the

1940s to the 1970s, the husband in question was a local man. This suggests a strong class

148 Pseudonym.

149 PANL, MG 63, Box 23, File 428, "Barnard, Mary Penelope," Barnard to Spalding, 24 September 1942.

195 bias in terms of who the Mission considered to be appropriate partners for their nurses. In the case of one marriage, the husband in question was a local school teacher, and while

Yates did not attack the match as a terrible mistake, as she attacked marriages to men that she considered to be of a lower social standing, her support of the marriage was somewhat vague. She did acknowledge the marriage, but not in the same celebratory language that accompanied the "IGA weddings." From the perspective of the Grenfell administration, if a nurse married a local man whose background could be considered

"humble," her own social standing (as a bourgeois-trained nurse) could decline based on her association with him and her choice of him as a husband. On the other hand, if a nurse married a Grenfell physician, her social standing could increase based on her perceived social success.

SUMMARY

The Grenfell Mission attracted hundreds of single young women into its program of overseas nursing between 1939 and 1981. Nurses applied to work with the Grenfell

Mission for three main reasons: 1) all of them wanted travel and adventure; 2) some wanted to perform a Christian duty, and perceived the Mission as an avenue to fulfilling that desire; and 3) others wanted a unique and professionally demanding work experience. As a respectable middle-class medical institution, the Grenfell Mission offered women (particularly single, young women) the opportunity to leave home and escape the protective gaze of parents and family. The Grenfell administrators presented the Mission as a guardian of moral behaviour; they expected nurses to behave in a non sexual manner and to uphold a strict moral code. However, during their employment on

196 the Coast and the inherent personal freedoms involved with the work, nurses enjoyed an opportunity to socialize with young men, from foreign medical professionals to local fishermen and labourers. Despite the desire to employ women of an asexual nature who were devoted to Nightingale ideals of service before self, personal relationships did develop between the nurses and other Grenfell staff members and with local men.

The Grenfell Mission attempted to balance the individual motivations of their nurses with the institution's middle-class public image, and its responses to those relationships and were positive or negative depending on the socio-economic background of the husband in question. As graduates of formalized nursing institutions, the Grenfell nurses were considered to be representatives of a bourgeois culture regardless of their family or class-background. The overseas nursing experience provided an opportunity for women to improve their class status, and the crowning achievement (if they insisted on marriage) was marriage to a Grenfell physician. Responses to the marriages of nurses with physicians or dentists were always celebrated, except in one case where the physician was a Newfoundlander and not considered to be a particularly glowing example of the bourgeois character. In the meantime, responses to the marriage of nurses with local men were usually questioned or treated with ambivalence. The pattern that developed, from the perspective of the Grenfell Mission, suggests that class biases were connected with preserving the perceived moral code and public image of the Grenfell

Mission and constituted a strong component of the Grenfell experience from nursing recruitment to socializing and marriage.

197 By attending a nurse training program, especially one based on the middle-class ideals of

the Nightingale system, nurses were considered to have attained a maternalist bourgeois character that would contribute to the Grenfell agenda in northern Newfoundland and

Labrador. Chapter 5 explores the range of duties performed by Grenfell nurses on the

Coast and the ways in which they exhibited, and were expected to conform to,

traditionally gender-appropriate modes of behaviour, despite the fact that they worked in

unusual and challenging circumstances.

198 CHAPTER FIVE

"There is No One to Turn to for Help": The Work Experience of Nursing with the Grenfell Mission

When I left England two years ago I little expected to have such a many- purpose job. The trained staff of one has a variety of duties to perform, among which are those of housekeeper, cook, farmer, butcher, gardener, painter, carpenter, general overseer and handyman, clothing-store-keeper, accountant, nursing and dentistry besides.1

Jean Smith was not exaggerating when she listed these duties of the Grenfell

Mission nursing staff in the pages of Among the Deep Sea Fishers (Fishers). The nurses posted to the isolated nursing stations, in particular, became adept at "changing hats" and assuming whatever role was necessary for the smooth running of the station. This chapter discusses the range of duties performed by nurses with the Grenfell Mission, which have been categorized under the following headings: 1) Standard Nursing Duties, 2)

Midwifery/Obstetrics, 3) Public Health, 4) Dentistry, 5) Domestic Chores, 6)

Administration, and 7) Supplementary Duties. The nurses' responsibilities were not necessarily uniform over the period because changes in technology, communications and transportation had a direct impact on nursing in the region; for example, many stations during the 1940s relied on wood-stoves and furnaces for heat and a nearby stream for water. However, by the 1970s, all stations had electric heating and lighting as well as hot and cold running water. The nursing experience was also contingent upon to which hospital or station the nurse was posted. The numerically larger staff at the St. Anthony hospital meant that nurses there were usually not required to perform domestic chores, although they sometimes performed non-nursing chores during periods of staff shortage,

1 Jean B. Smith, "Flowers Cove," Fishers 45.2 (July 1947): 36.

199 such as the Second World War. At the same time, nurses posted to the stations experienced the necessity of adjusting to the "many-purpose job" described by Jean

Smith.

The Grenfell Mission in northern Newfoundland and Labrador provided nurses with the opportunity to partake of an "exceptional female work experience." Nurses with the Mission, especially those posted to a nursing station, enjoyed a degree of responsibility that was unusual within larger, more conventional medical institutions.

The nursing stations usually consisted of a dispensary and four to six beds for inpatients, which were usually obstetric cases. In 1953, each nursing station averaged 100 inpatients

(mostly maternity) and 2500-3000 outpatients every year.2 Through these stations, the

Mission relied heavily on nurses, both in terms of administration and for the provision of medical care. The nurses who practised in these isolated stations were mostly middle- class British women who were also trained as midwives; since the majority of medical cases in these areas were maternity, the Mission purposely recruited British-trained midwives for the centres.3 In fact, trained midwives were so essential to the administration of the nursing stations that the Mission frequently petitioned the Grenfell

Association of Great Britain and Ireland for more British nurses: for example, in 1947

Charles Curtis, then Medical Superintendent of the Mission, wrote to Betty Seabrook, secretary of the Association: . .if it were not for the excellent English nurses which you

2 PANL, MG 63, Box 9, File 113, Folder 1, Charles Curtis to Betty Seabrook, 17 November 1953.

Canadian and American nurses also worked with the Mission, but since nurse training in North America did not include midwifery they were usually appointed to the hospitals, where physicians were present to deliver babies and the nurses' role was based on the standard hospital hierarchy.

200 send I do not know what we would do."4 Several years later, he reiterated these sentiments and stated, "...the English nurses are most useful in Nursing Stations."5

Performing such a variety of duties in isolated regions was not particular to the nurses of the Grenfell Mission. Indeed, recent studies in Canadian nursing history have illuminated similar situations in other rural areas of the country. Several historians have argued that outpost nurses out of necessity frequently performed tasks normally delegated to physicians- because they were the only medically trained individuals in the region.

Nicole Rousseau and Johanne Daigle discuss this theme in their article, "Medical

Services to Settlers: The Gestation and Establishment of a Nursing Service in Quebec,

1932-1943."6 Rousseau and Daigle survey the establishment of nurses' dispensaries in remote areas of Quebec and argue that these nurses often performed non-nursing medical duties.7 The system of nursing-based health care was created by the government because of physicians' refusal to practise in rural areas. This is a major theme in the historiography of rural medicine, especially in terms of the challenge rural nursing presented to the gendered division of health care provision. However, a more nuanced and critical approach to these recent revelations might illuminate professional gendered restrictions placed on nurses in such unique situations. The Grenfell Mission was clearly a paternalistic organization and maintained gendered parameters for their practising

4 PANL, MG 63, Box 9, File 113, Folder 1, Curtis to Seabrook, 25 September 1947.

5 PANL, MG 63, Box 9, File 113, Folder 1, Curtis to Seabrook, 15 December 1952.

6 Nicole Rousseau and Johanne Daigle, "Medical Services to Settlers: The Gestation and Establishment of a Nursing Service in Quebec, 1932-1943," Nursing Histoiy Review 8 (2000): 95-116.

7 See also, Victoria Page Sparkes Belbin, "Midwifery and Rural Newfoundland Health Care 1920-1950: A Case Study of Myra Bennett, Nurse Midwife," Honours Essay, Memorial University of Newfoundland, 1996.

201 nurses. As Jill Perry explains, "the Grenfell discourse admitted that nursing in northern

Newfoundland and Labrador required a high degree of independence, courage, and hardship. But these unusual female job requirements were rationalized by a gender ideology which reinforced a traditional view of women."8 According to their correspondence and the contents of the Fishers, the most widespread duties performed by nurses with the Grenfell Mission consisted of traditionally female/nursing areas of work.

This could reflect both the silence of nurses in leaving written documentation of decision making regarding their practice and also the larger message of the official Grenfell discourse in which nursing with the Mission was an acceptable female endeavor. In either case, the performance of male/medical duties was often an exception rather than a rule; however, that did not prevent nurses on the stations from performing medical duties when the situation called for it. Indeed, Grenfell nurses were exceptionally pragmatic - when faced with medical emergencies and sick patients, they performed whatever duties were necessary to remedy the situation.

Before distinguishing the duties performed by Grenfell nurses, it is necessary to establish how nursing was defined and conceptualized during the period in question. The

Textbook of the Principles and Practice of Nursing, a common nursing textbook from

1939, defines nursing as "that service to the individual that helps him to attain or maintain a healthy state of mind or body; or, where a return to health is not possible, the relief of pain and discomfort."9 To inform its outline and content for the education of

8 Perry, "Nursing for the Grenfell Mission," p. 59.

9 Bertha Harmer and Virginia Henderson, Textbook of the Principles and Practice of Nursing, 4lh ed., (New York: The Macmillan Company, 1939), p. 2. The same definition of nursing was used in the 5th ed., published in 1955.

202 nurses, the text referred to A Curriculum Guide for Schools of Nursing (1937) by the

Committee on the Curriculum of the National League of Nursing Education, which

classified the major activities of a nurse as:

1. Those that have to do with the organization and management of the patient's environment to secure for him maximum physical and mental comfort. 2. Those concerned with his immediate personal care. 3. Those performed under the direction and in cooperation with the physician. 4. Those that have to do with the family and community health service.10

The Textbook also divided nursing into four main activities but underemphasized the

League's commitment to family and community health services, or essentially public

health. Instead, the text devoted one section to "the fundamentals of nursing care" and the

other three sections to assisting the physician with diagnostic procedures, therapeutic

measures, and medical and surgical nursing. In each of these areas, the responsibilities of

the nurse are integrally tied to her position as assistant to the physician. The work is

mostly manual rather than intellectual, although the text also encouraged nurses to use

their own judgments while performing their duties in a manner appropriate to their station.

STANDARD NURSING DUTIES

For the purposes of understanding the extent to which the nurses with the Grenfell

Mission may or may not have extended their professional responsibilities in isolated situations, it is necessary to establish a clear definition of standard nursing duties - the

fundamentals of nursing, assisting the physician with diagnostic procedures, therapeutic

10 Quoted in Harmer and Henderson, Textbook, p. 6.

203 measures, and medical and surgical nursing. The fundamentals of nursing include those activities concerned with the patient's physical and emotional comfort and health, especially: organizing, regulating and cleaning the patient's immediate environment; maintaining a sterile environment and controlling the spread of communicable disease; selecting and preparing sterile instruments and supplies; observing the patient, reporting and recording observations; maintaining patient records; checking the patient's temperature, pulse, blood pressure and respiration; assisting the patient with their dietary needs, their personal hygiene and their elimination; assisting the patient with their posture, exercise, rest and sleep; providing diversion, occupation and recreation for the patient; and admitting and discharging the patient.11 Regardless of the level of professional independence Grenfell nurses experienced on the stations, performance of these standard nursing duties accounted for most of the nurses' daily work schedules. At any given moment, each hospital and station housed a number of inpatients - children and adults at various stages of illness and convalescence - for which the nurse was responsible in terms of these standard nursing duties. Mabel Hainsworth described the demands of administering antibiotics to a patient at Harrington Harbour Hospital where there was no nursing night staff:

I am on night duty at the moment, there is a patient on...Penicillin, and evidently it is the rule here, to have no night staff, but one of the day staff to stay up to give the 11 pm dose and then get up & come down in your dressing gown to give the 3 am dose & then be on duty at 7 am in time for the 7 am dose, but I told Miss Hewitt that I could not do that, she said she had always done it, so I said, I would not do it, so I went on nights, & that does not suit her. ... I came on duty at 8 pm and remain on until 10 am to

1' See Harmer and Henderson, Textbook.

204 help make all the beds, so I do not see why Miss Hewitt should be run off her feet.12

While the performance of standard nursing duties constituted the majority of the

Grenfell nurses' work schedules, they were rarely considered interesting enough to garner attention in the nurses' correspondence. It was usually only when a nurse was commenting on her over-work or venting professional frustrations that she mentioned the fundamental nursing duties she performed. For example, when a physician was present to perform surgery (either in a Grenfell hospital or when the physician periodically visited the stations), the nurse had to prepare the room, prepare and sterilize the medical instruments, and assist the physician as he or she performed the operation. However, the only reference to these tasks in preparation for operations came from Jean Smith, who described this process while she was working at the hospital at North West River. The hospital had run out of space and the staff had temporarily taken over the operating room with additional beds. As a result, when an operation was scheduled, Smith had to collect furniture from other rooms to put together an operating room:

.. .when an operation comes up we have to take down beds and shunt all the stuff around [from] here to there and back again afterwards. Quite a little game. Takes about 2Vi hrs moving the furniture before we set up instruments even .... We manage pretty well though tis awfully awkward at times. As on the occasion earlier this summer when we were operating and had [just] taken the patient back to bed when a message was dropped from a plane overhead to say that they had 3 diptheria cases for us. We had no choice of places to put them; but immediately cleared out the operating room just vacated.13

12 Provincial Archives of Newfoundland and Labrador (PANL), MG 63 Grenfell Association of Great Britain and Ireland Collection, Box 41, File 913 "Mabel Lilian Hainsworth," Hainsworth to Seabrook, 9 January 1949.

13 PANL, MG 63, Box 66, File 1585 "Jean Battinson Smith," Folder 3, Smith to Seabrook, November 1950.

205 Operating the dispensary and treating outpatients, sometimes referred to as holding clinics, at the nursing stations and answering sick calls in the community also demanded much of the nurses' professional time. Occasionally the demands of treating outpatients were so overwhelming that some nurses would close the clinic on a Sunday and refuse to answer the door, except for emergencies. And in situations where a nurse was hired specifically for public health, she would sometimes restrict the clinic to three days a week in order to focus on health visiting for the remainder of the week.14

Operating the dispensary, holding clinics, and treating patients in their homes15 involved listening to the patients describe their symptoms, deciding on the best method of treatment, and taking the necessary steps towards that treatment. The three options available to the nurse were: 1) prescribing the necessary medication, such as aspirins, cascaras and soda-bicarbonate,16 and sending the patient home; 2) admitting the patient into the station for short- or long-term care and observation; and 3) providing first aid if necessary and sending emergency cases that were beyond her abilities to the nearest physician. It was while treating outpatients that the Grenfell nurses experienced the most professional autonomy. With no physician present on the stations, it was the nurse's responsibility to see every case that came in the door, determine their needs and take the necessary steps. Even in the smaller hospitals (Harrington, Cartwright and North West

River) if the staff physician was away on a medical trip, which could last for several

14 PANL, MG 63, Box 51, File 1174 "MacQuiens (Rawlings) Sheila," Seabrook to Rawlings, 14 September 1967.

15 Nurses usually visited patients in their homes in cases of influenza or pneumonia. See PANL, MG 63, Box 27, File 520 "Bridge (Currant) Ethel," Currant to Spalding 26 February 1939.

16 PANL, MG 63, Box 23, File 428 "Barnard, Mary Penelope," "LABRADOR: An Account of a Summer Spent at a Grenfell Mission Station," nd.

206 weeks at a time, it became the nurse's responsibility to see everyone who came to the hospital for care. As a result, nurses on the stations and smaller hospitals took part in the diagnosis of patients to a greater degree than nurses in larger, more conventional western hospitals. Furthermore, the nurses often performed emergency first aid at various levels of difficulty, especially cleaning and suturing lacerations of arms or legs and treating septic fingers and abscesses. These types of accidents occurred to varying degrees in all communities in northern Newfoundland and Labrador, whether associated with the fishery, the lumber industry, hunting and trapping or the everyday business of life in rural areas.17 Nurse Ivy Durley commented on emergency first aid that "[s]ewing up axe wounds, opening abscesses comes fairly easily, in fact when you find yourself the one to do it, it almost seems as if you have been doing it always before. I suppose it is because we have watched it done so often."18 Durley enjoyed the work but also felt "there [was] a good deal of anxiety in having the full responsibility."19

MIDWIFERY/OBSTETRICS

Nurses from Britain were especially useful on the isolated nursing stations of the

Grenfell Mission to fill the great need for midwives to assist local women in childbirth, and according to one British nurse who worked with the Mission, "a lot of the work was

17 In her reference letter for a Grenfell nurse, Betty Seabrook commented that the nurse had been stationed lumber community, and therefore had experience treating "many serious accidents there with the electric saw-cutters and other equipment." See PANL, MG 63, Box 32, File 656 "Cowley, Patricia," Seabrook to Miss Peebles (Matron, Brook Hospital London), 2 December 1968.

18 PANL, MG 63, Box 35, File 738 "Durley, Ivy Constance," Durley to Seabrook, 16 November 1947.

" PANL, MG 63, Box 35, File 738 "Durley," Durley to Seabrook, 4 April 1948.

207 midwifery."20 The Association recruited nurses who had full midwifery training (in the form of certification through the Central Midwives Board (CMB) in Britain) to fill the nursing station posts.21 The Board was a product of the Midwives Act of 1902, which was created "to secure better training of midwives and to regulate their practice."22 The

Act prohibited anyone to use the title midwife if she was not certified, and in 1910 it prohibited anyone from practicing who did not have a certificate from the CMB. The

Board approved the courses of training, established examinations and regulations for practice and maintained a register of practising midwives in Britain.23 Local Supervising

Authorities enforced the regulations, investigated incidents of malpractice, and reported any infringements to the CMB.24 Midwives certified under the CMB provided prenatal care, abdominal examinations, and guidance and assistance during labour and delivery; they also often held ante- and post-natal clinics for mothers.25 By requiring that British nurses could work on nursing stations only if they were certified by the Board, the

20 Margaret Campbell, Telephone Interview, August 2004.

21 Between 1902 and 1926, education for midwifery was three months and focused exclusively on labour. In 1926, the program was expanded to twelve months and included training in ante- and post-natal care. In 1936, the program was increased to two years (with one year remission for trained nurses) and in 1938 it was divided into two parts: Part I consisted of theoretical training and focused on abnormal deliveries while Part II was six months in length and included three months of practical experience on the district. Since 1968, training has been in single format across Britain. See E.A. Bent, "The Growth and Development of Midwifery," in Nursing. Midwifeiy and Health Visiting, in Peta Allan and Moya Jolly (eds.). Nursing, Midwifery and Health Visiting since 1900, (London: Faber and Faber, 1982), pp. 191-192.

22 Quoted in Robert Stevens, "The Midwives Act 1902: An Historical Landmark," Midwives 2002 5(11): 370. See also, Jean Towler and Joan Bramall, Midwives in Histoiy and Society, (London: Croom Helm, 1986).

21 Eva H. Jones, "Some Aspects of the Midwives Act of 1902," The Journal of the Royal Society for the Promotion of Health 27.12 (1906): 734-735.

24 Hester Viney, "The English Midwifery Service," The American Journal of Nursing 30.4 (1930): 409.

25 Mary Laetitia Flieger, "Midwifery in Great Britain," The American Journal of Nursing 28.12 (1928): 1195-1198.

208 Grenfell Association of Great Britain and Ireland ensured a strong supply of such midwifery services, which were severely lacking in northern Newfoundland and

Labrador.26 With their midwifery training, British nurses were overwhelmingly posted to the isolated nursing stations rather than Canadian and American nurses, who were most often posted to one of the hospitals where physicians performed obstetric services. In fact, the Grenfell Mission discouraged the appointment of English midwives to hospital positions because with the presence of physicians in hospitals, there was not enough midwifery for them to do.27 In 1971, the Staff Selection Committee of the Grenfell

Mission clarified the role of a station nurse with the provision that "[n]ursing stations

[were] to be staffed by nurses holding their Midwifery Part II certificate with the exception of Cartwright which is to be staffed by a midwife and a Public Health Nurse or a R.N. performing the duties of a P.H. Nurse."28

Obstetrical work (prenatal and post-natal care and deliveries) was routine for

Grenfell nurses who were posted to the stations. During the year June 1946 - May 1947,

Iris Mitchener had eighteen obstetrical admissions to the station (including twelve deliveries - nine were normal deliveries, two were forceps deliveries, and one was stillbirth), which accounted for 24% of in-patient admissions. She also attended five deliveries in the mothers' homes, and conducted ninety-six prenatal and twenty-three

2(' British nurses without midwifery training could also work with the Mission, but were posted to hospitals rather than nursing stations. See PANL, MG 63, Box 56, File 1313 "Newton (Ormerod), Margaret," Ormerod to Spalding, 24 May 1944.

"7 PANL, MG 63, Box 6, File 59 "Nelson, Barbara," Seabrook to Nelson, 1 November 1965.

28 PANL, MG 372, Box 7, File "Staff Selection Meetings Minutes," IGA Minutes of the Meeting of the Staff Selection Committee held at the IGA Ottawa Office, 29 June 1971.

209 post-natal visits in the Forteau area.29 The reports from other nursing stations also underline the prevalence of obstetrical work; for example, in 1950-51, 79% of the patients admitted to the nursing station at Mutton Bay were obstetrical cases, 64% at

Forteau, and 51% at Mary's Harbour (which was also a centre for convalescent tuberculosis patients at that time).30 Patricia Cowley had so many maternity cases at the beginning of one month at Port Saunders that "it was like the caplin coming in."31

Obstetrical work was also unpredictable, since the start of a woman's labour could only be approximated and the length of time for the delivery was always unknown. Dorothy

Jupp testified to an autumn rush of deliveries in her Fishers article, "Five Babies in Six

Days." By the time she got to the last delivery, "[their] supply of sterile goods had been used up, but the kitchen oven was pressed into emergency service and [they] soon had enough to use."32 They also ran out of room for the babies and had to put two in a cot, with one at the top and one at the bottom.

Providing prenatal care and attending women in childbirth was so commonplace for these British midwives that their personal correspondence lacks any detail about the ordinary aspects of this work. The nurses only referred to their general obstetric work in letters early in their Grenfell tenure, when the post was new and they were excited about sharing their experiences with others, or if a delivery was particularly difficult or unique.

Both instances apply to Ivy Durley and her first letter to the London office after arriving

29 Iris F. Mitchener, "Forteau Facts," Fishers 45.3 (October 1947): 68-71.

30 [Charles S. Curtis], "The Superintendent Reports," Fishers 49.3 (October 1951): 69-71.

Jl PANL, MG 63, Box 32, File 656 "Cowley, Patricia," Cowley to Seabrook, 14 March 1966. Caplin are small forage fish of the Atlantic Ocean that "roll in" onto the beaches of Newfoundland every summer.

Dorothy M. Jupp, "Five Babies in Six Days," Fishers 47.4 (January 1950): 116.

210 in Roddickton in 1947. Durley's letter expressed her sheer excitement with her post and contained a detailed description of a "bad spell" she had had with a woman in labour:

She very nearly died on us. Was a toxicomia with ecleampsia [s/c]. Started to fit just before full dilation. I was able to call Miss Burgess and together we tackled her. I applied forceps but both of us at full blast could not budge the head. She is a very thick set girl, and it was like working between two oaks. On account of her serious toxic condition, we could not try anything further, so had to put her under morphia, and start frantic plans for her removal to St. Anthony. She started a haemorrhage later which we eventually controlled by 2 am. This loss was good in so far as it reduced the likelihood of further fits, but weakened her considerably. The menfolk moved off early on to try to make arrangement for boat transportation. My utter helplessness is a thing I shall have to get used to. It seemed terrible to me that help was so utterly out of reach. ... However, the woman still lives by Divine intervention 1 believe.... (The baby was 10'A lbs (dead of course) about 4 lbs too heavy for such a woman. She should certainly have been in St. A. for a caesarean section. Had she attended the station for A.N. care I should certainly have sent her.)33

This passage demonstrates the level of responsibility that certified midwives held on the stations and how they approached complicated deliveries. They were not trained to perform caesarean sections nor did they have immediate access to the extensive medical facilities at St. Anthony. Therefore, when a nurse recognized that a delivery was beyond the scope of her practice, it was her responsibility to do whatever she could to save the mother's and child's lives and transfer them to the nearest hospital for emergency care.

