[
    {
        "id": 213035,
        "series_id": 26,
        "series_slug": "histsyn-rashkb-journal-engine",
        "series_title": "RASHKB Journal 皇家亞洲學會香港分會學刊",
        "series_use_hku_proxy": false,
        "document_key": "RAS-1993",
        "page_number": 103,
        "title": "RAS-1993",
        "content_text": "83\n\nestablishment in 1893 of the Nethersole Hospital for women and children, as part of the Alice Hospital, with Mrs. Stevens as Matron. These three steps drew attention to women's health in general, but a maternity service for Chinese women in particular resulted from the support of the Chinese elite and the LMS in the context of public health fears about infant mortality.\n\n4\n\nMrs. Stevens had reported in 1898 that the Alice hospitals did not have enough wards for women. The two beds set aside for maternity cases at the Nethersole Hospital were not only inadequate to meet demand, they were inappropriately placed in the eye ward, where labour was disruptive for general patients, especially when an operation was necessary, and the mothers and other patients were at risk of cross-infection. The number of cases treated had steadily increased to seventeen in 1900. Therefore an Obstetric Bungalow was mooted and a call for public subscription made in 1901. Correspondence notes that funds were only slowly forthcoming, fund-raising limited by the guidelines of the LMS as a mission. For example, the enthusiasm of the wife of the American consul was dampened when the LMS would not agree to fund-raising from a Charity Ball or Theatricals. It took a move from the Chinese establishment and the sanction of government for midwifery training for the plan to materialise.\n\nFor the government, infant mortality was not only a public health risk, a fear heightened at the time of the 1894 plague because of the abandonment of bodies, it also prevented a tidy collecting of demographic statistics. Births and deaths information was of course essential to plan public health services and control contagious and infectious diseases. The problem was that deaths were not recorded and it was only male babies that were registered at the ancestral halls when one month old. In 1896 a Bill recommending the registration of Chinese Midwives' and 'Chinese Doctors' was drafted, but not presented, such regulation being seen as premature.\n\nHowever, it became clear to the government that a Chinese midwifery service which would enable the recording of births was desirable. In 1901, the Medical Officer of Health recommended the payment of a small fee to the Chinese midwife to report the birth, and in 1902 arrangements to train Chinese midwives at the Civil Hospital were made. In 1904, an Inquiry into Chinese Infant Mortality recommended the payment of a fee to the registrant of a birth, and the employment of female visitors to verify",
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    {
        "id": 213042,
        "series_id": 26,
        "series_slug": "histsyn-rashkb-journal-engine",
        "series_title": "RASHKB Journal 皇家亞洲學會香港分會學刊",
        "series_use_hku_proxy": false,
        "document_key": "RAS-1993",
        "page_number": 110,
        "title": "RAS-1993",
        "content_text": "90\n\nto them that I came from the new Hospital and that I should be glad to do anything for them if they would send for me Very few of them grasped it I am afraid Chinese husbands I suppose do not tell their wives much.\n\n35\n\nThe remedy for this situation was precluded by the organisation of medical practice at the time, the second issue. Professional ethics made it impossible for Dr. Sibree to increase her work by taking patients from the registered doctors in private practice in Hong Kong, 36 who in 1900 numbered fifteen. Outpatient work and home visits amongst poor patients were the territory of students of the Hong Kong College of Medicine, for whom the Alice was the training ground. While Dr. Sibree bemoaned the fact that she was becoming 'rusty' for lack of general medical work and that the work with women and children was inadequate, with no way clear to improve the situation, Dr. Gibson was adamant that she be given no share of the general medical work of the Alice or Nethersole Hospitals. Indeed, he dissented from the District Committee's support for her clinic at Sham Shui Po on the grounds of her health, itself an attitude produced by prevailing views about women:\n\nWith reference to the foregoing minute and Resolution Dr. Gibson desires it to be recorded that he takes no responsibility in the event of the work becoming too great for Dr Sibree as it is likely to do if she undertakes much general medical visitation.