History of Nursing in Pacific Canada

[W.H.O. Diary Entries 1949-1952?] Creelman, Lyle, 1908-2007 1952

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  PI Aire
~1fttiy 31,1949—-Left London about 9 A.M. in the pouring rain.  The B.O.A.C,
craft was very comfortable , more so than the T.G.A. except that the
seat<g are not adjustable.  Not the long hops here.  It was fine when we
were flying over France and about noon I looked up and there were the
Alps towering over the Juras in the brilliant sunshine.  In a few
minutes we were circling over beautiful blue Lac Lehman and then we
landed at the Geneva airport.  Customs was very simple and very soon we
were seated in the big open roofed bus and off to Geneva.  I liked the
first sight o^f the eity and the flower boxes everywhere reminded me so
much of home and especially of Victoria. Olive Baggallay met me at the
Station and then we went to Hotel Victoria where I was booked. We had
lunch in in outdoor cafe and the pleasant life of Geneva seemed very
attractive.  A'he language was confusing and I wondered if I would ever
understand any of it or make myself understood. jfln the afternoon we
were to go to Br. Eliot's for tea. Olive called for me and I was
surprised to find that triere were just to be the two of us.  After tea
Dr. Eliot proceeded to go over a new organization chart which she was
preparing for W.H.O.  In it I could see myself set aside in the M.&.C.H.
Section and almost completely away from nursing.  I felt very discougageS
That was partly because of the strangeness, the fact that I was tired and
homesick, and fundamentally because I was not yet prepared to take the
second position.  When I got back to the hotel I felt that I just could
not cope with going out to eat although I was rather hungry.  When I
opened my door there was a lovely planf and a little note of welcome
from Yvonne and Fetch.  That meant a great deal to me.  Then in a few
minuted the phone rang and Yvonne was downstairs.  I told her that I had
just decided that I couldn't cope with the language enough to order a
meal so she insisted that we go out for a little drive and then have some
tea.  We later called on Fetch who was in hospital. Thus ended my first
half day in Geneva—it seemed a very long and difficult one.
AugS 1—Reported at the office.  Room 440, with a lovely view of Mt.Blanc
and the Lake. Olive had spoken of the luxurious office and I was rather
surprised to fing bare walls and floor, and also to f ing her sharing it
with a South African sanitary engineer, Mr. Schultz.   I went the usual
round of personnel and finance , met the M&CH Section— Dr. Leopo,
Dr. Downs, and Dr. Monthus. Dr. Williams was away and did not arrive b
back for a few days. Met Dr. Miller also. Neither Olive not the Section j
people did very much about taking me around to be introduced.  I made
most 4f the way myself and after the first two weeks think I knew more
about the people and the facilities than Olive did.  Dhe arrived about
two weeks before I did. That first week was very long and I was very
homesick.. I seriously considered sacrificing my fare and expenses and
going back to the job in N.S. ( |ji>s I write this on Sept. 24th that
seems very funny, but I was in a very unsettled state of mind for the
first week or so.) On Tues. I moved into the Apartment which Fetch had
vacated at 44 rue de Ptquis. My first reaction was not too pleasant,
the usual big cupboard in one corner, a very large day bed, and a roung
table in thefoiddle of the room.  Now the cupboard is moved out into the
hall, the table is in the corner, and my pictures are on the wall. %
mueh more liveable room but still leaves much to be desired.  That first
week I discovered that lie  was in Geneva.  I left a note at his hotel for
him to get when he returned from aw conference at Berne.  He arrived
about 9 P.M.  I think it was quite a shock to him to learn that I was
here and in W.H.0-f|| He wanted sfco mpch to be in it himself.
Monday, August 1st was a National ^ete day for Switzerland. Yvonne
advised ifee to take the boat trip in the evening id at all possible-.  The
woodsman compete to ;see who can build the biggest-^ld highest fire and
there were many bonfires to be seen in the hills. I went alone and sat
among the jabbering French.  I spoke a little to a merchant from India
who was sitting beside me.
August 7th--Sunday and I met Susan-Haines and went to the nice partment
of two IRQ girls, Miss Green and Miss Brown. Miss Green has a: big Mord^m
Convertible and we were to go for a drive.  As I did not have a French
visa the drive had to be confined to Switzerland znd we went to       pi
 2.
Montreux. J|l was very impressed with the country between Montreux and
Lausanne .  Had never seen vinyards before.  When we arrived at Montreux
the^Castli of Chillon was closed.^^e had dinner at a very nice open
air reataurant and I sat where I could see Montreux and the Dents du
Midi.  ook a photograph at sunset—came out well.  I felt very much
like a plutocrat and rather uncomfortable in the big American car and
the US license.  Not that there are not huge and luxurious cars here, but
they are out of place on these narrow roads and this countryside which
seems so neat and petite'in spite of the grandeur of the mountains.
Aug. 14—The next Sunday—Olive, Susan, xigusta (the girl at the house
where Susan lives) and I took the morning train to a stop beyond SB Cerg^
ue. ?/^ then hiked for about a couple of hours and then found ourselves
on the DOle, the second ^^^^^^^^^^^p the Juras#f| from there one has
a lovely view of the country down to the lake and across to Mt. Blanc.
I was most Impressed with\he cows, srach one with a, tinkling bell,  there
is %  cabin belonging to the Nyons ski club. Hffoere we had tea served In
soup bowls and at an exhorbitant price.JI We came back a different way
through very lovely valleys and past the ski chait lift out of St..
Cergue.  We stopped for tea and then missed the tra,i§.  We wanted to
get back to see some of the festivities in Geneva.  fhat week end wad H
the Fete de Geneve. On Saturday I saw the lovely flower floa,ts but I
did not tke part in the bait tie of^ongetti which apparently always, goes
along with this Fete.  There were to have been fare woarks but tha,t week
end La Beise 'was' on and they were postponed to the 2oth.
Aug. 20.  The fireworks were really a sight to behold.  I went along wit
Mr. Schultz and Marlene.  We joined in the Battle of Confetti after
and had a lot of fun.
On Suaday Olive, Ruth Taylor of the U.S. Children's Bureau, and I went
up on the S&leve.  It is very lovely there also and need not be describe
here because there will probably be many more trips there.
During this week the World Federation of Mental Health met in Geneva.
Elizabeth Brackett and Ruth were here for that.  It was very interesting
There were about 150 delegates from 21 countries. Thejc all seemed like
very normal people and not at all like psychiatrists and mental hygienis
ts, and psychologists! Everything wa^s translated in English and French.
My ear was getting a little better attuned and it was all a good
language lesson for me/ffThe whole group divided into nine small
discussion groups for three of the afternoon sessions. I was in one whi<c
which was assigned the topic of planning for rural mental health. In
that group there were thirteen people consisting of two from the U.S.,
a ffinn, an Irishman with a delightful brogue, a Venezualen, two from
Argentine,two Swiss, a beautiful young woman from India, a Frenchman,
an Austrian, and myself. They all understood English but sometimes
when they became excited they needed an intetpreter to express their
ideas, one afternoon the interpreter was using Bnglish, French, Spanish,
and German. Dr. Leppo was made chairman and I had to work a couple of
evenings with him. Aid was quite interesting the first night because
the Venezualen, Db. Ramas Callas, was working with us. He told us
something of his country. At home he carries a revolver all the time
because, as he said, ttI have enemies Iw His home is in Caracus. In
1945, just prior to the Revolution,he decided he had better go to his
home in the country until things cooled off a little bit. He says the
present military Govt, is really very astute.  They recognized that
the former man, with Wham Dr. Ramas Callas was very friendl£> had all
the best people in key positions and gradually they have all been recalled. But he likes it to be known there that he is always prepared
to fight for'his life.  In one of our sessions we were tai king about
the shortage of Doctors.  The Austrian, whom I liked teery much, said
that they had more than they could place,  the health program which
Dr. Kearney from Ireland described as being developed there is most
modern, Canada will have to look to its laurels, but I still think
we give a better preparation in public health nursing.
The highlight of the meeting was a trip on the Thurstay to Monthey,
where Dr. Repond has has centre for his world famous mental health
program. We set out in four busses at 9:15 and proceeded along the
southern shore of the lake to the French frontier. We had to turn
 Mm      - '•
/
back because in the group there were Austrians, Germans, and some other
nationalities who are not permitted French Visas.  In spite of tlae
fact that this had; all been cleared previously the local officials
would not let us go on, so we came back through Geneva and around the
other side arriving two hours behind schedule.  I saw nothing of the
set-up, because after the first wine, we sat down with rather giddy
heads at the tables set under the trees.  We had Raclet and more
Raclet, wine, and ^wiss songs sung by men and women i& national costumes.
It was a lovely setting and I took many photographs, after fruit,
coffee and a very potent liqueur, it was time to take the busses again.
Oh, yes there were speechs no end, all in French, A very jovial young
priest sat opposite us (Elizabeth, Ruth, and I) and after one lengthy
speech we asked him what had been said. He said, "WelcomeI11. On our
way back all the busses stopped in fromt of the hospital to seranade
Dr. Repond who was convalescing there. fHe was elected President of the
World Federation for the coming year.  Saturday morning was the final and
there were a few very moving moments when a representative from Germany,
a woman, got up and in a firm, but sometimes on the verge of breaking,
voise expressed their thanks for the privilege of being there, for the
assistance given to get them there, and forthe Inspiration and help
which they had received.
Aug. 28.^—Had a, quiet week-end^. Went to the American church and was
very disappointed in the young minister.  In the afternoon had a swim and!
Olive and I went out to Fernex to see if we could locate a place to live.
At that time we thought we might find something together but she has
| since located a place and I have made arrangements to shaire with Marti,
all of which Is very much better.  Fernex Is a delightful spot but I
am not sure but what I would feel a little isolated and eertainly friends
would not be so likely to call.
Sept *3-%4.  A delightful week-end at Chammonix. Olive and I set out
about 9 A.M. We got through the French frontier successfully we thought
ffMand then suddenly were stopped by a second lot of frontier officials.
As we were on a street car track and a car was coming the officer took
a look at out book and then said to go on.|S When we came back we were
in difficulties because he was supposed to have stamped the book.  It
took a lot of explaining and appearing not to understand to get back
into Switzerland again.
It was a lovely day and before long we were driving through a valley
with the rolling mountains close at hand and the higher ranges in the
distance. I felt that we were never really getting into the country
because we were always coming to little villages and sometimes quite
large centres.  We followed the River Arve, which joines the Rhone at
Geneva, most of the way. About 11:30 we got hungry so we stopped and
got a bottle of beer and two glasses, all for the sum of about 400,
and then found a nice spot by the roadside in full view of Mt. Blanc to
the right and 4 range called Aiguflles de Rouges to the left.  (More
about them later.) Aigu§lles means neddles but at this point this particular range did not have very many sharp peaks.  Then we proceeded to
Chammonix where we arrived about 2:30.  It is really only about 50 miles
from GenevaǤf It is a delightful town in the narrow valley and almost
nestling at the foot of Mt. Blanc. After doing a tour of the shops, y*he*
where we each bought a cane because apparently it is the thing to do,
we went to a tourist office to decide which one of the many possibilities
for sight seeing we would choose.  We finally decided to take the
Teleferique to Brevent.  this ds dine in two stages, (return fare about
9O0)  first to Plan Plaz where1 there is a hotel where we booked for the
night.  *he *eleferique up to there is not bad because there are huge
concrete supports at intervals and you feel some security at least.  It i
climbs almost straight up all the way and it takes about 12 minutes. At
that elevation you are at about 6000 feet|| Then you get out and get
into another teleferique which takes you to the peak called Brevent
and which is over 7,500 feet.  The cables to that point have no supports
and you are suspended in the air, at one point it is about three
quarters of a mile straight down to the valley below. At Brevent there
is not much to do except to gaze at the grandeur of Mt. Blanc. On
 Brevent there is a large round slab of marble mounted as *a sundial and
on it is drawn in a circle all the peaks that one can see—there are
over 175 names! Almost every elevated stone is named. Except for Mt.
Blanc neatly alio the mountains are needle like which accounts for the
many peaks ahd  names.  We arrived back at the car just in time to catch
the last teleferique to Plan Plaz.  I don ft know what would have happene
d if we had been left behind.  It's a long walk down, although next
morning when I discovered the trail up I thought^that the next time I
would go on foot. ^Somehow? ones seems to cheat when you take the easy
way. Anyone can do that but.not so many take the trail and have the
longer time to drink in the beauty of the scenery.  We each had a nice
room but unfortunately, of probably fortunately, three husky mountaineers had |fhe attic above.^Jpfhey arose at 4 A.M. and I am sure the first
thing S;ey did was to put on. their boots l Shortly after f ive||| gave up
trying to sleep, got up, dressed, and went out on a hillside where I
could see Mt. Blanc, all '^e mountains in the ridge and the valley
below.i^Tl arrived on ray perch just as the first rosy rays of the sun
were striking Mt. Blanc.  I had with me a book, which had the peaks
pictured and named and I was able to pick them all by name.  I felt
I knew the place much better when at Ia.S^I arrived back at the hotel
arid ordered my breakfast Increased by°an egg.#I ate it on the terrac
in the morning sunshine.  At 9 ^equipped with a lunch, JffgL haying
paid our bill which wad 10 francs more than we had, we set out on a hike,
following a rocky upward trail which was ^signed;|on3ething like -"Gol et
LatVCornu".  We kept zig-zagging back and forth wondering which Col
would be ours*cf;We finally arrived, by this time quite determined that
even though we had nov'bathing suits we were going tj§. have a swim.  We
followed the trail down the other side and finally came in sight of a *wa?
very beautiful clear lake.  We soon reachei^it and had our swim and our
lunch>j|| Further on there was the same range of mountains we had seen
during our $fech time the day before, the Aiguilles des Rouges. Jl|hey
reminded mejlpjery much of pictures I have seen  ojl||fthe Grand;|||fenyon
^5®pntry I^Col^Bdo.  There were ^^tre^.as all of our hike was well
aboiae the tree^ine^g^We came back and decid^,to try a different trail
home thinking that we would join our original one further onj^ Unfortunately we were wrong and let ourselves in for steep down grade and a
climb back to the level of iur hotel||F When we arrived there w:e were
tired and thirsty hnd  since we had no more French francs all we could
ask for wa,s water and they didn't offer us anything else I  It was my
first hike in my new boots and as they were a, bit stiff my ankle was
sore.  We went bairk down the first Aalf ofh the teleferique^ and were
glad vto get off our feet and seated in the car.  The driire home was
very pleasant and it was a very lovely week-end.^|S The next time we go
back we want til explore the other side of the valley and take the train
which will go to the glacier^ We will reserve that when we have to take
visitors who do not want to go in for strenuous exercise.