The nurses tried to prevent emergencies in childbirth by holding ante-natal clinics and examining the mothers during their pregnancies, but inevitably not all local women attended the clinics or went to the nurse for examination. In such cases, as in Durley's experience, there was a strong undertone of blame towards the mothers for not having seen the nurse before the delivery and its subsequent complications.

PANL, MG 63, Box 35, File 738 "Durley, Ivy Constance," Durley to Seabrook, 16 November 1947.

211 As nurses adjusted to the circumstances under which they worked and

increasingly gained experience dealing with emergencies, such descriptions of their

activities usually became less frequent. But accounts of exceptional obstetric experiences

were published in Fishers. During the 1940s, Dr. Curtis was especially eager to praise the

work Grenfell nurses in the pages of Fishers and on three separate occasions he focused on emergency obstetric care. In an article titled "Heroines," Curtis described the midwifery abilities of Ethel Currant at Flowers Cove:

No matter how weary and exhausted Miss Currant was, she never failed to answer a call for help. Last October she was called to an obstetrical case twenty miles from her station. When she arrived she realized that she was up against a very serious case and wired me the condition of the patient. The case was a hundred and fifty miles from St. Anthony, there was a heavy sea running and it was impossible for any doctor at St. Anthony to reach this village in time to render assistance. Miss Currant was faced with a problem that she herself must undertake alone, that of trying to save the life of a mother. Sometime after that I had a letter from her telling the outcome of the case. She realized that it was impossible to deliver the woman in the surroundings. ... Putting the patient in a boat through the heavy sea, Miss Currant and the men finally reached the nursing station at Flowers Cove and there, with the help of a very efficient local woman, Miss Currant was able to do an operative delivery and save the life of mother and baby.34

The details of the delivery were not discussed, and Curtis did not explain what he meant by an "operative" delivery. His purpose in sharing this story with the readers of Fishers was to praise the Grenfell nurses at a time when the Mission was having difficulty obtaining staff. However, owing to the isolated and scattered pattern of settlement in northern Newfoundland and Labrador, Curtis genuinely appreciated the presence of trained midwives to attend local women in childbirth. In the October 1946 issue of

Fishers, he again praised the British midwives in his report "Medical Work."

34 Charles S. Curtis, "Heroines," Fishers 43.2 (July 1945): 46-47.

212 Commenting on the increase in obstetrical cases admitted to the St. Anthony hospital,

Curtis stated that they were "very fortunate to have on [their] staff two nurses who [were] excellent in midwifery and who were invaluable in carrying on this work."35 He also referred to the nurses as "the backbone of [the] Mission" and gave another example of the nurses' midwifery abilities:

[e]arly in the spring this year one of our nurses was called to a fishing village many miles from the station to attend a very difficult obstetrical case.... This nurse, alone with no other help, was confronted with one of the most serious of obstetrical emergencies - a situation that would cause worry in a lying-in hospital well staffed with obstetricians, nurses and transfusion apparatus and all means of saving life. This nurse, working alone, saved the life of the mother although when she arrived she was in a desperate condition.36

Curtis did not give the name of the nurse nor explain the precise condition of the mother in question, but his desire to share these midwifery emergencies and praise the Grenfell midwives was clear.

Perhaps an even stronger testament to the necessity of British midwives in northern Newfoundland and Labrador was reflected in the attitudes of the patients themselves. Although Fishers did not often publish articles by local patients, in the

January 1949 issue, Curtis submitted a letter from a patient thanking the Mission for the services of Dorothy Jupp during her recent delivery. The patient wrote: "Except for the resourcefulness and cool-headedness of Miss Jupp and the advantages of the hospital at

St. Mary's River 1 would not be able to write these few lines today. I am deeply indebted to Miss Jupp, to the Grenfell Mission, and to God Almighty for saving my life at the

,5 Charles S. Curtis, "Medical Work," Fishers 44.3 (October 1946): 79.

36 Curtis, "Medical Work," p. 81.

213 recent birth of our son. Many thanks to all concerned."37 The letter was published in conjunction with a short article by Curtis, "Note of Thanks," which explained that Jupp faced "one of the most difficult and serious obstetrical complications, entirely alone on her own resources."38 He did not detail the nature of the situation, but pointed out that he could only advise Jupp over the wireless, that she was resourceful and calm and possessed "great skill and ability."39 Curtis again highlighted the obstetrical challenges facing midwives with the Mission and praised their skills and abilities.

Curtis was not the only Grenfell physician to appreciate the contributions of the

British midwives. John Brocklehurst, physician with the Grenfell Mission, collaborated with Nurse Ruth Ross to publish an article in BJOG: An International Journal of

Obstetrics and Gynaecology on familial eclampsia in Flowers Cove. The study was based on Ross's experiences as a midwife in Flowers Cove and examined ten women who had experienced eclampsia during pregnancy and/or labour. Eight of the women were in the same family and in five of the women, the convulsions were related to individual hypertension, oedema or albuminuria. Brocklehurst and Ross argued that there was "an exceptionally high incidence" of eclampsia within one family compared to the rest of the population in the area, which supported previous theories that hypertension and other causes of eclampsia were inherited.40 By publishing this paper with Ross in an academic

37 "Letter from Celesta Gerber Acreman to Charles S. Curtis, 13 September 1948 (Battle Harbour)," Fishers 46.4 (January 1949): 117.

38 Charles S. Curtis, "Note of Thanks," Fishers 46.4 (January 1949): 117.

39 Curtis, "Note of Thanks," p. 117.

40 John C. Brocklehurst and Ruth Ross, "Familial Eclampsia," BJOG: An International Journal of Obstetrics and Gynaecology 67.6 (December 1960): 971-974.

214 journal, Brocklehurst demonstrated professional confidence in the abilities of Grenfell

Mission midwives.

PUBLIC HEALTH

Inspired by global public health initiatives of the nineteenth and early twentieth centuries, public health became an important part of the Grenfell Mission work in northern Newfoundland and Labrador. Public health originally developed in response to the high-mortality rate associated with infectious diseases: air-, water-, and food-borne diseases. Edwin Chadwick, a leading public health reformer of nineteenth-century

Britain, endorsed the miasmatic theory of disease which understood disease aetiology to be related to gases released by decomposing organic matter. In a sense, "bad air" was thought to be the cause of disease epidemics.41 As a result, public health authorities targeted unsanitary living conditions and the squalor of urban environments in their campaign for health reform. The earliest public health measures involved sanitary reform in the form of sewage systems and clean water supplies, immunization against infectious diseases (particularly smallpox), and quarantine for those infected. These efforts had positive results, and by 1914 the major infectious diseases (smallpox, typhoid and cholera) had essentially disappeared as a cause for public concern. However, as the threat from infectious diseases diminished and the overall death-rate declined, public health concerns shifted to private hygiene, infant mortality, nutritional diseases, and endemic diseases, especially heart-disease, cancer and diabetes.42 By 1900, disease became

41 Roy Porter, The Greatest Benefit to Mankind: A Medical History of Humanity, (London: W.W. Norton & Company, 1997), p. 411.

42 Anne Hardy, Health and Medicine in Britain since 1860, (Basingstoke: Palgrave, 2001), pp. 29-39.

215 understood as a social as well as a biological phenomenon, and a more holistic vision of public health developed. "Social medicine" appreciated the importance of economic income, employment, education, lifestyle, habits, diet, and family structure in determining individual and social health.43 This was the inspiration for the vast, institutionalized public health efforts of the twentieth century.

Public health nursing in Britain took two distinct forms - "district nursing" and

"health visiting." The responsibilities of a district nurse involved visiting people in their own homes, providing direct patient care, and offering advice to the patient and family members concerning treatment and recovery. District nursing was originally aimed at the urban poor, especially in Liverpool, Manchester and London; but it reached into smaller towns and rural communities as well.44 As a result, there were individual district nursing associations scattered throughout the country. In 1887, the Queen Victoria Jubilee

Institute for Nurses was created in order to establish a national system of affiliation to coordinate these associations, to provide a post-graduate district training program for nurses, and to set national standards for district nursing.45 The Institute, which became

43 Porter, The Greatest Benefit to Mankind, p. 634.

44 For an early history of district nursing, see William Rathbone, Sketch of the History & Progress of District Nursing : from its commencement in the year 1859 to the present date, including the foundation by the "Queen Victoria Jubilee Institute" for nursing the poor in their own homes, (London: Macmillan & Co, 1890). Mary Sewall Gardner, Public Heath Nursing, 3rd ed., (New York: The Macmillan Company, 1936), and Mary Stocks, A Hundred Years of District Nursing, (London: G. Allen & Unwin, 1960).

45 The Queen's Institute of District Nursing was originally called Queen Victoria's Jubilee Institute for Nurses; the name was changed to the Queen's Institute of District Nursing in 1928 and to the Queen's Nursing Institute in 1973. Its predecessor, the Metropolitan and National Nursing Association (1874), was the first organization in Britain to provide special district training for nurses after their hospital training. The Institute provided post-graduate district training until 1968. See Monica E. Baly, A History of the Queen's Nursing Institute: 100 Years, 1887-1987, (London & Sydney. 1987); Anne M. Lamb, Primary Health Nursing: A description of the work of health visitors, district nurses, domiciliary midwives and school nurses, (London: Bailliere Tindall, 1977); and The Queen's Nursing Institute, "Our History," http://www.qni.org.uk/aboutus/

216 known as the Queen's Institute of District Nursing in 1928, did not directly employ nurses but "operated a national system of affiliation, training and inspection to promote and standardize district nursing."46 Queen's Nurses were well suited to nursing with the

Grenfell Mission on both practical and theoretical levels. They were practically prepared for nursing in patients" homes through their district training and experience. In fact, nursing in rural areas of Ireland and Scotland presented challenges similar to those found in northern Newfoundland and Labrador, with comparable levels of local poverty, scattered settlement patterns and the logistical challenges of travel over land and sea.47

Theoretically, British authorities preferred district nurses to be "women of good education," since they would be required to exercise more "personality and initiative than was ordinarily required for work in hospitals where discipline was rigid and expert advice readily available."48 In this sense, the push to attract educated women to the Queen's

Institute and to increase the social standing of district nursing fit well with the Grenfell

Mission's social reform agenda. Florence Lees's (first superintendent of the MNNA) rationale for recruiting educated women echoes the Grenfell discourse concerning spiritual and social reform:

[t]here were several grounds for this decision, and these were chiefly that, in nursing the poor in their own homes, nurses were placed in positions of greater responsibility in carrying out doctors' orders than in hospitals; that women of education would be more capable of exercising such responsibility; that the vocation would attract women anxious for independent employment, and a corps of nurses recruited altogether

46 Enid Fox, "District Nursing in England and Wales Before the National Health Service: The Neglected Evidence," Medical History 38 (1994): 305.

47 Stocks, A Hundred Years of District Nursing, pp. 163-167.

48 C.R. Kratz, "District Nursing," in Nursing, Midwifery and Health Visiting since 1900, Peta Allan and Moya Jolly, eds., (London: Faber and Faber, 1982), p. 80.

217 among educated women would have a greater influence over the patients, and by their higher social position would tend to raise the whole body of professional nurses in the consideration of the public.49

The responsibilities of a health visitor were different from those of a district nurse and involved forms of health supervision in situations where bedside nursing was not required. Health visiting was born out of the public concern over high infant mortality rates in the early twentieth century. A health visitor has been defined as "a nurse with a post-registration qualification, who provides a continuing service to families and individuals in the community."50 It is a post with a wide range of responsibilities, including 1) the prevention of ill-health; 2) the early detection of ill-health; 3) the

"[recognition and identification of need and mobilization of appropriate resources, where necessary;"51 4) health teaching; and 5) the provision of care (support, advice and guidance). Essentially, health visitors focused on activities related to the promotion of health and the prevention of ill-health in the community, especially among families.

According to Mary Malone, health visiting was a form of "social action" born out of the reform agendas of the public health movement. It was based on a philosophy which criticized the disease-centred approach to health and pushed for a focus on the social causes of illness.52 In practice, health visitors would advise mothers of young children on feeding, safety, hygiene, disease prevention, as well as physical and emotional childhood

49 Quoted in Amy Hughes, "The Origin, Growth, and Present Status of District Nursing in England," The American Journal of Nursing 1902 2(5): 339.

50 G.M. Owen, "Health Visiting," in Peta Allan and Moya Jolly, eds., Nursing, Midwifery and Health Visiting since 1900, (London: Faber and Faber, 1982), p. 96.

51 Owen, "Health Visiting," p. 97.

52 Mary Malone, "A History of Health Visiting and Parenting in the Last 50 Years," International History of Nursing Journal 5(3): 31.

218 development. Their primary focus was "health education and social advice, especially in terms of the family unit.53 Recruiting British nurses with health visitor certificates was clearly advantageous to the Grenfell Mission and its interest in reforming the social health of the local people.

The first Queen's Nurse, who was also the first Health Visitor, hired by the

Grenfell Mission was Evelyn Poppleton in 1926, although she was not working through the Queen's Institute when she applied for the post in Labrador.54 Wilhelmina Murdoch was another early Queen's Nurse with the Grenfell Mission (1930); but after her, no other

Queen's Nurses were hired until the Mission became affiliated with the Institute in

1947,55 Over the next thirty years, the Mission hired approximately eighty nurses who had trained as Queen's Nurses, Health Visitors, or Public Health Nurses, or any combination of the three. Considering the socio-economic background of the people in northern Newfoundland and Labrador and the lack of accessible medical facilities in the region, district nursing and health visiting were ideal for providing health care under the

Grenfell Mission agenda. Grenfell nurses were often required to visit patients in their own homes and spread awareness about public health and hygiene. With this in mind, the

Association became affiliated with the Queen's Institute, who assisted with recruiting

" Owen, "Health Visiting," p. 95.

54 Poppieton also worked with the Mission during the Second World War, although her release in 1944 was questionable because of her Health Visitor Certificate - Health Visitors were in high demand in Britain during the war and needed special permission to be released for overseas work. See PANL, MG 63, Box 59, File 1400 "Poppleton, Evelyn," Poppleton to Spalding, 1 October 1944; and Contract, 19 August 1929. For reference to the shortage of Health Visitors in Britain, see PANL, MG 63, Box 56, File 1313 "Newton (Ormerod), Margaret," The Ministry of Labour and National Service to Spalding, 28 September 1944.

55 PANL, MG 63, Box 55, File 1295 "Murdoch, Wilhelmina," Contract, 9 January 1930.

219 nurses for the Coast. The Institute was enthusiastic about supplying nurses for the

Grenfell Mission, and Betty Seabrook testified to the success of the partnership:

[t]he Queen's Institute have been most helpful and have advertised the posts in the Nursing papers and are sending us particulars of those who have applied. I went to see Miss Hill the other day and we agreed that the nurses would serve under the Grenfell Mission and not under the Institute.... They have met us more than half way and are very interested in our work. Miss Hill telephones this afternoon to know if one or two members of the Committee would go along to the Institute...to discuss further the possibility of sending out nurses from the Queen's Institute.56

The arrangement was particularly beneficial for the Association since the Mission was increasing pressure on the association to procure British nurses for the Coast. Curtis was especially keen to have British nurses because "he [felt] they [had] the right training, and

Queen's nurses certainly [had] the right background for a nursing station, or for any work, on the Coast."57

The public health duties of Grenfell nurses changed between 1940 and 1960 - these changes reflected general advances in science and medicine, knowledge based on these advances and taught within district nursing and health visitor programs, and also the changing health needs of the local population. During the 1940s and 1950s, the primary focus of public health nursing along the Coast was immunization.58 The Grenfell Mission did not hire any nurses under contract as "Public Health Nurses" during the decade; rather, they relied on nurses posted at the stations to conduct this work. The nurses would

56 PANL, MG 63, Box 48, File 1081 "Kirby (Banyard) Helen Mabel," Folder 1, Seabrook to Kirby, 31 March 1947.

57 PANL, MG 63, Box 48, File 1081 "Kirby (Banyard) Helen Mabel," Folder 1, Seabrook to Kirby, 31 March 1947.

58 Some nurses also conducted first aid and health talks for girls. See, for example, PANL, MG 63, Box 50, File 1145 "Lumsden (Watson), Barbara," Watson to Seabrook, 21 November 1955.

220 take lengthy immunizing trips around the communities in the region to administer large- scale vaccination campaigns. This usually addressed the most pressing needs of the people in terms of infectious diseases and also reflected the availability of vaccines to combat those diseases. Iris Mitchener, Margaret Seaman and Ivy Durley conducted inoculations for diphtheria, pertussis (whooping cough) and tetanus (DPT) between 1945 and 1948, at a time when child health and mortality in the region was a widespread concern.59 Diphtheria, in particular, was endemic on the Coast, and even into the 1960s

Grenfell nurses were concerned with the prevalence of the disease and the possibility that scattered children might not have been previously immunized. Mary Stephens, who was both a Queen's Nurse and a Health Visitor, went to great lengths to centralize the records of immunizations in northern Labrador in an attempt to discern whether immunization had been performed effectively.60 In the 1950s, with the prominence of tuberculosis as a leading cause of death on the Coast and the recent availability of Bacillus Calmette-

Guerin (BCG), concern shifted to addressing this disease. In 1953, Sheila Rawlings travelled with the Newfoundland Tuberculosis Association on an immunizing trip around

White Bay, with plans to make similar rounds of the Flowers Cove area during the winter.61 The Mission also administered BCG to local children via the hospital ship

Gould, which visited fifty settlements in 1956 and administered 1500 doses of the

59 PANL, MG 63, Box 64, File 1543 "Seaman, Margaret," Seaman to Mrs. Collins, 17 December 1945; Box 35, File 738 "Durley, Ivy," Durley to Seabrook, 4 April 1948; and Ivy Durley, "Mainly Medical: Flower's Cove - 1947-1948," Fishers 46.3 (October 1948): 75.

60 PANL, MG 63, Box 68, File 1616 "Stephens, Mary Kiese Jean," "Public Health Nursing in Northern Labrador, Past, Present and Future," November 1961.

61 PANL, MG 63, Box 45, File 1008, "Hughes, Winifred Helena Rose, nee Burgess," Burgess to Seabrook, 22 August 1953.

221 vaccine.62 Tuberculosis was especially problematic among Native communities in

Labrador; and the public health nurses frequently conducted follow-up tuberculosis checks along the Coast.63 The 1950s also witnessed epidemic polio in Newfoundland and

Labrador, and a resultant widespread immunization campaign. Rawlings, along with

Ellen Wilkinson, spent the summer of 1958 giving first and second polio injections (Salk vaccine) along the Labrador coast, which also included many aboriginal settlements.64 In addition to these lengthy immunizing trips, the Grenfell nurses sometimes gave vaccines to patients at the station, if they realized the individual had not been protected from a certain disease.65

The Grenfell Mission began contracting Public Health Nurses, as separate from station or staff nurses, in earnest during the late 1950s. The Mission recognized the importance of public health on the Coast, and instead of relying on station nurses to fit public health into their busy schedules, they hired nurses to travel through the region specifically for that purpose. The Public Health Nurses were usually based at a hospital or a nursing station, but spent most of their time in the community and outlying region; for example, Seabrook also clarified the position of a Public Health Nurse to Isabella

Henderson in 1970:

The Public Health Nurse at Flowers Cove would be based at that nursing station, which is administered by two District Midwives. They are h: Charles S. Curtis, "Air Era: Report of the Superintendent for 1956," Fishers 54.4 (January 1957): 105.

M PANL, MG 63, Box 68, File 1616 "Stephens, Mary Kiese Jean," "Public Health Nursing in Northern Labrador, Past, Present and Future," November 1961.

64 PANL, MG 63, Box 51, File 1174 "MacQuiens (Rawlings), Sheila," Rawlings to Seabrook, 23 March 1959. See also, "From Cartwright," Fishers 56.3 (October 1958): 85.

65 In 1946, Iris Mitchener gave one inoculation for smallpox. See Iris Mitchener, "Forteau Facts," Fishers October 45.3 (October 1947): 69-70.

222 responsible for the running of the station and the district work. The Public Health Nurse is based there but, of course, runs her own district and her work independently/ There are roads along this part of the coast and the Public Health Nurse has a vehicle so that she can drive to various schools and communities. The roads are not first class and, during the winter months, one has to be careful of ice and snow conditions. Only in recent years have we been able to appoint Public Health Nurses, so to a certain extent, this is still pioneer work and quite a challenge.66

The earliest Public Health Nurses with the Mission during this period were Mary

Stephens at Hopedale (1958), Pam Sweet at St. Anthony (1959), and Jean Clark at

Harrington (1961). When Clark was initially considering the post, Seabrook explained that public health "[was] becoming a very important part of [the] work on the Coast. It

[meant] spending some time on the district, travelling by dog team and plane, giving injections, visiting the sick, seeing to anti-natal and pre-natal mothers, etc. etc. Very much the kind of work one would do on the district in this country."67 The presence of a

Public Health Nurse in the region also relieved some of the workload of the station nurses, as Eveline Selwood noted in 1964 in regards to Audrey Plint's health visits to

Port Saunders. Plint was based at Flowers Cove but spent one week each month at Port

Saunders and held "Well Baby" clinics in all six settlements in the area.68 The nurses during this wave of public health with the Mission were very much involved in coordinating a public health strategy for the areas they served. Stephens provided the most detailed documentation of public health work in her report "Public Health Nursing in Northern Labrador, Past, Present and Future," and in her proposal to the Grenfell

66 PANL, MG 63, Box 43, File 966 "Henderson, Isabella McBeath," Seabrook to Henderson, 16 September 1970.

67 PANL, MG 63, Box 30, File 619 "Clark, Jean May Deller," Seabrook to Clark, 5 May 1961.

68 PANL, MG 63, Box 59, File 1398 "Plint, Audrey Robson," Plint to Seabrook, 1 February 1964.

223 Mission for a fourth nurse at North West River to carry out public health work in the community there. Stephens conducted tuberculosis surveys in the north with the use of an x-ray machine and checked on the state of immunizations wherever she went. She compiled a register of all people on the Coast who had ever had tuberculosis and she used that register to perform follow-up checks on those who were still on treatment. Stephens also spent time at Hopedale, treating outpatients, providing ante-natal care, checking on tuberculosis patients, providing routine polio and DPT immunizations of babies, and doing as much health education as possible. She also held Child Welfare clinics each week at the hospital in North West River and conducted public health education among the residents.69 During the early 1960s, the Grenfell Mission also became interested in organized health education and hired Caitlin Williams to deliver a series of six lectures on hygiene and health principles at Spotted Islands. Her duties were not limited to these lectures, however. Being the only trained nurse in the area, Williams had to divide her time between "supplying medical care, preparing the lectures, visits to neighbouring settlements for clinics and public health rounds, answering emergency calls and tending to the major and minor ills of the crews of visiting schooners."70

Dorothy Sutcliffe began an extensive public health program out of St. Anthony in

1965, and since she worked out of the largest hospital in the north, which had a large supply of staff nurses to perform the standard and bedside nursing required at the hospital, she was able to focus her energies exclusively on public health. In terms of

69 PANL, MG 63, Box 68, File 1616 "Stephens, Mary Kiese Jean," Stephens and Elsie Coe to Paddon and Thomas, November 1961, and "Public Health Nursing in Northern Labrador, Past, Present and Future," November 1961.