\n\n19\n\nThe Sham Shui Po clinic apparently did not eventuate. Why was Dr. Alice Sibree not acceptable for general medical in addition to maternity work? Before her arrival, Dr. Gibson had requested that a male medical missionary be sent as locum so that he could take furlough. It is not coincidental that this request was made shortly after the appointment of Dr. Sibree had been advised. Dr. Sibree, although a claimed equal, was not considered, and appears to have been excluded from consideration, as an acceptable replacement for Dr. Gibson. The reason becomes clear when the locum, Dr. Mitchell, explained why Dr. Sibree had been excluded from general medical work. The reason, simply stated, is that a woman doctor was unacceptable to the Chinese, be they patients, doctors or medical students:\n\nNeither of the House Surgeons would be willing to take orders from a lady doctor, nor would it be easy to find any Chinese medical",
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    },
    {
        "id": 213050,
        "series_id": 26,
        "series_slug": "histsyn-rashkb-journal-engine",
        "series_title": "RASHKB Journal 皇家亞洲學會香港分會學刊",
        "series_use_hku_proxy": false,
        "document_key": "RAS-1993",
        "page_number": 118,
        "title": "RAS-1993",
        "content_text": "98\n\nwere well pleased with her qualifications. From 1 January, 1911, Dr. Perkins took over the supervision of government midwives. One can only assume that, although the position had been more or less promised to Dr. Sibree by the government's Medical Officer of Health, Dr. Gibson was able to gain the reinstatement of the AMMH. This was probably supported by the Legislative Councillor and Chairman of the Alice Hospitals, Dr. Ho Kai. Thus, the AMMH was again the provider, through its Lady Doctor, of the supervision of government midwives. That decision was clearly linked with the designation of the Medical Superintendent and Lady Doctor of the AMMH as members of the Midwives Board in the 'Midwives Ordinance', proclaimed in September, 1910.\n\nThe resistance of the District Committee and Dr. Gibson to the inclusion of extra Chinese subscribers on the maternity hospital's management subcommittee was overcome shortly after, when a proposal to add two subscribers was linked with a proposal to build a Training Institute for Nurses and Midwives. As well, the right of subscribers to nominate students for training was agreed. Finance was subsequently raised in the Chinese community for the project, which was opened in March, 1914.\n\nOutcomes and Implications of This Development Process.\n\nBetween 1903 and 1911, then, the first maternity hospital for Chinese women was built and training for Chinese midwives set up. That it happened at all was due to the convergence of interests of the LMS, the Chinese elite and the Hong Kong Government. The struggle for control in pursuit of sectional interests, Dr. Gibson versus the LMS District Committee, Dr. Gibson and the District Committee versus the Chinese subscribers, and the position of the LMS in relation to medical education, placed difficulties seen to be insuperable in the way of the Lady Doctor and the development of her service, as she was excluded from general medical work.\n\nIt is hard to reconcile the picture of Dr. Sibree as portrayed in the correspondence of her detractors as unable to adapt; lacking initiative; reluctant to state her case to the District Committee directly, rather going behind their backs to the LMS; and publicly denying any problem in her relationship with Dr. Gibson, with the strong figure she later appears. Dr. Sibree married Mr. C.C. Hickling, son of the Rev. C.H. Hickling, pastor\n\nI",
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    },
    {
        "id": 213052,
        "series_id": 26,
        "series_slug": "histsyn-rashkb-journal-engine",
        "series_title": "RASHKB Journal 皇家亞洲學會香港分會學刊",
        "series_use_hku_proxy": false,
        "document_key": "RAS-1993",
        "page_number": 120,
        "title": "RAS-1993",