Sept. 10—The 8th, Thursday , was a holiday.  I, bought my little Fiat
from the Persian^'lompleted the transaction on ^^#^m*P^^St^^^^l
but of no moment to record hereM Paid 2860, francs and hope I have not
been taken.  In the meantime Helen Martikainen arrived.  I did not
really meet her until Friday.  I liked he immediately. On Fri.
Mme Brunei, my French teacher, told me about the apartment that she
would have for tent on the first of October. Marti and I decided we
would like to share, we looked at a couple of others, one at 880 francs
per month and 130 extra each month for heat, and one in Fernex where
we arrived in the middle of a thunder storm and all the lights out.
We did not like the prospective landlady there nor the apartment.
By ^eptx 13th we had made our decision to wtake the apartment at
8 rue de la Routisseri^^^^.s going to be more expensive4|fpr me
than here but it will be a lot more fun and a lot more like living.  I
will try it for the winter anyway and hope that my grading will be
changed. On ^at. the lOtfearti and I drove through Gaix and up the
Jura to a small hotel where we had wine overlooking the countryside to
Geneva. We spoke so highly of this spot that we^changed o«^inds
about going to Montreux on Sunday and with the two ess ^ ^lire
Elizabeth, Marti and 1, we drove through Gaix, had our ^,^r^ft
Sills ide in the region of the Dole,, and then went on to the chair
 ■
and had a ride in it.  That was quite a thrill. Elizabeth was not
equipped for rough walking so we did not go to far on the top.  It is
worth going back to again to explore.  We came back and had some rer-
reshmehts at the same place we had stopped before. Marti had to be
back to go to a tea at Dr. Eliot's so Elizabeth came with me and we
took out time about returning, stopping at Nyon and exploring the
interesting museum there.  That is also very interesting and worth
another look and a description of the details of the old Roman settlement which apparently was in that vicinity at one time. After we
returned Elizabeth and I had dinner at a nice restaurant in the old
Gite'.  A grand steak and lots of wine.  Am afraid I talked too much as
the temptation id when you get with someone who talks the swme  language
in nursing.
Sept. 17-18.  A grand week-end at Zermatt.  The party consisted of
Marti, Olive, Miss Brown (an American nurse here on her way to a team
in India), Dr. Youliruokainen (a Finnish Dr. also on her way to India)
and I. We met at the station at 6:15*,and took the train.  We had to
change at Lausanne.  From there we followed the Rhone River to Visp.
the scenery was lovely, with land cultivated for up on the hillside
where we would never dream of trying to produce anything. Makes one
realize how much waste land we have in Canada. At Visp we changed to
a smaller train which took us to Zermatt.  This route was along the
JSiver Visp and was through a very narrow valley.  It reminded me much
more of the trip from Goldon to Revelstoke.  We climbed steadily all
the way an d after about an hour and a half we had our first sight oft,
the Matterhorn and v^e were in Zermatt.  We had noticed that the highway,
after a station about half way up which was called St. Nikolas, looked
impassable;and we learned later that that is a^s far as cars can come
and so there are never any autos in Zermatt, sshieh adds greatly to its
charm.  We arrived about noon and stEted up the narrow main street
looking for a hotel.  We choose une  with nice colorful shutters and lots
of flower boxes.  Unfortunately the woman only had two rooms, one with
a bed which she insisted was double but onJ.y looked single to me.
She was very kind and phoned another hotel for us and so we finally
landed at a very modern looking place, not at all Swiss, the Hotel
Perronjg;. It was built so that every room looked out to the Matterhorn
and what a view.  It was also right beside the fast flowing Visp.  ^he
first lady had invited up to come back sometime for lunch and this we
did immediately. Had the most delicious cream of vegetable soup
strongly flavored with sauerkraut, openfaced sandwichs, and much to my
sorrow later, beer. f;Lhis is the German paort of Switzerland and at times
there was talk in English, German, French, and even Finnish, because
Marti, although born in America, is of Finnish parentage and sometimes
she and the K lapsed Into Finnish.  After this sumptuous lunch we
set out-on a hike.  As I was the only one with a knapsack I carried all
the extra,s.  Maiti carried it for a little ways once but I felt so sorry
for her that I retrieved it.  I'll be glad when the others get a bag.
We started out up the hillside where there was a trail and we thought it
w#uld lead us to a good view of the Matterhorn.  The beer slowed me up
and the Dr. whom we never saw again on the trailj^she wss just like a
goat) and Olive';got ahead and followed a trail which never did come out
to the view I wanted. However we kept on going up a very steep climb
until we came to a small hotel which was closed . By this time I had
gotton my second wind and from then on was able to keep up and frequently
ahead.  We went on up across a rushing stream which was coming down
from the glacier to ?/hich our trail was apparently leading. After about
two hours we arrived at another hotel which was also closed.  As we were
resting a fairly elderly couple came along and gave us some very
interesting information.  Although we thought we were almost up to the
glacier they said it would take two more hours to reach it, and pointed
£ut another hotel which had just been built very near to the glacier.(I
don't know the name of the glacier).|§^11 these hotels had just been
closed the day before, pupplies are taken up by mule and we met a
mountaineer coming down the trail with two laden mules, I suppose
bringing things down forom the hotel. The elderly couple also told us
of the tril we should have taken which was really the.one I had spotted
at first, but the others got too far ahead for me to call them back
 6.
so I just followed, ^owever it would have taken us longer and now we
know for the next time^To finish with^fche old couple,he was a very
colorful character with a beard and he spoke English fairly well.  *he
next day on the Gornergrat we met them o^amhe  trail again JSf'l got
enough neirve to ask if I could have their picture with the Matterhorn
In the background, el'm afraid I focused on themi^flfhey must both have
been neared£||p than60-~hope it" am that good at that age. From our perch
'under' the glacier we|§Iould look back across the valley and see the
pa,rt we were to go t|||ihe next day and thought we were nearly as
high up then, but froi the Gornergrat we looked over our trail of the
previous day and realized that we had hardly been out of the valley! ,
On pur way back down to the village we stopped at the English church
where there are several graves of climbers who tried the Matterhorn
and came to a sad end.  I had been told about #his cemetery and was
looking tuT  it.^i must say that most of them departed before 1900J
Then we started exploring some shops,  "^here was one lovely place
with wood carvings and the most wonderful musical boxesi^l.We had a
delightful time.We learned that the shop was closing that night for the
winter—the season for the production of more goods,  the man who
does the furniture which was on display and which waxs very beautiful
was in the store.  Prices are much more reasonable than in Geneva so
I must remember to go back next year.  While we were in the store we
heard bells tinkling and along came the herd of goats which were being
taken back, by about 6 or 8 children,.mp their little chalets which
we had passed on our way up ti the trail.  These goats have a most
beautiful view of the Matterhorn fgyom their chalets I   J§f always thought
a chalet wasj.-a very grand structure but I have learned that any wooden
building is a chalet.  We would only call most of them ftafeins1 A house
which is no ^wooden is called a ' villa1.  to go back to;||ie goats, they
belong to several but all are herdedf&nd looked after together while
they are grazing.  They have a funny variety, the front quarters pure
black and the hind white. No patches of black and white.  By this
time it was dark ancd we were ready for dinner. When we arrived at our
hotel we found that our Finnisii^r. had returned and had gone off for a
'Sauna' (Finnish bath) as she had noticed a clinic which gave them.  She
came back glowing and very much refreshed to the env# of the rest of
us who cqujd not get a bath until after dinner because the tubs were in
use.  You just don't go and help yiurself—you have to ring for the
maid and she runs the tub, etc. and I expedt a franc is added to the
bill .  We got up the next morning at 6:15 and got out to catch the
7:30 train up to the Gornergra.trlf" We had learned that the fare on the
early tr a. in was 16 francs and 22 francs an hour later, f hat was a
?/onderful ride and withlfi beantiful view all the way of the Matterhorn
and the valley.|j|lt was a very steep climb, 20$ gradient, and was' a'/
wonderful bit of road building.:M$t  was built 51 years ago and is thi
highest open air railroad in Europe.  -here are three stations on the
wayj^he^las-t, the Gornergrat is 10,300 ft. From there of course the
view is magnificent of the ^atterhorn, Breithorn(oyer 12,000 ft) the
Mt. Rosa group (over 14,000 ft) and all the glaciers in between.^fhere
was a teles cope; to look -through for *£^l franc and a guide who gaveSj||ts
of interesting informalion. Looting at the Matterhorn we saw the last
little hut where the climbers can stop.  We saw the foot-print||.in the
snow right up to the top.'||Pe told u^Sthat two to three thousand people
climbed' the Matterhorn and at timegVwhen he looked through the telescope
he could see a pqrsa©In every foot-print. Rather crowded! Two lost
their lives this, year on the Matterhorn from falling rocks and on the
Ireithorn three were lost in an avalanche. He showed us other trailis*
one up the Mettiehorn^-apparently on thees&me trail we were on the day
before but two or three hours beyond. It would have a magnificent view
and would not be hard to do, so I'll try it begore the MatterhornJ  We
found that the train went back in a couple of hours and if we waited
over weecould not catch: a train back to Beneva until  quite late.  So
there was not much time to do much hiking butW;did get back a little
piece and got many pictures including the one of our friends.  We
picked out all sorts of trails lower down which we all want to explore
so I guess Zermatt is good for many more week ends.  We were told that
December and January are the best winter months.  *he railwaay stops f|||
 Bet. ana Nov. and starts again in Dec.  They say the skiing is wonderful
daen one  should go back in June which is the best time for the Alnine
Ilowers. SWe already have two trips planned for next June—this one to
Zermatt and another to Berne when the National yoedling festival is to
De held;  The trip back down the valley was lovely but we had seen so
mu^h grand scenery that the lower mountains did not interest us as much
aH  ^t^ °n the\ Way *p#  I cannot say that it is any more beautiful than
what I have seen^n our mountains. On our Sat. hike I was reminded very
frequently of Kthe hike which I took just over a year ago to the Beehive
at Lake Louise,  ^his was not as beautiful, but it was extremely interest
ing.  I think the things that stand out in my mind, in addition to the
sight of the Matterhorn and the other mountains from the Gornergrat,
were the evidences of Swiss industry^ I just couldn't get offer seeing t
the little chalets away up on the hillside, or rather mountainside,
and the little patches of cultivated soil . Apparently the routine is to
graze the goats and cows on these patches in the early spring, then to
take them off and let hay grow. After the hay is cut, the animals graze
again , and then finally manure is spread for fertilizer.We came on one
such patch quite high"up . And the women seem to do most of the work
of an agricultural nature.  The women in Switzerland do not have the vote,
and we see so many evidences thatkheir status is considered lower than
thaet of the male*f| Many of the women see no reason why they should have a
vote, but there are some groups who are working to get it and no doufet
before another generation or two the conservative Swiss male will find
his power slipping..^fo continue on our trip, we had two hours in Visp
to wait for the train*|^ We sat out to find a place where we cou^d find
a restaurant for a cup of coffee and the remanants of the lunch we had
taken up the Gornergrat.  (I forgot to say that we had a most wonderful
lunch at out restaurant in Zermatt.  As we were not staying at the hotel
we were not supposed to be serves^ but we were smuggled in to the back to
the private dining room. By this time we had been joined by Elizabeth
Brackett of Rockefeller who had come up from Italy) We found a place in
Visp with a terrace on the back where we sat watching a game of nine-pins.
The equipment was most primitive. Only men were playing, the woman's role
seeming to be to serve the beer. We couldnStfigure out the scoring, and
in order to see the figures more clearly I had to look through my field
glasses,  this caused dome amusement for the locals.  Then when we finally
mastered the scoring system we sat out to look at the town.  I should
judge it is a very ancient one as it had many interesting old streets and
buildings.  It was a 3?«14g4eu6-hel4 special gunday and many of the townspeople, dressed in black were either going to or coming from church. We
saw an interesting church perched high, up and wandered up.  We walked *ha?e
through the small graveyard on one side of the chureh and then we looked
to our right and we saw the most amazing sight.  There was a part under
the chureh which was open to view and there we saw to our astonishment
a very neat pile of human skulls and 16ng £ones. We made an estimate of
the number by counting one row up, in length, and in depth, and there
must have been about a thousand.They were very white and most carefully
placed . We just stood with the tears srreaming down our cheeks until
some church goers came around the corner and we just had to appear a
little more serious.  Then we went in to the back of the chureh where ther
were many beople kneeling and chanting in unison with the priest. Unlike
the little church in Zermatt we wandered iruto, the men  and woman were
mixed here.  In Zermatt the men were on one side of the church and the   i
women on the other .and there being no priest in evidence the women would
chan? a bit , and Wn the men.  Well we thought we had seen enough for
Se day so Mil looking up the Rhone towards the Simplon which was
vervinviting, we went to the station and eventually caugnt to* train,
men Te  retSfeed to Geneva it was raining, but we had had perfedt weather
and felt that it had been a most worth-while trip.  It was the first
time Marti had seen the mountains, and it was interesting seeing the extrc
thrill she got out of them .
 Dear; 0|ive;
Just before I %eft %he offigf I wrofKSg^t a eaJble for Doris
to  send to you re Alsing a|^r^iodgson.     I am afraid shf|Hmay not have
time to follow it up    wirth a letter in  the pouch to-morrowjS^We seem
to have been in conferences all day and poor f|pris has not had a||5ihanee
to  clear her bi§£es since we came back.
