Canadian Nurses of the North China Mission

This group was a part of one mission of six involved with the Canadian presence in China during the missionary era. The Presbytarian’s (later United) Church’s involvement in the North China Mission was one of the first overseas missions established by Canadians in 1888. By 1923, it had grown to include three main mission compounds at Weihui, Anyang, and Huaiqing, as well as some other smaller stations in cities of the Henan province in Northern China. The North China Mission is notable for its advancement of the nursing profession in China, as demonstrated from the Canadian nurses who worked in Henan in the sixty year time-time frame that they trained and worked in the area until the Mission’s official end in 1947. Canadian nursing in Henan was characterized by personal and professional struggle amid the tumultuous political background of China at the time.

Background

Before modern nursing practice was introduced, the care of the sick in China was the responsibilities of the family members or servants. It was not traditionally acceptable for females taking care of the male patients, because of the convention of no physical contact between men and women. This is one of the reasons why few nursing training schools of the first period recruited female nurses. Nursing as a profession in China emerged much later than physicians. In Henan, nurses were not a part of the original plan for missionary work. The first two Canadian missionaries to Henan, Reverend Jonathan Goforth and Dr. James Frazer Smith, were appointed in June 1887 by the general Assembly of the Presbyterian Church in Canada. However, learning that Chinese mores would not allow missionary men to have contact with Chinese women in 1888, Goforth wrote to the Foreign Mission Committee to appoint a nurse. This is ironic, since Goforth was originally against the idea of female nurses, while Smith was a proponent for it. On 25 May 1888, the FMB appointed Harriet Sutherland. Smith then engaged the services of two additional nurses, Jennie Graham and Margaret MacIntosh.

The Coming of Modern Nursing (1900-1927)

The Boxer Uprising

In 1888, Hudson Taylor warned Jonathan Goforth of the anti-foreign nature of Henan. As a result of the Boxer Uprising, 188 Protestant missionaries, 22 Roman Catholic priests and nuns, and thousands of Chinese died. On 28 June 1900, the missionaries decided to evacuate their mission because of rumors of increasing anti-foreign violence. The group of missionary doctors and their wives and nurses began their migration to Shanghai from Henan in the month after. They experienced many hardships during this trip, such as facing bandits, injuries, and death.

Second Generation Nursing

The first generation of Canadian nurses were the first round of nurses that came to Henan in pre-1900s (including Margaret MacIntosh, Harriet Sutherland, and Jennie Graham). However, the Chinese Revolution of 1911 opened up new opportunities for medical missions in general and for nursing in particular. In 1911, the China Medical Commission had found that only one in two hospitals had a nurse and that there were only 140 nurses in all of China. After the "Christian Medical Association of China" prepared a pamphlet in 1913 that urged mission boards to have at least one foreign-trained nurse in each hospital, the Henan Mission appealed to the Foreign Mission Board (FMB) for a fully qualified Canadian nurse. However, these nurses were not to do hospital work. The nurses were to care for missionaries and their families who would pay for their services. The FMB appointed Miss Mary Elizabeth McNeely to Henan in 1914. Margaret Gay was appointed to a different China mission in 1914, where she worked in a Wuan Canadian hospital. While there, Gay desired to learn more about nursing. Her implementation of nursing services at the Presbyterian Mission after returning to China in 1922 was instrumental in the development of modern nursing in Northern China. Jeannette C. Ratcliffe volunteered her services in Henan in 1910 as the matron of the school for missionaries' children. She had already completed nurses' training and one year of university when she came to China. The second generation of nurses showed a commitment to the implementation of modern nursing.

Establishing and Progressing Modern Nursing and Nurses' Training (1921-1937)

Despite ambitious plans to expand and improve medical and nursing service in Henan, the Canadian Presbyterian mission's progress lagged behind that of other missions. In a report entitled "An enquiry into the Scientific Efficiency of Mission Hospitals in China," Henan hospitals rated near the bottom of the scale. The development of the Canadian Presbyterian mission in North Henan required the development of nursing services. In 1922, Anyang had two old hospitals: a men's hospital and a women's hospital. Poor lighting and heating made it difficult to do efficient work. As a result of these poor conditions, a new hospital in Weihui, called the Weihui Hospital, opened in 1923. A new Weihui nursing school had already begun in 1922. The construction of these two buildings catalyzed the modernization of nursing in the area. Although all the Weihui students were Canadian mission school graduates who had been exposed to the worldview of the Canadians, there were still cultural barriers. Chinese students and Canadian instructors had disparate views on illness causation, personal hygiene, and the importance of precise measurements. In the first year of the new four-year nursing program at Weihui, eleven pupils enrolled, but only eight were accepted for training—five women and three men. By 1926, the Weihui nursing school had twenty-three students, most of whom were male. By the end of the school year, three senior nursing students successfully completed their nursing examination, the first class of graduated nurses in North Henan.

The Great Exodus of 1927

The year of 1926 saw unrest and upheaval as a result of political developments amid the development of Chiang Kai-shek's Nationalist Revolutionary Army. By the time the Nationalist army entered Nanjing, many foreign missionaries had already been evacuated to the safety of the coastal treaty ports. The Henan Canadian missionaries did not evacuate until they received a telegram asking them to leave. During the exodus to Tianjin, the Henan Mission lost twenty of their ninety-six missionaries, including missionary nurse Margaret MacIntosh. Although Tianjin had seemed a safe haven, there was still concern that it would come under attack. As a result, all Canadian missionaries returned back to Canada.

