HISTORY OF NURSING IN AFRICA
The word “nurse” originally came from the Latin word “nutrire”, meaning to suckle, referring to a wet-nurse; only in the late 16th century did it attain its modern meaning of a person who cares for the infirm.
The history of Nursing in Africa, evolved through the pre colonial, colonial and the post colonial periods. In the pre-colonial days in most African countries, not much is known about nursing. However, like in Europe and rest of the world, nursing care took the form of experimental practice arising from the sick and the wounded, especially in certain parts of the countries where inter and intra-tribal wars frequently occurred.
This article would look at the history of Nursing in Africa, narrowing it down to certain highlighted African countries.
COLONIAL INFLUENCE IN AFRICA
Owing to the British colonial influence in the African region, the concept of regulating the health professions extended from South Africa throughout the continent. Nursing and midwifery professions were the first professions to be established on the African continent and to ensure statutorily recognised education and training centres, statutorily recognised curricula, statutory nursing examinations, and statutory certification of nurses (Searle et al., 2009).
Colonial influence in South Africa
South Africa has its own Florence Nightingale in Sister Henrietta Stockdale, who established a great nursing school in Kimberly in the 1880s. Not only was she the first to establish modern professional training standards, at least for white South African women, but she also provided the profession with its founding charter. Her influence was felt and appreciated from Cape Town in the South to Bulawayo in the North (Marks, 1994).
Colonial Influence in other African countries
The independent states of Botswana, Lesotho, Swaziland, Zimbabwe, Zambia and Malawi have British colonial influence on the development of nursing and midwifery. The statutory provision of state registration for nurses and midwives which was enacted in the Cape Colony in 1891 was of a voluntary nature. The Cape colony hospital boards entrenched the concept of requiring that all trained nurses and midwives appointed to posts under their control be registered, so that standards of education and training, and level of competence, responsibility and accountability, could be verified and disciplinary control exercised legally (Searle et al., 2009).
The authorities responsible for the Southern Rhodesia (Zimbabwe) and Malawi required all trained nurses and midwives appointed to posts under their jurisdiction to be registered with the Colonial Medical Council of the Cape Colony. Zambia recruited nurses from Great Britain, South Africa and Zimbabwe and few Zambian personnel were sent to these countries for training.
Cape Colony in South Africa was the first in the world to provide state registration for nurses under the Medical and Pharmacy Act 34 of 1891. Ethical concepts became integral in the teaching of nursing and midwifery (Searle et al., 2009).
The change in the 1940s included gender, colour, class, and racial discrimination. Hospital was a profoundly gendered social institution. There was subordination of almost the entire female profession to nursing and medicine to their male counterparts. While discourses of gender were central to much colonial thinking, many middle class women successfully manipulated these discourses to their own advantage.
Not only the black nurses experienced the turmoil, but also the white sisters against their colonial bosses trained in Britain and Europe (Searle et al., 2009). The immigration of overseas trained nurses increased anxieties about white nurses in a colonial environment and new tensions between the local and the overseas nurse came to the fore. The Nursing Act 69 of 1957 provided for the distinction in respect of training and registration to be made on racial grounds.
Colonial Influence in Nigeria
When Nigeria became a formal colony under the British Administration in 1914, nursing was among the first recognized and accepted professions in the British colony. The immediate benefit was the recognition of the overwhelming need of Nursing and Midwifery Services in all its colonies by the government of Britain. Nursing and midwifery practice was given its prime position, because of its relevance and direct impact on the lives, health and well being of the army, administrators, their families and the society in general.
The British government therefore made efforts to modernise nursing education and practice in the colony in line with the wind of change that was blowing across Britain due to the results of the post Crimean War .During the colonial period, as Florence Nightingale evolutionary concept of nursing was gaining foothold in Europe, so was the effect in communities with European presence and Nigeria being a colony of the British at the material time was no exception. By the time the British Empire took over the administration of the territory of Nigeria as one of its colonies in the fall of 1861, the European style of nursing care had started to influence the practice of nursing.
In 1930, formal training of nurses and midwives started in Nigeria mostly in the mission hospitals and a few locations in the existing government hospitals (Adelowo, 1988). The training of nurses and midwives in the country then was regulated by the Nursing and Midwives Board of Nigeria established by the Ordinance of 1930 and inaugurated in June 1931. In 1952, the University College Hospital, Ibadan established its School of Nursing with Mrs. Bell, a graduate of Florence Nightingale School of Nursing, St Thomas Hospital, London and a nurse tutor from Britain, as the first principal of the school. The minimum basic education entry was a full secondary education. However, for reasons unknown, the minimum acceptable educational qualifications were Standard VI and Government Class IV perhaps for other government nursing schools, due to limited number of qualified candidates.
At the end of the training, the graduates obtained the State Registered Nurse (SRN) Certificate of the Nursing Council of England and Wales. The training at the School of Nursing, University College Hospital, Ibadan was recognized for the British State Registered Nurse (SRN) Certificate, thus the tone for higher and better nursing education in the country started to have a facelift (Koyejo, 2008).
MISSION HOSPITALS AND TRAINING OF BLACK NURSES
Missionaries trained the first professional African nurses at the beginning of the
twentieth century in South Africa. Miss Mary Balmer in February 1903 started training two black women as professional nurses: Cecilia Makiwane and Mina Colani at Victoria hospital (Marks, 1994). In Nigeria, there was no formal training for the treatment of the sick as missionaries in the 19th century who settled in Abeokuta (South West Nigeria) and Calabar (South South Nigeria) and engineered the establishment of dispensaries and mission posts, and helped in the treatment of the sick and carrying out relief work amongst the citizens in addition to the care of those in the convents. It later progressed to other towns including, Lagos, Ibadan, Ijaiye, Onitsha, Bonny, Calabar, Itu, Unwana, Lokoja, Wusasa and Zaria. Each of these mission posts had a doctor and nurses resident therein. These e structures later formed the nucleus for the early training schools of nursing and midwifery in Nigeria. The training of nurses and midwives during this period was informal being an apprenticeship-type of training of “do as you were told”.
HISTORY OF NURSING IN KENYA
In 1908, nursing in Kenya began when missionaries who visited Kenya provided training. The first nurses were primarily male and were known as “dressers.”Their primary responsibilities included dressing wounds, administering injections, and managing hospitals
Before 1950, nursing in Kenya was conducted without a formal framework. Most health care institutions provided in-service training for healthcare workers, to assist the whites in the provision of required healthcare, thus making it difficult to identify healthcare workers according to their level of training and scope of practice.In 1950 meeting of the Nurses and Midwives Council of Kenya members passed a resolution that formally described the different cadres of nurses who were practising nursing in Kenya at that time. The titles of State Registered Nurse, Kenya Registered Nurse, and Assistant Registered Nurse Grade 1 and 2 remained in force on the basis of Registration and Training.
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Chukukere Chidimma Adaugo