70 PANL, MG 63, Box 75, File 1798 "Williams, Kathleen," "Spotted Islands, Summer 1963."

224 maternal and infant health, she held ante-natal clinics at the hospital and biweekly ante natal classes for expectant mothers. She also travelled to outlying settlements for the purposes of ante-natal visits and the promotion of family planning. In terms of child health, Sutcliffe visited twenty-seven schools in the region, to which she applied significant criticism:

.. .most of them are very poor places compared with English schools. Of course, very few of the teachers have any qualifications so education is not of a very high standard, the buildings themselves leave much to be desired. Many of them have no toilet facilities & not even anywhere for the children to hang their outdoor clothes if they could be persuaded to take them off! Quite a bit of work for the Public Health Nurse! But where does one start?7'

She started by completing medical inspections of all the schools in her district and visiting most of the homes with children, the elderly or chronically ill residents.72 By

March of 1967, Sutcliffe was pleased with the results of her efforts and reported that

"[njearly all the schoolchildren now possess a toothbrush and a good number are using them regularly - very different from two years ago!"73 She also began a program of personal hygiene and sex education lectures at the high schools in St. Anthony, "(female audience only) and [received] a request for similar talks to be given to the boys."74 She was encouraged by these results and hoped that one of the physicians would address the boys in the near future. The following year, Sutcliffe had ventured into a type of social counselling for families - she advised parents to attend parent-teacher meetings,

71 PANL, MG 63, Box 69, File 1642 "Sutcliffe, Dorothy Amy," Sutcliffe to Seabrook, 11 March 1965.

72 PANL, MG 63, Box 69, File 1642 "Sutcliffe, Dorothy Amy," Sutcliffe to Seabrook, 19 November 1965.

73 PANL, MG 63, Box 69, File 1642 "Sutcliffe, Dorothy Amy," Sutcliffe to Seabrook, 16 March 1967.

74 PANL, MG 63, Box 69, File 1642 "Sutcliffe, Dorothy Amy," Sutcliffe to Seabrook, 16 March 1967.

225 encouraged teenagers to stay in school after the age of sixteen, and persuaded others to return to school after working for a year.75 Sutcliffe's public health program was detailed and extensive, more so than previous such programs with the Mission. As public health nurses gained more knowledge of health and disease prevention through their training programs, they increasingly applied this knowledge to their approach to public health nursing in northern Newfoundland and Labrador. While the public health program of the

Grenfell Mission in the 1940s and 1950s involved station or staff nurses providing immunizations and health advice on an ad hoc basis, in the 1960s the program had become comprehensive, organized and methodical.

DENTISTRY

Dental hygiene was a widespread problem in northern Newfoundland and

Labrador during the mid-twentieth century, largely due to the paucity of professional dental services and the local diet of "potatoes, white bread, milkless tea with molasses; not to mention the numerous candies."76 In her memoir, Labrador Nurse, Canadian nurse

Bessie Banfill described her first experience with the decayed state of teeth on the Coast:

"Rows of blackened stumps with gaping, rotten holes in the center confronted me. I could think of nothing but fire-charred tree stumps with decayed cores."77 During a routine extraction, Jean Smith managed to pull two teeth at once even though the forceps were

75 PANL, MG 63, Box 69, File 1642 "Sutclifle, Dorothy Amy," Sutcliffe to Seabrook, 28 March 1968.

76 PANL, MG 63, Box 66, File 1585, Folder 3 "Smith, Jean Battinson," Smith to Spalding, 12 June 1945.

77 B.J. Banfill, Labrador Nurse, (Toronto: Ryerson Press, 1952), p. 66. While this description was in reference to a patient during her first year in Mutton Bay (1928-29), she faced similar "long-rooted, black- cavitied, shell-edged teeth" again in 1942-43. See Banfill, Labrador Nurse, p. 173.

226 only around one tooth - perhaps a testament to the poor state of local teeth rather than the brute strength of Nurse Smith.78 As a result of the poor dental hygiene, dental extractions were frequently performed by nurses on the stations, even though they had not received formal training in this area. Some nurses who trained and/or worked in England during the Second World War did acquire experience extracting teeth during their employment, such as Lydia Veitch79 and Sheila Fortescue.80 However, in general, most Grenfell nurses had never extracted teeth before their tenure with the Mission.

To prepare for the prospect of dentistry, Canadian nurse Mary Taylor sought instructions from a dentist in Ottawa before she left for the Coast. The dentist showed her how to inject local anaesthetics and perform the extraction, but Taylor passed out after the extraction, while they were examining the dental instruments.81 When she was on the

Coast, she approached her first extraction with apprehension and in her memoirs recalled:

"Getting out my metal syringe and a vial of local anaesthetic, I set to work, hardly knowing which way to put it all together, but eventually did so. I injected the anaesthetic around the offending tooth and did the extraction successfully but not, however, without causing my young patient a lot of discomfort.''82 Elizabeth Bailey also attempted to learn

78 PANL, MG 63, Box 66, File 1585, Folder 3 "Smith, Jean Battinson," Smith to Mrs. Smith, 25 February 1945.

79 Veitch was stationed at Harrington Harbour during the war, which was the only time the hospital was without a resident physician. She noted how valuable her previous dental experience was while she was extracting teeth there in 1944-45. See PANL, MG 63, Box 72, File 1710 "Veitch, Lydia," Veitch to Spalding, 8 February 1945.

80 Fortescue trained at the Prince of Wales General Hospital and was employed there during the war, where she acquired dental experience as a Junior Casualty Sister. See PANL, MG 63, Box 37, File 805 "Fortescue, Sheila Mary, Nurse: 1951-56," Note by Seabrook, 11 October 1948.

81 Mary Taylor, Light on the Labrador, (St. Anthony: Bebb Publishing, 2001), p. 19.

8: Taylor, Light, p. 24.

227 basic dental techniques before she extracted her first tooth on the Coast - she asked the

Mission for a book on dentistry. Seabrook advised her to ask the visiting dentist for some practical instruction and information on dentistry, but dentists only occasionally visited the nursing stations, and out of necessity Bailey learned the process on her own "the hard way."83 Experienced Grenfell nurses themselves sometimes became mentor exodontists to incoming staff. In 1964, Barbara Greenwood demonstrated her procedure for extracting teeth to Margaret Harris, who was the new nurse at Roddickton. In her first letter to Seabrook after arriving on the Coast, Harris was pleased to report: "From

[Greenwood's] her instruction I now have 'hauled' well over twenty and enjoy doing it too!"84

Despite their lack of preparation and early trepidation regarding dentistry, nurses on the stations performed many extractions over the courses of their contracts. Within months of arriving at Flowers Cove, Ivy Durley had already pulled "dozens of teeth" and felt quite used to it. She facetiously told Seabrook: "My good strong arms have served me well on the men's back molars."85 Lesley Diack became so adept at "hauling teeth" that she actually extracted one of her own, and was "agreeably surprised to find how

83 PANL, MG 63, Box 22, File 415 "Bailey, Elizabeth Mary," Seabrook to Bailey, 28 July 1961.

84 PANL, MG 63, Box 42, File 936 "Harris, Margaret," Harris to Seabrook, 27 March 1964.

85 PANL, MG 63, Box 35, File 738 "Durley, Ivy Constance," Durley to Seabrook, 16 November 1947. Apparently. Grenfell Staff sometimes taught local people how to extract teeth for situations in which a dentist, physician, or nurse was not available. In her contribution to Them Days, Mary Ann Howell of Spotted Islands recalled" "My husband hauled hundreds of teeth, he learned it from an International Grenfell Association dentist that came here. Many a man, woman and child, Jim put out of pain from toothache. Some Sundays they'd come here by the boat loads, fishermen from vessels and places where they used to fish, to have their teeth hauled. I still got his old instruments that IGA gave him." Mary Ann Howell, "Lots of Fish and Hard Work," Them Days 4.4 (1979): 19.

228 painlessly [she] extracted teeth."86 In terms of comparable statistics, during the year

1950-51, dental extractions on the nursing stations totalled 612 at Flowers Cove, 566 at

Roddickton, 419 at Forteau, 129 at Mutton Bay, and 103 at Mary's Harbour.87 These figures do not represent extractions performed exclusively by the nurses since the

Grenfell Mission also hired dentists who were based at the hospitals and visited the

QO nursing stations on a yearly basis. However, the availability of dentists was not consistent and although the hospitals at St. Anthony and Harrington Harbour usually had resident dentists, North West River and Cartwright and their outlying settlements were not always so fortunate.89 In 1948, E. Terry Hunt was hired as the dentist at St. Anthony, but he had to divide his time between that hospital and North West River and

Cartwright.90 At each of these hospitals, Hunt was also required to travel to the smaller communities in outlying areas. Considering the infrequency and short-duration of the dentists' visits and the poor condition of local teeth, it is safe to assume that the station nurses performed many dental extractions.

Not only did dental extractions constitute an ordeal for the Grenfell nurses, but for the nurses' patients as well, and patients' apprehensions sometimes bordered on terror.

Nevertheless, the nurse had to muster up the courage to face an event which both she and the patient knew would be an unpleasant and painful experience. Whether or not she had

86 Lesley Diack, Labrador Nurse, (London: Victor Gollancz, 1963), p. 95.

87 Charles S. Curtis, "The Superintendent Reports," Fishers 49.3 (October 1951): 70-71.

88 During the year 1950-51, the Mission had an American dentist on staff at St. Anthony, Dr. Alexander T. Andrews. See Eleanor J. Cushman, "Our Staff," Fishers 48.2 (July 1950): 43. s<) In 1955, Betty Seabrook noted that North West River and Cartwright has been without a dentist for six years. See Betty Seabrook, "A Return Visit to the Coast (concluded)," Fishers 53.4 (January 1955): 113.

Eleanor J. Cushman, "Our Staff," Fishers 46.3 (October 1948): 80.

229 previous instructions on extracting teeth, the nurse had to present herself to the patient as calm, prepared, and proficient. The anticipatory terror of dental pain was often worse for

the patient than the extraction itself. Some of the most frightened dental patients were

children, whose mothers willingly brought them to the nurse for extractions, although

they were less enthusiastic about subjecting themselves to the prospect. In 1947, Maijorie

Wheeler informed readers of the Fishers that a mother brought her ten-year-old son to the

station who was "going to be a man while Miss Wheeler pulled his three teeth,"91

according to the mother. Wheeler noted that the boy was visibly "quaking in his boots,"

at the prospect of his ordeal, but she implied an ease of extraction with her following

statement, "Out came the three teeth.. ,."92 Juxtaposed against the image of a ten-year-old

boy quaking in his boots, Wheeler underemphasized the process of the extraction and in

so doing she implied that with the application of her own exodontic skill she quickly

eased the terror and discomfort of the young child. In the meantime, after the son's teeth

were removed, the mother informed Wheeler that she was also experiencing dental

discomfort: "The mother in all trust showed me a piece of an old tooth she had under her

dental plate, which 'hadn't bothered me a bit these thirteen years, but it do now, Miss.'

As she opened her mouth I ran the elevator around the shell of the old root, and with a

quick movement of the wrist I had made another friend: 'I'm some proud, Miss, to have

that out, but if you'd have told me you was going to take it out, I couldn't have faced

91 Marjorie Wheeler, "Letters from a Nursing Station," Fishers 45.2 (July 1947): 38.

02 Wheeler, "Letters," p. 38.

93 Wheeler, "Letters," p. 38.

230 Although Wheeler described her patients displaying fear and hesitation over the dental procedure, more nurses described their patients displaying fortitude and nonchalance. In reference to one of her dental patients, Jean Smith wrote to Seabrook: "I am amazed at the nerve some folk have. To let me extract 8 teeth without cocaine and then to say: 'Thank you kindly Miss, I'll be back next week for you to haul 6 more.' And so the good lady was; but my they were hard teeth to haul I was stiff for a few days afterwards."94 Not only did Smith emphasize the physical demands of extracting teeth, she also suggested that the local woman was surprisingly stoic about the pain, and indeed was ready to brave another dental ordeal the following week. Was Smith, with her British middle-class background, trying to suggest that the local people (an "inferior" class) had a higher threshold for pain than the "cultured" middle-class? A similar argument has been made by Patricia Jasen, in reference to colonial constructions of aboriginal women and their experiences in childbirth. Jasen argues that "the agents of colonization" in Canada's

North during the nineteenth century followed the dictates of Social Darwinism - they perceived aboriginal women as experiencing painless childbirth because the survival of their race depended on the ease of reproduction.95 Jasen also suggests that there may have been similar notions in Europe in terms of class, that "the aboriginal woman had parallels among the poorer classes of Europe."96 Was Smith exhibiting similar Social Darwinist concepts in her astonishment of the local woman's dismissal of dental pain? Or was she

1,4 PANL, MG 63, Box 66, File 1585, Folder 3 "Smith, Jean Battinson," Smith to Spalding, 12 June 1945.

95 Patricia Jasen, "Race, Culture, and the Colonization of Childbirth in Northern Canada," Social Histoiy of Medicine, 10.3 (1997): 383-400.

% Jasen, "Colonization of Childbirth," p. 385.

231 conforming to official Grenfell discourse, which emphasized the hardiness and resilience of the local people?

Banfill demonstrated similar perceptions of local people in terms of their calmness and fortitude in the face of dental pain: "1 marvelled at... the patient's endurance. After one brief interval when he got rid of the blood in his mouth he enquired calmly, 'How many more, Doc?'"97 The dentist told him there were four more to remove, to which, according to Banfill, the patient replied, '"Go ahead, Doc."'98 After the offending teeth had been removed, the "victim" paid the dentist, expressed his gratefulness, and had barely 'reached the outer door [when] the second victim was in the chair."99 Evidently, according to Banfill, the residents of Mutton Bay were eager for dental extractions, calm, composed and pragmatic about dental pain. This theme emerged again during Banfill's second term at Mutton Bay (1942) when a young fisherman asked her to remove a tooth that had been causing him sleepless nights during the fishing season. The importance to him of effectively participating in the fishery was clear, as he willingly subjected himself to dental pain for the sake of his occupation.100 However,

Banfill was from a Quebec farming family and was less likely to possess preconceived middle-class assumptions like Smith. Perhaps Banfill was more influenced by her middle-class nurse training and was subscribing to the Grenfell discourse in describing the fortitude of their patients. And in this sense, the Grenfell discourse itself appears to be

97 Banfill, Labrador Nurse, p. 66.

98 Banfill, Labrador Nurse, p. 67.

99 Banfill, Labrador Nurse, p. 67.

100 Banfill, Labrador Nurse, p. 173.

232 based on Social Darwinist concepts that viewed the local people as closer to nature and thus more capable of withstanding pain than the British and North American middle- class.

DOMESTIC CHORES

In the midst of this exceptional nursing experience in northern Newfoundland and

Labrador, the Grenfell nurses devoted a significant amount of time to gendered domestic chores in and around the nursing stations. These chores consisted mostly of cooking and housekeeping, and to a large extent depended on the individual station and the time period in which the nurse practised there. Nurses usually faced greater demands in terms of domestic chores if they worked in the older Mission buildings - those that were in operation in 1939 had been built before electricity and indoor running water had reached the Coast. As a result, in the old Flowers Cove nursing station (which closed in 1948), the nurses had to function in an un-insulated building with "...no basement, no lighting system, no running water, only one small room for patients and in winter five stoves were needed to keep it tolerably warm."101 When modern conveniences did arrive on the

Coast, they did not reach all the hospitals and nursing stations at the same time. The new station at Flowers Cove opened in 1948, and from then on the resident nurses no longer worried about blowing out oil lamps and carrying waste water buckets, which made maintenance of the station much easier.102 Ella Hewitt faced the same transformation when the new hospital opened at Harrington Harbour in 1950: "How convenient to have

101 Charles S. Curtis, "New Nursing Station at Flowers Cove," Fishers 46.4 (January 1949): 103.

102 Ivy C. Durley, "A Nursing Station Grows," Fishers 47.4 (January 1950): 112.

233 hot and cold running water, and electric lights!"103 However, in 1951, the nursing stations at Mutton Bay and Spotted Islands had no electricity or indoor plumbing.104 They required a stove for central heating and water was attained from "the stream at the foot of the hills."105 Even as late as 1957, the station at Mary's Harbour was heated by spruce and fir firewood via a large furnace, and cooking was also done by wood fires. In order to operate this station, the staff consisted of the Nurse-in-Charge, "a cook, two girls to help carry the trays and keep the place clean, and a 'handy man,' to carry in wood, run the engines, etc."106

Whenever the Mission opened a new nursing station, the nurse posted to that station assumed many housekeeping chores before the Mission obtained the services of a local nursing aide, housekeeping assistant, or cook. While the new Flowers Cove station was being built, the nurses assisted with the construction by scrubbing floors, washing dishes and cooking for the men who were working on the building - gendered assistance to the men and the Mission that elicited praise from Dr. Curtis.107 Ethel Currant was sent to the community of Roddickton in 1937, to open a nursing station in an old building acquired by the Mission.108 She was involved in the initial set-up of the station and told

103 Ella E. Hewitt, "Harrington's New Hospital," Fishers 48.3 (October 1950): 77.

104 Diack, Labrador Nurse, p. 61.

105 Anne Robinson Hopkins, "Island Summer," Fishers 48.4 (January 1951): 102.

106 "Mary's Harbour Nursing Station," Fishers 55.1 (April 1957): 23.

107 PANL, MG 63, Box 9, File 113 "Dr. Charles Curtis - 1941-1963," Curtis to Seabrook, 25 September 1948.

108 She was originally sent to Englee, where a new nursing station was supposed to be built, and had to temporarily reside in a local home while arrangements were made. She was advised to bring her maternity bag and medical supplies with her because these items would not likely be available in the community. Indeed, nothing was prepared in advance of Currant's arrival, and she voiced complaint about the situation,

234 Kate Spalding: . .once more we have to struggle trying to make a home out of chaos with the help of a few chairs and boxes and a few pieces of N fid furniture."109 This statement demonstrates the importance of creating a home environment within the walls of a nursing station, a theme discussed by Jayne Elliot in her dissertation, "'Keep the Flag

Flying': Medical Outposts and the Red Cross in Northern Ontario, 1922-1984." Elliott points out that the Red Cross outpost buildings served as both professional and private arenas for the outpost nurse, and highlights the tension that existed between the two. In

Ontario, outpost stations were praised for being tastefully decorated and retaining a

"home-like atmosphere"110 for the comfort of patients and staff; but at the same time, nurses sometimes gave up their own beds to accommodate their patients.111 As well as being the health care centres for local communities, these buildings constituted the nurses' (temporary) homes; and working on a station with the Grenfell Mission, as with the Ontario Division of the Red Cross, provided nurses with a "home of their own."112

The nursing stations were usually staffed with local aides to help with cooking and cleaning; and American volunteers, or Workers Without Pay (WOPs), arrived in the to which Kate Spalding replied, "It was too bad you should have arrived with nothing prepared but that casualness is rather characteristic of the Coast, I think." In the end, no new station was built at Englee; rather, the Mission acquired a building in Roddickton and Currant opened a station there. See PANL, MG 63, Box 27, File 520 "Bridge (Currant) Ethel, Nurse: 1935-1974," Spalding to Currant, 7 January 1936; Colonel Shnyder to Spalding, 23 September 1935; and Currant to Spalding, 31 October 1937.

IW PANL, MG 63, Box 27, File 520 "Bridge (Currant) Ethel," Currant to Spalding, 31 October 1937.

110 Jayne Elliott, "'Keep the Flag Flying': Medical Outposts and the Red Cross in Northern Ontario, 1922- 1984," (PhD Dissertation, Queen's University, 2004), p. 125.

'"in the Ontario Red Cross outposts, Elliott found that "[o]vercrowding could also literally displace the nurse from her bed." At Harbour Deep, in 1961, Nurse Annie Rhodes also gave up her own bed for women in labour. See Jayne Elliott, "Blurring the Boundaries of Space: Shaping Nursing Lives at the Red Cross Outposts in Ontario, 1922-1945," CBMH 2004 21(2): 318; and PANL, MG 372 Gordon Thomas Collection, Box 3, File "Correspondence 1961," John Grey to Thomas, 3 November 1961.

112 Elliott, '"Keep the Flag Flying,"' p. 169.

235 summer to assist with gardening, chores, and community-related activities. These aides were informally trained and performed duties comparable to "ward aides" in the

Canadian tradition described by Kathryn McPherson - "Ward aides...quickly became permanent features of ward life, performing housekeeping and cleaning duties on the ward and around patients' beds, carrying and collecting trays, tidying linen and supply cupboards, and performing messenger duties."113 However, the supply of aides and

WOPs was not consistent, and if a station was short-staffed the nurse had to take on the domestic chores herself; on several occasions that pages of Fishers emphasized that the

"[l]ack of staff meant that the Nurses-in-Charge became Domestics-in-General."114 In

1953, Joan Stedman found that she "never had a full quota of aides" at Cartwright, and she subsequently informed Seabrook: . .1 spend so much of my time helping with

Domestic chores & worrying about [laundry] & meals, that if that could all be delegated to someone who knew something about it, the nurse could nurse!"115 Dorothy Jupp obtained the services of a local girl to assist with the laundry at Mary's Harbour when her cook had to leave to attend a sick relative, which had left the station temporarily understaffed.116 Even at the hospital in St. Anthony, which was the best-staffed building on the Coast, the head nurse was often "dietician and housekeeper as well."117 In order to ensure a steady supply of aides for the hospitals and stations, American nurse Selma

113 Kathryn McPherson, Bedside Matters: The Transformation of Canadian Nursing, 1900-1990, (Toronto: Oxford University Press, 19%), p. 222.

114 Margaret E. Darby and Edith O. Miller, "Ringed with Fire," Fishers 44.4 (January 1947): 108.

1,5 PANL, MG 63, Box 67, File 1611, Folder 1 "Stedman, Nancy Joan," Stedman to Seabrook, 8 May 1953.

116 D.M. Jupp, "Coast Chronicle: St. Mary's River," Fishers 48.2 (July 1950): 50.

117 Charles S. Curtis, "The Superintendent Reports," Fishers 48.3 (October 1950): 68.

236 Carlson, who worked at the St. Anthony hospital for over twenty years, establish a training program in cooking and housekeeping for local girls who wanted to become aides.118 Upon her retirement, Dr. Curtis praised her housekeeping, cooking and teaching skills: "The hospital was never messy. Everything was kept neat and clean and in perfect condition. She was an excellent cook herself and taught a great many of the local girls the art of cooking for an institution She was an expert in using the fish, berries and other

produce of this country."119 Carlson was "the female embodiment of a 'superior'

culture,"120 which Jill Perry identified as central to the Grenfell Mission's early

employment of nurses as both health providers and social reformers. The cleanliness of

the hospital and the effectiveness of its routine reflected Carlson's own personal and

professional middle-class standards - hence the praise from Curtis. In fact, Curtis considered the domestic arrangements of a nursing station to be reflective of the nurse and her own standards to such a degree that he would refuse to recommend a nurse for re

employment if he had been displeased with her personal hygiene or the cleanliness of her

station. PI"

Occasionally, a nurse arrived on the Coast who was not prepared for the domestic

demands that were placed on her - the most dramatic example being Jean King's arrival

to Happy Valley in 1961. King became caught between postwar nursing ideologies (more

118 Many of these local girls also pursued nurse training in Canada, the United States or Britain, with the financial assistance of the Grenfell Mission. See "Northern Nurses," Fishers 42.2 (July 1944): 37-39.

119 Charles S. Curtis, "Miss Carlson has Left the Coast," Fishers 45.4 (January 1948): 107.

120 Perry, "Nursing for the Grenfell Mission," p. i.

121 See PANL, MG 63, Box 55, File 1295 "Murdoch, Wilhemina," Report on Staff Members by Charles Curtis, 21 October 1937; and Box 74, File 1728 "Wenyon, Phyllis," Curtis to Spalding, 12 January 1942.