With regard to Alsing for Th^^and,'.|pris do.e^not fe^;that:her
public health experience is stroftftenough.    ||aey waa4?s°meone i& there
who  is rather senior and still have $heir mt$& se|%ifft^Ickie*J§ However
|||Jwaat her to hold off on this unt^l we get our present:||dmmittments
placed. .Jfbris thinks Miss Alsing would be «[uite good>%or He pediatric
position in Afghanistan and no.J^^bC'ti wduld be well^o ^f^^^^ll
public health-'approach^^ andkwo^^^^pf.in-^||k ,:
Br.  (Jade providing the-;:^^ttejg|sdoes ri||fehave her^ind sip^p- "^S
someone else.     I think she has beeiiawriting dire^^^to some British
nurses|^kfflAny way; ..Mis^^lsingl^wname will be;-;|^*$ehtpd:'|^;the
Selections 6ommitte|||pn Wednesday (I thought it met to-day)  and Ihen
her credentials will hav$ to be sent to Afghanistan .."bofoaS^; we can mote
on it.    Mails to Afghanistan frequently get lost it seems!
With" regard "tottbdgsoi^^here, •is^^p're^^^Khat she-has'^'ero-,
■midwiferyvtuto.r's  cet|ificate and ;f|j|a^^ says  that
a certificate means a l|pt inlhdli^g|d: it'wouldffl:^^^ftst unwiset^p^^f.
gfpmeone in that.position ;|^^^id- not^ave.Jl^^giiPwrhapd she .Is'".rights
I have not been to Calcutta;^ seeSthe aettiH. situation $ and neither
has'-Doris for a year)     and'Miss Ad^^valae^-'away;^^: there is^n^^^ai^^B
to discuss  it withgier.    Would you send the references on Miss Hodgson
plus your persona^opinion and also her experience in teaching,    p am
quite sjire she has had a lot fmt just have no&ing to show as evidence.
I have reviewed Miss Robert^ file and feel sure whe will be very
good for Burma.    .'However ';fl|ete aga^^fier name willlliave to'.go  to|||he
Government and §1 hesfiate ^ make ^Jmove unti|. we hear from Mrs.  Aung
San regarding whether or not she wfjl have a senior nursi*f    Will wait
to hear from you as  to how far Robertrs recruitment has proceeded.  ^Pl|
Wh^S: are we going to do  to    prevent these embarassing s|^paiions?
I know how much you would like to send %fie t^gK there now on to Delhi
but I honestly believe it is better to keep them in Geneva.  lif they
cannot be^hsed it is better that we do not have the expensj^^f the
trip.     I am sure you have explored all possibilities but ili^there no
place in one of the Pakistan projects?    After all the EMRO  selected!
them.    Perhaps they could join the Lahore  team until  the other projects
are ready,   epien of course the ugly head of accommodation etc.  looms.
Dr.  Mani  is no||^too favorably disposed to  Ingram retiring to
Burma.    But i£ she is requested byjthem we can wasily persuade him.
He had a staff meeting this afternoon and gave a very interesting
account of 11  the meetings h#||f;^ttended in Geneva.    Of course I do
not know how mu^'Jie left out but what he saici was excellent*     I  think
.his'idea of a pll||^^ fhls wi^g
be the Mason Officer:%ype suggest^; by Dr.  Sinai I suppose.^ I wonder
if it might change the situational little regarding eountry nursing
advisors.     I will have  to  think this through.     It should not change
because goodness knows||t needs  to be a nurse for nursing.    Would
appreciate your comments.
Am going now to have dinner with Mis? Pentz of the  School of
Social Work'M Understand Miss Craig will be there.    Had hoped I  could
mret her through Doris but It had not worked out that way.
Going to the Lady Reading to-morrow and to Nafafgarh oon Thurs,
with Dr.  Mettrop andB Dr. Warner.    Will be out of Doris1  way for a pgile.
and give her a chance.
no on
#on't know what I shall do if you go away on Feb,.21st and I have
ie in the Office to dash off letters too like :^^|g
 ^&>as^:^^^^^|^^||ew deliS
v
^Sbas;^dor HoteT ^M^SmW$,
BERSBKAL
Dear Olive,
Arrived In lew Bel!fit this morning after an all night flight frc^||
Rangoon.    Couldn^ sleep on account of the noise ^iahave been at the
office nearly all day.    tat a placet I admire fyfrls1  placidity.
first of all aboftt Burma.    Hext Tuesda^0»;j the pouch I wilj^sejs^t
you my linages of typed notes^^^Probably manya^fe;^a l^tatementsi^^&ld
not have been mad||. and some of^i^pem were modified later,  but they writing
of them did help ^relieve my||§elings atpthe ^me and I shall send
them to youepfor ^jur personaj- information.    To  summart&B, no action As
%oJbe taken^yet regarding^pditional personnelT^^X'MutMng Advisor iso
definitely not "aceeptablepa I think tlie original presentation must have
been poor||| After all Mrs. Aung Sa^|is a'n^e    and it is a touc^asituation
vJlf^have to admit you need advice-from |lf|^
However I  think perhaps a sen^^^^^re'in "i^^^erson..;:^g;'Ruth:'Ingram jpll
unite the present group in    order .'^ givfifmore effective service might
be acceptable.    Mrs. Atng-f a^ know.     A
third public health nurserMs neededo|f||r Rangoon an^M# wanted byf^he
gpvernmenTT^ Ordln^ariTy^T would not agre[|>t©t^bch ^ appointment^^less
. the senior nurse wasa appoi|k^^^ut1^;think ;^^H1^ situation wh^ythe^^g
^^llpSsonality digfici^^be  tlftes position wotO^^^^^^lfie^^ven^ t&p££
leade^^j;'',:'rWjected..:>^^^^i^^|tve '^/ rei^^^^^^te--^|Miss ^^^|rs;;^^
see  if she wouf^be  suitable 4n  the':l^^pof ou^0)res|^t' ii^rma^>n.
I  suggested to Mr|||;Aung San that we woi™: not r|pruit tf|| publl^pealth":
nurse until we had her BHwfla^ ■ sO;|^atkf|^^p|wo
could go .at  the  same ;time  if possi^e.     There ai^some rj^i- difficTa^^es^;
in thii team digfleto personalities.^, I  think perhaps more. selee.tilS|£
recruitment wo||Ld hare weeded out the two ;|pouble mak|rs--*§^aham a^Bg
Quaid.    More details of this  in my note#|||
From the casu&l comments  I have.,picked||||ffl tq^^^^^e Delh|ffl^.ttiati^^
is  in a b;^;ofea mess... ;- You will already-have had;--"^^ cable as^^g.'-forw-
delay in the recruitment of Miss Roberts.     If you have not already seen
.it get the  copy ;|||§' the letter sen^^feDr.  Verhoestrate^dated 3l|l|an frojfig
Br.   Ghellopah to Br.  Raja.     Dr. M4.i^^^o:thinfoDr. Mani  is  fed up with th|j§
Government here and that he will close the MCH project.   fjff this happens
Miss Roberts might be placed  in Burma oijjln Thailand.     f|f§pld ©oris  that
we" must place" her as we have gone t^^^a|^|a gettinga^P^release ,-*f^|jEf
you have not already done  so pleas|filet us know hq^Jhera^cruitment st|&>ds
and I will do my best  to' get another suitable§||ssignment.     I 7^^'-aW^^^3H|
to  send-you a signal  to recruit Dickie for 'Thailand whe^^k'heard\o^^^^^S
other situation.    We had better still hold#f o^^biit until E|§ave an
opportunity to teview ail of th^^&rojects.
Miss Gray and Miss Witherspoon ate-hereMe I observed to-day's
briefing.  ' They sat in Doris1   ^^^^^^^^^^^^^^^^^ the :infoxm^^^^
that was given cold have been given in a half-^^||i    3)oris makes a lot
of j the- administrative .details -whi<^^^^pll have^^ikthe^fcaff "rule^^^^^
am afraid she misses almost entirely the professional aspects,   ;jp|is
was also apparent in the Burma interyiews«^She is extremely kind to   |p|
them    but I  am afraid we must give the nursing policy guidanc^.^^H.Q.^
Recieved your letter and the  copy of Dr.  Sinai's report. a^^feha^H
give it som^careful study, '-||? couldnH agree more about the moire specific
objectives^  in relation to  the planning of the nursing projects.    How
much of that I can get over remains 1^ be seen.     I am a little diseduraged
about the possibility of doing much but that may be because I am in need
of sleep just now.
Glad the Working inference plfi^s are going so nicely.     I do hope if
you go thfc    Middle East t&at no  emergencies ariscsduring your absence.
You did not mention imj^at connection If you wished me to  come back
earlier.     I  am going to need  all of the two months #ere but i« necessEy
could try to  shorten the  time.  Hope  the'^^ypfS before
then.    Sinclair-Loutit Is here now;  he really could have been in a serious
situation there.    Lost all his baggage including Passport and ^aissez-Passer
 /^m%
S||||   Wit^t*ega#f tor^^&^^^Sl*0J^tt  ^J^&IP- iQf^ for the jj^Kafviiext
^^^^^^-"- It ]&fc': go ing t^fei;d^|,fic^t to|^K"down tl^ any planning with
^or^?j|ft^^ Miss Wi^erspoon;':Off on Mcmds^lliid.
get^ler/desk- cleared of;||^
all'^Jit s|§ms  to me thaS^s^^^jt^ * have been ever|ypo much better froa^fej;
briefing.^|:iht^of view'^p. she l^-gone on to Th^tlantf andv.in-^^uced
them tok the people o# -|||e ' spot^^^shall-. boat^^tr^^p^*^ firsi^'part^-bj
/ttfet week on the Delhi Proje&^f&f
Havf£;not found any message from Elizabeth so do not know when I
shaff^ mak^ contact with her.    Miss Broefs  itinerary has been r|$ieved.
Had a brief chat with Misii^Bf^s. yesterday.     s&e has cert^hj^^l-en ■•"'
pushed around but^i^^^ notlif^4|^ any complaint^K' %he hax .||§en
asked i|j|: tfee a P.;|^|e6urse^^J^^|^^^^alth nursing a^lhek^ilege.
Miss Craig-does not;eM;em to have ahyffl^idge^^^^^^^fe>wever.     I get
^^. !'impr ess ion thiatf the ^^^ag of t^ off ic^^^^l^fthat if TOD pulls
out of flfeything hefre that Point 4 Ipt'd  tii# Colombia Plan and waiting
around like vultures  to  s^^i^Ln.
It is now morning.     I  could not contin^ last nigh#.    W|j||reee to
sleep fil: blanke|p: over me.gi Rangooao^Shee^coul^"hardly b4nte$£r~
ated even witti^^^fan^)ing':all nigi^^^ggam afraid I did hot bjfeiitft
the right clothes^ If Ijbere Is any oppo^tuni% to  send anything wit%e
anyone I wonder|||f Marty wou$£ colled^ nay blue pglm beach suit and jj|:ngw
black and jgj^feftpBBBK ATJjbb w|ih bo th tKeHihor^and ^|he long ^skir^l^^kv
am definite^! go£hE^Bb^>^^ ^ra^t^^^^ong^^fefflevening.
Yesterday morning a||/the   i|^I^P#^,^t 5 $jBh were 'Mpi by Mi||*s Hudaon,
Handx; Boase iuid Miss Br^^pn.     *hey hai^eis for u$*^j^e, ^^fr^*^*^S
^^orated-^^^^iprikssc^-Is ^kM^^^^Ml ^on?J^%now'^
plans forz.l^^:i^efy^^^^y roay ask Missi^^^fe  to^Bankok and send MiT^p
Iril^^on -w^^t^^^^ |«| gather f r||l^^
Team Leader  in Thailand w$p notfmuch good an^.-that M^ss Eriksi^^aad
a much feette§|knowledge ^^iphe T#%#%tspects than he did.
To go back again to Rangoon pleai^^il LouifSVerhoestrate that
Dr.  MacPhail is ..doing a very goo|^|tob.: | He has. been placec^la^ an..-
impossible situation    with that groujp|f nurses.  He has good ide^^|
goes abo^'doing things .;.^ietl^and -^I^Dfl^^^pive the -T^^^cii^f the^
local group^^Se works very haxeijg
The beared should  soon be: bringing my ^^^^Ml. getting to lifcfS
that service in  the morning.
wTe|||-Martyffl to write and let me kn«^hef^p-ans fflgf going^^^^g
to Wash ington.  Wish she  could be around for the Working Gonfer^^|||
My regards  to  everyone,
Sincerely,
 \     \ FIELD TRIP--.  SOUTHEAST ASIA REffffiOH	
<v '•■■'..'■'•   ■"•'":       ■ efflfflk^^ke
Mi&*' 11f^.-Strand^W^tel,  Rangoon.    I haV^^H^book twice at;,.;4^#:::4ate l|§§
^l^iiev^it.'''     Must be at least 80 degree^lifcteide.    Arrived yesterday
ijpout' 'three P.M.  after an uneventful tri^^^felot of waiting arettud in
London where I nearly froze, and did not rea^w get W€um^»ibil Gai*||||lg
Was in a double-seat with^^jry nice travel^^feuompaa^ps—an Sfogliisrhman
and his wife- and four- ye^^id...son who wea^^ijag ba#:'k:^K'Hong-Kong afterg
a visit home.    Sever s§w g better youngster on mtrip.    Every bump in the
air was., a huge joke^tf-Consequently ..the only *©ugh part of the flig^^hich
was from Basra to ^araoh'i,  was a lot^f. fun* ^-AtN|pLiro the military
atmosphere j^evaded^We^weretttiid that we must waii^'^^^e plan* until
the authorities boarded and that"probab!l|p^ However the
little, man c«rying thefbomb never got*'beyoa|^jtha:.Tdat'Sj^the stair-way
and we were spared  thaMunpleasantness.piProbably the# \ere celebrating
for:^^Baew Prince*    We:were escorted thethe restauraat^S^ at teast^i^e
poliaemanf^nd the mlriads of others- who hang about^>3^^|swarmed around
the plane and I prayed- .that there was -some good  supervision!       In Basra
•and Karachi alsj^.;.thel:#^fere lots of do-nothings around .butk^tft'.the same
military atmospherefwlz*> ^a^ a delight te get off "at Calcut1^&id meef|J|
the. friendly' and efficient atmosphere there. |§?he ilxport attj|&fuittf'
neatly unifarmed and /everyone most courteous. ||3j| lisP
lewa^'iet herf jpy Dip'Hufman (who" Is the '■•ijssiBtai&'aR': Mrs. j|pg~san
understt^i^pfer ■^^|/"HacPhall and 'apparently lots'•^..O't^er things w^ieh He •
doubt I  shall  leara/' in due  course)  and Miss Graham.     Apoligies frotffl
Miss    Pedersen /who,* was- at that moment meet ing with Mrs. Aung~aan ^fP*
.the nvm&kg personnel npltA senp||il BurmatlglAs a matter of fact '£imp]j*e
girls waited  tjjb  come to meet me but  there is a petrolShortage^.-thi^K|l
. eompaj^;^pstrike#i Tea afgjihe hotel where we were Mined by Ulsu ^f^S^^
Miss  Sctytt,   D$*.    Mac^hail,   and Dr." Kimball t#B«   Team)     Then I was aske^^g
."to. joinia special -.party wh;ieh had been arranged at the swimming .clul*^ Tl^ed
as I w#s" I thought ijtiad better go...    Turned aut to be aa^pRtr-doo^^lneioa'
at the ^relgners el||b—a most terrible picture of the Hollywood kind.