Rehabilitation of Hospitals and New Nursing Schools

By the end of the fall of 1928, the situation at Henan was settled enough for the missionaries to return. Finding the hospitals in "shocking condition," the medical and nursing staff opened up clinics at Weihui and Huaiqing while the rehabilitation of the Weihui Hospital got underway. After the rebuilding of the Weihui hospital, the North China Mission opened new rooms to accommodate both male and female patients. In 1935, the hospital opened a separate children's ward, an extra men's war, and a delivery room. The larger number of patients meant more nursing staff was needed. As early as 1931, nurses at Anyang and Huaiqing discussed the possibility of opening their own nurses' training schools. In 1932, students from Huaiqing and Anyang joined students at Weihui for a six-month "central training course" under the leadership of Mrs. Jeanette Ratcliffe. In compliance with new Ministry of Education regulations, the face of nursing was becoming increasingly Chinese.

Scattering of NCM Nurses: China under Japanese Rule (1937-1945)

Sino-Japanese War

The year of 1937 marked the start of a period of great upheaval for Canadian nurses and missionaries in the North China Mission as a result of the Sino-Japanese War. In the year of 1937, Japanese armies advanced toward Weihui along the Beijing-Hankou train line. During this time, a large amount of refugees traveled into Henan from the North. On 1 October 1937, Anyan was heavily bombed. The nursing staff at Weihui Hospital spent their days caring for the wounded and for refugees. Under Japanese rule, the Anyang women's hospital and training school for nurses had been carrying on with a limited staff and more patients—Chinese, Japanese, and Korean. On 5 October 1939, the missionaries at Weihui received word that they must leave by 12 October or "drastic action" would be taken on 13 October. They planned to leave in small parties and reunite in Beijing. With the Canadian nurses having to evacuate Weihui, Chinese nurses took over. As a result of the Anti-British Movement and the worsening war conditions in Japanese-occupied Henan, the North China missionaries were exiled from Henan and scattered around China and Canada. At the end of 1939, nurses Clara Preston, Margaret Gay, Dorothy Boyd, and Mary Boyd were in Tianjin working among refugees. Many of the nurses of the North China Mission were transferred to work in the West China mission stations.

War Years

On 6 May 1941, nurse Dorothy Boyd wrote a letter of resignation. At about the same time as Boyd's resignation, Margaret Gay made the sudden decision to return to Canada "at once" to help care for her sisters. By March 1943, the Japanese had decided to move "enemy aliens," kept under house arrest to that point, into large internment camps. In March 1943, Canadians in other parts of northern China were also transported to internment camps. The sole North China Mission nurse at this time in China during the post-Pearl Harbor period was Clara Preston, in Sichuan, where she worked at the WCM hospital at Chongqing teaching in the nursing school before returning to Canada. By 1945, all of the Canadian North China Mission nurses had departed China.

Postwar rehabilitation (-1947)

The Sino-Japanese War came to an end after atomic bombs were dropped on the Japanese cities of Hiroshima and Nagasaki by the American military. In April 1945, a group of North China Mission missionaries in Toronto named fourteen missionaries to go to China before the end of the year. Among these fourteen was Clara Preston.At Weihui, a 1946 financial report estimated the 1939 replacement cost for hospital land, walls, buildings, and supplies at a total of Cdn$115,000. However within one month, morale had increased enough for the newly repaired hospital to be built before October 1946. On 1 June 1947, a small committee of Chinese missionaries gathered to write a confidential report on the conditions of Henan. Missionary Margaret Brown, who authored the report, was convinced hat sharing the information indiscriminately, even among other missionaries, could result in harm to Chinese Christians as a result of in Communist China. The report gave just cause for dissolving the North China Mission altogether because of the fear many missionaries felt. In August 1947, the North China Mission Council convened and agreed that the establishment of the Christian Church in North Henan would not re-enter North Henan for residence or work. After the decision to end the mission was made, nurses of the North China Mission were relocated to other hospitals in other parts of China.

Notable Female Missionary Nurses

There were many notable nurses who played a role in the start and build of nursing within North China Mission in Henan.

Margaret MacIntosh

MacIntosh was one of first Canadian missionary nurses to be employed in Henan in 1889. By 1891, she was the only nurses at the mission at the time. Under the instruction of Dr. Frazer Smith, MacIntosh gained a knowledge of nursing from the Toronto General Hospital (TGH) Training School for Nurses. She retired from her Henan post in 1927.

Margaret Russell Gay

Gay was appointed to Henan as an evangelistic worker 1910. However, she turned to aid as a nurse while there when she was confronted with the health needs of the rural population in Henan. Gay left Henan in 1945. Rather than envisioning nursing as either evangelism or service, Gay saw missionary nursing as both. She implemented this shift of focus while arriving at Henan after nurses' training at the Vancouver General Hospital. Gay pursued a nursing practice in Vancouver with a model for illness care that stressed efficiency, orderliness, and, most of all, cleanliness. Together with her colleagues at the hospitals at Weihui, Anyang, and Huaiqing, Gay strove to develop a system of nursing that she thought was necessary in Henan.

Louise Clara Preston

Preston arrived in China in 1922. Her career in China ended in 1947 when the North China Mission officially ended. Preston fully supported the modernizing efforts being made by the Henan Mission at Weihui. Preston was present in China during most of the time during the Sino-Japanese War when Canadian nurses were exiled from Henan.

Legacy of the Nurses at the North China Mission

The North China Mission did not bring nursing to China. Before the mission, China already had well-established nursing traditions, ranging from care provided by female family members to traditional healing practices provided by healers to paid care by male attendants. However, the nurses at the North China Mission did bring a particularly and relatively new form of nursing practice rooted in Catholic and Protestant religious communities and adapted and popularized by Florence Nightingale. This system of professional nursing—variously called modern, Western, or scientific nursing—became the standard of nursing practice in North China and around the world.