237 definitive job descriptions and evolving conceptions of what it meant to be a nurse) on the one hand and the demands of being short-staffed at a nursing station in a frontier community on the other. In the postwar period, the availability of new drugs and medical procedures required that nurses assume certain medical tasks previously performed by physicians. In turn, these over-worked and under-staffed nurses remitted some of their own duties, those that required less formal preparation, to "non-professional" workers who had less education and less professional status - practical nurses, nursing assistants, and ward aides.122 As a result, nurses' job descriptions and professional delineations became more defined and emphasized among nursing circles at this time. It was in this ideological atmosphere that Jean King arrived at Happy Valley, which was then "a pretty grim place."123 The Grenfell establishment at Happy Valley was young, the station having opened in 1951,124 and the community itself was known through the decade for the range of social problems that accompanied the Valley's rapid growth and modernization. People from outlying settlements flocked to town to take advantage of the high wages offered to civilian staff at the Canadian and American Air Force Base in

Goose Bay. Happy Valley characterized a booming frontier in the form of an exploding population of people with new-found disposable income and a myriad of ways to give in to "temptation." Isobel Fredman observed that for the local residents, especially the

McPherson, Bedside Matters, p. 221.

123 PANL, MG 63, Box 37, File 805 "Fortescue, Sheila," Seabrook to Sheila Paddon, 6 July 1955.

124 Gordon W. Thomas, From Sled to Satellite: My Years with the Grenfell Mission, ([Scarborough]: Irwin Publishing, 1987), p. 117.

238 recently-arrived Inuit, it was "difficult to cope with the old and new way of living at the same time."125

The Mission eventually posted two nurses to the station who, along with nursing and midwifery, had to divide the cooking and housekeeping between themselves.

However, the workload became so heavy by the end of the 1950s that Nurse Jo Lutley refused to return to the station unless the Mission appointed a resident physician; "She

[felt] very strongly about this and [considered] it a [prerequisite] for the Happy Valley situation." " However, no physician was posted. Enter Jean King, who became so upset at the housekeeping chores that she was expected to perform that she threatened to resign.

In an attempt to placate the nurse and ensure that she fulfill her contract with the Mission,

Betty Seabrook encouraged her to transfer to the hospital at St. Anthony, which had a much larger staff and King would "of course, have no cooking or housekeeping to do."128

King eventually settled down at Happy Valley. However, even though the Mission hired an assistant for the station, King reiterated her displeasure with the domestic arrangements in a light-toned statement to Seabrook: "As usual, the cooking has been the biggest nuisance for Sadie and I must say we seem to do more and more. The housekeeping is a great experience but I do feel that sometimes we need a 'Good

Housekeeping' Diploma more than our nursing certificates!!!"129 Although she

125 PANL, MG 63, Box 37, File 817 "Ray Isobel Fredman," Fredman to Seabrook, 25 October 1956.

1:6 PANL, MG 63m Box 61, File 1462 "Richards, Lydia Joan," Richards to Seabrook, 1 December 1957.

127 PANL, MG 63, Box 13, File 217, Folder 1 "NEGA," Seabrook to Shirley Smith, 10 June 1960.

1:8 PANL, MG 63, Box 48, File 1076 "King, Jean Frances," Seabrook to King, 3 October 1961.

129 PANL, MG 63, Box 48, File 1076 "King, Jean Frances," King to Seabrook, 21 September 1962.

239 eventually adjusted to the situation, her initial alarm at the prospect of performing domestic chores was caused by the collision of postwar nursing ideologies with the realities of nursing in an understaffed frontier nursing station.

ADMINISTRATION

The Grenfell nurse was expected to be an able administrator, especially if she was posted as nurse in charge of a station or head nurse of a hospital. The general running of the nursing stations in particular relied on the leadership and decision-making abilities of the nurses in charge. As a result, Grenfell nurses were involved with making household arrangements, balancing budgets, raising funds, ordering supplies, advising incoming staff, supervising the summer WOPs, and managing the Clothing Stores. Seabrook was well aware of the administrative requirements of nursing on the Coast, and informed one prospective candidate: "Head Nurses at our small hospital stations need to have administrative ability as they are often in charge of the hospital whilst the doctor is away, and are responsible for the nursing and domestic staff and the housekeeping."130 Nurses on the stations held administrative responsibilities exclusive of the nearest physician, and sometimes the work became so heavy that a second nurse or general assistant was recommended. Margaret Harris was relieved to learn that the Mission was sending her a general assistant, someone who could "really help with the administration - typing and book keeping."131 Ethel Currant was one of the most able nurse administrators on the

Coast. From the beginning of her tenure at Flowers Cove, she made a concerted effort to

1.0 PANL, MG 63, Box 59, File 1398 "Plint, Audrey Robson," Seabrook to Plint, 28 January 1955.

1.1 PANL, MG 63, Box 42, File 936 "Harris, Margaret," Harris to Seabrook, 2 May 1968.

240 balance the budget and make the station as self-sufficient as possible. She created an extensive gardening program and preserved "great quantities of food - fish products, vegetables and berries, keeping her own station well supplied with very palatable food and providing an 'export surplus' for St. Anthony."132 She also insisted that patients pay their fees for health services, and if people could not pay in cash she accepted fish, wood, or any other supplies that the station could use.133 However, the combined medical and administrative duties at Flowers Cove were heavy even for Currant, and Curtis confided to Spalding that he "should like to have a nurse there with her and let her run the business at the station."134 Indeed, in 1948 the Mission began posting two nurses to the Flowers

Cove station instead of one.

The nature of the administrative duties that a nurse performed often depended on the station or hospital to which she was posted, and the composition of the staff. For example, after Currant had established her system at Flowers Cove - extensive agriculture, bottling preserves, and insisting that patients pay for their health care - the precedent for that station (and for the community) was set and any successor at that station had to fill a certain role. One nurse asked to be posted to Flowers Cove after

Currant, but Curtis expressed misgivings about such an appointment because the nurse did not have the forceful personality of Currant: "She is a very good nurse and an excellent midwife, but she hasn't the personality or the business ability to carry a

1.2 [Harriet H. Curtis], "Ethel Currant," Fishers 44.3 (October 1946): 85.

1.3 Charles S. Curtis, "Heroines," Fishers 43.2 (July 1945): 46.

114 PANL, MG 63, Box 9, File 113, Folder 2 "Curtis, Charles S.," Curtis to Spalding, 22 March 1944.

241 station."135 And the administrative demands of new nursing stations could be even more

immense. Barbara Watson was posted to Happy Valley during the second year the station

was in operation, and the logistics of supplying the station with food, medicine,

equipment, and furniture had still not been arranged. In an attempt to rectify the situation,

Watson contacted Seabrook:

I wonder if you can help me to sort things out over the matter of where to apply for supplies etc? There still seems to be some confusion & we go on living from hand to mouth as it were. According to Dr. Curtis, St. Anthony will not supply this station. We have been getting off supplies from NWR but at the moment they haven't enough to cover both places, as the requisition was only made out to cover one hospital. I feel too that the 'staff here are entitled to the same amenities as at NWR but all the equipment eg beds, mattresses, etc is RCAF surplus & far from comfortable. There is not even a comfortable arm chair & I am not sure how to remedy this, as they have not decided who is responsible for the poor Valley!1 6

In the more established stations along the Coast, supplies arrived each summer via the

Mission's supply boat, and it was then the nurse's duty to oversee the unloading of those

supplies at the station.137 A far more onerous task faced Watson at the young Happy

Valley Station. It is unlikely that she expected to be tracking down a source for basic

necessities and begging for supplies from nearby hospitals when she initially accepted the

position.

In addition to balancing budgets, which Currant in particular did so well, nurses

were also involved with raising money for the station or hospital. This was accomplished

through two methods: holding "jumble sales" and running the "clothing store." Nurses

115 PANL, MG 63, Box 9, File 113, Folder 2 "Curtis, Charles S.," Curtis to Spalding, 22 March 1944.

1,6 PANL, MG 63, Box 50, File 1145 "Lumsden (Watson), Barbara," Watson to Seabrook, 30 October 1953.

117 PANL, MG 63, Box 62, File 1491 "Ross, Ruth Zena," Seabrook to Ross, 11 July 1955.

242 seemed to have a love-hate relationship with these events - on the one hand, it was an exciting day for the women of the community and a great opportunity to raise funds for the Mission. But on the other hand, there was a tremendous amount of work in preparing for such an event, and the day itself was long and exhausting. Several nurses noted that

"would be Jumblers" were at the station at 5:30 in the morning or before the nurses were awake.138 Joan Stedman disliked the behaviour of the attendants on Clothing Store day:

"all the folk seem to show their worst side, its just grab and snatch, and now a few try to pass the odd thing out of the door without my seeing it. But that, I guess is rather like

'The sales' in England."139 The jumble sales and clothing stores consisted of new and used clothing, toys, magazines and other supplies that had been donated from across

Britain, the United States and Canada, and the items were offered to local residents at a nominal rate. The donations arrived at the hospitals and stations in large bales and boxes, and the head nurse or nurse in charge had to check the items, oversee their storage, organize the jumble sale or clothing store day, manage the accounts, and send acknowledgements and thanks to the Grenfell Mission branches that sent the donations.140 The sales served two important purposes for the Grenfell establishment in northern Newfoundland and Labrador - they provided people with an opportunity to buy clothing and items that were not readily available in the region and they raised funds for the Mission. After a successful Annual Jumble Sale at Flowers Cove in 1945, Jean Smith

138 PANL, MG 63, Box 66, File 1585, Folder 3 "Smith, Jean Battinson," Smith to Spalding, 12 June 1945; and Box 45, File 1008 "Hughes, Winifred Helena Rose, nee Burgess," Burgess to Seabrook, 15 October 1947.

IW PANL, MG 63, Box 63, File 1496, Folder 1 "Stedman, Nancy Joan," Stedman to Seabrook, 13 September 1954.

140 [Donald G. Hodd], "Mrs. Thompson Leaves," Fishers 43.3 (October 1945): 78.

243 noted, "In two days sale we realised $125.00.1 was really very pleased. I could have done with twice the amount of material that I had."141

The Grenfell nurse also had to fill the role of hostess at the station, which involved accommodating the physician during a medical visit and entertaining distinguished visitors to the Coast. Both of these responsibilities draw strong comparisons

with the dictates of traditional female work, especially within a paternalistic household structure. The physician's visit to a station was a celebrated occasion, a "red-letter day"

for the station and for the community. Helen Leeson described the general excitement

over the doctor's visit in her Fishers article, "A View of the Straits." Most people in the

community would have been aware that the doctor was coming through the "bush

telegraph," and the station's waiting room would be full of people from all over the

region wishing to see the doctor.'42 In the meantime, the nurse welcomed him into the

building, made arrangements with her staff for his meals and accommodations, and

assisted him with clinics and surgeries. As a result, the workload at the station increased

dramatically with the doctor's arrival. At Flowers Cove in 1948, Ivy Durley received the

doctor and dentist on the same trip - the former stayed at the station for almost two

weeks and the latter for one month.143

Along with visits from physicians and dentists, nurses on the stations hosted a

range of individuals who were touring the region (politicians, clergy, and members of the

executive or administration), en route to another hospital or station (other Grenfell staff

141 PANL, MG 63, Box 66, File 1585, Folder 3 "Smith, Jean Battinson," Smith to Spalding, 12 June 1945.

142 Helen Leeson, "A View of the Straits," Fishers 54.4 (January 1957): 109.

141 PANL, MG 63, Box 35, File 738 "Durley, Ivy Constance," Durley to Seabrook, 4 April 1948.

244 members and transient workers), or who were interested in experiencing the Coast for themselves (former Grenfell staff and family members of current Grenfell employees).

The demands of accommodating visitors to the Coast were both logistical and social. In terms of logistics, for example, in 1950, L.W.S. reported: "We have been ever so busy in

Forteau. The periodic arrivals of boat loads of visitors, guests, transients and occasional

'look-sees' have given us a great experience in improvising 'sleepers' for more than we normally accommodate."144 The staff subsequently had to "drag four mattresses out of nowhere and put [their guests] to slumber on the floor of the waiting-room."145 Some nurses also found it difficult to entertain visitors if the station was particularly busy, while others approached the situation with more humour. Reflecting on a recent influx of visitors to Roddickton, Arnold Lancaster informed Seabrook,

I don't think Jo [Lutley] likes visitors very much and entertaining is difficult when the hospital is busy, but I guess these things are as much part of the job as stitching up axe cuts and delivering babies. ... At present we have Peter McAskill (Rev.) and two missionaries whom he is carrying around the Coast. (They won't bless me, banging a type-writer at 7 a.m....)146

Visits from politicians or Grenfell executives proved more demanding for the station nurses because they were conscious of making a good impression on behalf of the

Mission and the stations under their charge. Confederation with Canada in 1949 increased political interest in northern Newfoundland and Labrador, and the period immediately following Confederation witnessed an increase in political visitors to the

144 "Coast Chronicle: Forteau, August 13th," Fishers 48.3 (October 1950): 78.

145 "Coast Chronicle: Forteau," p. 78.

146 PANL, MG 63. Box 49, File 1099, Folder 1 "Lancaster, Arnold (Miss)," Lancaster to Seabrook, 8 July 1961.

245 Coast. Members of the Grenfell executive were especially interested in witnessing their establishment, especially in view of the increase in government funding for health care in the region after 1949. In 1958, Grenfell Directors Arthur W. Bingham Jr. (along with his wife) and Andrew Y. Rogers (along with his son) spent seventeen days touring and inspecting every hospital and station on the Coast.147 Other distinguished visitors to the

Coast included the secretaries Betty Seabrook (twice)148 and Dorothy Plant (Grenfell

Labrador Medical Mission),149 Director, Denley Clark,150 Sir Leonard Outerbridge, as

Lieutenant Governor of Newfoundland,151 and Premier Joseph R. Smallwood. During each of these visits, the nurse and her station would have been evaluated, to differing degrees; but most nurses seem to have taken the visits in stride since they rarely made reference to these occasions except in passing. Unfortunately for Joan Stedman at Mary's

Harbour, her visit from Betty Seabrook coincided with the arrival of Premier Smallwood, so she could hardly appreciate Seabrook's presence in a more relaxed manner. Stedman did take the opportunity to inform the London office: "A pity, also that [Seabrook's] visit coincided with the Premier being stranded here in the fog - but you will [hear] all about that, and how I threw the bathroom door open for her to go in, only to reveal Mr

147 The report of this trip was published in Fishers. See "Two Directors Report: Part I," Fishers 56.3 (October 1958): 73-76; and "Two Directors Report: continued," Fishers 56.4 (January 1959): 104-107.

148 Betty Seabrook, "A Return Visit to the Coast," Fishers 52.3 (October 1954): 70-73; "A Return Visit to the Coast, concluded," Fishers 52.4 (January 1955): 113-116; and "North Again," Fishers 59.3 (October 1961): 72-75.

149 Dorothy A. Plant, "Lasting Lure," Fishers 58.4 (January 1961): 102-104.

150 PANL, MG 63, Box 22, File 415, "Bailey, Freda Helen," Seabrook to Bailey, 2 February 1962.

151 Sir Leonard Outerbridge, "A Governor's Visit," Fishers 51.3 (October 1953): 66-67.

246 Smallwood shaving himself - we knew he was on the station, but to find him in the bathroom was a shock."152

SUPPLEMENTARY DUTIES

In 1928, the Grenfell Mission began an agricultural program for the purposes of addressing deficiency diseases - especially beri beri, scurvy and rickets - that were widespread on the Coast before the 1940s. The program was placed under the direction of

Fred C. Sears, an American horticulturalist and orchard pioneer at Massachusetts State

College.153 Sears traveled to northern Newfoundland and Labrador every year between

1928 and 1939, promoting horticulture and expanding the agricultural program. In every community where there was a Grenfell hospital or station, the staff developed vegetable gardens for the Mission and helped local residents establish their own gardens. As a result, Grenfell nurses often found themselves engaging in gardening and overseeing a farmyard, encouraging their patients with gardening, and holding garden contests in the community.154 Ethel Currant was the most well-known nurse for her gardening abilities; she frequently received high praise from Curtis and other Grenfell nurses for the abundance of vegetables at her station and for bottling local produce for the winter. When she arrived at Flowers Cove in 1944, Jean Smith was particularly impressed by Currant's legacy and recalled, "You can imagine my surprise to find all the food that there is here.

Garden vegetables and dairy produce. Miss Currant has certainly worked very hard 'on l5: PANL, MG 63, Box 67, File 1611, Folder I "Stedman, Nancy Joan," Stedman to Mrs. Challis, 15 July 1954.

Rompkey, Grenfell of Labrador, p. 243.

154 Fred C. Sears, "The 1933 Labrador Garden Campaign," Fishers 32.1 (April 1934): 8-12.

247 the land.'"155 From the perspective of administration, Flowers Cove was the cheapest station that the Grenfell Mission operated. Curtis considered that to be "due to Miss

Currant's efforts," as he explained to Kate Spalding: "...almost everything is supplied by the community. When one visits there you have excellent food, all local products. Her gardens surpass ours here."156

Flowers Cove may have been the premier example of agricultural success on the

Coast, but each station made efforts at maintaining a vegetable garden, a root cellar and a farmyard of goats, pigs, cows, hens and ducks,157 and for many nurses, "[b]eing a farmer was just another new experience."158 It is difficult to gauge the extent to which the nurses participated in direct gardening themselves. The stations usually welcomed volunteer outdoor workers during the summer months, colloquially known as WOPs, to assist with gardening, manual labour and the general maintenance of the premises. Therefore, in many instances the nurse may have been more of an overseer of the gardening program rather than a labourer herself. Indeed, Flowers Cove may have been so successful because Currant was an able overseer. According to Curtis, Currant would require the patients to pay for her medical services by sometimes having women help her with the garden: "On certain days a week they came and weeded and hoed it, and in the fall they came and got in the crops."159 In 1932, Wilhelmina Murdoch reported that her

155 PANL, MG 63, Box 66, File 1585, Folder 3 "Smith, Jean Battinson," Smith to Spalding, 15 November 1944.

156 PANL, MG 63, Box 9, File 113, Folder 2 "Curtis, Charles," Curtis to Spalding, 9 August 1944.

157 See, for example. PANL, MG 63, Box 55, File 1295 "Murdoch, Wilhemina," Murdoch to Spalding, 6 December 1932.

158 Jean Smith, "Flowers Cove," Fishers 45.2 (July 1947): 36.

159 Charles Curtis, "Heroines," Fishers 43.2 (July 1945): 46.

248 community worker, Elizabeth Craig, "had ground cleared over by Roberts' Room and

there we raised quite a crop of turnips and carrots and potatoes."160 It is not clear whether

Craig cleared the ground herself or found someone in the community to do so, or if they

planted the crops themselves or, again, found someone in the community to do that. At

the same time, Penelope Banyard referred to gardening as a "side-line" to nursing, along

with canning milk and berries for the winter, which suggests some level of manual

participation in gardening.161 The extent of gardening that the nurse performed probably

depended on the nurse herself, the business of the station, the extent to which agriculture

was established at that station and the availability of outdoor staff for assistance. For

example, in the late 1950s, when the other stations had long-established agricultural

programs, Happy Valley's program was in its infancy. Writing in Fishers in 1958,

Kathleen Lutley recalled the summer months she spent creating a garden in an area of

low prospects:

June and July were quiet months and I was able to find time to do some clearing of the grounds of a tangle of bushes and long, rank grass. I made a vegetable garden out of the ground that had been the dog pen when Miss Rhodes was here and then a chicken run. I dug out 22 tree roots and dug in seven sacks of manure that the men from North West River brought up from the barn on the Lockwood. The vegetables did not quite come up to the standard of those I saw at St. Anthony but were very promising for what was previously uncultivated soil.162

Thus, according to her report, Lutley performed a significant amount of manual labour in

her attempt to establish a vegetable garden, which may have been unusual compared to

160 PANL, MG 63, Box 55, File 1295 "Murdoch, Wilhemina," Murdoch to Spalding, 6 December 1932. See also F.E. Shnyder, "Report of the Staff Selection Committee," Fishers 28.3 (October 1930): 87.

161 PANL, MG 63, Box 48, File 1081, Folder 1 "Kirby (Banyard), Helen Mabel," Banyard to Spalding, 5 April 1938.

162 Kathleen Lutley, "A Word from Happy Valley," Fishers 56.1 (April 1958): 22.

249 other station nurses. Previously at Happy Valley, in 1953, Barbara Watson informed

Seabrook that after she had completed her list of nursing/station duties one day, she spent the rest of the day "persuading plants & vegetables to get on and grow...."163 Watson did not report performing the same level of manual gardening as Lutley, but was still watchful over the patch under her care.164

Considering the prevalence and the importance of animals on the Coast, especially as sources of food and transportation, it is not surprising that Grenfell nurses were sometimes called upon to nurse sick or wounded animals. As Iris Mitchener amusedly informed readers of the Fishers, "Cows, dogs and chickens, have all featured in the out-patient book! The cows suffered from intestinal upsets, the chickens 'drooped' according to their owners, and one dog had a dislocated shoulder. One is expected to be able to deal with all these minor calamities."165 If local residents were experiencing problems with their animals, they often approached the nurse for her assistance. In 1955,

Mary Stockley, nurse-in-charge at Mutton Bay, removed tangled long grain from one particular hen and was rewarded for her efforts with a dozen fresh eggs.166 Dogs in particular were prone to minor accidents, especially related to their function hauling sleds

16:1 PANL, MG 63, Box 50, File 1145 "Lumsden (Watson), Barbara," Watson to Seabrook, 17 July 1953.

164 For an examination of food security and nutrition in Newfoundland and Labrador, see Linda Kealey, "Historical Perspectives on Nutrition and Food Security in Newfoundland and Labrador," in Resetting the Kitchen Table: Food Security, Culture, Health and Resilience in Coastal Communities, Christopher C. Parrish, Nancy J. Turner, and Shirley M. Solberg (eds.), (New York : Nova Science Publishers, 2007): 177- 190.

165 Iris F. Mitchener, "The Louie Hall Nursing Station, Forteau, Labrador," Fishers 46.1 (April 1948): 4.

166 PANL, MG 63, Box 28, File 546 "Buckle (Stockley), Mary," Stockley to Seabrook, 19 May 1955.

250 over long distances in treacherous conditions.'67 In order to ensure their health or to control infectious diseases, dogs were sometimes treated with vaccinations. Stockley had to visit several communities in her district to perform vaccinations on dogs, and described one such occasion in a letter to Seabrook: "1 set up shop in [JM's] back kitchen - and while [H] hauled dogs in and out, and held them; I prepared the vaccine and gave the injection. I was surprised to find that none of them gave any trouble."168 Whether or not nurses had to perform these vaccinations usually depended on the station to which they were posted. Stockley was at Mutton Bay and had more responsibilities with animals there than nurses who were closer to a larger Grenfell centre. In fact, the same year that

Stockley was vaccinating dogs in JM's back kitchen, Barbara Watson at Happy Valley was benefiting from the proximity of a trained veterinarian stationed with the United

States Air Force base at Goose Bay. There had been sickness among the dogs that year, so the veterinarian visited Happy Valley, gave the dogs inoculations and treated them for distemper and liver disease.169

SUMMARY

Nurses with the Grenfell Mission, especially those on the nursing stations, performed a myriad of health-related and non-health-related duties. Their experiences and their level of responsibility depended on a range of variables that defined the

167 For example, in 1947, Jean Smith at Flowers Cove reported, "A dog was brought in last week, paw torn on a nail. Nine sutures were needed. What bawling!" See "Coast Chronicle: Flowers Cove," Fishers 45.3 (October 1947): 77.

168 PANL, MG 63, Box 28, File 546 "Buckle (Stockley), Mary," Stockley to Seabrook, 22 March 1955.

169 Barbara Watson, "Youngest Station," Fishers 53.2 (July 1955): 36.

251 particular hospital or station to which they were posted. These included three main factors. 1) The size and constitution of Grenfell staff in the building determined the activities that a nurse would perform - for example, nurses at the St. Anthony Hospital were not usually required to perform domestic chores because the hospital had a steady

supply of aides and maids; whereas nurses on the stations often cooked meals and did the

housekeeping. 2) The kinds of modern amenities (or lack thereof) that the building had

affected the nurses' daily activities - changes in communications and transportation did

not reach all the hospitals and stations at once; so while some nurses enjoyed the

comforts of electricity and indoor plumbing, others had to make arrangements for

firewood and for buckets of water to be carried from a nearby stream. 3) The location of

the building also shaped the nurses' experience - if the station was isolated or a distance

from outlying patients, larger medical facilities, or a resident physician, the nurses were

required to travel in all conditions and to use their own judgements in transporting

patients when necessary.