And lets of people in evening dress—they tell m«that jit Is a gcfod
idea as it keeps the mosquitos away*:^Sverybody seemed fp"if$ bitten.but
me so prol|l&bly J don^t need to go formal! ' g|i     ^M
%e ||eason I have time for this long introduction is that I [begged off
the first1 engagement this morning which was at §.AfM.  to  saresom^I school
opened*  $hd now at 9:30> iss pedersen Is having an appointment with Miss
(Juaid.    ./[jy the wdy rooms are very scarse here and apparently a arable
went tc* Delhii  and- may'-'or may not have been relayed to Geneva,   telk:^p|>
menot/kto TOme onifjlliat acq^untt;^^nyway Miss pedersen is otftwIth'Eit '
Grahzm    (who didfpt gaatjjpthe part^O and I am |%$lipying the spare ped"in
Miss Quaid1 p room.      At i&iTj& there ist^pe a meeting witSa the iv^^bb$
and at 11S30 up until about 12 we meet Mri^^eag-Sang and a whole r^ft of
others in-succession,  according to Miss Sedersenl^S^^Jt $£§x&
4.P#K*j|lhis is iduite a situation!    First there was a tetief meeting phis
morning wltjpthe nurses. -eThe need for nursing leadership Is mo^^^vious.
The tutor gtfpyxp and -the public health group each gol^^%|ie?«own way.
Boris hers#3«*^fers t%Jp* division in the team and' i^jfa^-?cmk|parsing
education    as apart from public health.    Hiss Graham was Unavoidably late
and took v0^jil3.|Lttle part toc-the discussion whieh 1% effectxwas really
not a discussionJfJt was a little scolding from th* Ntarsing Advisor on
wfeheirn&t working as a feaam and on their behavioral was embarrassed for
itheir sake tha% I was present*      Miss Scott mad|§a plea for ftaff meetings
so thafc she coiild geiwfcoi'". know of the work and plans of the ethers.    Miss
Bavies seems to thinMthat they are co-operating very well when they ask
the public health nurses to give lectures to the studKs*    So doe® £ ^
Misi Graham-^Miss Bavies seems to be the spokesman for the two.    fortunately
there was l«is than an h^fo^his meeting and we are te have a long one
to discuss^hursingS
 Them-Br.    MacPhail,  goris and I went to pay the official call on
ME0. Aung- Sam    This was very friendly and ao business, ,   but she asked me
tt lunojh with her ^f^^R^ome*    We then called on Br* Tha Oya^^ireetcr
.of Health Seryjpes. -^||^|^ttnd-er him that nursing pervll^is administered,
ffhe training 'and" the service -are still under separate (departments although
I was sure that In a, report in Geneva recently I read ithait they were now
under one.. . Wishful thinking!    We spoke   -very briefly ,;,to 'iijim but there
there was time for him to get in'..-a dig-about difficuiitieslIn accommodation
whieh :|pi'-^| sere question here now.'   We also, saw m* Barnabas*  Chief
of the UUICEF Mission in Burma. .  He is having a get  together of all W
people In Burma hext:fhursday and invited £oris and I«|\ •     gjSffil
Then lunch with Mrs. Aung-San at her rather deli^ht^l'^i&me.     It
lasted nearly two hours and Mcertainly hearSer si»|fA:th|s^i^Bt'■
would seem that the difficulties stem from the fact -thkt vhad.lttes Graham
and Miss Davies' first came they were shown the  two  rooM* intthchospital
which were allotted to them and refused tot&kt them u$til th«ir4^were some
major "alterations made.     This would have been very costly and \bo: they
were put in the Hotel.    When Mrs. Aung -San returned from-(Jen e^ra she found
them, there.    3he was very upset,  fundamentally because j she. does not like
hotel life for nurses and. does not like the example set to Burmese    girls.
I certainly would ggree-gwith her*-   S^Pthe last two months -the£e girls have
been in the hospital but Insisted on a private bath which    has been ma&® for
them at cons Id arable expense*     According to Mrs Aung-Sap thy wanted folding
bed© and several other cemmoditees. which could, not be provided.   W^ehall see
for myself and get their ide ff the story.       Apparently, there has "been
some talk of moving Miss %tald. Mrs.  A~S says that Is nbt the wayVto
handle the situation,   that the mistake should be corrected with ,h,ei%     She
apparently is very high-handed with Br.  Haufman.  ulB3 Bplrd went tc live
at the hostel when there was a room ready*     There was a' second for    Miss
Quaid at that time but .$he refused to go.    Miss Baird dies a lot of her
own work and appareffitly has the Burmese just eating from her haad*    Am
going there fox^ dinner ''so will be able to judge ^r mys#1£pk%|toSrnt^
I should imagine that Br. MaePhall is not ^leader^^Kli*' is being
put in a very difficult position    and it Is not fair to expect hia to be
- the leader of wh4efe~4fee  '% project of which the major part is nursing,
they certainly do not/want any more, nurses until the acceded o tion
situation is corrected ..(The .hotel .has not reeieved a ee*l% yetfS^lkerc ie
opposition to4!^pMWeing Advisor but ohiefly beeause o^the aeebmmcdation
and also because they are afraid of the kind of person they wil^jet^It
seems to me know that a solution might fee to. re-write the' present project,
making It two—a nursing,   and an M*C*E.,  and to put in a good leader of
the nursing team who woult have the same advisory .responsibilities as
though | separate project were made of the Btirsing Adyiso^^sitlen.
Of course this la one side of the story -Jbd It is quite obvious that one
of the major difficulties Is the fact that Mrs. A-S.  Is herself I| nurse
and takes responsibility    for too many details.
An  Interesting side-1ight~the nurses  expressed  the opinion    th&t the
reason Iss Btiipnan,   the "atron of the hospital *  does not- have more
authority iftifflher-own hands, is because she' Is Anglo-Burmese.    Mrs. A*«8
expressed the/opinion that the reason the *HD nurses do not pay as much
respect and'courtesy to Miss Biekmaa is because they ps^bafely consider her
as only Anglo-Burmese 5d
Delightful dinner at Miss Bairdfs.  ■ She  is on very friendly terms
withfflBr^'Huffmen,  wh^ch mayd$i||may not; be good,  and Bi^ftuffmaa^s cook'
prepares Miss Baird1 s;-meals and ybk$^bearer goes for. them 'Cat his bicycle.
She has a room in the■ hostel and has fixed it very nicely having £$ught
some furniture herself.    £«"'is on the ground f&oor and has had to have
special' wire screening on the doors and windows because, of. the danger
of deeoiters.    In whe samerbuilding there are about forty health yisitors
~fehom Miss Baird teaches.     ?he partitions are very thin and their laughter
'^d sieging were clearly audible all evening.    Later they did some
base dancing fQ^foxB.3^11 are a very happy and wholesome leaking
tp of women m<L% girls.    I had the feeling that Miss Baird was one
them  ,   that $he really liked  them and  they! were very fond of her.
Baird has two dogs-,  one of which will, pro due e more any day I
 -A--.wd~- II
Jaa 22*    J^G't back from a most delightful three day trip up country. •
left Rangoon via gtrmese airways,   with a;;   the local passengers and
freight,   at 8*30 uunday A.Me    Our party consisted of Br. MacPhail,
Br. %ffman, ^oris and I,       e were very fortunate to get permits to go,
-Local l.C.A. people cannot go up unless on business 'Wgpthe other S.O.A.
team at Taunggyi,•the capital of the .Shan States.    Our destination
was Taunggyi. OTe reached Heho air strip after about t?o hours flight
-and ?/ere met by the civil surgeon of Taunggyi and an  armed guard of
about five soldiers who travelled in;..''a big lorry behind us.    There are
both insurgents and deeoiters In this area,and ^pcour^e it Is quite
a responsibility ate the Gov* t to have foriigh people travelling afro$t.
The 22 mile drive was through beautiful hiliy country with all sort cf
flowering trees i^^i^as0tf»ffl?^ie mostt#ttrac'ffipi/iias the flame of.'the
forest,  and when we got to  Taunnpyi  itself' 'the  cherry trees were in
bloom.       It isj|tfaiifel&ed town and the health facilities we visited
were a 20 bed maternity home and a tSO "bed hospital.    It is tc the latter
place that there was a proposal to send a ?/.H*0»  sister tutor.
The Maternity. Home seems to be run by a group of volunteer women.
It is poorly equipped*    Ih the wards there are only wooden; beds,  and a
delapidated bedside cabinet beside each.'   'Onejrf the wards is for free
catients to whom the family brings in food.      here were 8 patients st
the time of our Visit.    In an adjacent building *here ^^^r^f^
one a very small one for class-room purposes,  and the ||ft^|S|pgS
with about a dozen beds for the student midwlvesfl Staff consists of
tt matron,   2 n^rse-midwives,   5 Mdwives taking a refresher course,^
learned-later thatphe E.G.A. nurse was working with ||f|||^g^«
trainees.    M,e trainees spend about two years  •Jgt w^s very diificult
to 3H much a-curate information^ It seem that these,  like the n ax sea
in the hospital wedvisited next were the people formerly drained' by
S.  Seagreaves nnd when has place was closed they were brought here xor
proper*   training.    Incidentally Br,  Seagreaves has returned and will
probably be r.f^^artlng his w#i*.n
' Our next visit was to  the hospitla.    Maximum  capacity 157,  now
140 patients.     Staff:  Matron,   6  staff nurses,   1  sister tutor   (not
teaching full time)  2 ward teachersJ|p students in third year and four
- in   . the second year.     There ate none in the first year.    When asked
about this  they said none had been taken because of a stated policy
by the government that alt training of nurses was to be centralized in
Rangoon.'"   This policy is now being re-considered«>^|he sister tutom
was efte who  took the course in Rangoon but who did very poorly and
Did not pass  the examinations.    There are no lectures given by doctors*
The civil surgeon obviously looks on student nurses aimplji as people
to help him look after the patients.    He says that he and the tteree
other doctors woulf have no  time for teaching*      he nurses home consists
of a bamboo hut of one large room andtrosrs of beds down either #ide.
jt is definitely very cold at nights in this part and this is not very
good accommodation.     The hospital is across the road*    farther a poor
set-up.    Absolutely cut as a place to send a WH.O. nurse.    The sister
tutor showed us charts and teaching models supplied by USICSF*
In the evening the 1.0.A. people came to see usJldThese were Br.
and Mrs ITutt   (the latter is a nunse and assists the B.C.A. nurse in
some teaching) Miss    Mortvedt,   the nurse,  and Mr.  8~,?~  ,  Health
Educator.     The latter Is- really stationed in Rangoon but visits the
.group here.'   The EGA program is fuite. extensive arid In health features
malaria and M.G.H.     Incidentally the W.il.O. malaria team have not been
In contact with   'the EGA malaria people*    Br.  MaePhail  says  that is
not their fault  (W.H.0*fs)   as it was brought up at theco-ord ination
meeting and B.Allen    ,   head of the EGA health program did not1 widh it*
There does seem to have been one major oversight however on the part of
cur group*    the Shan Stated do not- consider themselves as part of
Burma and they do seem to have some laws unto themselves.    The Health
Officer In the- Shan States has apparently not met our malaria team nor
had he been contacted ^'-arrangements^-d
Sfis& Mortvedt is trying to do something with the nurse midwives
and is teaching the five who are taking the refresher course,  something
about public health.    S.e*A* program In fcl.G.II.  is  to  set up 10 centres
sand also!'to have a mobile team.". . As I understood It there would be
 a midwife and a lady health visitor 4n each centre.    Miss Mortvedt    was
[ therefore  con cam ed Tcith getting some people ready for this "...program.
She'did net know about'the p*K*H*   course in Rangoon.    Asked about the
possibility of sending'some to Beirut.   ;^^.A#; "has fellowships not used.
%e is also, working, *l#j|;the.nurses  in the hospital on job definition
and on pro^M.ures*   • Told bar about what the W.H.O.  group arc doing on
procedures'.     She is coding, to Rangoon in. Feb.  end eill'see bur'nurses
Hope they will work out  something to-gether so that various groups of
Vthe Burmese nurses will have a part  in  these procedures "which are being
■prepared fox them. y ,  •   r
On Monday;;morning we left ^arl^fe^with^.fur escor^ and called a t a
T&ry colorful local bazaar ,on our way l|l|^ o*
interesting! f&i^ cqntairid.-a lot of
these along witSp'rice :,and very "littie,. sweets*    Had long wait at the airport:.
as- we'had been given wrong inf rotation  about plane times.    While waiting
had; some' delicious': Burmese food served in ,-p|^her' miestionaMe surrouniings
as far as  sanitation  was  concerned*       After1.3^fiinutei^llght arrived
fflgoMandalay where we were met by Miss Williamson, MiCs/^Ties^'^^^ftranp
Medical Superintendent of the Hospital,   and M4se4||eBaw Tin Hlaing,   the
Matron*       Taken %TBr. lyanf||-home for lunch*    He and .^iskivife are Chinese
Got a shock' when I/saw ^||ie primitive bathroom facilities and. '.realized
that these people probably think us most-unreasonable when we -ask fl||y|
those things v/hich we consider as minimum for comfort..
