UNITARIO VALOR TOTAL

Although many medical missionary women claimed to have set their sights on medical work early in life, and indeed some pursued years of medical training in specifically to become eligible for medical missionary work, when they applied to the CEZMS, WW, or ZBMM, they applied to become missionaries, and to do the work the society asked of them. The CEZMS application let applicants indicate the type of work they were most interested in, but also asked whether they were “willing to go elsewhere or to another department of work if the Committee thought it desirable.”144 Until the latter part of the nineteenth century, most women missionaries in India were what would come to be called “general” missionaries or workers. The first

professional single women missionaries targeted Indian “ladies,” especially those who practiced female seclusion, thus earning the name “zenana missionaries” after the zenana, or woman’s

143 _{The CEZMS applications are contained in the “blue packets” which include correspondence between applicants} during the application and pre-leaving period; the application form and supplementary questions; letters of

recommendation; the reports from the training centers; and sometimes letters from the field. The WW Minutes end in 1932. The ZBMM Minutes included in the microfilmed CEZMS collection end in 1936.

144 _{Although Margaret Roberts specifically applied to medical work, she indicated that she would be “willing to go} elsewhere or to another department of work if the Committee thought it desirable.” This is one of the question from the CEZMS application, Margaret Roberts’ “Blue Packet,” CEZMS collection.

quarters. These early women missionaries’ work primarily consisted of activities that most middle- or upper-class British women could perform: visiting Indian women in their homes, teaching women and children Bible stories and lessons, working on basic reading and some domestic skills such as needlework. The goal of their work was to make contact with Indian women who, by virtue of observing seclusion, were inaccessible to the male missionaries. This work required neither specialized education nor professional credentials, but could be taught to most middle-class British women as part of their missionary training. The focus on visiting women in their homes proved ineffective for conversion, but such exposure led to new avenues for women’s missionary endeavors, including education and medical work.

In the first decades of women’s missionary work, the scope and quality of “medical” care was rudimentary and carried out by women who had acquired some basic “medical” training, which could be as little as a few weeks of experience in midwifery and dispensing. This training had no prerequisites, and did not qualify the women as licensed practitioners. But as

missionaries discovered that many Indian women were willing to try their services, they opened dispensaries, clinics, and even hospitals, thus taking on significant medical responsibilities. Writing in the 1950s, the author of a history of the ZBMM explained that while none of the medical workers in the 1870s were doctors, their credentials and work as providers of medical care were acceptable since “except for Dr. [Elizabeth] Garrett Anderson and one or two others, they were the nearest approach possible for a woman in Britain” at that time.145 _{As the}

missionaries’ main goal was to bring women to Christ—reaching them via eye drops or tonics for coughs was merely a medical means to a spiritual end—their work was good enough. While

145 _{J. C. Pollock, Shadows Fall Apart: The Story of the Zenana Bible and Medical Mission (London: Hodder and} Stoughton, 1958), 35.

missionaries wanted to relieve physical suffering, the missionary rather than the medical connection was what mattered most to the societies and supporters at home.

By the 1880s, women could complete medical training in Britain. Many of these early women physicians devoted part or all of their careers to missionary work in India; significant numbers of women who entered medical school in the 1880s and 1890s did so with the goal of

becoming medical missionaries.146 Now that missionary societies could include “fully qualified”

or “fully trained” medical women, there was reason to reconsider the policies and goals for the work: if societies could send fully-trained doctors to India, then they could also provide more comprehensive care. And if societies had the ability to provide better medical care, they had to ask whether providing the best quality of medical care—rather than enough care to possibly draw a patient to Christianity—should be the goal of the medical work. But if societies started to employ some fully-qualified doctors, could they afford them, and how might they affect the work being done by women without such qualifications? Finally, women who had studied and trained to become physicians—which was no small feat in nineteenth-century Britain—were well- educated, and some saw themselves as scientists; it was conceivable that they might consider themselves to be “doctors” who were missionaries rather than missionaries who did some medical work.

With the rise of professional medical women in late Victorian Britain, North America, and Europe, these are the questions and issues related to medical work and workers that the societies might have pondered in the early decades of the twentieth century, but, for the most part, did not. Instead, for many years the societies continued to focus on finding women with the

146 _{In 1900, approximately one-fourth of all British women medical graduates were working in India. The goal of} becoming a medical missionary was also a driving force behind many Australian women’s enrollment in medical school. See Suzanne Parry, “Women Medical Graduates and Missionary Service,” for a detailed analysis of Australian women’s medical training and professional paths.

desire and ability to become missionaries—rather than the ability and qualifications to do medical work. The assumption was that most missionaries could be trained to do medical work, rather than that most medical women could be trained to do missionary work. And during the decades when these societies employed “partially trained” women who could do some medical work, the strategy paid off.