Generally speaking, nurses on the stations held positions of greater responsibility

than those in the hospitals. This responsibility was mostly associated with the nurses'

local authority and their decision-making abilities, which did include providing the initial

diagnosis of patients and treating emergency cases. According to their written

correspondence and the articles of the Fishers, the majority of the nurses' duties were

associated with traditionally gender-appropriate activities, especially standard nursing

duties, midwifery and obstetrics, and domestic chores. Even when nurses were required

to perform tasks for which they had little or no training, the final estimation, according to

the official Grenfell discourse, belonged to the physician - nurses were expected to

252 contact the physician for advice, follow his instructions specifically, and present their results to the physician for professional approval. Nursing with the Grenfell Mission did constitute an "exceptional female work experience," and nurses certainly performed tasks that were traditionally beyond their formal training. But officially, the work experience was limited by established gendered parameters which were appropriate to the dictates of the paternalistic medical hierarchy of the Grenfell Mission.

Nursing with the Grenfell Mission involved some instances in which a nurse was required to exercise responsibility and judgement that would have been unusual in a traditional hospital environment. Chapter 6 explores some of the major "truths" of the

Grenfell Mission as portrayed through the official Grenfell discourse. The Mission consciously presented an ideal of nurses as maternalist, accommodating, obedient and submissive; yet the archival material paints a more complex picture of nursing on the

Coast.

253 CHAPTER SIX

Challenging the "Truths" of the Grenfell Mission Discourse

The Grenfell nurses' professional position with the Mission in northern

Newfoundland and Labrador was often of a contradictory nature. The amount of authority they exercised in the local communities, their personal and professional relationships with other nurses, and the professional boundaries between physicians and nurses on the Coast were often theoretical and always fluid. In this unusual work environment, conflicts sometimes arose as nurses interacted with people in the community, other nurses, and Grenfell physicians. Yet the official Grenfell discourse described a Utopian health care establishment on the Coast which was characterized by uncompromising gratitude of the people towards the Mission and its staff, harmonious relationships between employees, and the submissiveness of nurses towards the physicians. This chapter challenges some of those "truths" associated with the Grenfell

Mission. There is strong evidence to support the fact that the local people accepted and appreciated the Grenfell Mission, that nurses and physicians cooperated with each other to bring health care to the people, and that conflicts were the exception rather than the rule. However, personal and professional conflicts, which were documented in the archival material, shed light on the nature of those relationships between the people, the nurses and the physicians and highlight the influence of gender in professional conflicts on the Coast.

Exploring three of the major truths surrounding the Grenfell Mission underlines the contradictions in the Grenfell discourse and allows a more complete picture of nursing with the organization. Truth #1: There existed a high degree of collegiality

254 between the nurses and the local community and people were overwhelmingly grateful for the Grenfell Mission. In actuality, the nurses were not only expected to be leaders in the communities but also had to accommodate local individuals who represented their own or the larger community's interests. Truth #2: Grenfell nurses displayed selflessness and belonged within a sisterhood in which they worked together amicably to meet the needs of the station and the community. In actuality, while nurses were expected to demonstrate strength, adaptability, and assertiveness in providing health care on the stations, they also lived and worked with other strong-minded nurses. Truth #3: Grenfell nurses understood and accepted their place within the medical hierarchy and were submissive and obedient towards physicians. In actuality, nurses sometimes challenged

Grenfell physicians and the organization through whatever means they could. The

Grenfell discourse was influential in determining how its readership understood the organization, its raison d'etre, and its professional components. And as Chapter 3 demonstrated, even nurse authors contributing to the Fishers perpetuated the themes of maternalism and submissiveness towards physicians. However, the archival material demonstrates that in some instances these Grenfell "truths" were professionally challenged.

CONFLICT WITH MEMBERS OF THE COMMUNITY

From its middle-class and colonial beginnings, the Grenfell Mission became the established medical and social authority of the Coast; and the nurses, as agents of the

Grenfell agenda, were expected to carry that authority into the communities in which they worked. According to the official Grenfell discourse and the truth presented in the

255 Fishers, the people of northern Newfoundland and Labrador were overwhelmingly grateful for the services of the Grenfell Mission and heaped praise on the nurses and the organization. However, it was in the service of the Grenfell agenda that most conflicts

between the nurse and the community occurred. Indeed, the nurses' personal middle-class

philanthropic intentions combined with their positions as health care representatives of

the Grenfell Mission brought them into direct conflict with the local people. Conflicts

within the communities between the nurses and the people were usually the product of: 1)

the Grenfell nurses* status in the community and relationship with the people; 2) racial

and cultural differences between the nurse/the Mission and the people; and 3) non

medical participation of nurses within the community. This section explores occurrences

of conflict between Grenfell nurses and the residents of northern Newfoundland and

Labrador in terms of these three factors of disagreement.

Local Gratitude in the Fishers

In the Fishers, the residents of the Coast were portrayed as tremendously grateful

for the Grenfell health services and worthy of the Mission's attentions. In fact, during the

1940s and 1950s, the Fishers was saturated with references to the gratefulness of the

local people, especially towards the nurses. Curtis was particularly vocal in expressing

the degree to which the local people respected their nurses,1 but other physicians

contributed as well: Donald Hodd referred to nurse Thompson at Harrington Harbour as

being "known by all, up and down that Canadian Labrador, as their good nurse and kind

' For example, on the retirement of Selma Carlson, Curtis stated that the patients "had such confidence in her." Charles S. Curtis, "Miss Carlson Has Left the Coast," Fishers 45.4 (January 1948): 111.

256 friend.... all the Canadian Labrador folk regret her leaving."2 The Fishers also published letters directly from patients on the Coast, expressing that gratitude towards Grenfell personnel and/or the Mission.3 In 1949, a maternity patient praised her nurse for recently saving her life, in a conversation already cited in a previous chapter:

Except for the resourcefulness and cool-headedness of Miss Jupp and the advantages of the hospital at St. Mary's River I would not be able to write these few lines today. I am deeply indebted to Miss Jupp, to the Grenfell Mission, and to God Almighty for saving my life at the recent birth of our son. Many thanks to all concerned.4

On another occasion, Curtis related his conversation with a local fisherman, who admitted: "We have a very fine nurse here now and she has had some hard times."5 Thus, the Fishers used the gratitude of the people to support its cause, and also ensure that the readership knew that the poor were good "god-fearing" folk who deserved the middle- class support. The Grenfell Mission was keen to present the residents as appreciative of the Mission's services.

The Fishers also highlighted the gratitude and affection that the people had for the

Mission that they expressed outside of medical circumstances. The October 1943 issue

2 D.G.H., "Mrs. Thompson Leaves," Fishers 43.3 (October 1945): 78.

3 For example, see Charles S. Curtis, "Heroines," Fishers 43.1 (April 1945): 4. This could perhaps exemplify more than class-based issues from both perspectives (i.e. the Fishers point of view in trying to substantiate or justify its presence and garner donation support; and also the people's point of view respecting the nurses' middle-class status and striving toward it.) It could it also potentially be an issue of gender, in that the nurses were women at a time when there was still an emphasis on traditional gender roles such that women were to be respected as ladies, and they were supposed to be helpmeets to the male role of protector provider. So this local respect of the nurses could be in part based on class but also in part based on gender.

4 "Note of Thanks," Fishers 46.4 (January 1949): 117.

5 Charles S. Curtis, "Heroines," Fishers 43.1 (April 1945): 4.

257 contained a duplication of a letter written from "a Labrador girl"6 named Bessie in which she expressed her affection to Curtis: "I now sit down with the greatest of pleasure to write to you. Although I have never written to you before I suppose you will accept a letter from me."7 The published letter included spelling mistakes, grammatical errors, and quaint local colloquialisms that would have presumably been in the original letter. Bessie asked Curtis if he would write to her, because "...1 would love to get a letter from you."

Not only did this letter highlight the bonds that formed between the people and the

Grenfell staff, but it also demonstrated how a local girl, presumably less educated than the readership of the Fishers, had taken the time to reach out to Curtis on a personal level and write him a touching letter. The Fishers referred to local hospitality towards physicians and nurses in illustrating the gratitude of the people. When Tony Paddon, physician with the Grenfell Mission and medical officer for northern Labrador based out of North West River, was embraced by the people of Hebron, he reflected: "The entire population [came] running out to welcome us, and [made] up by their warmth the deficiencies of the climate."9 Christmas was an especially social occasion, and Winifred

Burgess commented on the experience of home visiting on Christmas Eve in 1947, where she was "welcomed and offered more good things than it was wise to accept."10 These examples, while illustrative of human fellowship, also demonstrate the Grenfell

6 Fishers 41.3 (October 1943): 66.

7 "Letters from Labrador," Fishers 41.3 (October 1943): 83.

8 "Letters from Labrador," Fishers 41.3 (October 1943): 84.

9 Wm. Anthony Paddon, "Northern 'Cruise,' Winter 1947-48," Fishers 46.3 (October 1948): 82.

10 Winifred Burgess, "Flowers Cove Household and Social Work," Fishers 46.4 (January 1949): 104.

258 Mission's interest in reassuring Fishers readers that the local people tried in their own simple ways to express their appreciation for the organization and Grenfell staff members."

The Fishers articles also underlined the cooperation, gratitude and appreciation of the people towards in Mission after Confederation with Canada. When reporting on the polio epidemic at St. Augustine (Quebec) in 1950, Donald Hodd affirmed that "...the patients and the parents co-operated flilly, remaining calm and giving every assistance."12

The fact that patients (and parents) were reported as being so cooperative with Grenfell staff confirmed the faith that the people had in the health care delivery of the Mission.

Other articles in the Fishers confirmed the gratitude and appreciation of the people towards the medical and nursing staff. When Nurse Joan Smith opened the new nursing station at Englee in 1952, the people were so grateful that they "immediately had a 'time' and raised $250 which they gave to the nurse to buy anything she liked for the station."13

The appreciation of the patients was also remarked upon by outsiders to the Mission. In

" From a more political perspective, W.H. Davis, Executive Secretary of the Newfoundland Tuberculosis Association, travelled to northern Newfoundland on a health educational lecture tour during the first year of Confederation (1949) and authorized a radio broadcast on his experience. Reprinted in the Fishers, Davis colourfully described his experience in the Grenfell region: To appreciate fully what the Grenfell Mission has done and is going in northern Newfoundland, it would be necessary to go north, visit all the settlements, talk to the people, and see their eyes aglow with affection and gratitude as they recount this tale or that concerning a tragedy averted by the intervention of the Mission, or simply by one of the thousands of long remembered little kindnesses they've received. Yes, indeed, the Grenfell Mission is a veritable saviour in the North and the debt Newfoundland owes it is something not easily measured. If this medical and social welfare service were to be discontinued, it would result in heart-breaking sorrow and pain to hundreds of fishermen, their wives and families." Davis continued that the local residents were worthy of Grenfell services because, "the fishermen of the North are content to live in this remote area, working hard and uncomplaining under the most difficult conditions, producing one of our most valuable exports, with little help from anyone and isolated from the advantages of civilization." See W.H. Davis, "Fight for Health," Fishers 47.2 (July 1949): 50-51. This politicking served the interests of Grenfell Mission as well as the politician himself in order to drum up ideological, social, and economic support.

12 Donald G. Hodd, "Polio at St. Augustine," Fishers 48.1 (April 1950): 4.

13 C.S.C., "Coast Chronicle," Fishers 50.1 (April 1952): 6.

259 1953, the Lieutenant Governor of Newfoundland, Sir Leonard Outerbridge, visited the

Coast and reported his experience at St. Anthony hospital:

...1 went through the wards and spoke to the patients, who numbered over one hundred, and who included several Esquimaux and a few Indians. The happy faces and the freely expressed appreciation of the patients for the kindly expert attention they receive in the bright and friendly atmosphere of the hospital, with its comfortable wards, were good to see and hear and must be encouraging to the doctors, nurses, ward aides and all who work hard and long in this fine hospital.14

This description, from a wealthy politician's point of view, was indeed a Utopian representation of a "fine" hospital, in which the patients were "happy" and "appreciative"

- an "encouraging" work atmosphere for the "kindly expert" medical and nursing staff.

The professional and economic credibility of the Grenfell Mission was supported by these references to the patients' cooperation, gratitude, and appreciation for the staff, and the Fishers confirmed high praise for the Mission in 1959, when it published the "Two

Directors Report" which confirmed that "[i]t was obvious that all the people had great respect and affection for Dr. Curtis."15 The Fishers was clearly trying to reassure its readers, including politicians to whom they applied for government funding, that the

Grenfell Mission was appreciated and wanted on the Coast. The residents of northern

Newfoundland and Labrador were grateful for the Grenfell Mission's presence, they were worthy of Grenfell services, and they expressed this gratitude by being cooperative in medical situations and by being loyal, warm and generous in social situations.

14 Leonard Outerbridge, "A Governor's Visit," Fishers 51.3 (October 1953): 66.

1'Arthur W. Bingham and Andrew Y. Rogers, "Two Directors Report - continued," Fishers 56.4 (January 1959): 104-109.

260 The Nurses' Relations with Members of the Community

Despite the Utopian relationships, the benevolence, and the gratitude of the people expressed in the Fishers, the Grenfell nurses' status in the community occasionally placed them in precarious situations with local residents. The nurses were required to

negotiate with residents about logistics related to the nursing stations or to request assistance with patient transportation, grounds maintenance, fund-raising and other social events. As a result, it was important for the nurse to cultivate harmonious relationships with local residents. However, personal conflicts had been erupting between the Grenfell

nurse and local residents from the earliest days of the Mission on the Coast. In her study of the Grenfell Mission from 1894 to 1938, Jill Perry found that the male residents of northern Newfoundland and Labrador placed a "patriarchal limit" on nurses' professional independence. In particular, Perry argues that "[i]ocal men did not always respond

favourably to the prospect of women 'from away' assuming positions of authority in their communities."16 She highlights Cartwright as being a problematic centre for the Grenfell

nurses: in 1938, Evelyn Poppleton had difficulty procuring the support of local men for

Mission-related projects; apparently, there had been problems there in the past with local

men taking orders from the nurse in charge.17 In 1954, the Grenfell nurses were still

trying to manage the Cartwright station with minimal assistance, and sometimes outright

animosity, from local men. Helen Simpson had been warned by "everyone," including

16 Jill Samfya Perry, "Nursing for the Grenfell Mission: Maternalism and Moral Reform in Northern Newfoundland and Labrador, 1894-1938," MA Thesis, Memorial University of Newfoundland, 1997, p. 121.

17 Perry, "Nursing for the Grenfell Mission," p. 123.

261 Seabrook, that "if [Henry] [was] handled properly, he [could] be very helpful."18 But

Simpson refused to satisfy Henry's agenda and informed Seabrook: "...I'm afraid I fail to see why I should have to be completely servile to him, to get essential foodstuffs and equipment for the hospital, and I refuse to lick his boots, as several of my predecessors have done, and instead have been downright rude - with the desired effect - though I was just afraid that the anger I roused in [Henry] might precipitate one of his heart attacks."'9

Local men often presented a challenge to the nurse's professional and social authority in the community. At Cartwright in 1967, a local resident sent a letter to Paddon complaining of the nurse in charge at the station and claiming that she did not treat members of the community equally. He argued that he had been trying to arrange for the nurse to give his baby a vaccination, but that the nurse would not wake the baby on a home visit to give the needle, did not inform the family when Paddon was in town, and called his wife a liar. He proceeded: "The way this nurse acted, 1 don't consider very becoming of anyone much lone a nurse."20 The situation seems to have stemmed from a misunderstanding between the family and the nursing station. Paddon contacted the nurse about the letter, expressed every confidence in her and did not ask her for any explanation; but suggested that she try to "mend this situation in the interests of general harmony, even if it is entirely the fault of Mr B. No matter how obnoxious he may be I

18 PANL, MG 63, Box 73, File 1728 "Wallace (Simpson), Helen Jeanette," Simpson to Seabrook, 25 October 1954.

19 PANL, MG 63, Box 73, File 1728 "Wallace (Simpson), Helen Jeanette," Simpson to Seabrook, 25 October 1954.

20IGA Archives, File "Cartwright 1965-1969," L.T.B. to Tony Paddon, 23 June 1967.

262 am sure you will see that his child is inoculated at the appropriate time."21 Such misunderstandings occurred in the community when the residents had expectations of the health services provided that were inconsistent with the nurses' professional responsibilities.

If the nurse could not meet this challenge or successfully negotiate with the individuals in question, tensions would escalate and conflict ensue. Wilhomena

Murdoch's posting at Forteau (May 1934-1937), was tarnished by a personal disagreement with a local family, the McCarthys. Bill McCarthy and his son, James,22 owned property adjacent to the Grenfell Mission grounds in Forteau and a controversy developed pertaining to a fence between the two properties. The only primary document that references the situation is a letter from Murdoch to Spalding, 25 May 1935, which naturally depicts her perspective of the conflict and not the McCarthys'. And according to

Murdoch, the Grenfell Mission outdoor workers began piling stones along the outside of the fence (on the McCarthys' property) to prevent the fence from blowing down during a gale. But Bill and James "chucked every one of them back into the garden;" Bill yelled at the outdoor workers and told them they had no right to put anything on his property.

Apparently, Murdoch attempted to explain what they were doing, but Bill became unreasonable, and prompted a tirade from Murdoch in her letter to Spalding:

He said that I was being spiteful. He resents the men working here on the garden and when ever there is a crowd here he comes to try to make trouble. Mr. [James McCarthy] threatened to strike anyone of the men who tried to stop him. There was bother at Christmas time over the ownership of the Community Hall, Mr. [Bill McCarthy] was at the bottom of that as he has written Sir Wilfred a lot of lies with a little truth mixed in

21 IGA Archives. File "Cartwright 1965-1969," Paddon to Louisa," 6 July 1967.

22 Pseudonym.

263 to make it sound alright and this has caused unrest and unhappiness that need not have been. He says that I had no right to come back to Forteau, his reasons for saying this I do not know. Mr. [McCarthy] has always shown jealousy when help has been given to other members of the community but when asked to help us he never has the time. I feel that I cannot continue to live in Forteau while this state of bad feeling exists between myself and one family, as I am convinced that it is a personal dislike that he has and I would like to break my contract if other arrangements cannot be made.23

Evidently, Murdoch had a turbulent personal history with the McCarthys that went beyond the relatively minor disagreement over the fence. The fence fiasco sparked condemnation from Murdoch of the McCarthys in other aspects of community life, which suggests that Murdoch had been holding on to negative feelings towards the family. And although she protested that she did not know why McCarthy would say that she had no right to come back to Forteau, she must have been aware of their personal animosity towards each other when she did return, when they disagreed over the fence, and when she wrote her letter condemning him to Spalding.

At Forteau, Murdoch may have been at least partially at fault concerning the disagreement with McCarthy. Spalding herself had (previously) worked with the Mission at Forteau, but admitted that while she was there "'everything went smoothly"24 and relations were collegial between the Mission and the McCarthys. And while Spalding empathized with Murdoch's predicament in the community, she did not defend Murdoch or condemn McCarthy, but rather pointed out that McCarthy was "the leading man of the place and [had] a tremendous amount of influence,"25 and that she was wise to leave

23 PANL, MG 63, Box 55, File 1295 "Murdoch, Wilhomena," Murdoch to Spalding, 25 May 1935.

24 PANL, MG 63, Box 55, File 1295 "Murdoch, Wilhomena," Spalding to Murdoch, 26 June 1935.

25 PANL, MG 63, Box 55, File 1295 "Murdoch, Wilhomena," Spalding to Murdoch, 26 June 1935.

264 Forteau under the circumstances. When Murdoch finished her contract in 1937, Curtis presented a stronger indictment of her at Forteau in her Report on Staff Members, stating:

She... [w]as often in difficulty with local people and was so devoid of any personality, was never able to get any local support or any loyalty to the mission. It would be a serious mistake to ever have her on mission again and English office should be notified as I believe she intends or wishes to come out again.26

As the examples of Forteau in the 1930s and Cartwright in the 1950s demonstrate,

Grenfell nurses sometimes had difficulty negotiating with male leaders of the community on issues of Mission concern. Their success in this matter often depended on the manner in which they approached local men for assistance. Although Murdoch was present in

Forteau as a representative of the Grenfell Mission and as such carried an authority of her own in the community, that authority depended to a large extent on the residents' acceptance of her and her position. She might have had more success with the McCarthys if she had approached Bill about the fence before her workers began piling stones on his side of the fence. If she had respected his position within the community and involved him in problem-solving, perhaps he would have been more accommodating in such situations.

Controversy and conflict also developed between the nurse and the community if her professional status was unclear or if she and the residents had a different understanding of her job description. In 1967, May Foster arrived at Englee to conduct public health nursing in the region - the first public health nurse in that community. The

Director of Nursing Services, Barbara Nelson, her Assistant, June Kelly, decided to make

Foster's posting "public health" rather than "station nurse" because Englee was close

26 PANL, MG 63, Box 55, File 1295 "Murdoch, Wilhomena," Report on Staff Members by Charles S. Curtis, 21 October 1937.

265 enough to the Grenfell station at Roddickton that all serious cases and maternity cases could be sent there. As a result, Foster was hired as "the Public Health Nurse for

Mainbrook, Roddickton, Englee, Canada Harbour and Williamsport and she [was] located mainly in Englee Nursing Station, keeping that station open especially during the summer months when the fish plant [was] in operation."27 In the meantime, unbeknownst to Foster, a controversy had erupted at Englee long before she had arrived in

Newfoundland. The people of Englee had been demanding a full-time Grenfell station nurse: they did not want to commute to Roddickton for their health care and felt their population was large enough to justify a full-time nurse, and apparently Thomas had agreed. But Foster was not a station nurse, and when arrived at Englee, she "had hardly got through the door before the telephone was ringing asking when the nurse was starting daily clinics."28 Naturally, she was confused by the evident misunderstanding and asked the nurses at Roddickton if they knew what was happening. Her explanatory letter to

Seabrook revealed a complicated and political situation of which she had inadvertently become the centre:

On returning to Roddickton I demanded to know exactly what was going on and then 1 was shown letters of a political nature which were not very tasteful. One stated that I would be indoctrinated on arrival at St. Anthony. I feel that any indoctrination or brain washing should have been done in England before I left. ... I also learnt that my arrival had been broadcast over the radio giving my name to the people of Englee by an M.P. or someone. There are many other details which I cannot write down but apparently this political war has been going on for some months. I immediately decided that I had no intention of being mixed up in this affair and rang Miss June Kelly and told her I was leaving.29

21 PANL, MG 63, Box 6, File 59 "Nelson, Barbara," Seabrook to June Kelly, 24 May 1967.

28 PANL, MG 63, Box 38, File 809 "Foster, May," Foster to Seabrook, 13 July 1967.

:o PANL, MG 63, Box 38, File 809 "Foster, May," Foster to Seabrook, 13 July 1967.

266 Thomas and Kelly convinced Foster to give public health nursing at Englee a trial period, which she did; but she found tremendous hostility there. She summed up her experience to Seabrook: "Public Health work is difficult enough without hostility and a new job is difficult without unpleasant involvement. The people there didn't want me - they had been promised a Station nurse and someone they could call during the night. /1 could not settle there, I couldn't eat or sleep and was most unhappy and worst of all I dreaded going into Englee. I was also told by one person that the people wouldn't do anything to me but there were out for Dr. Thomas."30 The situation at Englee seems to have had escalated to the point of anger verging on violence; and although it was not Foster in particular who was the cause of the anger, she became the symbol of failed negotiations with Thomas for the (promised) station nurse. Foster described Englee as a "shattering experience"31 and told Seabrook that she would never have taken the post if the situation had been explained to her back in London.32 She left Englee one night without informing anyone on the Mission (apart from previously telling Kelly she was leaving, before her trial period); and, forthright to the last, told Seabrook, "...I'm sure you must agree that it is not a part of a nurse's duties to be involved with politics."33

w PANL, MG 63, Box 38, File 809 "Foster, May," Foster to Seabrook, 13 July 1967.