After lunch went first to the nurses quartealjffflof the hospital*     £he
girls  each:have a small  room.    Miss Efs  serves  also  as a dining rooia
and  an office.     They have    just acquired a kerosene  stove mid  intend  to
do  a little  cooking.     They have their own bearer '»ho  tmye  tljtii^- food -
which is   cooked  and   served  separately.     The  reminder of  the  first  floor
is; occupied;; by''-the trained!, staff. i|pt Is for'I^^Kgroup thai a(new
residence was to have been built thus releasing this space; fort'a&ore
students.   'Even by putting 3  feo a room however it wouldohly provide
for 18*    Bownstairs are  the  students rooms  and a sitting room for all
nurses.    Also; the small  class-room which will not accommodate any more
than  they have at present*   20 in  all,   9 being in the second 18 month
period and 11 In  the firsthalfi.    Sb    There tare  three  students  to  a room
but there  is  fairly .generous "space for clothing and personal articles.
We visited a few of the wards of  the hospital all;J|t which are rery
I crowded'and,patients  in  every  corridor*     There  are  335  patients  and  the
staff consists of the Matron,(rather weak and  inefficient),4  sisters,
6 staff nurses,   6 graduate nurses(those in.lpnd-;pir two years af tar. they
write, their ; exam in at Ion)'  and  the  20 s tud en ts. 1 When Miss Williamson earns
she was  told by Dio Lyan that the two most pressing problems were cleanliness
hcrfrather^fee lack, of It and poor discipline.-    Consequently instead of
being able; tostart5 on midwifery as had    been planned she set about with
a willtcHjgfe^ft-e general  side.     There were no sheets and very few towels and
face, clothes.    Now these are provided but 1 t&'-e  it the sheets are not
always laundered between patients.  The vermin were thicl&'r There has been
running" water only since the last month and even now this  is only to'.'the
door of ^tijii^isaternity ward|g|1?he labor ;room at|||fer far end has none. JlgPhere
wefer threfej-t cases - go ing on  in  this .-room-when we visited..  Babies are on  the
verandah ^ay from their mothers. \J
When! Miss Bavies  came  she took over the general  side but Miss Willlamsor
still  continues  to do a sertain amount of ward work and.wantsi^|rdo  this.
Miss  I.  new has   two'midwi fery students.     She gives  two  lectures  a week  to
these antjl they'b^Sytw lectures.    There should be 20 midwifery
studeritsiSut the prospects of getting them and also  the inereased nursing
students/ do not' seem very graet at the moment. -  This to be gonei'i&to
with    Mj/s.ffl.'.iSjiv;who does all the selection.     In addition to  thjjis Miss.  W#. r.
gives g;ke supervision-'^pp the midwives in the two maternity shelters  (about
10 bed# each)  and .to  the one clinic*     In  these, there are  three- ^idwives,
two of/ them• being lady health visiters.    One is hopeless^.M4^.Shere are
inly o^l^rined raidwives in  the  city and' Miss W.   is pi mm Ing to | contact
them vand arrange some type of -refresher course.     The incentive etc bring
them  in may be the DMICKP bags which apparently are ^erymuch needed in
ythls  country.    100 are-coming tciBurmafand^|;.beliege there has been some
simplification of them.
%B Miss Bavies started hero first P.T.S.  class  in Jan. Think there are
ly six In it and this time they came In a group.    Previously they casje
 Mrs*  A-S complained to me about the .nurses  insisting that they come as 'aI
group.     The matching nurse for Miss B#  has just returned from taking the
eour.se_ in; Ran go on and a holitay. glShe li Miss Keeley and Is working with
Kiss, lip She observes^the latter giving th^Lectures and then helps with
the demonstrations,    *or the next class Miss B.  plans  to have her take
ovb£ more qf the  teaching.     An  teaching is In English.    There is apparently
this poli^plwhich is one. of the factors In recruitment*    However the major
Is accommodation, ffl-There were 'supposed to be 60 -students,  or at least
thatywas-^pe promise when the agreement w~as made with W.H.O:#;viihere Is no
possibility that such will be provided within  the next' year end probably
I not with^»the next two years which is the extent of the project.
I   We discussed the question of the additional W.H#^fnurse^fflThe^-ls.
no accommodation for her as certa^^y three cou^rnc^^hare. the .type of
bathroom facilfliex provided and there Is no lipher roomsJBc|i|^,- bed-room.
Bven apartftorn the accommodation she is not needed wit]bi:^j5 present
student load*    Miss  ^illiamson feels she  can do" the midwifery and the
super^s^^^S^;.ti^^resentt.staff of lady health visitors and outside
midwives. -   *he're apparently are no  others.     She wants- also ■ to  continue with
some of the general.     the question of the additional nurse being a clinical "
Instructor was also discussed' but ruled out on the saJrt§|;basis.
Mis||f^avies*doe;s not know'how many.'students are; corning in April
and needs this Information" for planning «/. As far. as she knows only one
application has gone down to Ha-n go on.    Miss Bavies. Is a very mature:
person -and goes about her work in ' an assured and quiet manner      our opinion
of ^^^rom]^|i-Q.  contact has,   I  think,   been  confirmed.-    Had  she teen
here in Ra ngopn she could have been appointed as the "team leader but it
k*bu^fc.hav^||een tough on heri    whe has started a committee on procedures.
gl|c:ipf|ron*|raChairman andin addjjtcn to  theilwo of *fcfeem consists |pgl a
.^^Mp^-f^^^P sister tutor,  and three.^^aff^urses. f|fhcses all v#|aint
-eere^p Mow they are working out the basic fundamentals foSr the requisites for procedures.    S.G*  for temperature taking what are the basic number
of  thermometers needed.    Mow considering the same principles for macintosh
sheeting,     '*hey are really startli^at the fundamentals.    Suggested that
Mis||i)aviesi-have an opportunity  to   come do?m  to Hangoon to discuss with
the girls here-at some stage.i
' From  W.H.O. fs  point of view this has been a costly project in Mandalay.
However the girls have  certainly done a good job and have laid a foundation for something.    How long it would continue would be difficult to
say.     The$ certainly are at  the stage now when they    need more students
to adequately justify their continuance^
Jan* .23.   , Vis jl ted  some of  the" ante-n*atal,  maternity,, and clinlcal'y .
ficilities, in Bangoon which are visited and supervised by Miss Bair0 and
Miss  Quaid.     *irst  to  Tower    Bane which is  a tfe4~  seventy bed or so
mate^lty^she^ by midwl^s,  lady health visitors and
so calle^^rdftationers^^^hese la^tter. are^;^ust girls taken in ,and emg|||*
eyed uajUl tfae mext miderwifery class starts at the Dufferin. incidentally
I gaveMf yesterday trying to get figures ofg^aff,  patienQ^4ad etc..
It isjnit-e -obvious that there is understaffing in all  these places and
thatethe aumbe^pf patien^|^per^^Ctor'In the clinics is far jiicre than
can be/given any adequate teaching because of time and physical facilities.
Miss.paird iiaes Tower Lane  for teaching purposes for the five p.h.n.
stu0ntfe»fhey do group and Individual teaching with the probationers
and with the patients.       In- spite of ;the fact that the attendants all
wear masks and that the babies are fed on schedule Tower o^ane strike*
me as being a      good show.
Mexf wen to to Sand with Road where an infant clinic was in progress.
Miss Quaid ther^^This used as training field for L.H.V's anaf.H.I.fs
Their district is much tec small exd^e famines are visited more
frequenilyssven than every^ther dayi^his very crowded but XjlaTfc no
doubt t&at this and also all|i|ie ether places are much improve, since
dour people came.    Again I wonder about the effe etiveness of the approach
however.    I felt in thi* place as well as at the mte-natal clinic that
we visited ^ Miss Quaid that- this, was a'l#H|p
activity anddthat the changes ;rmade had not >een developed as Result
of very much thinking on the part of the lecal group.pi -might* h& wrong
 in this but; Certainly Jpiad the impression that Miss Quaid did not give
nearly enough responsibility to  the losal nurse in charge in showing
us the clinics*;'' |
- |f   yB^ater; in the af terpen we visite^prie^^ythe Sa*|b^i Butler
sinstit]^ ^e will return.    Miss Baird
*as haying/ atconference with her students  and a class was in session for
^^^^^^^S®.    The latter are all taughtjplf ^the Burmese l*i the native,
language*;:. Our people help them develop the lessons.'    IV'fchen went over
.to Miss Bjairdfs  which is near-by for an hour * a d i s cus s ion which was  all
too shor%;^id.krls [to bc^^jCtinued.. (
5 There hafflbeen^^^^^urriculiim dranw up for. the' preparation of
public health nurses.     *he  committee  consisted' of Br*   Suvi,  Br.  Huffton,
Br.M.acP^ail,  Miss Olmand (S.O.iu)   and Miss Baird  and  %'ald.    Learned
laterffl;f|rcm Miss Olrnan  that aha hadatsken'dv^^ .   '^he plan is
not to, train any L.H.?.:^;.any more and,..the program f&r the preparation
of P.l.K'.ls  Is to  consist of  the following* $|9^
tjp|     J5-months pi^^M^ital at the Harcourt Ins^Kf^Ci
__/      !  IB months..', ildw ifery athte Buffer In       . y '
6 mont^ll^iatrlcs and -genreral nursing ;.
• [r fla^ttMi' P^H^I^aal th^tdmlnlstrttticn. .«"•':    }\
Bli^e^ssed  the  teaching responsibilities of Miss-Baird'and Miss  Quaid*
Jt Is -«iite ob^^kusi'^^at- there are realldiff icultiesl^pisS; %aid
carries^ on    as 'at home.     She teaches Personal Hygiene ibut- it.was rather
diffi«(lt  to  find, out  exactly  what that  contained*     As Lli'sa Baird has a
course j||n which their'own health is discussed  I would ju^ge that  there'
must hoh much'over-lapping and that while the one lsr\theoretical  yihe other
is q5Si|ra Baid also   teaches  a cours& shet^alls Health
Education* ■ "he has.brought into   this Mr*  Hyerson,   Health Educator of   <;
B.G.A.  snd<'Mf>. Wrightfield,    Audio-Visual Expert of E.G*A*  \ There is 'a
course on Ll en tai Hygiene given by a well' prepared' Burmese Doctor*   A'
course on Community Hygiene is given by'Miss Baird.     In disclosing
thesilco||fics one had*the feeling .that Miss Baird. was 'doing sorae very
pr act! ea,! /teaching applied  to .the ;^tuati03p!here# 'ffl leig^art of the field
work progra& is well-planned by pre and post ^Jfenf erei|SiS with tke
group %m 'apparently their powers of observation as to what is Hght
and wrbhg are'very acute.    . Miss Bairdbwears a uniform—se'cr-suek "t.
MisjjpPedersen says that Mrs.  A.S.  has complained about Miss 'f&i&ld* @ ^
appearand. .J^be does--not^ear uniform;' f|f|
- ■■•  iSfflV^p'^^ - ' -   '. Sfflfflz.fflfflfflfflSfflOffl.k
Had a very nice discussion with Boris after lunchj|%ere •certainly
have been difficulties with this  team which".started even before arriveql
in Belhi according te her.    On arrival there it was very hot and for the
firs't few days there were tears and protestationsr that they could not
live in their quartersw^^^^ftitution House.        -fhe first point Boris
brought up waa  the meed for eyeful selection of personnel,   and how right
..she is.   'I am more than ever Impressed with 'the need for our personnel
fitting o|nto  the cultural pattern off|§|ie country even at great .personal
sacrifice to  themselveifflR.  Some of this team have not done that*/   ^or ,
example Mr.  Af S*  is 'trying to get the. Burmese nurses to wear uniform
and no jewelery.    Apparently Miss Graham ana Miss Bavies were no||||y
;. wearing unIform and were wearing rings and bracelets on duty*    -Miss
Graham stated in Belhi that she was in W*H*0.  only for the salary.
The fflbehavior of three of this team ihas been criticised, s Miss Pavies
apparenly went around with a married man while his wife was in England*    '
..©l^gwasj.jprobably;fflquite in order but In Burma it was questioned 'because
of the  cultural background.     They have all made a bidder Br. Mac Fhailfs
'favorsJ  all go to him individually,   and he has not had the strength
to unify them as a team and appoint a spokesman for them in relation
to  their nursing program*     *hls has certainly not toen entirely his fault
andh^tlris going tc be very difficult for-anyone, to bring abojut i#iy;;
unity.'   Much to my surprise'Jbrls suggested  that perhaps  if jRuth Ingram
came $ack she could do  it*    I had net mentioned, her 'najae- In [this
capacity .  u|hows the advantawge of biding, time I bunt
Oheck should be made with©urfinance .department* ||fhe jgirls should
probably have more than half  their salary sent to  them at first when
they gef out on field assignments.     It is during the first tfjo months of-
so  that expenses are heavy and the Installation grants are always a long
time in Ping.    Also,  above all,, they must not ^^^^^^S
♦n- rJFifltam in Swiss ?rsncs#Miss Prosser did this and it was
 7.
with great difficulty that she got them changed, in spite of the fact
that weeare told art the bank that they axe good anywhere. Also wiiht
regard to personnel selection, we must give serious consideration to
more reliable methods of selection and to the possibility of more
individual interviews.  This teas problbly got more than its share of
.problem s but there are certainly three who are not really here for
the purpose of the professional development of Burmese nurses and are
net pulling their weight*
Had a very helpful interview with Br. Alien the leader ®f the 1*0.A*
Health Mission* He asked!immediately when we were going to get the
nursing advisor and said this was now theirst urgent need, with which
I heartily agreed*.- They "have asked, for a Senior Nurse but have delayed
pushing it as they recogMze that it really should be our appointment*
I hope before we leave ,toe can return to Br* Allen and report some
suscess on this question*. If not the only hope I can see is iC appoint
a spokesman fer our nursing group from among the present members, and
to urge E.G.A. to get ;a. ^enior person* Laterjjf.-,fet£J|-out Miss Olman
on Miss Ingram. Reaction not so good at first but after further
discussion ;af the many factors concerned she agreed that it might-be the
best move*! . Her first .objection was that Ruth did not have public u
health an$Mthat • she did not. represent American nursing. ;m.was-' very
impressed^! th Br9 Allen and with Br* Laird whom we met there also
•and who 'h^ad just returned from a visit ti the W.H.O. malaria team*
Br. Laifjrd! id the B.C.A. malaria man, so at last local contact iftas been
made.  'Sold the W.H^* malaria show was very, good and that Br. leeks-
had some gjood.- training Started* (Incidentally there have been lots of
hints- about nurses, on malaria teams, and Boris- was, questioning Br* Laird
very m^^.^b^'ut- who carried out the health education in connection
with malfi[ria in! thelJ^frcjebtri;;Brj.ll^tve not said .a.word. /ft shall have
my turn mad It Is Interesting to note haw much Miss Nohr*s health
education work has been praised by Boris and yettche kept empAaeizlng
to us her leek of public health.) To return to Br. Allen, I' Sm quite
convinced that there can be the fullest co-operation on the lijcal
level* B2?* Kbhn is here now -also and he has been greatly impressed with '
E.C.A'i personnel and work*--;' Yesterday there was a great to-doyfjii the
papertabo^t Burma not signing M.S.A. T0-day there Is a little .Statement
to the eftect  tha .t  the Gov't .is discussing it with U.S. representatives
nY7ith a Mew to operating the said .wet in Burma without rmterlally
affecting) thi *r: sound's declared'foreign policy/1* 1 feel sorry r|f^*-k
the professional group of the U.S.P.H.8* -who have been dra,wn intog '
this political wrangle. Thenare certtoly most sincere In-their;,efforts
here to $o a good professional job. According to Br. Kchn they hive
dene a ^reatideal for the medical college. Have two or three professors
•there*^p:
fl
 n
Jan*   24."      Kent  through some of the wards of  the Rangoon General Hospital.
