GREN­FELL MIS­SION HERO­INES

Nurses work­ing in the iso­lated out­ports of New­found­land, Labrador, and Que­bec did it all. They pulled teeth, sewed up wounds, saved an­i­mals, and de­liv­ered many, many ba­bies.

Canada's History - - ROOTS - BY HEIDI COOMBS-THORNE

DR. CHARLES CUR­TIS did not hold back on his praise for nurse Ethel Cur­rant: “No mat­ter how weary and ex­hausted Miss Cur­rant was, she never failed to an­swer a call for help,” Cur­tis wrote in an ar­ti­cle pub­lished in Among the Deep

Sea Fish­ers in 1945. “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….”

Cur­tis went on to de­scribe how Cur­rant put the pa­tient in a boat in heavy seas and had her taken to the nurs­ing sta­tion at Flower’s Cove, a ham­let near the tip of New­found­land’s Great North­ern Penin­sula: “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.”

Cur­tis, the med­i­cal su­per­in­ten­dent of the In­ter­na­tional Gren­fell As­so­ci­a­tion, un­der­stood bet­ter than most how im­por­tant nurses such as Cur­rant were to meet­ing the med­i­cal needs of peo­ple in iso­lated coastal com­mu­ni­ties of north­ern New­found­land, Labrador, and Que­bec’s Lower North Shore. In Among the Deep Sea Fish­ers, the of­fi­cial pub­li­ca­tion of the as­so­ci­a­tion, he re­ferred to them as the “back­bone” of the Gren­fell Mis­sion, a phil­an­thropic med­i­cal or­ga­ni­za­tion es­tab­lished in 1892 by Bri­tish physi­cian Sir Wil­fred Gren­fell.

Be­fore Gren­fell ar­rived, the New­found­land govern­ment oc­ca­sion­ally sent a doc­tor up the Labrador coast on a mail boat or seal­ing ves­sel, and the Mo­ra­vian Mis­sion pro­vided ba­sic med­i­cal ser­vices to the Inuit in north­ern Labrador. But oth­er­wise there were no hos­pi­tal fa­cil­i­ties, no res­i­dent doc­tors, no nurses, and no con­tin­u­ous med­i­cal care in this part of the coun­try. When Gren­fell un­der­took his first med­i­cal ex­pe­di­tion in the re­gion in 1892, trav­el­ling along the coast through “ice and snow and gale” on the hos­pi­tal ship the Al­bert, he was ap­palled at what he found.

“They found whole set­tle­ments that had been wiped out by diph­the­ria,” said an ar­ti­cle in a 1903 is­sue of Deep Sea Fish­ers. “Wounds, no mat­ter how fright­ful, were treated by squirt­ing to­bacco juice into them and bind­ing tightly with an old rag. But even to­bacco and rags were want­ing in many places, for the Al­bert found set­tle­ments where the chil­dren were al­most naked and had to live in the very back of the hov­els to es­cape freez­ing to death.”

The med­i­cal missionary vowed to help “the un­happy souls that were im­pris­oned in ice for half the year, and cursed with pri­va­tion and sick­ness al­ways.” He de­vel­oped a net­work of re­gional hos­pi­tals and nurs­ing sta­tions staffed by highly qual­i­fied doc­tors and nurses from around the world. The first hos­pi­tals were built at Bat­tle Har­bour (1893) and In­dian Har­bour (1894), and by the 1960s the mis­sion had ex­panded into the in­te­rior of Labrador. While much is known about Gren­fell, who wrote sev­eral books about his larger-than-life ex­ploits, the mis­sion’s nurses were ev­ery bit as heroic. They were re­lied upon to use their best judg­ments in deal­ing with med­i­cal emer­gen­cies — a re­spon­si­bil­ity they of­ten car­ried out alone.

Ethel Cur­rant was a typ­i­cal Gren­fell sta­tion nurse. She was Bri­tish and was trained as a mid­wife. She was posted at the nurs­ing sta­tion at Flower’s Cove, a com­mu­nity not large enough to war­rant a hos­pi­tal. Of­fi­cially, nurs­ing sta­tions fell un­der the author­ity of med­i­cal di­rec­tors based out of the Gren­fell hos­pi­tals. How­ever, since the sta­tions were sep­a­rated from hos­pi­tals by vast ex­panses of ocean and/or rugged coast­line, nurses like Cur­rant ex­er­cised a sig­nif­i­cant amount of pro­fes­sional in­de­pen­dence.