11 PANL, MG 63, Box 38, File 809 "Foster, May," Foster to Seabrook, 13 July 1967.

33 PANL, MG 63, Box 38, File 809 "Foster, May," Foster to Seabrook, 23 June 1967.

" PANL, MG 63, Box 38, File 809 "Foster, May," Foster to Seabrook, 13 July 1967.

267 Racial and Cultural Differences

Cultural differences between the nurse and the white residents of northern

Newfoundland and Labrador were often subtle, based on class biases and usually presented in the form of patronizing language or disagreements over local domestic and/or child-rearing methods. However, racial differences between the nurse and First

Nations families of the region were less subtle, due in part to language barriers, and sometimes resulted in insensitive intrusions into aboriginal family life. The district of

Harrington Harbour contained large settlements of Montagnais (Innu) along the Quebec north shore. While on duty at the hospital in June 1952, Nurse Helen Simpson admitted

"an Indian patient" who was taken from her family in Romaine (north of Harrington

Harbour) by the Grenfell Mission.34 Simpson revealed her own racial prejudices as she described her first-impressions of the baby: "She was indescribably dirty when she arrived...and her habits are quite filthy—not a very good introduction to the Indians, but she is critically ill and won't live long."35 The baby had rickets and was underweight; however, contrary to Simpson's initial predictions, she made a good recovery. She was still at Harrington Harbour in October 1952 when her family arrived from Romaine and removed her from the hospital. Simpson described the event to Seabrook:

My little Indian baby was taken away from me, more or less by storm. The tribe arrived one Sunday afternoon, while I was trying to catch up with my sleep, having been up all Friday night on a midder case, and most of Saturday night with an emergency appendectomy, which Miss Hewitt brought up from Mutton Bay, and they snatched the babe out of the arms

14 PANL, MG 63, Box 73, File 1728 "Wallace (Simpson), Helen Jeanette," Simpson to Seabrook, 16 June 1952.

15 PANL, MG 63, Box 73, File 1728 "Wallace (Simpson), Helen Jeanette," Simpson to Seabrook, 12 July 1952.

268 of the aide on duty, and made off with her, into the woods, against the wishes of Doctor Hodd who tried to reason with them.36

The baby had been away from her family for four months, which must have caused anxiety for her parents and other relatives. However, when they chose to bring the child back home, Simpson described them as having infringed on her authority. Simpson used the language of ownership with regards to the baby, especially with her opening line:

"My little Indian baby was taken away from me...." She also implied that she was victimized by the family, who forcefully took the child away from her "by storm" and

"snatched the babe out of the arms of the aide and made off with her." According to

Simpson, the "tribe" could not see "reason," they took the baby away from the safety of the hospital, and "into the woods." Her language emphasized the lack of "civilization" within aboriginal settlements and the sudden and potentially violent behaviour of aboriginal peoples. She described the event as an underhanded act by the Montagnais, even though it was the Mission that had initially taken the baby from her family. It is unknown whether the Mission sought permission from the family to send the baby to the hospital or if their intentions for the child were adequately communicated or negotiated.

Non-Medical Participation of Nurses in the Community

The participation of nurses within the community, outside of health-related duties, was also a cause of friction for some nurses. Religion could be particularly problematic, especially considering the nature of the Grenfell Mission as a philanthropic organization and its tendency to attract nurses who were interested in bringing their form of

36 PANL, MG 63, Box 73, File 1728 "Wallace (Simpson), Helen Jeanette," Simpson to Seabrook, 12 October 1952.

269 Christianity to the Coast. In the 1960s, Mary Taylor at Forteau became active in religious activities contrary to the Anglican establishment there, and prompted action on the part of the church. After being contacted by an Anglican Bishop of Newfoundland about

Taylor's activities at Forteau, Thomas sent the following message in reply:

12 July 1962 Dear Lord Bishop, This will confirm to you that I have made a trip to Forteau, Labrador, to discuss with Nurse Taylor the complaints that have been made about her concerning her activities involving the Nursing Station, and upsetting the Anglicans who were admitted to the Station at Forteau. I once again pointed out to Miss Taylor the policy of the I.G.A. with regard to religious participation, and that although as an individual she was quite free to go to whatever Church she so desired, it was not in the best interests of the Nursing Station, and the health work she was primarily in Forteau to do, to become involved in any local religious differences, and that the Nursing Station was not to be used to further the programme of any particular group ....I pointed out... that we were not in any way trying to dictate to her, or to influence her in her own particular religious beliefs ... but that she should not involve the I.G.A. in any way.37

Thomas and the Bishop had been in correspondence regarding the religious controversies in Forteau for over five years. Apparently, the Grenfell nurse stationed in Forteau had upset the local Anglican minister and residents of the community by holding Gospel meetings on Mission property. Mary Taylor had joined the Grenfell Mission in 1953. She was a capable nurse and she managed the nursing station at Forteau for over thirty years, despite being politely reprimanded by the Superintendent for her religious zeal. When the controversy first arose in Forteau, Taylor herself wrote to Thomas accusing the Anglican minister of being "a real trouble maker" who went around "'making false accusations"

17 PANL, Gordon Thomas Collection MG 372, Box 35, File "Forteau - 1955-1962," Gordon Thomas to the Lord Bishop of Newfoundland, 12 July 1962. and apparently charging Taylor and an evangelical minister38 of "spreading 'filth' along the coast."39 Taylor seemed to take it for granted that she would be supported by the

Mission in this matter and in her defence she invoked the religious devotion of the

Mission's founder, Wilfred Grenfell. Taylor informed Thomas: "I fail to see that anyone can object to Gospel meetings being held on Mission property and I'm sure Dr. Grenfell would have heartily approved!"40

Whether or not Grenfell would have approved of such disruption in the Labrador community is a subject for conjecture. Wilfred Grenfell was certainly a pious man; he lived his life according to a Christian ethic and he hoped in this way to lead by example.

In the late nineteenth century he found in Labrador the opportunity to combine "the aspirations of a young medical man ... with ... a desire for adventure and definite

Christian work."41 However, Grenfell was never interested in extreme evangelism and proselytization in the same way as other conversion-focused Protestant missionaries of the Victorian period. He did believe spiritual health and physical health were linked and as a result he encouraged faith and prayer among his patients. But he was not driven to

38 George Campbell, an evangelist in Newfoundland and Labrador for thirty years. Campbell was born in Vancouver BC, 1 February 1927, and raised in the San Francisco Bay area of California. During the 1950s and 60s he traveled the Labrador coast by boat, the "Missionary Gospel Messenger", and met Mary Taylor in Forteau. See http://www.gospeIhall.org/index.php?option=displaypage&Itemid=97&op=page&SubMenu= and Mary Taylor, Light on the Labrador, (St. Anthony: Bebb Publishing, 2001).

19 PANL, MG 372 GTC, Box 35, File "Forteau - 1955-1962," Mary Taylor to Gordon Thomas, 4 February 1957.

40 PANL, MG 372 GTC, Box 35, File "Forteau - 1955-1962," Mary Taylor to Gordon Thomas, 4 February 1957.

41 Wilfred Grenfell, The Grenfell Association for Aiding Philanthropic Work Among the Deep Sea

Fishermen of Labrador, [Ottawa, 1907], p. 3.

271 convert. Rather, Grenfell created a social reform and medical mission in Newfoundland and Labrador - one that became increasingly secularized through the course of the twentieth century.

CONFLICT WITH OTHER NURSES

Nurses as Cooperative and Congenial in the Fishers

The official Grenfell discourse presented the nurses as cooperative and congenial with other nurses for the sake of the greater good of the Mission and its philanthropic purpose on the Coast. Articles highlighted the professional arrangements of the nurses in

larger stations, where one nurse would remain at the station to treat patients and the other

would travel throughout the district visiting people in their homes.42 At Flowers Cove,

nurses Smith and Wheeler cooperated to treat a baby girl with burn injuries, ease the girl's discomfort, and distract from her unhappiness at the same time: "Bessie was happy,

though, for hadn't she visited the Nursing Station and didn't Miss Smith let her hold a doll, a big doll that she had brought out to show the baby while Miss Wheeler wrapped

up the baby's burns?"43 The article, "Last Day of a Nursing Station," depicts the cooperation of nurses Burgess and Durley when they efficiently treated the burn victims of a nearby shipwreck and moved into a new building the next day.44 Other articles

42 Charles S. Curtis, "Medical Work," Fishers 44.3 (October 1946): 80.

41 Marjorie Wheeler, "Letters from a Nursing Station: Flowers Cove," Fishers 45.2 (July 1947): 38.

44 Shirley S. Smith, "Last Day of a Nursing Station," Fishers 46.4 (January 1949): 99; and Charles S. Curtis, "New Nursing Station at Flowers Cove," Fishers 46.4 (January 1949): 102.

272 emphasized the "happy atmosphere"45 created by the resident nurses and the warm

welcome provided by nurses towards new staff.46 And Helen Leeson and Ruth Ross were

so agreeable at Flowers Cove that they even composed a seven-stanza poem together,

titled "Ice In June."47 Although there must have been moments of stress, tension, and

disagreement between nurses in the hospitals and stations, the Fishers provided no

examples of such.

Conflict with Other Nurses

Grenfell nurses rarely detailed the daily trials of their work to the secretaries of

the Association; their letters were usually expositions about life on the Coast, the beauty

of the land and sea, or details of a recent adventure. But occasionally their letters

betrayed an eruption of professional antagonisms at the hospitals and stations, which

sometimes caused concern for Grenfell staff and administration. Staffing was especially

important in setting the tone of a station: the right combination of personalities could

create a harmonious and effective work environment, while the wrong combination could

create an unhappy and tense work environment. The Grenfell organization tried to

circumvent staff conflict by gauging the personalities of prospective nurses during

interviews and posting together those who they thought would amicably live and work

together. However, staff conflict on the Coast was inevitable, especially considering the

array of personalities on staff, the intimacy of living and working in the close quarters of

45 Dorothy A. Plant, "Lasting Lure," Fishers 58.4 (January 1961): 104.

46 Elaine Groves Harp, "How Shall I Remember Forteau?" Fishers 60.2 (July 1962): 42.

47 Helen Leeson and Ruth Ross, "Ice In June," Fishers 55.2 (July 1957): 34.

273 a nursing station or small hospital, and the isolated nature of life on the Coast. Indeed,

"the Coast" itself was often considered a catalyst of negative change in staff members whose personalities shifted from pleasant and enthusiastic to difficult and tempestuous.

Seabrook made reference to this Coast phenomenon in 1955, while lamenting their recent staff problems to Betty Fyfe: "people seem to be extremely nice when you meet them, and they are nice, and good workers, but the Coast seems to do something to them, and there have been quite a number of difficulties this year."48 This section discusses staff conflicts within the Grenfell Mission between 1939 and 1981, particularly among nurses.

While the Mission attempted to create an agreeable work environment on the Coast, personality differences and the strain of working in cramped quarters and isolated communities often took their toll and sometimes resulted in spectacular staff conflict.

It was not uncommon for a nurse to have "a stormy beginning"49 on the Coast, as

Paddon referred to one nurse's arrival at North West River in 1954. But perhaps the stormiest beginning was the arrival of Frances Reid50 at Happy Valley in the fall of 1961.

Reid arrived in late September and was so unprepared for life at the station that she wrote to Seabrook on 26 September, stating that she was leaving the Mission and would be back in England within two weeks. She explained:

the living conditions were a big shock to me and the cooking and housekeeping something that I am not prepared to do. I feel that I've made a bad beginning with the Association and although Dr. Paddon has been most kind I am not happy about staying on at this stage.51

48 PANL, MG 63, Box 10, File 140. Folder 1 "Betty Fyfe," Seabrook to Fyfe, 12 October 1955.

49 PANL, MG 63, Box 9, File 122 "Tony Paddon," Paddon to Seabrook, 3 January 1954.

50 Pseudonym.

51 PANL, MG 63, Box 48, File 1076 "[Frances Reid]," [Reid] to Seabrook, 26 September 1961.

274 According to Shirley Smith, Seabrook was "furious at that one, [Reid], who apparently left the minute she arrived, and Seabrook [could not] understand it at all, as [Reid] seemed particularly co-operative and said she didn't care where she went [on the

Coast]."52 Smith herself felt that Reid must have been "a schizophrenic,"53 since her behaviour was so extreme - both her enthusiasm during her London interview and her panic at the station. However, despite her initial shock and her determination to return to

England, Reid ultimately decided to stay with the Mission. Paddon convinced her to try

North West River for a few weeks, which she did, and she came to enjoy the work. In fact, at the end of October, and again in December, she spent a week substituting for another nurse at Happy Valley and informed Seabrook that Paddon was planning to send her to the Valley permanently. Obviously, Reid overcame her initial misgivings about life at the Valley. However, as Smith pointed out in a letter to Thomas, "no one will ever know what really happened the day she arrived at Happy Valley."54 Whatever happened was significant enough to prompt her to resign within days of her arrival. Reid herself admitted to being overwhelmed with the Valley and unprepared for certain domestic duties; but there also seems to have been serious conflict between Reid and the other

Grenfell nurse already stationed at Happy Valley, Eleanor Lewis.55 Reid told Seabrook that her week at the Valley in December was a test to see how she and Lewis got along, and to determine whether a permanent transfer would be feasible. She also admitted that

52 PANL, MG 372, Box 3, File "Correspondence 1961," Shirley Smith to Gordon Thomas, 2 October 1961.

53 PANL, MG 372, Box 3, File "Correspondence 1961," Smith to Thomas, 9 October 1961.

54 PANL, MG 372, Box 3, File "Correspondence 1961Smith to Thomas, 27 October 1961.

55 Pseudonym.

275 she and Eleanor were then working well together, but that she knew Eleanor would

"never quite forgive [her] for the way things were the first week and has said so."56

Paddon also noted that "[Eleanor had] been progressively less hostile to [Reid]," and that the two "[seemed] to be working together fairly satisfactorily."57 In the meantime, Shirley

Smith's response when she learned that Reid and Lewis were working well together was:

"Oh, hum, who knows?"58

Smith summed up the impossibility of predicting whether or not staff members would work well together on the Coast. Frances Reid had clashed so much with Eleanor

Lewis at Happy Valley that she was immediately determined to resign; yet, three months later, the two were "getting on amicably."59 Those Grenfell members involved with staffing the Coast put tremendous effort into combining suitable personalities in each station and hospital. The secretaries of the Association often corresponded with Dr.

Thomas and the Staff Selection Committee about who they thought would clash and who they thought would agree. For example, in 1960, Seabrook informed Shirley Smith at the

Boston office that she felt that Muriel Ingalls, who was an older nurse, would be "a good person for a young nurse to work with."60 And indeed, the Grenfell Mission found the right mate for Ingalls in Mary Terryberry, who enjoyed working with Ingalls and in 1963

56 PANL, MG 63, Box 48, File 1076 "[Frances Reid]," [Reid] to Seabrook, 3 December 1961.

57 PANL, MG 63, Box 9, File 122 "Tony Paddon," Paddon to Seabrook, 13 December 1961.

58 PANL, MG 63, Box 13, File 217, Folder I "New England Grenfell Association," Smith to Seabrook, 4 January [1962].

59 PANL, MG 63, Box 13, File 213, Folder I "New England Grenfell Association," Smith to Seabrook, 4 January [1962].

60 PANL, MG 63, Box 13, File 217, Folder I "New England Grenfell Association, 1944-1963" Seabrook to Smith, 30 November 1960.

276 hoped for another posting with her.61 A similar situation arose with Dorothea Fooks and

Ruth Ross in 1957: Seabrook gauged Fooks to be "a very fine woman" who would "take most things in her stride and keep her thoughts to herself."62 She also told Thomas that although Fooks was older than Ross, she thought they "should get on well together" because Fooks "[did] not mind working with someone who [was] so much younger."63

Furthermore, the Grenfell administration often encouraged individuals to accept posts based on the personalities of those nurses already stationed there: in 1957, Seabrook felt that Joan Richards would "probably get on with [Kathleen] Lutley better than Sheila

Rawlings," so she wrote to her "to tell her that there [was] a vacancy at Happy Valley," where Lutley was posted.64

It was often only after nurses had been on the Coast for several months (or years) that significant conflicts arose, and most disagreements occurred when the wrong personalities were posted together. Sometimes a nurse was successful on her own, in a one-nurse station, but had difficulties with a specific coworker in a two-nurse station - such as Lesley Diack, who worked well by herself but was reported to have had difficulties with Sheila Rawlings at Flowers Cove.65 In most cases, problems arose if two strong personalities clashed. However, there were also instances when two nurses did not

61 PANL, MG 63, Box 13, File 217, Folder 1 "New England Grenfell Association, 1944-1963," Seabrook to Smith, 19 November 1963.

6" PANL, MG 63, Box 13, File 217, Folder 2 "New England Grenfell Association, 1944-1963," [Seabrook] to Smith, [September 1957].

63 PANL, MG 63, Box 13, File 217, Folder 2 "New England Grenfell Association, 1944-1963," Seabrook to Thomas, 1 July 1957.

64 PANL, MG 63, Box 13, File 217, Folder 2, "New England Grenfell Association, 1944-1963," Seabrook to Smith, 19 September 1957.

65 PANL, MG 63, Box 35, File 738 "Ivy Constance Durley," Seabrook to Durley, 20 December 1955.

277 necessarily clash, but their combination wreaked havoc for other members of staff. For example, Gwendoline Bloomfield and Phyllis Wenyon did not fit in at St. Anthony, and according to Curtis, "most of the trouble was their own fault."66 As a result, the two were separated for a summer: Bloomfield to Spotted Islands and Wenyon to North West River.

Wenyon did good work while Bloomfield was at Spotted Islands, but when she returned to North West River in the fall, "trouble began." Apparently, they were critical of the people and of other staff members, especially the Newfoundland school teachers and the

American physicians and dentists. Curtis described Wenyon alone as "a fair nurse, a hard worker and a willing worker, but the combination with Bloomfield [was] bad."67

Bloomfield he described as "a crude, uneducated, poorly-trained woman who completely

[dominated] Miss Wenyon, and [was] constantly looking for trouble and [stirred] Miss

Wenyon up."68 Curtis's solution was to keep the two separated as much as possible. He refused to accept Bloomfield back on staff, but was willing to consider Wenyon on her own.

A more problematic combination occurred at Cartwright in 1954-1955. Helen

Simpson transferred to the small hospital in October 1954 and had difficulty settling down there, even though she had requested the transfer herself. By January 1955, there was tremendous friction at the hospital between Simpson and Dr. Coetsee, on the one hand, and Annie Rhodes and Miss Weaver on the other. At the time, Rhodes was superintendent of the Dormitory and Weaver was her assistant. While exact details of the

66 PANL, MG 63, Box 26, File 493 "Gwendoline Bloomfield," Curtis to Seabrook, 12 January 1942.

67 PANL, MG 63, Box 26, File 493 "Gwendoline Bloomfield," Curtis to Seabrook, 12 January 1942.

68 PANL, MG 63, Box 26, File 493 "Gwendoline Bloomfield," Curtis to Seabrook, 12 January 1942.

278 tension are not known, Curtis and Seabrook concluded that the fault lay with Simpson and Coetsee. Simpson had written a letter to Ethel Graham (through which, Seabrook felt, she had "given herself away")69 stating: "Unfortunately, on the Mission all is not well.

This is a house very much divided against itself and the petty bickering, backbiting and two-facedness, even open and violent rows...."70 In the meantime, letters from Rhodes and Weaver did not betray the slightest of problems with other staff members (which

Seabrook felt was "very tactful and loyal.")71 Simpson also wrote to Seabrook, full of blame towards Rhodes and Weaver, stating that there was "mounting tension and unpleasantness at the Dormitory," and that she had "the unenviable position of intermediary" between Rhodes/Weaver and the schoolteachers who were not on speaking terms.72 After the debacle, Simpson and Coetsee wrote letters of apology to Curtis, which

"[did] not appeal to [Curtis] at all."73 And, despite Simpson's attempts at presenting herself as peacemaker, Curtis and Seabrook defended Rhodes and agreed that "Dr.

Coetsee and Helen Simpson [had] not been all that they should. Dr. Coetsee, as the

Medical Officer in charge, should have remained impartial, but apparently she [had] taken sides."74 Seabrook concluded that "it [was] the old story of the wrong people being

69 PANL, MG 63, Box 9, File 113, Folder 3 "Charles Curtis,'- Seabrook to Curtis, 17 February 1955.

70 Quoted in PANL, MG 63, Box 9, File 113, Folder 3 "Charles Curtis," Curtis to Seabrook, 14 February 1955.

71 PANL, MG 63, Box 9, File 113, Folder 3 "Charles Curtis," Seabrook to Curtis, 17 February 1955.

12 PANL, MG 63, Box 73, File 1728 "Helen Jeanette (Simpson) Wallace," Simpson to Seabrook, 21 January 1955. n PANL, MG 63, Box 9, File 113, Folder 3 "Charles Curtis," Curtis to Seabrook, 18 March 1955.

74 PANL, MG 63, Box 13, File 217, Folder 2 "New England Grenfell Association," Seabrook to Smith, 28 February 1955.

279 cooped up together,"75 and Curtis decided to "clean out the whole bunch that [was]

there."76

Occasionally there was one individual at a hospital or station who seemed to

individually cause the majority of conflict among staff members. In April 1973, Lillian

Smythe was on furlough in England when she encountered Dolores Brown,77 a Grenfell

nurse who had worked with her at North West River. Brown was excited about having

been accepted back into service for that hospital. However, Smythe knew nothing of

these arrangements, which had apparently been made through Tony Paddon, even though

she had been Director of Nursing Services at North West River for over two years.

Smythe's correspondence that followed her meeting with Brown illuminates the depths of

professional conflict that had developed at North West River between several Grenfell

nurses. Dolores Brown was blamed for most of the friction at the station, and also for

previous staff problems at St. Anthony, where she worked before her transfer to North

West River. In fact, the Director of Nursing Services at St. Anthony (Elizabeth Goldie),

filed a negative report against Brown in Ottawa and warned Harry Scrimegour, Grenfell

physician at North West River, "in no uncertain terms [about] [DoIores]'s character."78

Brown did not seem to perform any better at North West River, because Smythe, as

Director of Nursing Services there, suspended her from duty because of her lack of ability as a nurse, her inconsistency, her inability to get along with the other nurses and

75 PANL, MG 63, Box 13, File 217, Folder 2 "New England Grenfell Association," Seabrook to Smith, 28 February 1955."

76 PANL, MG 372, Box I, File "Curtis 1954-55," Curtis to Thomas, 5 April 1955.

77 Pseudonym.

78 PANL, MG 63, Box 67, File 1595 "Lillian Smythe," Smythe to Yates, 29 April 1973.

280 "the trouble she made as an agitator."79 Therefore, when Smythe learned that Brown was planning to return to North West River, she became immediately distressed and

"consulted Joyce Paul about her feelings on the matter as she was the one most badly hit by Dolores, she immediately turned blue and white and declared she would leave or transfer."80 Smythe admitted to feeling the same way. She did not elaborate on what had happened between Brown and Paul, but it was significant enough to prompt Brown to write a letter of apology to Paul (which Smythe qualified as being "2-3 years late"81) before her planned return to North West River.