Was agreeably surprised with "the tidyness and cleanliness.       Although
it Is a 500 bed hospital- and the- census yesterday was more than 850
it did not have the appearance of this much over-crowding.    Most of their
equipment was taken by the *aps and they are oEfy gradually building It up
afeain.    They are. in great need    of more but B^MacPhail tells me they
misuse what they have and mned a lot of .advise along, this. line.
We were accompanied by    Miss Bickman the Matron.    She id Anglo-Burmese
and obvi^tisiy is rathcrf^Eisecure in'her position foij^hat reason and also
professionally^ Shel-ls not a very' alert and  intelligent appearing
person *     Saw the P«T.$.  where a class was  In  session and being taught by
one bf the local tutwtu-    Unfortunately Bl^'Huf^on joined us in the
middle of our tour aj^ ^^xiplc''^  the very end which rather spoiled our
opportunity for discussion    with Miss Bickman r|||W.H.O. nursing relationships.    Miss Biekman-did speak of  the clinicel ■ supervis1on  which had
been'" started and seemed  to  think it was a. good; procedure.   .She was
definitely much more on  the defensive after Br*H*   joined us.
Sext went to  V-.B*  01 In I e where Sf.lUO*  team are Working.    They are just
moved to new quart caff and* have-£utip are. getting them . prepared.    Miss
Scott seems  to have.rapi|ygood relationships  with the locsl nurses.     The
outside investigations' are done by^^trained .workers tmo  are political
appointees.    Howevel^he aays they tare beginning to  reppend to  training.
The Fellowship nu-r^bs   -who will return in onsfiycar is. to -leave for Wash. _
on $at.     The team |lie^c.-^piry upset because the Burmese fov..* t have not
sent the  telegrams/ they  sre required  to  send  to notify tof her arrival.
'To be sure that sijle: would be met at  the airport I  sent m cable to Agnes
Chagas.  Br*   Tucke^ is making the plans for the  extensldlx of. the program
and  in  a', month or; so   the   team  hope: to  go   to Mahdalay.    'the  Tuckers have
been doing a ijjj^j- of complaining about accommodation.     They saaid at first
they did not waapttya hous^feHow they are most dissatisfied and complain
about expenses,,  difficulty of getting food for" the baby &tc.    A lot of
this  eotnplsihBag  is unreasonable* gap
Lunch with Miss Baird and Miss Sawyer of Voice of America.
^^^i/erview with Br.   Sulvi, Director of the Harcoutt Butler Institute*
fe s$?frjs he' hopes/to  have" a public health nursing course next 'year but
onl;^pf':he  can get  enough suitable recruits*    Otherwise he will have  the
L.H.p'fflSt.course only*    Apparently the course I outlined prevloutsly is
for LJH..V. rs  fcuid not  for P.II.K.'s.     According to Br*   3uivi  the  course
for- the latter 'would consist of the-three yeaars general trainingsfollowed
by nine months of midwifery and nine months of public health*     f  tried to
inject the idea of putting some public healife into the 'has i0Jut I think
•'it fell on barren ground.    Bid not get mu^ghel^ from Boris  in  this.     She
blunders on I    Perhaps It Is  too much to  expects en acceptance of this
idea in these countries where everjppinute of the student1 stinie is neijifc&b
ed for service. ; At any rate it certainly shows the need of a Nursing
Advisor who  will, be on  the  spot all  the   time  and  will use every opportunity
to bring about the gradual  change.     Have a feeling that Br.  Suivi does
too much of|^|[^pafl^ing on his own wihtout consulting nursing*
To  tea at -pL  Barnabas* s.     About 30 present of which aboiit 26 were
actually U.K.   employed people working here in Rangoon.     Ther,e were
2 Technical- Assistance,   2 P.A.O*,   2 or 3 UNI'CEF and  Vqe  rest ;W..H.G.
It was decided, hto  form, an'informal  association.     xhe    uckez;s ,;put  the
emphasis on    the negative side—to  air their  complaints.     I]r.. MacPhall  ■.
spoke up and  said  tffyfe objective; should be  to  get to-gether ';to know what
each agency is doitf&rand tc be better able to co-ordinate activities
and plan for  the  t/oial  program.     He made several good  contributions  to
the discussion ani. Mxg.  Barnabas gave excellent leadership.  , A Committee
was  formed    on rhi.ch each of the agencies has  a representative.     W.H.O.
has  two,  Br * Maolh,, and ' M j ss Baird* . .. j ^;
Went to  tliei£fclace- to,: see the. future accommodation*    Wey will cerainly
.-adequate  a$d '^mfor^^lte.ia^he rooms me small  end I  casikv-fersee a lot
Complaining.  - Especially 1     since'the hotel rates are gbing up and a
ling has ie^:^efinii^»'settled with thw Gov't as to  tlfxflr contribution,
osedly 1^ wi 1 not b$ 'rnjore than 10 rupees per day.    Ch&ljh-irlth Miss
 9.:i; ill
Schultz and Miss Grassmo |§ the B.(J.G. Team who are already housed there.
They are verydhappyiln their wo rk.^J^omewhw. hamper end li their movipi&nts
for B#C*G«" Work due' to-present political  conditions* -jgs
Forgot to." add  in r'eference to Br.  Suivi1 s plans thai he has a pife-
dream of a central l^^^^br the whole of Rangoon  ,  or'rather Burma,   to
be in Hangoon.     About•300 students*    Plans,to  take  the. present P.H*K. m
students for the  teachers*.:.  Pointed out the fallacy^H-'Tthis and  the
unwieidiness of such a schools    Mot much help farom ^oris here either who
said  we would 'like to help in. this In provision of .international nurse
■ttitors:Jpd she ;pad'f^get ideas snow for they IS |||l^g^|   "lbuldnf^|^^
dream of touching another nursing project'here until ;f Nursing Advisor
has' been on .the spot for  some  time. '    *&|g? I
an*v-^^:Me;^Sor three hours  In the morning with iiis$[Graham and-Miss
UtrSfflea.affl   ffleaaekSfflOrffflOffla- fflffl-'lffleffl *&$$fMb^ JJl^lIll^
Bavis.   This  was I. thought p. fairly good meeting, and Wjb were able ''-to get
a number of points  cleared.    Miss Graham startedeOtt^p^gdescribing their
program*     At first under Miss  Ingram * s direction  theyVgave lectures  to  all
classes.  ' At' that  time there were • only two.Burmese ^fester Tutors"'- and  they
had nc^lpr study.    Sow there are four Burmese and  they have  taught    theft
to  take;/^cs.|»f the lectures for  the P.T.S.     The W#H.O* nurses supervise
and disejuss rthe lectures wit&tthem.    Also help them' with 'their lesson
plans., ./Am nfeiuisure if'they'are doing enough of this and are perhaps
relinquishing their responsibilities a little too  quuickly.    -Then discussed
the next 'sister tutor's course*     Tried to bring out the point that one
of them should be the responsible person but here met -a sto^fewal^li-winally
presented  the  idea that Mrs. Mclntyre,   who  is the seniarr of th«KBurmese
group an^jpfor apparently vexy good,  might be responsible and the .Iff.H.O.
act as hiz?, ^advisors* f jjpp|
A clinical instruction program has beeii ■Introdub.et^^i Through no apparent
fault'of fhe WHO nurses  the Matron was ordered by Mrs.; AiS*  to ^put'ffl^is.-'
into effe^'lmmediatelyi®-;Consequently .the slsjjjer tutors thems&seives were
not prep$rjed for -this nor were the .'ward listers.    However it seems "flfy
be smoothing out now'*-
Asked- about, plans for the future.     These were listed 1p Miss Bavis as
the foliofing. oh-yvMi-
1. d e velopinen t o f more ace apt able, student accomplishment records.
2. Clinical, teaching ward program.
^^f:^^^^^^^^K^^^^^^^^^^^ more classes so  that they"W4||| be
^fcell established in this before WHO finished.
4. 'Jpompilaiion of a comprehensive syllabus with a fairly wide content.
^^^fejln discussion of this the Inclusion of publii^eall^^fcd not
a /; .       feature.    More, of  this later.) W$S^
! 5/^try ,to help improve the school of nursing records;,   lib
6/.     get some in information on the number of girls graduating,   thB
^p   number entering" nursing and the number going to other professions*
aogoe (' fflUfyt;
flpis cussed their procedure " committee^ Boris had'already discussed
thi"S»t length so this was not gone into fully.    She had the j Impress ion
tHa^lSb^re is not nearlypenough Involvement of local nursesjS; *here
have been some difficulties with Miss Bickman who a^parentljWs^t^ the
fact that one meeting was cancelled because tome of the sister tutors were
Aot present*    Miss"Bickman is reported to have felt that since she was
there ijt should .have been continued*    Mrs.  A.S.  tejd me of tlfls 'ajiso.
Anothergincidentwhich was. reported to GovVt was  that Miss B$.vis \on meeting
bojfch BrMJiuffton and Miss Bickman together said tetood-morning^pad not
'♦Gocd^bming Matron11.    This was apparently discussed at the fjlb-ordinating
meeting and also  told  to -me by Mrs.  A.S*       This-seems  to be related vto
Miss Bickmankf-s-'insecur        as an Anglo-Burmese. fill   Iral&li
fheh dlficussed inclusion of public health met a blank in Miss G^pajs*
She i^mot convince^p-;   O&t cf this grew an expressionof pers<|b^lty
feeliiigf ad a definite stqtement Of the unco-operatiyeness «^^i^^pJraham
and Mfisp Scott||fe can say most ebjectivelly that these lattb^^i*o are
the r^ly mature women on the team, both professionally and socially*
,; Mi(ss Gr aha® made the statement that they, have never been igi fen a ;||rd
cf.fir«se.    This after    I1 did comment on the gocd Job done*||; ^he|OTfcg|
askedfflicr a private interview.
 ■'•""  10.
I* discussed the means by which we could bring about some unity in
the nursing program.     I .emphasized the need for,the  consideration of
a progran in nursing and not the two  separate parts,   of  fsick nursing1
and public health nutsing.     They suggested • meeting? and we listed a
number of things M be brought up to-morrow.     (To-day asjl write having
watched a beautiful Rangoon sunrise and had my moraine tea.)     In the
course of the luncheon conversation we were able ^Ifeel'them out on
Miss Ingram.   I  think she would be acceptable*   1.1  am more \than ever
convinced  that Miss  Ingram is  the only on||j^ A new
person would be floored  at  the  outset*     V/e had ^revi o^sl|* discussed  ttee
need of. a nursing leadj^; to which they had  agreed 6   ' fee pressed that   ||p
those-here must be a. united group before she  com es.i        Ml.
I was feeling quite- pleased about this meeting unl^w' an evening
.dinner  to  which I had invited' all  the nurses*     1 had bebri1, willing to
think  that', they were really making a reasonable' prof.esBioiaol effort and
that perhaps Boris might have hadma little too  strict aorvV-'code  *     That
was  sheetteyed*     Boris  is right.     *here jflre three on ecliies   t#anh whose
primary objectives, in being in W.II.G*   are based" on f e^yi'e instincts anA
are not related to professional nursing.     They are ous^^^ man*     The ,.
talk at dinner w$s mainly about clubs arid  clothes,   and parties  and boy
friends,.     I  hr^ it to Boris,   she reilly kept a-conversation going
around her*     I .could not compete with the loud piano uriasic and  I  was
tired hkei only'had one small drink.    Ford which I  shall no doubt be
considered a,prM#*       I have just been glan cing at Mr*   Keeny• s monthly
report/ for Becember.    On page 7 he lists  some very good:"oual'if ications
for Intern aiional personnel *;' His  statement  in relation   to   the frequenting
of  oiubs  j/s par11 eularily applIcable here.    Miss Bavis andlliss  Graham
belong to  three.Although only one has a color bar few Burmese fo  to
©ie  others* A**** ^^^»
At  4.   we had a Meting .with Miss Grsha» and Miss  Qualdt'e.   It was
most uncomfortable  with Miss <Quaid  starting out with the^AfJ.'statement
that we mttstyle loyal to each other.     She accused Miss' waBS|^j^| &°t g
accepting her social invitations etc.     She  Is most plausible/^d most
difficult.     I  am convinced that Miss Ingramfs statements we^^^rrect.