In­de­pen­dence suited her, as, like her coun­ter­parts, Cur­rant had a keen sense of ad­ven­ture. Be­fore ar­riv­ing in New­found­land, she had nursed in In­dia, Zu­l­u­land (South Africa), Gu­atemala, and Bri­tish Hon­duras. She spent five years at Flower’s Cove, re­spond­ing to con­stant calls.

“Although she was al­ways on the move, trav­el­ling many miles on foot, by dog team in win­ter and by boat in 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,” Cur­tis wrote in 1946 as Cur­rant was about to re­turn to Eng­land.

Since they were the only med­i­cal per­son­nel in the dis­trict, nurses on the sta­tions had to be­come adept at as­sum­ing what­ever role was nec­es­sary for the well-be­ing of their pa­tients and the smooth run­ning of the sta­tion. The in­de­fati­ga­ble Jean Smith re­flected on her first cou­ple of years with the Gren­fell Mis­sion, also at Flower’s Cove, in an ar­ti­cle in Deep Sea Fish­ers in 1947: “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.”

Smith was from a very able Bri­tish fam­ily — her fa­ther, grand­fa­ther, and brother were all doc­tors. Smith her­self was highly rec­om­mended by Gren­fell med­i­cal alumni in Bri­tain. In Deep Sea Fish­ers, Cur­tis praised her abil­i­ties: “The dis­trict is seventy miles long, in­clud­ing two thou­sand peo­ple, and is wholly de­pen­dent on this one nurse for med­i­cal as­sis­tance. Dur­ing the ‘ flu’ epi­demic Miss Smith was called upon night and day to see sick peo­ple, some­times thirty or forty miles away.” Smith later took up posts at sta­tions in North West River and Cartwright in Labrador and served for fif­teen years be­fore re­turn­ing to Eng­land.

ravel, some­times haz­ardous travel in what the lo­cals called “dirty weather,” was a stan­dard part of nurs­ing with the Gren­fell Mis­sion. The hos­pi­tals and sta­tions cov­ered large ge­o­graphic dis­tricts with nu­mer­ous out­ly­ing and sparsely pop­u­lated com­mu­ni­ties. Un­til the 1940s, there were three modes of travel to reach pa­tients: by foot, by boat, or by dog team. The lat­ter was the nicest, “though it has its thrills and spills,” Cana­dian nurse Ella He­witt wrote in Deep Sea Fish­ers. He­witt de­scribed one such trip: “The man on the fly­ing trapeze had noth­ing on us as we sailed down [a steep] hill amidst rac­ing, bark­ing dogs and shout­ing men, anx­ious to reach the bot­tom right side up! I grasped the sides of the coach box and held my breath as we charged into the set­tle­ment at the foot. … It was a most thrilling trip!”

After the Sec­ond World War, bush planes and snow­mo­biles were in­creas­ingly used to reach pa­tients. But these modes of travel brought other dan­gers. Nurse Jean Calder­wood was in­volved in a plane crash in 1946 while try­ing to reach La Ta­batière, Que­bec, where an in­fluenza epi­demic was rag­ing. As they were ap­proach­ing Tête-à-la-Baleine ( Whale Head) they no­ticed smoke com­ing from the en­gine.

“[ The pi­lot] took one quick look over his shoul­der and started to dive,” Calder­wood re­called in Deep Sea Fish­ers. “There was no time to pick a spot to land; we just went down at what seemed a ter­rific speed — a hun­dred miles an hour. The land­ing was any­thing but smooth, we bounced and pitched and all but rat­tled out of the cabin. We could plainly see the flames out­side the win­dow and fi­nally, when the plane came to a stop, the flames were lick­ing up through the floor boards. We wasted no time in get­ting out. I fell flat on my face un­der the plane be­cause of my slip­pery skin boots. … We all gath­ered at about fifty yards and watched the bag­gage, first-class mail, and my big black bag go up in smoke. We had no time to get these out since the plane was a roar­ing in­ferno al­most im­me­di­ately.”

Com­mu­ni­ca­tion was also a chal­lenge. Dur­ing emer­gen­cies, nurses could reach physi­cians by wire­less, but this was not al­ways re­li­able. Ra­dio-tele­phone sets were in all the sta­tions by the midtwen­ti­eth cen­tury, but fog of­ten played havoc with re­cep­tion, and there was no guar­an­tee of get­ting through.