        "content_text": "100 \n\n빠 \n\nin the schools of Hong Kong, although the strength of traditional attitudes is reflected in the failure to admit female students to the University of Hong Kong at its inception. Dr. Sibree's relationship with the LMS in Hong Kong was permanently soured, although in a letter to Dr. Thompson in 1910, she said: 'I assure you I felt leaving the LMS very much and am anxious to help the Society as I ever was',\" and she corresponded warmly with Miss Rayner, the Matron of the Alice, during the 1920s. Mr. Pearce advised against her being invited back to run the maternity work in 1922, claiming that she wherever possible undermined the mission's work.\" She is seen as the most significant figure in the development of maternity services and midwifery training in Hong Kong, yet the most successful part of her career appears to have followed her resignation from the LMS. \n\nThe dominant position of the Alice group of hospitals in the development of Western medicine for Chinese people, and in particular the provision of midwifery and training of Chinese midwives was itself undermined in later years, overtaken by secular progress in provision of maternity services, and the lack of continuity in its own service, as Dr. Gibson had feared. Dr. Perkins resigned in 1913 to marry Dr. Mitchell, returning to Hong Kong and the hospital in 1919, and a new Lady Doctor was not in place until Dr. Turner arrived in 1921, but she also resigned to marry in 1922, the year in which the Drs. Mitchell also took leave. A long-term woman doctor was only found in the arrival in 1925 of Dr. Annie Sydenham, who developed the maternity service until her retirement in 1954. Dr. Gibson served as Medical Superintendent from his arrival in 1896 to 1918, and again from 1924 to 1935, in all 33 years, during which the hospitals expanded, including their maternity work, \n\nIt is ironic that the much vaunted factor in preventing Dr. Sibree's satisfaction with her work, the fact that she was unacceptable to students and hospital doctors, backfired. With the professionalisation of medicine, the Hongkong College of Medicine was transferred to the University of Hong Kong in 1911. Dr. Gibson was proud of his role in lecturing to the College students and was concerned that the Alice should maintain a role in clinical teaching after the establishment of the University faculty. An Endowment Fund had been set up in 1907 to support the growth of the Hongkong College of Medicine in a separate building. At the opening of the University, Dr. Thomson, the former Medical Superintendent of the Alice, and Dr. Gibson were appointed life members of the Court. Subsequently, Dr. Gibson's teaching was removed. In 1913, he reported \n\nPage 120\n\nPage 121",
        "txt_file_path": "txt/dfo323lmgvd/RAS-1993.txt",
        "external_url": "https://digitalrepository.lib.hku.hk/catalog/66833t302",
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    },
    {
        "id": 213053,
        "series_id": 26,
        "series_slug": "histsyn-rashkb-journal-engine",
        "series_title": "RASHKB Journal 皇家亞洲學會香港分會學刊",
        "series_use_hku_proxy": false,
        "document_key": "RAS-1993",
        "page_number": 121,
        "title": "RAS-1993",
        "content_text": "101\n\nthat he had been reinstated as a lecturer, but in 1916 he resigned that position, since the Chair of Surgery had been established, and could only be held with clinical rights at the Government Civil Hospital. Why Dr. Gibson was treated as Mr. Pearce said 'shabbily', is not known, although in Dr. Mitchell's eyes, there had been no necessary connection between the LMS and medical education, and he had warned against any expectation of a linkage.\" The effect, however, was to remove the students from the institution of the Alice, and with it, the main rationale justifying the exclusion of the lady doctor from general medical work. By this time, maternity work had grown and lack of work was no longer an issue. 