It is so .difficult $o prove.    I think hen^intractashould' hyt-»l .confirmed
beyond the probationary year.       Were able to bring out that( one person
should beyrc^ponsible for the public health nursing aspect j®t tlw<^
progrcam and Miss  Quald verbally agreed  that; it should be Mi's 9  GlpSai!*-.     I
understand ..she is reported to have said that she should be-:;fme' tfpam
leader since she hsM had seven years of international  expex;;i#ncewv    X
strongly, recommend; that we do not take any further nurses straight from
I.R.O.    ^iey must \get experience in a generalized program at firsts
Apparently there are some real difficulties with;;Miss Rouffjign^n who--also ;
came straig]||gfrom I.R.Qv I'    ^^M
Boris  and I have prepared our agendas for. discussion qn wmk»  with
Dr.  MacPhail and then with all  the nurste a# a grpup. ;'    '     '   g,
Boris  and I  called for a half hour at Br.  PapanicolaCU^M;'f«B*w
show.    A fine one on paper and statistically.     "tyiere are eight Burmese
nurses all doing a specialized follow up program.-How much better ft
these nurses  could have taken the p.h*n.   course and a generalized
programtbeen developed.     It could have    been done but of course this  is
beyodg his  interest.     Speaking of D&. 3?fs con.versa.tion  topics?)!   I am
told heehas only twoj   tuberculosis and one whiclKl cannot write ecen in
this personal diary J    '; fill
 n.26.    Bq/r'i# and 1 met with Br* MacP.   at 8j30 .     I have  tried   to keep
nlm involved In all^f this and aware of our discussions with the nurses*L
He is agreed on the:heed for a nursing leader and agrees that Miss
Ingram would be- a -good choice.     We discussed- Miss Quaid and how we could - ~
Impr0-^^frej^ationsj^^p^with the public health nursing grouped Decided
that we^^babl^;^i^vnot do. anything about Miss Quaid at. the moment*
^c are afefe/M tUaii perhaps 'the best, solution" would be. to put in a third
nurse to work /closely with Miss Baird and  to be responsible for a good
educational/jf^l«;work program with -the public health nursing students.-
We will, see '^hat/Mrs.  A*S* * s reactions are  to  this.     I had  to do a lat
Of talking.-gtb  tr$r  to  put over  to Boris my .convictIon that our first
emphasis'^^P^^pi'witM|3bhe if^H^O. public health nursing students and  -
if there 'is ^Iq/e  to  give some guidance to  the L.H«V.fs.     Am net sure
that I have : coif vin eed her yet put  I  believe  the others and    Br.  MacP.
agree. ,.   Mr ^Sel
At X^^$mrmet with, all the nurseslp-1 4n4a?educ€d-:t ids:tarted with
a bit1 of!mMg^iiBtery dffhow nursing started, in WHO and related that to
the sirrtln^ of the Burma team project which has a large nursing aspect.
Emphasised tour responsibilities as nurses in the whole. WHO program.
Then thre^' tile meeting open for discussion*     It went very will with the
suggestion  o^p  staff meetings for. the discussion of nursing matters.
It was Jroi^d to -hav*^ rotating chairman and Miss lavis 1$ to- be the
first  n#i&  eallaa meeting- next  Saturday.     Miss,Graham  expressed her
doubter that_ they, meetings would be of any valuj|||    Cannot see 'the
contribution-of p.h.n.     -.'Miss  Scott was most helpful in the discussion.
Tp my surprise Boris did, not think  the discussion went well.     DonH
kn^r. wh^t^she expected.     It was  really    very good*     There was  time left
[ f'.io   tell/ about some II. fl^fccti^ties^-f Boris was  to  have told about the
sExpert JGfcmmftttee and Advisor's meeting she-attended b^; she shirked  this
and I included;    it briefly* I  I am afraid  that If  1 had not been here
this meeting to  try to unify the group would not have taken place and
there voulfcl have been no discussion .about W.H.O. activities in general.
I would 'have liked/fffiUch more and have thought of lots of things 'since  .       ,
that' they should have.bben told blithe personnel $roblems: have taken..
the tlm^JvTOieh should h&ve been devoted by H.G.  and Regional people to
policy matters and planning.       We now have, to get.Miss Baird,fplss  .
Quaid and'Miss Scott together to formally get them going on the p»h.nfg
aspects.     They have left Miss Scott out completely and have considered
her only in relation' to.. ¥.1).     She  told Boris  that she had never, been'In
such'a situation before and wafcSJhrery worried fey the lack of professionalism the behavior and  the  continual gripping.    Br. Kimball,  who is a
grand person,   told her very wisely that the only thing for her to do was
to show them that she was bigger then  they were.
Had lunehgwith the Belgian. FAO'raan and hic^if^tf  They are.a most
vivacious  couple and ijlf-'was a joy to-hear  the, mixing of the French and the
Sxglish again* '. ::        flit
At  4:3G had a tcj^for the W.H.O. nurses and, their matching members.
Very impressed, with Mrs. Maclntyre,   the senior tutor.     %ere were 14 of us
At 7:30 went  to  dinner at Mrs.   A.S!s.     Present in addition 4b
Boris- and i; waa Mrs.  Green,   wife of Br.  Green JBA orthopedic surgeon
at the Medical College;   a Mr. Miller who  turned out to'.b© the manager
of Nestle1 Ib  here,   a bachelor,   and a frightfUltl^re;     Another Britisher
who  spoke./iBurmese fluently  and. lives up near Maadalayl ' Had a nice
Burmese dinner—which- I do not fing as palatable^as Chinese food.
 Jan.  27.     Sunday.     To  Shwe Dag0n Pagoda with Miss Scott,   a Br.  with whom
she works and the Dr1 a,mother who  is an ardent Buddist.     Very interesting
but  a very strange fajJCii     Gompletelfelndividuallstic and  everything
seems  to be done by the- individual to gain merit.     It seems a bit out
of place to  see-all/^ite*'gold and precious stipes in these pagodas when
there are so many poor. land money is so much needed to rebuild the country.
And .'the millions being||oured,.in from outsidlf|f
Lunch at Br.  Huffton1s.    A deldcious Burmese meal.-    Interesting
discussion with Rev.   .Huffton who  ia Principal of  a large boy's school.
Have 110Q*    Teach English from  the beginning although in the Gov*t
schools It  is not now started until  the  5th Stand^^^Mr.  H*  s&ys there -
is Increasing #ecogjS^ion of||he need for English-, and  that there is a
movement  to  start  in  the third standard*
. .-'Quick swim wi;th Miss Scott before going to the first birthday te*.
. fcl^alerle Jean Tucker at the -Strand.
Dinner -mthe    evening with the T.B* ,team.    Mice'.people*    Dr.  P.
has recently- been  to ilongKong suid  has brought  soae of  the most gorgeous
brocades .and  .l/vdry carving.    Not very. Impressed with hipu.
Jan.  2|Sp^&%! to  see-the EGA Aung San Myo Demonstration Health Oentre
beyond llisein  and about 15 miles. outside  the  city*     Are 'building a more
or less.Mfdel health Cent re    end  are planning to  in-corporate  the €
surroundIng villages.   r Will  serve about  5000 people.    Miss yDlton  the
nursevin\ oharge,  has $nree lady health visitors.  Going to  ta&e the
I student p*h*n.fs for field work In  another month.     This- whole centre
Is heirfg set up for the purpose of providing' supervised field work
training for all categories of public health and related workers*IDther
stated objectives  are- *?to demonstrate proven and established !health
practic^ not yet universally accepted  in Burma, and- yet know^ to be y ?
capable, of  contributing materially to  the health and welfare!of the
citizens'-of Burma-'1*',   and,   * to provide an opportunity for experimentation
and research in  the field of public health practices,   selecting problems  fasto  the many areas  of public health  in  which  satisfactory preventive
frarocednres have not been.      developed or in which significant limprov'emfent
s an • ever ,• present possibility. * VfBpX 119^*11
/Mr*  G'arley,   Environmental  Sanitation,   Is  the  senior member of tte
'..team and mpst kindly showed us aroung and gave us a lot of his  t^me.
So-did Ite.; Heir son.  Health Edusation* They are handicapped \at present
.due to lack-of matching personnel.     There are no matching Drs.; for the
two EGA/men. Mr.   Oarley 'is most anxiousS develop the most- practical :fij9
and economical ways of taking the village a raore' healthful! lilace in  JB|
which tog'liv^.    For example he showed us little drinking qupjptoade. of
bamboo; which they hope  the  children will; be able to mpke  there selves and
which Mil ^epMLce: the common drinking cup In  school.     '%ey hpye experimented wit;'ht he making of a bamboo  crib for babies so  that, tlif mothers
will be  encouraged not  to "have  the baby beside  them on  the flexor as  they
sleep.    Ur^   Hlerson  has^ivery practical  approach  to  Health Education.
(Se^'prog^a^'outlineiEit^Sldji:'   The-personnel "here hope tha^fif^All
national;'., international, .and private health,   and; social progremte  sponsored
by the -government  shofcld'" consider  establishing  ?.nd   co-ordinating
their projects at the, Centre. *    J*- think we have made a $tep toward a
better^^o^inaticn;^,^BnrsIng.    For soioe reason this ,has lagg.edV::ahd'
Miss Olton (has not been brought in  te, meetings lately.    Miss Bair$ I
plans to'^ft".togeth0^Siph her.^pcr^;and "I ax& meeting the p.h.nyf®
to-morrow and  will iqskeftte finite j>lans  for this. fflls§
We discussed evaluktion—they are planning a. four day working ug
conference very soon  t<?<  consider what  they had when they started,  what :
progress they have nade,   and how their objectives should be re-defined in
the. lijght of experience; I tp; date.
'.Entertaining Mrs* /A.S.,   Kiss Dickraen,   and   Matron kolly^f  the
Dufferin  for dinner.     Jock sorae  time off this afternoon for a little
.personal' shopping.    Beautiful lacquer work,  and-many Jbovely precious
s tonsil   Burma is apparently famous fo^Its ruW.es toft I did net indulge^
 13.
Jan. 29.- To "Dufferin Hospital at 9 A*M* Shown every bed in it by the
M-atron, .Sifeter Mylly| 208 beds, 325 patients* Staff consists of $he
Matron,   who  took midwifeery In England in 1925 and has been in this
position  ever sin'i«pt':--sister tutor who  is  supposedly full time but for
^he last two months  she has been the sister in charge of the infectious
section,   (she returnedfrom taking a tUtor^.a:-course in England three
months ago)j-  6 nursing sisters  24  trained nurses, -'-('these, and the nursing
sisters are all  trained mid wives and nurses j   the trained nutses  are
filllAg their compulsory two pars);   and 145  students. .There are two away
now on British Councilr fellowships in England.    At least one of them is
taking her G*M*B||| Ulster Molly was not sure what the other one was doing.
Supposedly when, they return    they are to assist with the  teaching.
At present the educational program Is nihl*     The students are taken
in in three batches yearly.     Some come directly from school and others
have had anything up to  three months as   * probationers*  at Tower Lane, (see
previous notes-)   J?or  thr  first three months  they get' one hour1 s lecture a
day on general nursing!    This  apparently is given  .in 'the evening and in
the day tipe  they ate on  the wards, ' some of  them even having as-their
■yfi3t»;. inti^dutlongervj^, in  the labour room^.Sister;,llylly said th^||
some'.who were coming directly 'from High S^^^ywer^S^viiig* ■-^houid think
the reasons would be obvious.,..  After  this  first  three months  they are
given  twji- med Ical  leetures  per week*     To tin lectures—100 hours,     The
regular /course 'is 18 months,   for graduate nurses; it is 6 months.     This six
months is  taken with the lasM six Months group of  the regular ..course*
When these peopl^piftlsh theybusually take  the, L.B.VH course*
-.  '1 Sid notb'see'-|||e Birector of-.the Hospital who  Is supposedly
against foreign .personnel*  Br* Breen Aroitage who  ham been here under the
auspices oftthe British    Council for  the last!ten days has been doing
. a series of gjm* -.operations and one was going onnin  the 0>*H. Boris
apparently already had a meeting vita Bister li0lly$- the Birector,   aid
Mrs*  A..S.  ahd she  said  that the director does not wan.t an  international
sister tutor.-    Said  that vaith .the present one and 'the  two who are
returning llrom fegland^^pfty/Could manage.     There  is no' doubt but that
some assistance is needed but there -is, no poinl|k^yf|^lng someone on
them*     And. 1 am  still of  the o|>inion  that nothing should be done  to: try
to persusdf^fthem ;'mtil:!:We haye a nursing a dvisor«:The sidwife^feaspecti
are negl'^f^ed,  and should be strengthened by a preliminrry courke in
general nurteing and an organised midwifery  ccurse.     Biscussed  trie   inclusion
hcf!.S0B^--experience  in domiciliary midwifery with--Sister Molly bjjli. she was
mmme interested in    having some advice on how to prevent linen losses.
This, was given I ;'.  .y  '.
^trJBpB we'went for our appointment with Mrs.. A*8. but site had heen
called-tb''"the Pri rue Minister otflfyery short notices    Hope  the .onfe now
scheduled  for 11  to-morrow comes off* B ■
Met Tfi'ti;i the p.H*K*s. at tea-time and discussed  their getting together* to 'discuss  the P.H.H*g aspects of  the program.     They are< "keen to
do  thi*f :.aiid^psponsibi^ty forg-p^p^-ordination has been given; to
Miss BairdJ '' They will" soon bring In'Kiss Sllmsn   (liUG.A.)   and will also
ineludfe' trie |B*0.«&*  nurses*     1  urged :tw0-',thingsJ;^fhat  they  consider
p.h.tffik only as si part of. the  total nursing plan, ■ and; that  they net
fcr^tj^^TOflifet they decided, in, their meetings wall not to be eo^Mdered j
as th eH, plan' for Burma,   the Burmese nurses roust be brought  in for that*
Ee.t Mi S3 Graham for private interview at .^b^^^pi l^agineyi^;
surprise vihen her request tas to know the posslbilit^|S.f changing to ,
anotlS^pvft^fti' at the  end of a year here.    1 gave her  to understand
that this;Would not be an acceptable request from the organisation*s
point-i^f view*    In discussion it came out that sh«raffeallyydC;CJi not like
- nursing,   she likes office worlM   Therefore she is definf^ely/|| pK^lpi
selection  for a h.H.O* nursing position.':'gl-wonder if    W£. had our \
applicant's "-write in  a"" narrative state taent if this situati^K-woul|^ha^p,
been discovered before recruitment.    Her reason for wanting a change Is
;.;that Rangoon  Is  so dull-and there  are no  social outlets, n t^ier w*k had
a grou# dinner and I .was sitting beside'Mrs. Kisslegaard,  lfbhc! younjig
fforwegiega Mfe of the leader of the B.C.©* Teaa*    %e lives l^ere fet the
hotel^4i|^sked her how she puttliflpra^
Sh«  wrf t^W"l.fttters.   reads.   se?/s.  knits,*, does her own washing.''-    A !<jjade
 14.
being able to make an individual  adjustment.