De­spite the dif­fi­cult work­ing con­di­tions, the mis­sion rarely

UN­TIL THE 1940S, THERE WERE THREE MODES OF TRAVEL TO REACH PA­TIENTS: BY FOOT, BY BOAT, OR BY DOG TEAM. THE LAT­TER WAS THE NICEST, ‘THOUGH IT HAS ITS THRILLS AND SPILLS.’

had trou­ble re­cruit­ing nurses. Some felt called to serve peo­ple in need, while oth­ers de­sired the unique pro­fes­sional ex­pe­ri­ence the mis­sion of­fered.

The nurs­ing sta­tions usu­ally con­sisted of a dis­pen­sary, four to six beds for in-pa­tients, and an out­pa­tient clinic. It was while treat­ing out­pa­tients that the Gren­fell nurses ex­pe­ri­enced the most pro­fes­sional au­ton­omy. With no physi­cian present at the sta­tions, it was the nurse’s re­spon­si­bil­ity to see ev­ery case that came in the door, de­ter­mine their needs, and take the nec­es­sary ac­tion. Even in the smaller hos­pi­tals at Har­ring­ton Har­bour, North West River, and Cartwright, if the staff physi­cian was away on a med­i­cal trip, which could last for sev­eral weeks at a time, it be­came the nurse’s re­spon­si­bil­ity to see ev­ery­one who came to the hos­pi­tal for care. As a re­sult, nurses at the sta­tions and the smaller hos­pi­tals took part in the di­ag­no­sis of pa­tients to a greater de­gree than nurses in larger, more con­ven­tional hos­pi­tals.

They also per­formed emer­gency first aid at var­i­ous lev­els of dif­fi­culty, es­pe­cially clean­ing and su­tur­ing lac­er­a­tions of arms or legs and treat­ing sep­tic fin­gers and ab­scesses. The wounds as­so­ci­ated with the lum­ber in­dus­try were of­ten the most trau­matic. In 1944, a young Cana­dian nurse from Van­cou­ver, Alice Phillips, was posted to the nurs­ing sta­tion at Rod­dick­ton on the east side of the Great North­ern Penin­sula, an ac­tive log­ging dis­trict. Although she was a re­cent grad­u­ate and had no pre­vi­ous ex­pe­ri­ence in out­port New­found­land, she ac­cepted the post when no one else was avail­able dur­ing the Sec­ond World War.

Cur­tis re­ported on one of her ex­pe­ri­ences: “Miss Phillips wired me late one day that she was bring­ing a man with a trau­matic am­pu­ta­tion of the leg. At two o’clock in the morn­ing after a twelve-hour ride, an open mo­tor­boat chugged into the har­bour. Go­ing to the wharf we found Miss Phillips and her pa­tient, who was cov­ered with can­vas and sur­rounded by hot wa­ter bot­tles. His leg had been torn off above the knee when his clothes were caught in a mov­ing belt. Miss Phillips had given him in­tra­venous glu­cose, tied off the bleed­ing ves­sels, sprin­kled the wound with sulfa pow­der, and wrapped the stump in ster­ile dress­ings. We took charge of the pa­tient, and I told Miss Phillips to go to bed and stay in bed all the next day to get a rest. She replied that she would go to bed for a few hours but she must re­turn at day­light back to her post be­cause there were a lot of peo­ple who needed her at­ten­tion.”

There were many of these types of ac­ci­dents in the fish­ery, the lum­ber in­dus­try, hunt­ing and trap­ping, or the ev­ery­day busi­ness of life in ru­ral ar­eas. Bri­tish nurse Ivy Dur­ley per­formed so much emer­gency first aid that she re­flected: “[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.” Dur­ley en­joyed the work but also felt “a good deal of anx­i­ety in hav­ing the full re­spon­si­bil­ity.”

Nurses were also ex­pected to pro­vide vet­eri­nary care. Nurse Iris Mitch­ener re­called that “cows, dogs, and chick­ens, have all fea­tured in the out­pa­tient 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.” They were not al­ways the calmest pa­tients. An Au­gust 1943 re­port from Flower’s Cove in Deep Sea Fish­ers noted, “a dog was brought in last week, paw torn on a nail. Nine su­tures were needed. What bawl­ing!”

Den­tistry was an­other chal­lenge for Gren­fell nurses. Lack of den­tal hy­giene was a wide­spread prob­lem in the re­gion, largely due to the lack of den­tists and the lo­cal diet of “pota­toes, white bread, milk­less tea with mo­lasses; not to men­tion the nu­mer­ous can­dies,” wrote Smith in a let­ter to an­other nurse. Since nurses had no for­mal train­ing, they had to learn den­tal pro­ce­dures on their own, and not with­out ap­pre­hen­sion. Faced with her first ex­trac­tion, Cana­dian nurse Mary Tay­lor re­called get­ting out a 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.”

