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Even before the passing of the Nursing Act (69 of 1957), the international and local nursing communities were discussing its implications, as well as SANA’s position as an ICN member (Borcherds 1957:32-23; DENOSA 1960c:1; Madsen 1959).

The SANA Board’s disquiet about the new Nursing Act deepened after it was promulgated. The board debated whether its delegates should attend the ICN Board of Directors meeting scheduled for July 1959 in Helsinki, Finland, at all. In a private letter to Miss Gwen Buttery (ICN Deputy General Secretary), Miss Radloff (SANA Organising Secretary) expressed her concerns about how the South African delegation would be received and if SANA “will be able to save” its ICN membership as “public opinion seems to have hardened so much against us” (Radloff 1959). The SANA Board could not agree on the appropriate response to a possibly hostile ICN Board meeting. In the end, they decided to send Miss MG Borcherds (SANA President) and Miss DH Radloff to Helsinki with a mandate to withdraw SANA’s membership from the ICN if need be (Borcherds 1959b; DENOSA 1959b; DENOSA 1959c; DENOSA 1960a:13-14).

The ICN President, Miss Agnes Ohlson, asked the two South African delegates to stop en route in Copenhagen, Denmark, to “discuss the South African question” (Magnussen 1959) with the Chairman of the ICN Membership Committee (Miss E Magnussen) and the Chairman of the ICN Constitution and Bye-laws Committee (Miss Pearl McIver) (Borcherds 1959c:20; DENOSA 1959d:1). The SANA delegates left South Africa for Copenhagen and Helsinki with a typed guideline that explained SANA’s position on the Nursing Act (DENOSA 1959b), a typed speech and an unsigned, one-paragraph letter. The letter addressed to Miss D Bridges (ICN General Secretary) and the speech announced SANA’s immediate withdrawal from the ICN (Borcherds 1959b; DENOSA 1959c).

eligibility of SANA to remain an ICN member association. Some ICN member countries felt that SANA, by separating its branches and meetings on grounds of race and colour, dishonoured the ICN ethics code and the ICN constitution (Borcherds 1959c:23-24; DENOSA 1959d:7-9).

Miss Borcherds (DENOSA 1959b; DENOSA 1959d:7-9) used her prepared guideline to explain that South African nursing’s position was complicated by politics and certain organisations e.g. the Federation of South African Nurses and Midwives (FOSANAM), the Africa Bureau and the Young Africa League. Her defense rested on the belief that SANA was a purely professional association, one that was not involved in politics. In SANA’s opinion, the abovementioned organisations “show a strong bias against objective thinking” (DENOSA 1959b). She argued that the ICN had admitted SANA in 1922 as a member knowing that it had only White female members. And she reminded the ICN that it should concern itself with nursing services in the world, not politics. She then challenged the ICN Board of Directors to explain in what way SANA dishonoured the ICN code of ethics and how the SANA constitution was “incompatible” with that of the ICN. The Chairman of the ICN Membership Committee and the Chairman of the ICN Constitution and Bye-laws Committee (those of the Copenhagen meeting) confirmed that neither the ICN constitution, nor its code of ethics was violated by SANA. With that, SANA decided to remain a member of the ICN (DENOSA 1959b; DENOSA 1959d:7-9). Miss Borcherds did not have to use her prepared speech and letter of withdrawal.

The outcome of the ICN Helsinki meetings was communicated in confidence by Miss Borcherds to the SANA Board. Although SANA remained a member of the ICN, the meeting (after a debate about its formulation) accepted a resolution to which SANA objected. The ICN resolution stated that (Borcherds 1959a; DENOSA 1959d:7-9; DENOSA 1960c):

 The South African government decreed that statutory professional associations (such as SANA) must be divided based on race and/or colour.

 Only White members may serve on the SANA Board.  The ICN had an unwritten principle that professed equality.

 The ICN regrets the restrictions placed on SANA and hopes that SANA will continue to assist and support the professional growth and welfare of its non- European members.

 The ICN calls on SANA to prove its commitment to equality by inviting the two chairpersons of the Advisory Committees (for Coloured and Black SANA members) as delegates to the 1961 Grand Council meeting in Melbourne, Australia.

Brush and Lynaugh (1999:138) have demonstrated that the American Nursing Association (ANA) “just barely avoided … similar criticism by restructuring its professional organizations and including black nurses in ANA membership in 1952”.

If expelled from the ICN, SANA (and South African nurses) faced professional isolation. The value of being a member-country was illustrated in the Helsinki delegation’s report submitted to the SANA Board when it met on 10-12 September 1959 (DENOSA 1959d:1- 9). By being a member, SANA had access to the International Labour Organisation (ILO) (the ICN was on its special list), with which the ICN Economic Consultant had a meeting about nurses’ conditions of employment. The recommendations made after that meeting were published in the South African Nursing Journal. SANA also had contact with the newly established ICN Nursing Service Division, which had nurses’ economic and social needs listed as its priority. The ICN appointed a consultant with the specific task of advising national nursing associations (such as SANA) “on the development of an economic welfare programme and especially the development of a machinery for negotiation of salaries and conditions of service” (DENOSA 1959d:5). Other advantages of being an ICN member-country included access to the ICN’s newly established Education Division (the Florence Nightingale Education Division), contact with UN Headquarters, UNICEF, the World Medical Association and the International Council for Midwives (DENOSA 1959d:1-9).

The SANA Board congratulated its two-person delegation on the successful handling of the situation at the 1959 ICN meetings, but Miss Borcherds privately admitted: “This has been a ghastly time and I would’nt [sic] go through it again for anything but it had to be done and we have found that we have many friends” (Borcherds 1959a).

As a statutory body, SANA had an obligation to keep the government informed of issues that affected its only professional nursing association. Despite Miss Borcherds’ referring

Oxley was aware of the earlier discussions that took place at the ICN Board of Directors meeting in Rome, before the Nursing Act (69 of 1957) was passed (DENOSA 1960c:1). Reference was made to South African nursing being “in danger of being used as a political tool” and the “group of dissident non-white nurses … who formed the Federation of SA Nurses and Midwives” (DENOSA 1959a:1). Mr Oxley was also informed about the “political flavour of the discussions” (Radloff 1960) at the 1959 ICN Board of Directors meeting in Helsinki. The SANA Organising Secretary’s letter (Radloff 1960) to Mr Oxley concluded by stating that “I … would be pleased if you would deal with it in a manner you think fit”.

Miss Radloff’s letter confirmed that SANA did not openly challenge the government and deferred to its policies (Radloff 1970a:16-17), but it made use of socio-politically acceptable alternatives. In the 1950s delegates attended an ICN Congress, and in the 1960s the Chairpersons of the Advisory Committees and boards travelled as observers to an ICN Congress, followed by a study tour to England and Holland (DENOSA 1966a:15, 17; Radloff 1957). Also in the 1950s, the established SANA branches used their own funds to help start the association’s Black and Coloured branches. They also expressed the wish to have a continued exchange of ideas among all SANA branches (Board meeting … 1958:6).