272
PUBLIC RECORD OFFICE
Reference :-
TILTIC.O. 885
6
COPYRIGHT PHOTOGRAPH-NOT TO
REPR
WIT
ED PHOTOGRAPHIC- PERMISSION OF THE
OFFICE, LONDON
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Enclosure 3 in No. 6.
REPORT ON NURSING in MAURITIUS,
General Facts bearing on the Subject.
The population of Mauritius (1891) was 377,986, of whom 258,985 were natives of India or of Indian parentage. The general population numbered 119,001, including coloured Creoles, a small but socially important element of pure French descent, a still smaller English element, and about 4,000 Chinese.
The Roman Catholics number about 108,000, the Protestants 8,000, the rest are of various creeds proper to India and China.
The European residents, to whom the Right Hon. the Secretary of State refers in his Despatch of 27th December 1895, correspond practically to the English element. The average number They are distinguished into two groups-the military and civil. of soldiers in Mauritius, for the eight years ending 1888, was 436; perhaps it may be
I somewhat larger at present. The civil resident European population does not, hend, exceed 200. These are employed in different branches of the civil service and in mercantile houses. The English mercantile community, as also the civil servants, has decreased very much of late years.
appre-
Present Provision for Medical Care of the Creole and Indian Populations. The civil hospital in Port Louis is an important institution, with special wards for Europeans, Indian, and Creoles, and is nursed successfully by a Roman Catholic sister-
There is also in the town a convent hospital for private patients.
hood.
Local hospitals are maintained in the nine districts into which the Colony is divided. On each sugar estate an hospital is provided for the Coolies working on the estate and their families.
There are no fewer than 76 medical practitioners on the island, almost all of whom are natives, who have been educated in England or France.
Nursing-Much nursing at home, in cases of serious illness, is done by the sister- hoods of Notre Dame de Bon Secours, des Filles de Marie, des Réparatrices, and Nôtre Dame de Lorette. Still there are doubtless many instances among the poor Creole population in which a lack of good nursing is sadly felt. This class, as a rule, is too poor to pay a nurse.
Midwives.-The midwives in 1892 were 54 in number, two of whom possessed European diplomas of high merit, and one had a diploma from the medical authorities of Réunion, the others had been examined and licensed by the chief medical officer. They are restricted by law to the management of cases of natural labour only. I believe they perform their duties satisfactorily, but it is deserving of consideration whether something more should not be done to secure a higher training in midwifery as well as a training in general nursing for this class. The character of the examination might be raised with advantage, and should be conducted by a board presided over by the chief medical officer.
As the law forbids them undertaking any but cases of simple labour, it has been thought that the present examination furnishes a sufficient guarantee for their ability to fulfil the duties entrusted to them. But a higher standard of qualification is, in my opinion, both desirable and attainable.
The better educated a midwife is, the less likely will she prove meddlesome, and consequently dangerous, in simple cases, and she will be the more able to foresee danger and apply for help in time.
As her present functions are restrained and rightly so-chiefly to nursing, it is important that she should be able to do this well; but for this she requires special training, both in midwifery and in nursing. It would be an advantage for the com- munity to have at their disposal the services of a nurse so trained when she was not otherwise employed.
Should this suggestion meet approval, it should not be found difficult for the chief medical officer, who is a man of ability and experience, to devise the means of carrying out the training of the future midwife-nurses at the civil hospital or elsewhere.
European Residents.
It is of importance to observe that they form a very small body so that a scheme for supplying them with English trained nurses need not be an extensive or expensive one.
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The want of a skilled English nurse has often been felt by the English residents. Hitherto they have had to rely upon the willing, but untrained, assistance of their friends. In more severe and tedious cases, recourse has been had to the Sisters, who, in these circumstances, are sent in pairs, and, being trained, have proved very useful.
But apart from the fact that duties have sometimes to be performed that are repugnant to the feelings of a sister of a religious order, many patients naturally prefer to be attended in sickness by a countrywoman who understands English ways and feelings.
To meet this want, one, or at most two, trained English nurses would suffice. If the subject were taken in hand by the Governor's lady, or by some lady of social position and influence, there ought to be no difficulty in raising funds sufficient for the purpose. If two nurses were got out, they might do something (if they had their profession at heart) in training nurses for the benefit of the Colony in general.
I shall be happy to furnish any further information that may be required.
ANDREW DAVIDSON, M.D., F.R.C.P. Edin.,
30, Morningside Drive, Edinburgh.
Enclosure 4 in No. 6.
JAMAICA.
MEMORANDUM re TRAINED NURSES,
Prior to 1890, hospital nurses were partially trained at the Public Hospital, Kingston, by the matron; as the latter was not herself a trained nurse, the system was necessarily imperfect, and the nursing defective in many essential particulars.
In 1890 Bishop Nuttall, the present Primate of the West Indies, inaugurated a deaconess home in Kingston, in connexion with which he introduced a highly trained nursing sister from Mildmay. There being no practical field available outside the Kingston Hospital, I decided, after a conference with the bishop, to place a division of that institution at the disposal of Sister Kate as a nursing school; the experiment so far has proved eminently successful, and many highly respectable young women, some of them daughters of the gentry, are now available as expert nurses for all classes of the community both in town and country. The training also of persons to fill the position of matron to the Government hospitals in the country as well as for other public institu- tions where skilled training is so essential must be recognised as an additional benefit conferred on the country by the system now in operation. I should add that these excellent results have been secured without any expense to the Colony, and are mainly due to the initiative of the Bishop of Jamaica.
In 1891 the Victoria Jubilee Maternity Hospital was opened in Kingston for the reception of lying-in women. In 1892, before I returned to England, at the request of the Government I inaugurated a school for the training of midwives at this institution. Through the assistance of the Crown Agents a highly trained matron, possessed of con- siderable experience, was procured from England. Rules were formulated for regulating the admission, training, &c., of the pupils, who were provided with rooms and messed in the hospital. Numerous applicants were forthcoming, but, as the object of the scheme was to provide trained midwives specially for the humbler classes throughout the island, selections were in the first instance made from the different parishes with the view of distributing these trained midwives as much as possible in the several districts. All pupils before joining were required to subscribe to the following amongst other condi- tions. To complete the stipulated course of training, and, after examination, when certificated, to reside in, and to place their services at the disposal of the humbler classes in, the districts previously allotted at a small fixed rate, which was considered within the capacity of all except the very poor, and in the case of the latter the Inspectors of Poor pay the small fees.
The practical training and lectures are conducted by and under the immediate supervision of the medical officer and the matron. Each pupil, before being certificated, is required to undergo a strict practical examination. My successor, Crane, has testified to the excellent results already conferred upon the community by the above systems. The expenditure in connexion with the Jubilee Hospital and school is voted annually by the Legislative Council.
O 91826,
C