Within months of ar­riv­ing at Flower’s Cove, Dur­ley had al­ready pulled “dozens of teeth” and felt quite used to it: “My good strong arms have served me well on the men’s back mo­lars,” Dur­ley wrote in a let­ter to an­other nurse. Lesley Di­ack, who au­thored the book Labrador Nurse, wrote that she be­came so adept at “haul­ing teeth” that she ac­tu­ally ex­tracted one of her own and was “agree­ably sur­prised to find how pain­lessly [she] ex­tracted teeth.”

Mid­wifery and ob­stet­ri­cal work were also rou­tine, which is why the mis­sion re­quired that head nurses at the sta­tions also be mid­wives. Pa­tri­cia Cow­ley had so many ma­ter­nity cases at the be­gin­ning of one month at Port Saun­ders that she wrote in a let­ter, “it was like the [capelin] com­ing in.” In 1950, nurse Dorothy Jupp de­scribed in Deep Sea Fish­ers an au­tumn rush of de­liv­er­ies at her sta­tion. By the time she got to the last de­liv­ery, the “sup­ply of ster­ile goods had been used up, but the kitchen oven was pressed into emer­gency ser­vice” and they soon had enough to use. Jupp 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.

Some de­liv­er­ies were har­row­ing ex­pe­ri­ences for both mother and nurse. In a let­ter writ­ten in 1947, Dur­ley de­scribed a “bad spell” with a wo­man in labour who had blood poi­son­ing and eclamp­sia, a con­di­tion char­ac­ter­ized by high blood pres­sure and seizures. “She very nearly died on us,” Dur­ley wrote. She went on to de­scribe how she called an­other nurse, and “to­gether we tack­led her. I ap­plied for­ceps but both of us at full blast could not budge the head. … 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 hem­or­rhage later which we even­tu­ally con­trolled by 2:00 a.m. This loss was good in­so­far as it re­duced the like­li­hood of fur­ther fits, but [it] weak­ened her con­sid­er­ably.”

Dur­ley wrote that she was struck by a feel­ing of “ut­ter help­less­ness” dur­ing the de­liv­ery and by how fright­en­ing it was that “help was so ut­terly out of reach.” Nurses were not trained to per­form Cae­sarean sec­tions. When they rec­og­nized that a com­pli­cated de­liv­ery was be­yond the scope of their prac­tice, they did what­ever they could to save moth­ers’ lives and trans­ferred them to the near­est hos­pi­tal.

The moth­ers were un­re­servedly grate­ful to the nurses. One new mother wrote in 1949: “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.”

By stitch­ing up wounds, pulling teeth, and de­liv­er­ing ba­bies, the Gren­fell nurses were in fact the “back­bone” of the or­ga­ni­za­tion, as Cur­tis stated. The mis­sion con­tin­ued to pro­vide med­i­cal care for the re­gion well into the twen­ti­eth cen­tury. After New­found­land joined Con­fed­er­a­tion in 1949 it re­ceived ad­di­tional fund­ing from the fed­eral and provin­cial govern­ment, and in 1981 the or­ga­ni­za­tion handed all of its nurs­ing sta­tions, hos­pi­tals, and other med­i­cal re­sources over to the prov­ince.

To­day, the Labrador- Gren­fell Re­gional Health Author­ity de­liv­ers med­i­cal ser­vices to the area for­merly un­der the Gren­fell Mis­sion’s care. Gren­fell re­mains ac­tive as a pri­vate foun­da­tion and reg­u­larly awards grants to non-profit or­ga­ni­za­tions for im­prov­ing the health, ed­u­ca­tion, and so­cial wel­fare of peo­ple in north­ern New­found­land and coastal Labrador.

The map shows the lo­ca­tion of Gren­fell nurs­ing sta­tions and hos­pi­tals in New­found­land's Great North­ern Penin­sula, Labrador, and Que­bec's Lower North Shore, circa 1940.

A nurse stands by as Dr. Wil­fred Gren­fell ex­am­ines a young pa­tient be­ing held by a wo­man, pos­si­bly also a nurse, at Har­ring­ton Har­bour, Que­bec, circa 1905 to 1915.

Nurse Kath­leen “Jo” Lut­ley dis­plays snow­shoes.

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