To a researcher, Beatrice Clegg, who applied to the WW in the late 1890s, appears to have been a medical missionary: she held some recognized medical credentials and provided midwifery and medical care in colonial Ceylon. Clegg first emerges in the WW minutes in 1897, introduced as the daughter of Reverend James Clegg—a Wesleyan minister who must have been known to the committee members. At that time, Beatrice Clegg worked as a post office clerk, but she had acquired “some knowledge” of pharmacy and dispensing in her spare time, and she had applied for a paid position at the Holborn Infirmary for two years of formal training. She sought this medical training in order to be “useful” to the missionary society, hopeful that she would be chosen for foreign missionary work. Clegg was under pressure, since the WW told her that if she failed to find a position in a hospital, she should return to the post office, as the

committee could not accept all of the “partially-trained” medical workers who applied.147 _The

committee knew that Clegg had to earn money to support herself “as she cannot afford to wait doing nothing,” but the WW was slow to offer any financial assistance; as one of many “partially

trained” applicants, she offered nothing unique.148 _{But the WW eventually supported Clegg with}

funding for three months of midwifery training, which complimented her knowledge of

dispensing, thus providing her with useful skills as a woman missionary. Two years later, Clegg passed her London Obstetrical Society (LOS) exam and was in the middle of additional

147 _{Minutes, 13 July 1897, WW, MMS, 1105, 22.} 148 _{Minutes, 15 June 1897, WW, MMS, 1105, 22.}

dispensing lessons. By early 1900, Clegg found herself in Ceylon practicing midwifery, running a weekly dispensary, and engaging in village evangelical work.

Not long after her arrival in Ceylon, the WW noted that Clegg’s work had already

become broader than she—and they—had expected. In the home committee’s eyes, Clegg’s real work was to evangelize village women; the midwifery and dispensing were merely a strategy for

building relationships. Yet there were others in Ceylon who saw Clegg as a health care provider.

The Colonial Surgeon, who was not in the business of saving souls, wanted her to take on all the medical work for women in the area; Clegg was “anxious” about such a proposition, but

“show[ed] courage and skill.”149 _{The missionary and secular work kept Clegg occupied. Two}

months later, Clegg reported to the WW that she had opened new dispensaries, but was still communicating through an interpreter—because she was working so hard, she had no time to set aside for language study—and one of her dispensaries lacked not only furniture but also a

building. At the end of that first year, Clegg wrote to the WW, requesting midwifery

instruments, but her request was denied. The committee reminded her that she was not sent to be

a medical worker, but as an evangelist “trained to help the women,” which happened to include delivering their babies. Another year passed before the WW decided to send money for

instruments and drugs as a reward for Clegg’s work being “most satisfactory.”

Clegg continued her busy schedule of midwifery and dispensing work, but also asked for permission and funds to start a school. This request reveals much about Clegg’s perceptions of her work and professional identify: missionary doctors would not have claimed the credentials to teach or run a school; and while the Colonial Surgeon saw her as a medical worker, Clegg did not, but saw her role as serving all areas of her new community. The WW did not consider her

to be a “medical” worker, either, but as they did not see her as an educational worker, they

denied her request.150 When Clegg came home for her first furlough in 1905, the committee

agreed to pay to send her for additional midwifery training at the Women’s Hospital in Euston Road, to make her more useful. By 1909, the WW realized that Clegg’s work had grown enough that they discussed the possibility of sending a qualified woman doctor to join her since Clegg found that managing the medical work while simultaneously training multiple local Bible Women—a service highly valued by the WW committee at home—difficult. In 1911, when Clegg was seriously ill and incapacitated for weeks, instead of sending a doctor, the WW sent a trained nurse to work as Clegg’s colleague. At this time, trained nurses in the missionary field were rare and highly valued by the women doctors, so sending one to Clegg’s area—which had no doctor, and was not designated as a medical station—was significant. Clegg clashed with Nurse Barrs, but by this point, the committee found Clegg’s experience too valuable to risk losing her. In 1937—nearly forty years after arriving in Ceylon—Beatrice Clegg was still on the island, establishing evangelical work in a new circuit, where she chose to live alone instead of as

part of the European missionary community.151 Even though she had delivered babies and

provided basic healthcare across a region for years, she was and had always been an evangelist, and not a true “medical worker.”

Emilie Posnett and Sarah Harris, contemporaries of Beatrice Clegg, began their work for the WW in the princely state of Hyderabad in 1896. They both possessed some nursing training, and at that time the WW considered them to be medical workers. Like Clegg, their missionary

150 _{The SOAS, University of London, Library Special Collections Guide has a list of missionaries involved with} medical work, and Clegg’s name is not listed under the Wesley Methodist.