In the meantime, Paddon was apparently unaware of the problems that existed between Brown and the rest of his staff. In her Staff Suitability Report, which supervisors filed at the end of an employee's contract, Paddon stated that Brown's professional ability had "improved from satisfactory to excellent;" that her personality and attitude were "excellent;" that she was a "pleasant helpful girl - conscientious and forceful;" and that there were only rare occasions when she was not cooperative with other staff members, but "she was more than justified when she took a stand once or twice."82 In fact, Paddon highly recommended her for re-employment: "May rejoin IGA, if application received - should be appointed!!!"83 For whatever the reason, Paddon clearly disagreed with Smythe's assessment of Brown. At the time during which Brown was

79 PANL, MG 63, Box 67, File 1595 "Lillian Smythe," Smythe to Yates, 29 April 1973.

80 PANL, MG 63, Box 67, File 1595 "Lillian Smythe," Smythe to Yates, 29 April 1973.

81 PANL, MG 63, Box 67, File 1595 "Lillian Smythe," Smythe to Yates, 29 April 1973.

82 PANL, MG 63, Box 31, File 631 "[Dolores Christine Brown]," Staff Suitability Report, by Tony Paddon, August 1971.

81 PANL, MG 63, Box 31, File 631 "[Dolores Christine Brown]," Staff Suitability Report, by Tony Paddon, August 1971.

281 causing problems for the staff at North West River, Smythe did not complain to Paddon

about her because she wanted to keep problems with her nurses at her level of

administration, and also because Brown "was socially in the good graces of [the] Paddons

and Scrimegours."84 So he was not aware of the friction Brown created at the hospital

when he agreed to her reappointment. However, he also did not consult Smythe, his

Director of Nursing Services, about her opinion of Brown's nursing abilities or her

experiences with Brown on staff. For that reason, Smythe felt that Paddon had "kicked

below the belt again" and she was considering resignation from the Mission.85 Smythe

admitted that she was in a difficult position and wrote plainly to Yates: . .Dr. Paddon

should have consulted me really and I would have told him, this is the 2nd time I have

had this problem and really I could not repeat it, I would rather go."86

CONFLICT WITH THE PHYSICIANS

Nurses' Deference to Physicians in the Fishers

A prominent theme surrounding the portrayal of nurses in the Fishers concerned the deference of the nurse to physician authority. This was one of the most common methods the Fishers used to reassure its readership that the nurses, despite their extraordinary working circumstances, were accountable to the Grenfell physicians and the institution and thus fell in line with the "traditional" structures of social hierarchical

84 PANL, MG 63, Box 67, File 1595 "Lillian Smythe," Smythe to Yates, 29 April 1973.

85 PANL, MG 63, Box 67, File 1595 "Lillian Smythe," Smythe to Yates, 13 May 1973.

86 PANL, MG 63, Box 67, File 1595 "Lillian Smythe," Smythe to Yates, 29 April 1973.

282 male power commonly accepted by mainstream society. The administration may have feared that doing otherwise could have potentially presented losses in public sympathy and donor funding for an institution which relied on that kind of support to offer its regional services. Additionally, the gendered divisions (and class) in their workplace and home-life were so ingrained that this type of behaviour was often unconscious, unquestioned, and matter of fact. Illustrating these points, the Fishers sometimes portrayed nurses with the Grenfell Mission as assistants to the local physician in language reminiscent of Barbara Melosh's study, "The Physician's Hand": Work Culture and

Conflict in American Nursing}1

The Grenfell Mission had complete control over what was published in the Fishers, and its editorial policy determined what was written by nurses and about nurses. As a result, the language used to represent the deference of nurses towards physicians cannot be uncritically accepted as conclusive. In keeping with the stereotype that the quintessential Grenfell nurse recognized her professional place within the medical hierarchy and that she acquiesced to physician authority, Dorothy Jupp's articles to the

Fishers frequently portrayed her as being relieved when a Grenfell physician arrived at her station. In the winter months, the doctor's visits to a station usually spanned several weeks. In that time, many local patients would be waiting to have their medical conditions assessed by the Grenfell physician, particularly when he would be the authority for diagnoses and treatment which effectively tied the hands of nurses like Jupp until the physician arrived. For example, Jupp wrote: "We were glad to see him when he

87 Charles S. Curtis, "The Mission's Fiftieth Year," Fishers 40.2 (July 1942): 46. See Barbara Melosh, "The Physician's Hand": Work Culture and Conflict in American Nursing, (Philadelphia: Temple University Press, 1982).

283 arrived. It was so long since a doctor had visited us for any length of time and there were so many medical problems waiting for him."88 Jupp expressed similar relief during the fire emergency at St. Mary's River in 1945. Although Jupp was instrumental in evacuating patients and equipment from the station, her article on the event in the Fishers gives credit to "Dr. Miller" who showed up on the Maraval "at the most critical time" and Jupp claimed to have been "most heartened by the arrival."89 Jupp remained self- effacing in the article (another valued Grenfell characteristic): she downplayed her own role in the emergency and gave credit to Miller, the local men, and the crew of the

Maraval. Jupp's circumstances illustrate how the gendered divisions between the nurses' feminine receptive, resourceful assistant role and the physicians' masculine dominant and authoritative role, often hindered the health of individuals and communities. Yet, those individuals and communities adhered to these gendered divisions as well, and nurses were able to contribute their leadership within their accepted roles to a certain degree.

Thus, if nurses felt that they were not adequately prepared to treat the conditions of a patient, they were encouraged to contact a Grenfell physician for urgent advice. In fact, the nurses were reported to "do all they [could] and it any real emergency [arose] they callfed] for a Doctor from St. Anthony."90 Despite the excitement nurses felt with practising in an isolated region and without a physician in the vicinity, which is reflected in the private correspondence, the ASDF detailed several incidents in which a station nurse contacted a physician for advice on an urgent case. Curtis's promotional article,

S8 Dorothy M. Jupp, "Doctor's Visit," Fishers 43.1 (April 1943): 9.

IW Dorothy M. Jupp, "Holocaust at St. Mary's," Fishers 43.3 (October 1945): 68-69.

1,0 E. Terry Hunt, "A Dentist With the Grenfell Mission," Fishers 46.3 (October 1948): 85.

284 "Heroines," stated that it was customary for nurses to wire the doctor for advice on the treatment of a patient - the physician would provide valuable medical information to the nurse, suggest next steps for treatment, and, if necessary, make arrangements to visit the station/community or have the patient brought to him at a hospital.91 For example, Nurse

Laura Thompson was placed in charge of the hospital at Harrington Harbour during the war, due to the retirement of Donald Hodd and the impossibility of finding a replacement medical officer for the hospital during the war. Apparently, one week after Thompson had been left in charge of Harrington, she wired Curtis about "a patient with a strangulated hernia."92 Thompson informed Curtis of the treatment she had administered to the patient and asked for further advice. According to the Fishers article, Curtis approved of the treatment and wired her back that "her treatment was all that could be done. The next day she was able to wire [Curtis] that she had succeeded in reducing the hernia and the patient was out of danger and comfortable."93 This 'heroic' nursing story epitomized the Fishers ideal of a Grenfell nurse - Thompson was competent enough on her own to successfully treat the sick patient, but she still sought the advice, confirmation, and approval of a Grenfell physician whose education and skills were typically more advanced.

In some cases, the nurse's diagnostic abilities were confirmed by the visit (or the wireless communication) of a physician. For example, in 1946, Nurse Evelyn Poppleton

"diagnosed a very serious condition in a young woman, telegraphed to St. Anthony and

91 Curtis, "Heroines," p. 45.

K Curtis, "Heroines," p. 45. n Curtis, "Heroines," p. 45.

285 Dr. Smyth went on dogs, two or three days on the trip. On arrival he confirmed Miss

Poppleton's diagnosis. Patient was a serious operative case and it was impossible to convey her to a hospital by dogteam. There were no airplanes available. So, on a kitchen table a serious abdominal operation was performed and the patient was saved."94

Poppleton was credited for diagnosing the patient's condition, but she deferred to the physician's authority in confirming the diagnosis and allowing him to take over the patient's treatment. Likewise, Dorothy Jupp was similarly praised for contacting St.

Anthony in the event of an obstetrical case beyond her expertise; Curtis wrote: "During one of the worst storms of the season... Miss Jupp was faced with one of the most difficult and serious obstetrical complications, entirely alone on her own resources. It was impossible for us to send her any aid, owing to the storm, and we could only advise her by wireless."95 The story had a happy ending, as Jupp saved the life of both mother and son. These examples demonstrate how the Fishers and the Grenfell Mission adhered to gendered discourse based on the prominent social structures allotted for women and men during the period.

Clearly, deference to physician authority was a common recurring theme in the

Fishers during the 1950s. When combating the polio outbreak at St. Augustine in 1950, the resident nurses in the community earned the doctor's approval when "...she realized the arduous task the nurses had been called upon to undertake and the excellent work they had done."96 "Coast Chronicle," of 1952, praised the advent of radio-telegraph

94 Charles S. Curtis, "Medical Work," Fishers 44.3 (October 1946): 81.

93 Charles S. Curtis, "Note of Thanks," Fishers 46.4 (January 1949): 117.

% Donald G. Hoss, "Polio at St. Augustine," Fishers 48.1 (April 1950): 4.

286 system for providing "...nurses at the nursing stations an opportunity to consult with Dr.

Thomas, Dr. Paddon or Dr. Hodd regarding complicated cases in which they need advice."97 The radio-telegraph proved invaluable to the Grenfell Mission in the postwar period for maintaining important communications between the isolated nursing stations and the Grenfell hospitals. For instance, in 1953, Nurse Ivy Durley was able to maintain the life of a sick child by receiving instructions from Thomas over the radio-telegraph:

.. .Miss Durley notified up by radio-telephone, of a critically ill child, in a coma, who was admitted to Flower's Cove. By her description of the case, we diagnosed tuberculosis meningitis, but owing to the bad weather, we could not go to Flower's Cove, or have the child transferred here. Therefore, we instructed Miss Durley to treat the child herself until we could transfer her here. This she did, and very ably did daily lumbar QQ punctures, injecting streptomycin. This undoubtedly kept the child alive.

The Fishers rarely mentioned the precise medical procedures that nurses would perform on the Coast, but this case may have been considered exception for emphasizing the importance of radio-telephone sets for allowing the nurses to receive formal instruction from a Grenfell physician. Besides the gendered politics implicit in these examples, part of the Fishers' reasoning behind this portrayal of the usefulness of the technological network set up within the Grenfell services may have been to show the quality of

Grenfell services, but also to cater to the increasing need for government funding, discussed earlier (in section 4). The Fishers reported on several other nurses contacting a doctor for advice, instruction, or approval." To confirm the nurses' professional status on the Coast in terms of the medical hierarchy, the Fishers underlined the fact that the

07 C.S.C., "Coast Chronicle," Fishers 50.1 (April 1952): 5.

08 Gordon W. Thomas, "Coast Chronicle, Fall 1952," Fishers 50.4 (January 1953): 104.

)q See for example, Gordon W. Thomas, "Coast Chronicle: All in the Day's Work," Fishers 51.3 (October 1953): 83; and Lesley Diack, "The True Story of Our 'Siamese Twins,'" Fishers 53.1 (April 1955): 5.

287 Grenfell nurses recognized cases that were beyond their experience, and in such cases they would make arrangements for the patient to see a Grenfell physician.100 For the

Fishers, its readership, and the nurses themselves, this type of "common-sense" attitude and approach was popularly illustrative of the nurses' leadership as they fulfilled their maternalist roles for the Grenfell Mission in these regional communities.

Conflict with Grenfell Physicians

In October of 1959, a physician with the Grenfell Mission in North West River wrote to his colleague in St. Anthony pouring out his frustrations with the behaviour of one of the nurses. The nurse in question was Dorothy Jupp,101 a senior Grenfell nurse who had been employed in district nursing in Labrador since 1938. Apparently, Jupp had neglected to report an outbreak of measles, mumps and pneumonia in her community during which time two children died. Dr. Paddon argued that Jupp should have contacted him via radio; he could have advised her and evacuated her worst cases, which may have changed the tragic outcome. He proceeded to criticize Jupp's professionalism as a nurse and stated, "[t]his is the sort of thing that has bothered me for some years with her. She is absolutely independent. She does not consider herself a part of the medical team and she does not seem to want any help or advice about cases. I am sure she thinks of herself as a

100 Charles S. Curtis, "A Flying Trip to Labrador: Winter Style," Fishers 55.1 (April 1957): 6.

101 Dorothy Jupp was a British nurse, born in London. She attended Mayday Hospital in London for her nurses and midwifery training. She left England in 1938 and became a district nurse for the Labrador Development Company in Port Hope Simpson, Labrador. When the war started Jupp's work with the lumber company came to an end and she was offered a job with the Grenfell Mission at their station at Mary's Harbour. See IGA Archives, Box Dorothy Jupp, File "Dorothy Maud Jupp," "Dorothy Jupp, 1909- 1986."

288 Doctor rather than a Nurse."102 Dr. Paddon wanted Jupp removed from his district of northern Labrador. This episode was the culmination of several years of friction between

Dr. Paddon and Dorothy Jupp. Paddon was the physician at Northwest River and had medical jurisdiction over the northern section of the Labrador coast. Jupp was a nurse in his district and therefore, according to the structure of the Grenfell Mission, came under his authority. However, Paddon was only occasionally present in the communities where nurses practiced; he was primarily based at the hospital at Northwest River and would travel throughout the district at certain intervals during the year. While the majority of the nurse's work was associated with gender- and nursing-appropriate behaviour, she was the person immediately responsible for the people's health and had to rely on her own judgements on a daily basis.

The Jupp-Paddon conflict highlights several themes concerning the negotiation of professional boundaries within the Grenfell Mission. First, the Mission often attracted strong personalities of women to work in its Newfoundland and Labrador establishment.

These women were usually thrilled with the level of medical responsibility and independence from patriarchal authority that nursing with the Mission offered. However, the nurses' position in the Mission was of a contradictory nature - they had a significant amount of professional responsibility and freedom, but they were still situated within a paternalistic medical system. They were expected to use their own judgments to provide appropriate medical care but they were also expected to refer and defer to a physician whenever necessary. Second, although most nurses were apprehensive and nervous at the start of their Grenfell careers, especially with the prospect of so much responsibility on

102 PANL, MG 372, Box 32, File "Dorothy Jupp 1959-1961," W.A. Paddon to Gordon Thomas, 31 October 1959.

289 the stations, as they met the demands of nursing in the unforgiving coastal environment they became increasingly confident in themselves and their abilities. Third, nurses on the stations frequently came into conflict with physicians in the process of performing their duties, especially when the physician felt they had over-stepped the boundaries of their profession. With their developed self-confidence, some nurses became proactive in challenging the patriarchal conventions and regulations imposed by Grenfell personnel and the institution. Finally, the Grenfell station nurses sometimes resisted and challenged the gender-based medical hierarchy of the organization. Taken together, this chapter argues that as nurses met the challenges they faced on the nursing stations and negotiated their professional boundaries, they often came into conflict with physicians and administrators and developed the confidence to resist the dominant patriarchy of the

Grenfell medical institution.

As demonstrated by the Jupp-Paddon controversy, the Grenfell nurse sometimes came into conflict with the physicians as she met the demands of a nursing station.

However, Grenfell nurses did not often realize their own strength and abilities until they had some experience on the Coast. Campbell admitted that during her first two years with the Grenfell Mission she did not realize how valuable she was, but after a year on leave she returned to Labrador with a new attitude, stating, "1 knew I could come back on my own terms."103 Her early years nursing with the Mission taught her that the organization needed her, needed her abilities, and needed her services. This helped her become more self-confident and more assertive in negotiating her position with the Grenfell Mission.

Jupp's independence developed over years of living and nursing is extremely isolated

"" Campbell, Telephone interview, August 2004.

290 circumstances; she was stationed in some of the most northern communities in Labrador.

As a result, Jupp learned self-reliance. On the stations, Grenfell nurses did not know what

kinds of cases were going to come through the door, but they knew they had to deal with

whatever came their way. Furthermore, although most stations, by the middle of the

twentieth century, were equipped with radio-telegraphs to assist with communications,

the nurses sometimes could not reach a physician for advice if he was away on a medical

trip. The pressures on a lone nurse in the often snowbound communities of northern

Labrador can only be imagined. Years of dealing with unexpected medical situations

helped to develop Jupp's confidence in her own abilities and this, in turn, encouraged her

independent nature that so offended Paddon. One of Paddon's main criticisms of Jupp

was that, in his estimation, she was "absolutely independent" and she did not want

interference or assistance from other medical personnel.104

Grenfell nurses occasionally became unhappy in the Mission hospitals, where

they took direct orders from the physician in charge and where they were required to

follow formal medical procedure. Hospital nursing was perceived as the primary cause of

friction between Jupp and Paddon. From 1951-1959, Jupp nursed in Nain, a larger health

care centre in northern Labrador. She had a tremendous amount of independence from

medical authority and after years of nursing by herself on isolated stations she also had a

great deal of confidence in her abilities.105 Paddon believed that the problem stemmed

104 PANL, MG 372, Box 32, File "Dorothy Jupp 1959-1961," W.A. Paddon to Gordon Thomas, 31 October 1959.

105 Cynthia Toman identifies similar difficulties that military nurses experienced after the Second World War, when they returned to conventional hospital roles and found themselves unable to use the skills they acquired during the war. See Cynthia Toman, An Officer and A Lady: Canadian Military Nursing & the Second World War, (Vancouver and Toronto: UBC Press, 2007), 202.

291 from Jupp's unhappiness with hospital work and in-patient care. He intimated to her that she would be all right in a small station, on her own, and/or in district work. Jupp perceived "the hospital" as the only source of disagreement between herself and Paddon and she was certain their professional relationship would improve if she were transferred to a station in his district. However, Paddon's criticisms of Jupp ran much deeper. In

October 1959 he informed his colleagues in the Grenfell Mission, "1 do not think she can be depended on to take any responsibility, without the very closest supervision. I doubt that she is well enough informed medically - even if she were willing to be co operative."106

At this point in her career, Jupp had been nursing in remote communities of

Newfoundland and Labrador for twenty-three years and had been in Nain since 1951. She was an eminently qualified nurse, she knew the people of northern Labrador, and she had even learned to speak their language. Charles Curtis, who was then medical superintendent of the Grenfell Mission, appreciated her value to the organization; he disagreed with Paddon's assessment, and defended her to Paddon in the fall of 1958:

I saw Dr Paddon in New York in November and he told me frankly that he didn't wish you back at Nain. Most of his reasons I thought were not justified, and I told him that as long as he was in charge of Nain station he and the nurse must get along well together ... that when you were at St Mary's River you did excellent service and that you were a pioneer nurse under the most extraordinarily difficult conditions in the early days at Hope Simpson. I told Dr Paddon frankly my opinion of you and told him that I would do everything possible to see that you had a station on this Mission but... it would be unwise for you to go to Nain.107

106 PANL, MG 372, Box 32, File "Dorothy Jupp 1959-1961," W.A. Paddon to Gordon Thomas, 31 October 1959.

107 PANL, MG 372, Box 32, File "Dorothy Jupp 1959-1961," Charles S. Curtis to Dorothy Jupp, 19 March 1959.

292 Thomas was also in favour of keeping Jupp on staff in northern Labrador and he even recommended her transfer to Hebron, knowing that Paddon would disagree.108 The crux of the conflict between Jupp and Paddon revolved around her independence from his direct authority and became manifest in the nature of "station" versus "hospital" work.

Jupp disliked hospital work and in June 1959 she threatened to resign rather than transfer to a hospital: "1 have decided to return to England as soon as I can, unless I can get a post on the Labrador only ... 1 do not feel inclined to go into a Hospital, and as you intimated in your letter, you felt I would be happier in a District Nursing place."109

It is difficult to determine the degree to which hospital structure or routine was the root of the problem between Jupp and Paddon. What is significant is that both of them perceived their disagreement as stemming from hospital work - Paddon emphasized that

Jupp did not sufficiently understand hospital procedure and Jupp stated that she was happier working alone on the stations. However, although she preferred station work,

Jupp had trained as a hospital nurse and would have been familiar with its respective protocol. Why did such a disagreement erupt between the nurse and physician? Is it possible that Jupp had become so accustomed to the independent nature of nursing on the stations that she genuinely lost the ability to meld into the hospital structure? Did Jupp purposely cause problems for Paddon because she was unhappy with her duties there and wished for even more professional independence? Or was Paddon the source of the conflict? Did he resent the independence that the woman exerted and her lack of regard for male authority? In any instance, it is clear that Jupp had become highly qualified for

108 PANL, MG 372, Box 32, File "Dorothy Jupp 1959-1961," Gordon W. Thomas to Charles S. Curtis, 6 July 1959.

109IGA Archives, File "Makkovik, Miss Jupp," Dorothy Jupp to Tony Paddon, 28 June 1959.

293 station work and was uncomfortable nursing within the formal medical hierarchy that defined the hospital experience. Furthermore, from the perspective of the physicians, it was only Paddon who experienced outright conflict with Jupp; both Curtis and Thomas appreciated her contribution to the medical services of northern Labrador and, because of this support, Jupp won the battle against Paddon.

Several nurses voiced complaints regarding Paddon's disregard for their abilities and their authority, a disregard that was even obvious in the presence of patients.

However, most of the complaints regarding physician conduct towards nurses did not reach official channels. It is oral histories that provide a window into the nurse-physician relationship not evidenced in official documents. In an August 2004 interview, Campbell commented on "a considerable element of staff abuse" toward the nurses.110 The expectation level placed on nurses was enormous, especially on the stations; but the

Mission did not acknowledge that level of expectation. In remembering her days nursing at Happy Valley, Campbell recalled, "we were totally reliable and ... managed extremely well ... but the minute something went wrong She also remembered "being let down more than once in front of patients" by Paddon.112 According to Campbell, many of the nurses felt overworked and underappreciated by the authoritarian attitude of the

Grenfell Mission. The boundaries between traditional nursing and medical work - in other words, the boundaries of Grenfell nursing - were so blurred that Campbell doubted if the Mission authorities actually realized what they expected of their nurses and what

110 Campbell, Telephone interview. August 2004.

111 Campbell, Telephone interview, August 2004.

112 Campbell, Telephone interview, August 2004.

294 their nurses did in providing essential health services to the people of Newfoundland and

Labrador.

It was not only with Paddon that the Grenfell nurses came into conflict; another clash occurred between Diack and Thomas. Diack was stationed at Forteau for two years.

She began her tenure there in optimistic spirits and felt that she was fulfilling her destiny.

Many of her patients through the winter were emergency deliveries, and in one case,

Diack had to manually remove the placenta of a woman who had just given birth, a procedure that required her first attempt at giving an anaesthetic. The life of the mother was clearly in her hands and the ordeal caused Diack a great deal of stress. However, her second winter in Forteau brought her "the greatest trial of all, that of dealing with a paranoid personality in isolated circumstances."113 Very little is known about this situation except what Diack describes in her memoirs: "the paranoid stirred up more and more trouble, it was like having a poison pen maniac in our midst. I was so alone with it all, and it was so intangible, that at times it was difficult even to be sure of my own judgment. That others doubted it was made plain on one of the doctor's rare visits, and the more I tried to convince him of the horror of the situation, the more powerless I felt to convey one half of it."114 The doctor did not entirely trust the judgment of Diack in this situation. He remained wary of her diagnosis and his lack of support contributed significantly to her problems and unhappiness in the community. However, the situation was resolved when "finally no-one could doubt the diagnosis or fail to certify."115 The

Lesley Diack, Labrador Nurse, (London: Victor Gollancz, 1963), 44.

114 Ibid., 144-145.

115 Ibid., 145.

295 doctor himself gave the final diagnosis and, tired from the strain of her ordeal, Diack requested a six-month leave."6

Jupp, Campbell, and Diack also expressed frustrations over the physicians' lack of respect for their health care abilities. However, sometimes (especially in the hospitals rather than the stations) the physician's lack of respect concerned a nurse's professional evaluation of other staff members. Unlike the Jupp-Paddon conflict, which concerned the nurse's approach to her health care duties, the disagreement between Paddon and Lillian

Smythe, referred to earlier, centred on the physician's respect - or, more accurately, lack of respect - for Smythe's evaluation of another Grenfell nurse. Although she approached

Paddon about her concerns and wrote to the Association that "he was not very helpful, he said he felt humiliated and that he knew nothing about all her previous problems."117

Smythe threatened that she would resign from the Mission if this appointment went through.

Resistance to Paternalism

Threatening resignation was one method that Grenfell nurses employed in their attempts to influence their professional circumstances and to resist the paternalistic authority of male physicians and the Grenfell institution itself. They also questioned their subordinate positions within the Mission and petitioned the Grenfell administration to intervene on their behalf. Many of the nurses had joined the Mission specifically to have

116 lona Bulgin, "Mapping the self in the "utmost purple rim": published Labrador memoirs of four Grenfell nurses," PhD dissertation, Memorial University of Newfoundland, 2001," p. 257.

"7 PANL, MG 63, Box 66, File 1595 "Lillian Robina Smythe, Nurse: 1965-1980," Lillian Smythe to Shirley Yates, 2 August 1973.