94\n\nThe AMMH was most important in the establishment of Hong Kong's maternity service for several reasons: first, the resources set up were both hospital-based and domiciliary, and therefore set the parameters for subsequent development, which included hospitals, maternity clinics, and government midwives attending home births. Secondly, under the umbrella of the LMS, the place of Western medical practice amongst the Chinese people was strengthened, demand increasing in the post-World War I decades. Thirdly, female doctors acquired a primary role in service provision and thereby a career pathway for Chinese women as doctors and midwives was opened. That pathway was to extend to general nursing, although even until the 1930s at the Alice Hospital, male dressers, supervised by female European nurses, were needed to work in male wards. Fourthly, a service which was accessible to all classes of Chinese women was set in place. That is, poor women were looked after on the basis of need, whereas the wives of the wealthy Chinese subscribers were entitled to care in terms of the Lady Doctor's contract. The outcome was a service that was, as much by default from the power play between Dr. Gibson and Dr. Sibree as by intention, culturally appropriate to the Chinese community. That is, status differentials were recognised, and at the same time, the level of qualification seen as adequate for a public health-oriented service was selected, analogous to the level of training for the Chinese doctors.\n\nThe lack of continuity in the service left a gap which, with greater recognition of need, was filled by secular agencies, as the Chinese Public Dispensaries Committee set up a maternity home in Wanchai in 1919, run by Dr. Alice (Sibree) Hickling, followed by the Tsan Yuk Hospital in 1922. The Tung Wah and Kwong Wah Hospitals improved their maternity service, and domiciliary care was the province of the",
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    },
    {
        "id": 213054,
        "series_id": 26,
        "series_slug": "histsyn-rashkb-journal-engine",
        "series_title": "RASHKB Journal 皇家亞洲學會香港分會學刊",
        "series_use_hku_proxy": false,
        "document_key": "RAS-1993",
        "page_number": 122,
        "title": "RAS-1993",
        "content_text": "102\n\ngovernment midwives. The Civil Hospital improved its standards as it was required to provide the clinical training facilities for the University. The Chinese subscribers, who had so generously supported the development of the LMS hospitals, gained and strengthened their power on its committees, but were involved also in these secular developments. The death of Dr. Ho Kai in 1914 coincided with staff shortages and restricted finance for the hospital, as war clouds gathered, making it harder to regain the lead. On the resignation of Dr. Sibree, the impetus for leadership and innovation was lost by the AMMH, although demand grew. It was not restored until the arrival in 1925 of Dr. Annie Sydenham, who, as a long term incumbent, was in a position to introduce preventive and outreach programmes. By this time, the initiative and future form of the service had passed into secular hands, those of the Chinese Public Dispensaries and the Hong Kong Government.\n\nNOTES\n\n1LMS Eastern, South China Box 15, 1903, No 274 Mrs Stevens, (Matron of the Alice Memorial Hospital) to Mr Cousins, 24 April 1903\n\n2Hong Kong Sessional Papers 1884 29/84, Par 39-42 Dr Ayres' opinion could be seen as either to support the policy of separation of medical services for the Chinese, or, by suggesting the attendance of Western doctors, to be promoting increased influence over the Tung Wah Hospital. At the same time, the Civil Hospital was a general hospital, with no separate maternity area, and its role was to provide primarily for the non-Chinese community. The relationship between the Tung Wah Hospital and the Hong Kong Government is analysed in Elizabeth Sinn, Power and Charity: The Early History of the Tung Wah Hospital, Hong Kong (Hong Kong: Oxford University Press, 1989)\n\n3Daily Press, 27 April, 1897\n\n4Mrs Steven's Report 1891-99\n\n5LMS South China Box 15, 1901 No 263 Dr Gibson to Mr Cousins, 1 February, 1901\n\n6Mrs Steven's Report 1901 Alice Hospital Archives Copy\n\n7May to Lyttelton, 21 July, 1904, #291 CO129/323\n\n8LMS Box 12, 1892 No 212 Report of the Annual Meeting of the Finance Committee, enclosed with a letter from Dr. Burton, 19 April, 1893\n\n9LMS 1908 Box 17, 1908 Memorandum from Dr Gibson to LMS Directors, 26 March, 1908",
        "txt_file_path": "txt/dfo323lmgvd/RAS-1993.txt",
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    },
    {
        "id": 213059,
        "series_id": 26,
        "series_slug": "histsyn-rashkb-journal-engine",