151151 _{The WW Minutes end in 1932, but immigration records show Clegg traveling back and forth to Ceylon in the} 1930s, returning to Britain in 1937. This outline of Clegg’s work and experiences was pieced together from the WW Minutes, 1895-1931. Records of her life and work in Ceylon are available in the “Ceylon” collection of the WW archive, but were not consulted in this study.

careers spanned decades, and over the course of their careers, missionary medical work emerged as a distinct field, which affected their self-perception and missionary classification. One major change was the shift from the “dispensary,” which, as Clegg’s experiences show, could be as basic as a missionary with her medical bag standing under a tree, to “hospitals.” By the early twentieth century, anything that counted as a hospital needed to have a doctor on staff—or at least visiting very regularly—and, ideally, also appropriately credentialed nurses. By the 1920s, missionary hospital nurses were expected to have the qualifications of Sister or Matron, which meant significant leadership experience as trained, professional nurses, and the credentials to train and supervise Indian nurses. Posnett and Harris lacked this level of training, and were honest about their expertise and abilities as healthcare providers. As early as 1902, when their mission began to consider building a hospital, Posnett and Harris objected, stressing that if the station were without a woman doctor, there would be no one to run the hospital—they could not fill a doctor’s nor even a Sister’s shoes. Posnett and Harris had no desire to return to Britain to earn these extra credentials, believing they were “more useful” as touring evangelists who could

also provide some medical care.152 Others agreed: in 1920, they were recognized by the

Government of India for their pioneering work in villages, famine relief, and service to the

public during epidemics, including the plague.153 By the time they retired in 1939—after more

than forty years in India—they were among the last of their kind in the WW, and, like Clegg, were classified as “evangelists,” far removed from the “medical” work, even though many aspects of their careers had mirrored those of missionary nurses.154

152 _{Minutes, 8 April 1902, WW, MMS, 1105, 25.}

153 _{Emilie Posnett and Sarah Harris were awarded the Kaiser-i-hind award, along with fellow WW missionary, Mrs.} (Dr.) Olive Macdougall Monahan, in 1920. Many of the medical women in this study received this medal, which was bestowed by the monarch to recognize public service to India.

154 _{Georgina Green, whose career began around 1903, often referred to the fact that she, Posnett, and Harris were} “old-timers” and of a different generation and “stuff” when compared with the women missionaries arriving in the 1920s and 1930s. Green made comments such as, “Some of the new workers look very washed-out already. We old

As opportunities for women in the health care professions changed, and as medical work developed as a distinct field for missionary service, some women chose different paths than Clegg, Posnett, and Harris. Early “medical” missionary Elizabeth Bielby, a nurse, was sent to India in 1875 by what was then the Zenana Mission Society—later to be renamed the ZBMM. She established “the work” near Lucknow, where the ZBMM’s future Lady Kinnaird Hospital would eventually flourish well into the years of an independent India. Although only trained as a nurse, Bielby ran a dispensary and then a small hospital for Indian women where she provided as wide a range of care as possible, including midwifery services. The Zenana Mission Society was pleased with her work, but Bielby felt limited by her nurse’s training, frustrated by the physical

suffering she could not alleviate because she lacked a doctor’s medical skills and knowledge.155

Bielby was not satisfied to provide “some” care, to merely provide more than what was available to women from their local “traditional” Indian practitioners, nor did she subscribe to the

philosophy that medical care’s main purpose was to bring Indians to Christ.

Bielby’s opinions were influenced by the fact that medical education opened its doors to European women in the 1880s. Bielby decided to return to Europe for a few years, taking a much-needed break from the recurrent severe bouts of typhoid fever, to gain her full medical qualifications. By 1885 she was not only a licensed midwife, but also had earned her M.D. at the

stagers have twice their strength,” to which she added that missionaries in the 1920s had it much easier than she had when she was new and coped without motor vehicles, upper-storied houses, and six months of language study. Green to Bradford, 20 November 1922, WW, MMS, Haiderabad correspondence, 1058, 442. She sometimes closed her letters to Miss Bradford with “I am dear Miss Bradford one of the ancients.” Green to Bradford, 27 November 1929, WW, MMS, Haiderabad correspondence, 1058, 434.

155 _{This was a common complaint from the field, from nurses working without doctors. For an impassioned plea for} the need of doctors, see Anonymous, A Nurse’s Indian Log-Book: Being the Actual Incidents in the Life of a Missionary Nurse (Westminster: The Missionary Equipment and Literature Supply, 1925). In one annual report, the writer remarked that all “the work in the hospital is mostly medical,” meaning curative rather than preventive, and non-surgical, because there had been no fully-qualified doctor there for the past year. “Report on Akbarpur Medical Work,” 1931, WW, MMS, Reports, 1036, 45. Some of the missionaries who were neither doctors nor nurses but were still routinely presented with medical cases begged for any trained workers. Marian Bayton to Miss Bradford, 30 June 1924, WW, MMS, Haiderabad correspondence, 1058, 392.

University of Berne.156 She became a staunch believer that medical missionaries must be fully- qualified doctors, publicly and vociferously arguing that “[a] little knowledge is insufficient and without a medical education no one should undertake the duties of a medical missionary…We

should thoroughly understand our medical work or it must be a sham.”157 _{Bielby left missionary}

service, but returned to India where she spent the rest of her long career, first working for the Dufferin Fund and later as an independent practitioner.158 Although Bielby is often cited as a critic of missionary work, the ZBMM—the society for which she had worked—soon embraced her views, pronouncing

“the full course of scientific study [is] absolutely necessary for those going out in charge of a medical mission or hospital….As the opportunities available now to English female students are so much better than they formerly were, we feel we should not be contented with the lesser