296 charge of a health care facility and one nurse resigned her post at Harrington Harbour when the Mission could not secure for her a nursing station."8 By nursing for years in such remote regions, meeting extraordinary demands, and performing tasks they had never imagined, many Grenfell nurses developed confidence in their abilities to deliver health care and to cope with unexpected circumstances. They also gained an appreciation for their own individual value to the Grenfell Mission and as they realized their value, some tried to use this awareness to their advantage. As the Smythe example showed, if a

Grenfell nurse was unhappy with her working environment, she would threaten resignation - and usually, in such cases, the Mission negotiated with the nurse to reach a viable solution."9

Jupp asserted herself with the Grenfell Mission by threatening resignation if she was not posted to a Labrador station. With experience nursing in both Newfoundland and

Labrador, she grew to prefer the lifestyle of northern Labrador. She spent several years among the Innu and Inuit and even learned their languages in order to communicate with them. When Paddon attempted to send her to Englee, she was persistent in her refusal to transfer. While he was determined to keep Jupp out of northern Labrador, she was just as determined to remain. And she succeeded. Because Jupp had been so determined to remain in northern Labrador and threatened resignation if she was transferred, the

Mission found a compromise. Jupp was sent to Hebron and then Makkovik for a short

118 See PANL, MG 372, Box 35, File "Harrington: 1958-1962," D.G. Hodd to Jean DuMont, 1 July 1960.

119 Louise Greenfield and Sheila Chree threatened to resign in 1968 at the prospect of their transfer from Cartwright. See IGA Archives, File "Cartwright 1965-1969," Louise Greenfield to Paddon, 19 October 1968.

297 tenure and was transferred back to Nain in 1965, where she remained until her retirement in 1974.'20

Diack also threatened resignation from the Mission when she felt that she was being taken advantage of by the authorities. Diack's assertion usually took the form of letters and more letters to anyone who would listen. A main complaint was the terse manner in which the Mission transferred nurses on a moment's notice, along with the fact that nurses never knew if they would be stationed on the Coast. Diack was introduced to the Mission's sudden transfers during her first summer, when she was stationed at

Spotted Islands:

Then, all unexpectedly, one midnight, a familiar siren blew. It was the Maraval. I got a boat and went on board. 'Are you packed ready?' asked Dr Paddon. I said 'No! What for?' Apparently I was to proceed to St Mary's River on the Maraval, to relieve Miss Jupp while she went over to St Anthony for a holiday. Dr Paddon said all the Mission radio-telephones had been buzzing with instructions for several days, he couldn't think why 1 hadn't heard. I murmured that, not having an R.T., I was a little out of ear-shot. 'Anyway,' said Dr Paddon, 'when can you be ready? The • 191 Maraval's in a hurry, she's wanted back.'

This narrative highlights Diack's interpretation of the somewhat inconsiderate nature of staff transfers on the Coast. Not only did Paddon expect her to have heard the instructions over a radio-telephone, which the Spotted Islands station did not possess, but he also expected "several days" to be enough time for her to close up the station and leave a community that had been her home through the summer. Although Diack found this first experience with staff shuffling upsetting, she was still new to the Coast and had not yet developed her confidence and assertiveness in negotiating with the Mission, and therefore

120IGA Archives, Box: Dorothy Jupp, "Dorothy Jupp, 1909-1986."

Diack, Labrador Nurse, 8.

298 did not protest to the Grenfell administration. However, five years later, she contacted

Thomas to complain about the Association's tendency to transfer nurses to different communities with very little notice or consideration.122 In 1954, before she signed a new contract with the Mission, Diack told Seabrook that she would only serve under a two- year contract for Forteau and demanded the clause in writing. When the Mission ignored her demand, she returned her contract unsigned and stated that she was not prepared to return to the Coast with a contract that could send her "just anywhere."123 Compared to her first summer on the Coast, Diack had become much more assertive in negotiating with the Mission, especially in terms of the unpredictable nature of staff shuffling.

Despite her pleas for Forteau, Diack was sent to Flowers Cove, the busiest nursing station on the Coast. Her term at Flowers Cove was characterized by tremendous overwork and frustration with the lack of nursing staff - her co-worker was often

"borrowed" by St Anthony to substitute for nurses on holiday. Diack's frustration peaked in July 1955 when the Canadian nurse at Forteau took her second holiday in less than two years and Diack was asked to take on her maternity cases. The Canadian nurses were hired through Canada's Grenfell Labrador Medical Mission under one-year contracts and could negotiate an annual holiday. But British nurses were hired under two- and three-

Her letter aptly describes the emotional attachment a nurse could develop with the people of the community in which she practised: "out on the Nursing Stations we get our roots down deep among a particular group of people and their needs and their problems and it is very hard indeed to have to leave and start all over again, particularly out here where, on the N. Stns anyway, our only recreation is in the work, and where it takes most of a year: 1 To get to know the people, and 2 For them to know and have confidence in a new nurse." This letter also testified to the community-based challenge the Grenfell nurse faced in Labrador. In order to provide the people with quality health care she had to earn their trust and confidence. See PANL, MG 372, Box 35, File "Mary's Harbour 1955—62," Lesley Diack to Gordon Thomas, 20 October 1955.

I"5 PANL, MG 63, File 710 "Lesley Molloy Diack, Nurse: 1946-1970," Lesley Diack to Betty Seabrook, 12 January 1954.

299 year contracts, making holidays much more difficult to attain. The situation prompted

Diack to compose a list of recommendations for the Grenfell Mission concerning the shortage of nurses. She argued for higher salaries, holidays, and equality of contracts for nurses, regardless of nationality. She also pointed out the constant strain of nursing in a station:

There is never a single day in the year when we can relax and know that we wont be disturbed, never a single night when we can go to bed and shut the door and know that we can stay there till the morning... Neither Dr Curtis nor Dr Thomas have ever spent even one winter alone on the Coast and I dont think either of them have the slightest idea as to what that really means. I dont mean the isolation only, but the fact that there is no-one to turn to for help, that whatever comes, however tired or short of sleep one may be, one must still go on. Dr Thomas always laughs and says the nursing stn nurses always spend all their time sleeping when they get to St Anthony, but it doesn't seem to have occurred to anyone that that could be a sign of being over-done!124

Diack recognized an imbalance between the physicians and nurses with regard to coastal work. The hospital physicians did not experience the same feelings of isolation and the gravity of responsibility that the station nurses felt because they were not alone on the stations for any length of time. Furthermore, in the hospitals, the physicians had a large support staff. Diack's arguments regarding the shortage of nurses, their low salaries, and their lack of holidays reflected an acute awareness of nurses' professional, economic, and social demands that the Grenfell Mission, clinging to its missionary agenda (at least where the nurses were concerned), was failing to acknowledge.

Regardless of her two-year contract for Flowers Cove and her protests at being transferred yet again, Diack was sent to Mary's Harbour. She viewed this transfer as a demotion, since Mary's Harbour was less busy than Flowers Cove and provided less

124 PANL, MG 63, File 710 "Lesley Molloy Diack, Nurse: 1946-1970," Lesley Diack to Betty Seabrook, 26 April 1956.

300 opportunity for medical work. She wrote a letter of protest to Thomas concerning the breach of her contract, addressing him in the familiar as "Gordie," rather than the formal

"Dr Thomas," but she found no friends within the Mission hierarchy. Diack was clearly discontent at Mary's Harbour and pleaded to Thomas, "I do not like it here, in fact 1 dislike it intensely."125 She became increasingly frustrated at her treatment and at her lack of power within the organization, and she vocalized these frustrations in letters to

Seabrook and Thomas and to the Grenfell Mission board of governors. After several sudden station transfers and years of dealing with nursing shortages and unpredictable orders from the Grenfell Mission, Diack became disillusioned and acutely aware of her authoritative limitations as a woman within a paternalistic organization. The realities of nursing on the Labrador Coast, the nursing shortages, and the inequality of contracts and holidays for Grenfell nurses encouraged her to campaign for better labour rights and equality for northern Newfoundland and Labrador's nurses. Diack composed

"Recommendations for Consideration by the Directors of the International Grenfell

Association" - which included holidays for nurses, equality of contracts, and an improvement in nurses' salaries - and took her professional complaints to the highest level of the Grenfell Mission.126 Through such action, Diack became one of the most professionally assertive nurses with the Grenfell Mission.

125 PANL, MG 63, File 710 "Lesley Molloy Diack, Nurse: 1946-1970," Lesley Diack to Gordon Thomas, 20 October 1955.

1:6 PANL, MG 63, File 710 "Lesley Molloy Diack, Nurse: 1946-1970," Document: "Recommendations for Consideration by the Directors of the International Grenfell Association."

301 SUMMARY

The position of "nurse" with the Grenfell Mission in northern Newfoundland and

Labrador was of a contradictory nature. On the nursing station, where she was removed from direct medical supervision, the nurse held a position of local authority. But that authority was tempered by her gendered status within the community, her relationships with other similarly strong women, and her subordinate position within the medical hierarchy of the Grenfell Mission and by the expectation that she would contact the nearest physician in circumstances that were, according to the medical profession, beyond her expertise. As a result, conflict sometimes erupted between a nurse and members of the community, her coworkers, or the physicians. In the meantime, many of the women who nursed on the stations of the Grenfell Mission, like Dorothy Jupp, Lesley

Diack, and Margaret Campbell, learned to trust their own abilities, embraced the challenges they faced, and developed a strong sense of professional self-confidence. The

Jupp-Paddon conflict of 1959 demonstrated how tense relations between the physicians and nurses could become when the nurses exerted too much independence. After years of nursing by themselves on isolated stations, the nurses gained an appreciation for their professional abilities and also for their ability to cope with unexpected medical situations.

They developed a great deal of confidence in themselves and became more inclined to disagree with Grenfell authority and stand up for themselves in conflicts with physicians.

Diack took this a step further and became a vocal advocate for nurses' rights and benefits in the Grenfell Mission. These nurses met the challenges of nursing in northern

Newfoundland and Labrador and developed confidence in their own abilities; but their

302 behaviours were sometimes contrary to the matemalist and submissive ideal depicted by the official Grenfell discourse and the public image of the Grenfell Mission.

303 CONCLUSION

For almost 100 years, the paternalist Grenfell Mission provided essential health services to the people of northern Newfoundland and Labrador. This study has focused on the period 1939-1981, during which time significant social, economic, and political changes took place that had a direct impact on life on the Coast and the services provided by the Grenfell Mission. On the eve of the Second World War, the local people had been suffering from the effects of the Great Depression and were living subsistence livelihoods with no modern amenities. The Second World War, and the construction of military facilities in the region, ushered in a period of temporary prosperity especially in terms of waged employment for many Newfoundlanders and Labradorians. It also introduced local people to visiting American and Canadian servicemen and the elements of a North

American consumer society. Connections with the continent increased in 1949 when

Newfoundland became a province of Canada. Confederation marked the beginning of a shift in the Grenfell Mission from philanthropic organization to government institution, as the federal and provincial governments increasingly provided funding for the

Mission's activities and subsequently became influential in the direction of the organization. The Grenfell Mission became less accountable to its middle-class benefactors; and, in 1981, it turned over its assets to the government of Newfoundland.

However, throughout the period the region remained sparsely populated, with small communities of British and Irish descendants hugging the shoreline and Aboriginal peoples both inland and on the Coast of Labrador. Considering the challenges of providing health care to such geographically dispersed people and the difficulties in posting trained physicians to such areas, nurses became the backbone of the Grenfell

304 Mission. Not only was it financially and logistically feasible to station nurses throughout the region, it was also appropriate to the civilizing project of the organization and its maternalist agenda for nurses in providing social leadership to the people of the Coast.

This dissertation has explored the health services provided by nurses in northern

Newfoundland and Labrador, the impact that the official Grenfell discourse had upon the nurses, the manner in which the Mission balanced the personal motivations of their nurses against the public face of the organization, and the ways in which activities on the

Coast were sometimes at variance with the middle-class maternalist message.

With the exception of occasional references to Wilfred GrenfelTs socializing with the elite of St. John's, or to the anger of Newfoundlanders at Grenfell's portrayal of local poverty to a global audience, the Mission has historically been explored in complete isolation from the colony (and then province) of Newfoundland. Histories of the Grenfell

Mission have rarely situated the organization within the political and economic entity of

Newfoundland. Conversely, histories of health care in the province have rarely integrated the activities of the Grenfell Mission. Whereas these two histories have traditionally been explored separately, this dissertation has attempted to highlight the link between

Newfoundland's government and economy and the activities of the Grenfell Mission. The economic and political situation of Newfoundland before Confederation prompted the establishment of the Mission as an organization reliant on the philanthropy of middle- class American, Canadian, and British support. And the economic and political situation of Newfoundland after Confederation led to the dissolution of that very establishment.

The history of the Grenfell Mission cannot be adequately explored without taking the

Newfoundland context into consideration. And the history of health care in

305 Newfoundland must be conscious of the role played by the Grenfell Mission in providing health care services to such a large segment of the population.

Nurses with the Grenfell Mission represented a range of nationalities, although the majority of them were British, Canadian, and American; and they came from both middle- and working-class backgrounds. But the Mission considered all nurses to have attained a bourgeois "character" through their nurse training. Thus they were adequately prepared to assist in the civilizing project of the Mission. Although nursing history is a burgeoning field of historical inquiry, the potential of nurse training and practice as a formative experience in terms of class identity for women had not been explored. This dissertation has explored those themes and argued that nurse training, combined with the experience of nursing with the Grenfell Mission, was such a formative experience. While there are limits to ascertaining how thoroughly Grenfell nurses believed themselves to be middle-class, when stationed in a remote community in northern Newfoundland and

Labrador, the Grenfell nurses found themselves in positions of leadership which were shaped by the Grenfell Mission's middle-class maternalist agenda.

Furthermore, through their exposure to the Grenfell institution and the official

Grenfell discourse, the nurses self-identified as Grenfell nurses. They developed

Grenfell-centred identities that affected their experiences on the Coast, their attitudes towards the local people, and their relationships with other members of Mission staff.

Essentially, the Grenfell nurses adopted and replicated the mythology of the Grenfell

Mission - that there was a terrible need for social and medical services in northern

Newfoundland and Labrador, that the local people were worthy of assistance, and that the

Grenfell Mission was well qualified and well placed to provide this service. Among the

306 Deep Sea Fishers reproduced this mythology through its quarterly publication, and also reproduced the well-worn themes of the Grenfell nurse as adventurous, courageous, adaptable, selfless, maternal, and deferential to male/physician authority. As a marketing tool for the Grenfell Mission, the Fishers promoted a romanticized version of medicine on the Coast, emphasizing the poverty, ignorance, and child-like gratitude of the people together with the progress, social uplift, and quality of services provided by the Mission.

By presenting its staff as upholding and encouraging white middle-class standards, the

Fishers assured its readers that the Mission was doing a worthy work and that their support of the organization was well-placed.

However, despite the public image of the Grenfell Mission and its nurses as paragons of maternalist middle-class civilization, the nurses did not always adhere to middle-class mores or behave in an appropriate "Grenfell" manner. Nurses had their own personal reasons for working with the Mission and their own motivations on the Coast.

The majority of nurses were single young women, experiencing a new degree of personal freedom from familial obligations and surveillance. Although they often exercised a high degree of professional independence, their personal lives and individual behaviours sometimes came under the scrutiny and condemnation of Grenfell administrators with their middle-class agendas. The Grenfell nurses were expected to behave in a non-sexual manner and to uphold a strict moral code of behaviour. But the nurses did partake of socializing with other staff and with local individuals, and relationships did develop. As graduates of formalized nursing institutions, the Grenfell nurses were considered representatives of a bourgeois culture regardless of their family or class-background. The

Grenfell Mission responded to those relationships with enthusiasm, ambivalence, or

307 disappointment depending on the socio-economic background of the husband in question.

Class biases constituted a strong component of the Grenfell experience even on a personal level related to individual socializing and marriage.

Most of the duties performed by Grenfell nurses consisted of those traditionally associated with female/nursing areas of work. The nurses did perform male/medical duties, but not for the purposes of pushing professional boundaries - rather, they pragmatically performed whatever tasks were necessary to remedy a medical emergency or meet an individual's health care requirements. A nurse on a station tended to hold a position of greater responsibility than one in the Grenfell hospitals, in which the nurse

was immediately accountable to the physicians on staff. However, responsibility on the station was mostly associated with the nurse's local authority and her decision-making abilities. And according to the official Grenfell discourse, even when a nurse was

required to perform tasks for which she had little or no training, she was still required to contact a physician immediately, follow his instructions specifically, and afterwards

present her results to him for professional approval. Nursing with the Grenfell Mission

was, in the words of Jill Perry, an "exceptional female work experience," but it was

limited by gendered parameters of the paternalistic medical hierarchy of the Grenfell

Mission.

The boundaries within which the Grenfell nurses functioned were often

theoretical and always fluid. The amount of authority they exercised in the local communities, their professional authority over other nurses, and the professional

boundaries between them and Grenfell physicians were not consistent and were often of a contradictory nature. The nurses were expected to be leaders within the community, but

308 to also accommodate local individuals whose interests sometimes clashed with those of the Grenfell Mission. They were expected to be strong, adaptable, and assertive in providing health care on the stations, but to also live and work alongside other nurses with similar characteristics. And they were also expected to exercise a certain amount of medical authority on the stations and to contact a physician when appropriate. As a result,

Grenfell nurses came into conflict with members of the local community, with other nurses, and with Grenfell physicians and the institution in general. However, such episodes did not reach the readership of the Fishers. In providing health services to the people of northern Newfoundland and Labrador, there was a disconnect between the myth of the Grenfell Mission as presented in the official Grenfell discourse and the realities of nursing in such unusual circumstances.

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6. Them Days

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7. Government Documents

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Government of Newfoundland. An Act Respecting Health and Public Welfare 22 Geo. v. St. John's, 1931.

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8. Personal Interviews

Margaret Campbell (pseudonym), former Grenfell nurse. Telephone interview by author, August 2004. Happy Valley-Goose Bay, Newfoundland and Labrador.

Elsie Davis (pseudonym), former Grenfell nurse. Interview by author, August 2004; notes. St. Anthony, Newfoundland and Labrador.

Kate Mackenzie (pseudonym), former Grenfell nurse. Interview by author, August 2004; notes. St. Anthony, Newfoundland and Labrador.

Janet Stephens (pseudonym), former Grenfell nurse. Interview by author, August 2004; notes. St. Anthony, Newfoundland and Labrador.

Anne Thompson (pseudonym), former Grenfell nurse. Interview by author, August 2004; notes. North West River, Newfoundland and Labrador.

Agnes Warren (pseudonym), former Grenfell nurse. Interview by author, August 2004; notes. St. Anthony, Newfoundland and Labrador.

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3. Theses and Unpublished Papers

Belbin, Victoria Page Sparkes. "Midwifery and rural Newfoundland health care 1920- 1950: a case study of Myra Bennett, nurse midwife." BA Honours Essay, Memorial University of Newfoundland, 1996.

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4. Websites

Baker, Melvin, and Janet Miller Pitt, "A History of Health Services in Newfoundland and Labrador to 1982," http://www.ucs.mun.ca/~niclbaker/PublicHealthNL.pdf (accessed 7 September 2008).

Buss, Lydus H. "U.S. Air Defense in the Northeast, 1940-1957." Historical Reference Paper #1, http://www.pinetrecline.oru/olhcr/neac.htnil (accessed 3 August 2009).

Gospel Hall, htlp://www.gospclhall.org/ (accessed 21 March 2006).

The Pine Tree Line, http://www.pinetreelinc.oru/ (accessed 3 August 2009).

The Queen's Nursing Institute, "Our History," http://www.qni•Pru.uk/aboutus/ourhistorv.htm (accessed 12 February 2008)

The National Archives, The Catalogue, "Series details WO 399," http://www.nationalarchives.uov.uk/ (accessed 27 April 2008).

336 APPENDIX: Hospitals and Nursing Stations of the Grenfell Mission

Year Community Structure Details

1893 Battle Harbour Hospital Burned down 1930. 1894 Indian Harbour Hospital 1901 St. Anthony Hospital New hospital built 1927, 1968. 1906 Harrington Harbour Hospital 1908 Forteau Nursing Station New station built 1949.

1909 Cartwright Hospital 1913 Spotted Islands Nursing Station 1915 North West River Hospital New hospital built 1955. 1920 Flowers Cove Nursing Station New station 1949; renovated 1960. 1921 Muddy Bay Nursing Station 1924 Twillingate Hospital 1927 Mutton Bay, QC Nursing Station New station built 1964. 1930 Mary's Harbour Nursing Station Replaced Battle Harbour. 1936 Englee Nursing Station New station built 1951.

1951 Hamilton River (Happy Valley) Nursing Station Became a hospital 1965. 1953 St. Anthony TB Sanatorium

1956 Nain Nursing Station 1957 Roddickton Nursing Station 1961 Conche Nursing Station 1961 Hopedale Public Health Nurse Dispensary/residence built 1962. 1961 Harbour Deep Dispensary/Residence Small nursing station built 1962.

1961 Makkovik Nursing Station 1962 Bird Cove Dispensary

1963 Port Saunders Dispensary/Residence 1964 Port Hope Simpson Public Health Nurse Nursing station built 1975.

1965 Happy Valley Hospital

1969 Churchill Falls Hospital Assumed health responsibilities 1967. 1970 Black Tickle Clinic 1971 Davis Inlet Dispensary

1975 Charlettown Nursing Station

Source: Gordon W. Thomas, From Sled to Satellite: My Years with the Grenfell Mission, (Canada: Irwin Publishing, 1987).

337 CURRICULUM VITAE

MARIA HEIDI COOMBS-THORNE BA (Hon) History, Memorial University of Newfoundland (1998) MA History, Queen's University (2001)

PUBLICATIONS

"Interjurisdictional knowledge transfer in occupational safety and health: lessons from eastern Canada," (co-authored with E. Bradbury, B. Neis, S. Bomstein, S. MacKinnon and R. Parent), Policy and Practice in Health and Safety 2010; 8 (1): 95-109, "I am sure she thinks of herself as a Doctor rather than a Nurse": Conflict and Resistance to Paternalism - Nursing with the Grenfell Mission in Newfoundland and Labrador," Caregiving on the Periphery, Myra Rutherdale, ed., Kingston & Montreal: McGill-Queen's University Press, 2010. "'Mrs. Tilley had a very hasty wedding!': The Class-Based Response to Marriages in the Grenfell Mission of Newfoundland and Labrador," Canadian Bulletin of Medical History 2010; 27(1). "Knowledge, Power, and Health," (co-authored with L. Kealey, N. Turner, and S. Yeomans), Power and Restructuring: Canada's Coastal Society and Environment, Peter R. Sinclair and Rosemary E. Ommer, eds., (St. John's: Institute of Social and Economic Research, 2006): 107-128. '"I Guess I Should Have Been a Suffragette!!!': Profile of Lesley Diack, Nurse with the Grenfell Mission, 1950-58," Newfoundland Quarterly Summer 2004; 97(2).

CONFERENCE PAPERS

"'A Great Pity after all her Training': Nursing and Marriage within the Grenfell Mission of Newfoundland and Labrador," Canadian Association for the History of Nursing Conference, Vancouver BC, June 2006. "'My Pioneer Spirit' and the Myth of Christian Service: Secularism and the Nurses of the Grenfell Mission in Newfoundland and Labrador," Hannah 2005 Nursing History Conference: Identities, Diversity and Canadian Nursing History, Ottawa ON, June 2005. "'Along Those Bleak and Rocky Shores': How region defined the provision of health care of the International Grenfell Association in Labrador, 1892-1981," Canadian Society for the History of Medicine Conference, Congress of the Humanities and Social Sciences, Winnipeg MB, June 2004. ""I Guess 1 Should Have been a Suffragette!!!': Profile of Lesley Diack, Nurse with the Grenfell Mission, 1950-58," Newfoundland Historical Society Symposium on Health Care, St. John's NL, March 2004. "Expanding Professional and Personal Boundaries: Nursing with the Grenfell Mission in Mary's Harbour, Labrador," Social Sciences in Health Colloquium, University of New Brunswick, Fredericton NB, October 2002.