        "series_title": "RASHKB Journal 皇家亞洲學會香港分會學刊",
        "series_use_hku_proxy": false,
        "document_key": "RAS-1993",
        "page_number": 127,
        "title": "RAS-1993",
        "content_text": "107\n\n74 See LMS Box 18, 1909 No 311 Minutes of the HKDC Annual Meeting, 2-3 February, 1909, Box 18, 1909 No 314 Minutes of the HKDC Meeting, 22 June, 1909, and LMS Box 18, 1909 No 315 Mi Pearce to Rev G Currie Martin, Joint Foreign Secretary It is not clear why Dr Sibree did not resume her position. An amount of $1600 paid to her as Supervisor of Government Midwives was in dispute as to whether it should be deducted from the guarantors' payment at $10,000 (LMS Box 18, 1909 No 313 Mi Wells to Mr Cousins, 27 May, 1909), as well, the guarantors had declined to pay Dr. Sibree's rent (LMS Box 18, 1909 No 312. Mi Wells to Mr Cousins, 17 March, 1909) Thus, paradoxically, material matters may have been the last straw'\n\n75 LMS Box 18, 1909 No 315 Personal letter from Mr Pearce to Mi Currie Martin, 13 September, 1909\n\n76 The final evidence produced by Dr Sibree was the wording of Clause 4 of the 1910 Midwives Ordinance, which legislated his position that is, the Midwives Board was to comprise the Medical Superintendent of the Alice Memorial Hospital and the Lady Doctor attached to it, (plus three others). This indicates that the lady doctor was not the medical superintendent of the hospital of which she had charge See endnote 79\n\n77 LMS Box 18, 1910 No. 319. Dr Sibree to Dr. Thompson, 26 September, 1910\n\n78 LMS Box 18A, 1911 No 320 Dr Gibson to Mr. Martin, 17 December, 1910\n\n79 ibid, Dr. Gibson to Mr Martin. 7 December, 1910\n\n80 The agreement between the Hong Kong Government and the Alice Memorial Maternity Hospital, 31 December, 1904, stated that, on graduation, the midwives trained at the AMMH would be at the disposal of Government for three years, salaried and providing free services to Chinese women in labour under the supervision of the Lady Doctor The Lady Doctor, at that time the only one, was later taken to refer to the AMMH lady doctor Quoted in LMS Box 17, 1908 'Memorandum to Hongkong DC' from Dr. Gibson, attached to Mr. Pearce to Mr Cousins, 17 August, 1908\n\nWith the introduction of the 'Midwives Ordinance' in 1910, the composition of the Midwives Board was specified as 'The Principal Civil Medical Officer, the Superintendent of the Alice Memorial Maternity Hospital and the Lady Doctor attached to the same', plus three persons appointed by the Governor for a three-year term See An Ordinance to secure the better training of Midwives and to regulate their practice' No 22 of 1910, clause 4. Hongkong Government Gazette, September 2, 1910, p 395\n\n81 LMS Box 18A, 1911 No 323 Mr Clayson to Rev Currie Martin, 25 February, 1911\n\n82 The Hong Kong Daily Press, 24 September, 1928\n\n83 Blue Books 1918, 1926 Her title was in 1928 changed to 'Assistant Visiting Medical Officer to Chinese Hospitals and Dispensaries See Blue Book, 1928\n\n84. The China Mail, 22 September, 1928, The Hong Kong Daily Press, 24 September, 1928",
        "txt_file_path": "txt/dfo323lmgvd/RAS-1993.txt",
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    },
    {
        "id": 213061,
        "series_id": 26,
        "series_slug": "histsyn-rashkb-journal-engine",
        "series_title": "RASHKB Journal 皇家亞洲學會香港分會學刊",
        "series_use_hku_proxy": false,
        "document_key": "RAS-1993",
        "page_number": 129,
        "title": "RAS-1993",
        "content_text": "109\n\n94 LMS Box 19, 1913 No 340 Di Gibson to Mi Lenwood, 18 June, 1913 Enclosure - Maternity Hospital Statistics, 1912\n\n95\n\nIn her Annual Report of 1940, Matron Ward reported 'girls taken their turn at male nursing so naturally that we almost forget we ever worked in any other way' Report of the Alice Memorial and Affiliated Hospitals for the year 1940, p 9\n\n96. It is interesting that this principle underlay the use of \"barefoot doctors\" in China's recent history, and is a direction endorsed by the Alma-Ata recommendations of the World Health Organization in 1978 It can be argued that this policy direction reflects not race, but a rational and appropriate use of scarce resources.",
        "txt_file_path": "txt/dfo323lmgvd/RAS-1993.txt",
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    }
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