,j'an*  30.    Just before doing the above I watched from the.baleony a most
beautiful sunrise.    And I wish I  could describe the many varieties of
interesting costumes worn by the people as they passed bj; on  the street
below.    Many of them seemed to be hurrying to get' sciaelmilk or other
provisions  in the|jj|.' little tin cans,   some fat Burmese In Western costume
with their tennis racquets,  women and men in !oungyifs,  very pdcr
in rags,   Indians in their native dress.
Went with Miss Baird' toapodliffe mobile clinic. Whis is not a mobile
clinic in the true sense of the word*     4he equipment is taken out once
a week and a general clinic Is  set up da a basha hut*    Br* Huff ton and
Miss Baird go and one lady health visitor*       There is a volunta3^|^|up
of theiocal people who|||ielp*     ^he community insists of 8-800 basha
huts housing up to 2000 people,  many of whom are f^fugees from the
insurgent areas.    All, are ..labourers and there are many'cottage industries."    The leader of the voluntary group is a man who apparently has
some private means and apparently has a genuine interest in the welfare
of the people.     *hey have regular meetings and: they even: have a H.C.H.
committee*     They are planning to build a permme|||-.clinic,    this is a
real .*grass roots1   approach and I would hamrd a guess .that it will
outlast the E.G.A. project we saw toe other day. ■■   I   'went around .the
village and observed the cleanly swept mud streets*     Every so often  there
was a juasp around which there would be a group of adults and children
having their bath*doing their washing and collecting their water.
They are a very clean people and  throughout the c«J4ky outskirts of the
City one observes this public bathighg going on.     the children are
usually naked and the mother pours dippers of: water over thep*'    ihe
adults are very clever in bathing themseldes in a wet loungyfi ^na then
changing tc a dry $gie.    Went in to  two or ..three ■■hom||b^.The jbas.ha hut
homes may have dirt floors or they may be built up on  stilts! sai$ have
woodclnn floorsM|§^here; may be one e* two Mohairs silt usually jthe *• people
squat on a    mat and eat from a low table.     They also  sleep o|n a;fat
stretched out on  the floor.    Went to  the gchool which is on|e great
open-air room and hat overJpOQ children.     .hey were having tlheir opening
prayers and: all''were reciting in unison with their palms together In
front Cf their face .Took lots of pictures.    Pongyis everywhere with
their begging, pots* i'    kSJjM
f^his offers real possibilities for field work and- Miss jB&^r*!. is
very keen', on developing It but it must be done slowly.    Mrs!'.  A.S.  in
her characteristic fashion had just sent out word that it was to*, be■•
developed for domiciliary midwifery*! SI
At  2:30 met with    *wrs.   A.S.     A Nursing Advisor  as  such  Is nd>t acceptable.
On reading the project write-up  I  could understand tha-t.     jhey feel  that
they can get on rery well with the planning thefflfje'lvefi and that phey
do not even need  a National ndvisor until  they have produced about
8,  000-nurses which they now have on paper as their need.     A! nursing
leader to  co-ordinate  the  WHO nursing team and help lis do  thb mog\t.for
Burma recieved attention- and ;a note-was made when/ Miss Ingres n\me
was mentioned.'1      Mrs!. A.S*  promised  to discuss  this and let-.i^kn^w.
Before bringing jq^the question of a Nursing Advisor or a leaider ttas
mentioned we asked( aboi|p; the  third p.h.n.   to  replace Miss Nohjp.     W«
question    of acccramodatlpn was mentioned as a difficulty but It nas
agreed  that  this nurse was needed and  should  come,     I  suggested-^hat we
would'not send her until we had Mrs.A.SVs' answer regarding /t.hea-leader
as  It would make  It  easier on  all  sides  if  they  could  come   to-gether or
?j|f the leader couldlSome a little ahead. \ -s$M
Went-,in  the  afternoon  tJptry  to  see  the Minister and:. his %ctt\tary.!
All  in meetings  so   could, only leave   cards* IhkF     '
Br.  Huff ton  culled  to  say good-bye.     ahe says  she  thinks  that  t-lfe^Maa of
a leader and; Miss  Ingram will be acceptable.    Mr.S#   A.S.  has -aire^y
.tola the Minister  that 'they do not want a Eur sing Advisor and  thexe.tore
she cannot' r^ersegher 'dbcislon^^ >   w|
Saw Br.  Allen! and  told Zmm of out suggestions*    He will hold c|f bringing
Miss: Gardinerfl If he* ca#_until the decision is made in case Ifc, vvotxld
spoil our; changes of having a leader appointed.
 lip 15. lip    ffl
ffl;. ffl mew wzM jSp
Jan.  %llm'krrived"' at ^^.M*   * il&t by Marjc>me Hti$son,J||Wcy Boase,
end Co^3^ IrikssoJ^ttRad lelsgj|pr us..||^
and. a,fter.'on attempt at rest went down  to breakfast.     There forud
Br.   Si^cl&ir-Loutit who/ is just in from Cairo.     He had  a narrow escape
in lasjf; S#turd£yfs looting and burning of Sheppardfs Hotel.    Lost all
4 ; his baggage  including Jils Passport rend his Lalsseiz-Passer.     The way
I hǤ  finally got out of the country was to,, get a. chit from the British
m. Counsul , which vis sometimes given to drunken British sailors to get them
•Met  the office 'stjaff and  spend   the day la observing what goes on.
%r.S|vgets lc^fe>f iMerr^tions.    I".hayeep^e' feeiingi-that thingp§are
.lyft at quicker ai»^ion taken without ||§^h tipught.    She sp^Hp
scime time with Miss J%ay and Miss Wither spoony but going over a let of
admin strati ve  things whicli I  am sure have v hken done at H#Q*   and which
^b«^i|i^M»S|^^^^^H^R^iaLSfMpfl^^s anyway.  Very little of the professional
aspects  touched q!bi.    Mr.   Suindarham had told  theym- that as they were  .
on ^^^#!^ir conware^they wquld be ent|S^|^Pw borne leave atg^feend of
the ||&i^ ias .'extended*     I iwentiin q!n this  conference
and^,#ra8^ in hja Interpretation*    Had remembered
tp4'- experience ^iih.Miss Massej^. Why waa MI sis WitheWpoon only given
,.a one yeaik contract?  . ^aybe we should be more' careful fin checking this
Bad., 4 b:ici£f ;chat wither,* Iiettrep.  a,Says| ge is W.newnperson. since
he came dferej  TlW' Belhi'project Is under discussion now.    Talk of
not continuing because the &ovft have not met their obligations.    Also
the College J-of Nursing/have their own field work area.j ,, I wonder
originally-tjo what extent Miss Craig was drawn Into  th|e making of'the
Pla2p|B^^ get the impreasiqnhfj^^Mgbfflce"'-'that
Polntg«l^d-»he Golo^b^jare hovering aroundvlikferl^ttires waiting for
WHO "^^^^^l&^t so |&at:Mtheyi'can swoop In.;'SfeW Mise!T|ayis.    |5he seems
'to have -'been pushed around a lot but is not complaining*  • She may not be
a very, fqreieful person but I liked her attitude to  tlieffeitua^^bn.
Feb. ^^^^pjade epical i»ntacts with Indian ,^p>up so!co\ttd: see the
pro^li^p^ aiad facilities in India.  Went firs-^^^;,J)r* Bakchandani who
^fe t^J^glia^son offjicer Jl^plndia with W.H.O.    He.toofc:^^&o meet Br. Raja,
^^L^^^^hm^a.than$  °9/e^^^^e Beputies,  and Br. P8ndit.--^Soticed;.Br;...;.
| Waijpta^s' Office .neagx docu^^ Br.  Ranchandanl^^^p4'' conversation the
lack of ap^ce was .-mentioned and the fact that one of Pri Ranchandan^s
assistants ihad tc move ci>ut for Br.   Warner. ... .-Jh
Th§h j went through Old Belhi  to  meet Br.   (Ool) Bhankfet Nyran,
Birect.br [of Medical .Services  for Pelfti.  He is somewhat difficult and
I gather t^at relationships with WHO personnel heave not filways been, too
goood^i^lng J lj BJtple liltl
Appointment. Viih BrtMcWheeney to discuss  the disposal, of Miss Sriksso
Patak seetnsi; the' only possible assignment•     Suggested Boris',write to
H.Q.   explaining the' situation so  that Miss Harris might ;be 1 warned that
when she arrives here , she will be asked  to go  to Bank ok j.    tois cussed
briefing wi^-";^r|^a^^eeney]^^^^ admiai&t^^ seem to bfmthe
ones which loom largest in  their minds here and presumably tftis  is
based on difficulties they have had.     Shggwsted that each person have
a slip setting out clearly the salary,  pension,  what entitled \to by
bthebfe e/te.1    The per diem-It era  could only m completed by
the Region  siflnce Ij"^  Y^ould not have  that information.   J Suggest that
such a.-slip -be prejpared  ?, partly completed at H.Q.,   and,: the rest be
completed at jRegioh. ||g|
filh Miss Hudson to the Founder1 s lay of the New Blelhi School of
Social Work,    'Met: some interesting people.    Miss Moses  gave, the manual
Repo^-aak thll was^llowed^By"_a apeech by Mrs^Bowlerf^||Mf^ of the
Americaf^jbassai^or^^pn betalf of the U.S.Gov't she ^rcsentepl 300 books
/to .th§||^^ ail American^chool*^Am .W have dinner;"
with Beborah Peiu.tz op Monday s@ will!learn more about haw' thby have
^^^^K^^^^^^^^^^^^^^l mfe       i.'{;-;^',:
Binner with" Miss Gray . vrtio was entertaining Mr. and Mrs.] Bretton.
He isHcopresponddtot fctlthe Timea. She is an American/ and iscorresp-
ondeStVflr th^ Hemald Tribune.    Very nice people.       »      m§
 _        _  _._ l£#        __ mtmmmmm       _        ih ^w
Beb.2.     With Nancy Boase to Irwin Hospital.    Through a misunderstanding
the Matron was not previously warned of my visit. Poris feels this to
be serious an* just another straw to make such contacts, more difficult In
the future! : Miss Aleard  is  theMatron.     There is one full  time'-Sister
Tutor who last year took a course in Administration in ljew Zealand.    Bon * t
think she was very successful.  55-s    The hospitla "has "355 beds, and over
400^ffi^ents*:: tSome of the- child ten have been mov^d..t«^ie nei pediatric
unit which hax been very well -equipped by UN I CEP-'     p>me  '     of jthe
equipment Is still stored in  the isolation cubitfie asBt^u^t|be^cn display
there until the-building is officially opened by' Neru;.    'Thep$J'&r e    32
patients in the new unit end 40 in the old ward.    JChpi stajff * consists of
one sister,   2 staff nurses,   4 students from  the Ir'wln;•;and'; 5 College of
Nursing students.   The latter  come  from  7   to  1 only .and  ere not  tbisre for
several months  after March.     A ^ister,   Mlee Gomez,copes mci'tli ■ the!*! f rom Un
College.     She  just  completed her  course  I apt year ,T~n&gha/S  ikzify ^o real
experience herself   Miss Toy has worked withihe^;an4i^feK;5^^ two  groups
of students*     There have been three dlfferen»k^ she
has been here.     She. says-^Ic!College..girls are vjbry protedt^d %t that
'there. isMco!doubt but^b^^^^hey have a beite|K
Because of the difference In background- she has  tp  take    'the two groups
a<.r-studS^ is  edging back froii
a course In England in a month, or so.     She "Kill takc^sharge oftlipS^' whole
unit and by  that  time  It Is expected  that thi^^/flbpr will be 'open
making a bed capacity, of. 92.    There Is a. small medical, 0.P4B.  atmaci&W.
Nancy says ' the ward  sisters have  very little  time 'for [teaching*   \They
are responsible ofbr all ^plpment, linen,   et^^nd hj£ye to jmake.;SP-ft#^ .
- losses.     Consequently a lot of their time- is  spent in  checking and' VMBf^
minor administrative details whic||lshould be done fe$Is$meonje els£.||Rans||||
is leaving In March.     She wants  to  come back -and work "part -itime on a volunteer basis.     She Would.also be willing to  teach another- past jgraduate pediatric course on  thft* basis  if asked.       She haa nevMyha4;^--^a|tching member.
No doubt. WHO here would want her replaced oik  a full  time .c&)pacity however
on account of -©atl'the' WIOEF. equipment the use of which m'neieds  In many
cases  to be taught and supervised.     However apparently , the Qolonbo Plan
-have been askedu.to  supply two nurses  for thAft hbppiial.;  (Thlsjiwas later
confirmed by Br.! Warner*)     Apparently this request Was 'made |by% Miss
Adranvala without any consultation with WHD...j|^^ a
!surprise to all'/'concerbedeto learn of iii^Beek ot so- ago,)   /I   can*1
understand this [lack of co-ordins&lon! ;'      jm^k
To  sum up,  I would say that Nancy .has made k gopfe^t^^fction' here,
through:'her/te|i,qlhing,her paw'ln.^te planninj|^0'|f ,the aew^unit,-  and
her .supervision lend  instruction  in  the use^yJHtt^amillai^j^ Her
contribution: cjbulld  have    been!much more  effective  end  lasting   ff-  she had
-.'had. a matching; nlurse who  rpuld,«carry on  this instruction*,   ' She \fcerself
feels  thatj pexfhajps she has- been able to  change some attitudes ifrilth
regard to pediatric nursing, *ttiat the actual techniques w|ll be ',^*ickly
forgot ton :whe^  they go on  td other- services where*, there lB.no •■^uttpervision*
Already 14 the old ward many, things are allowed which $he previ ciu^sly had
the. girlftetraine^to do ctheaswise. ^^^^K^^^S
Bunch at' the) Club with Boris,  li^sses/lOray,.  Witherspqon, '^erifv, %iii4'sor!^
and/Mancy.     /! o ^Iil8 •'   •'■    ' ,-' ■'!.- x\
Shampoo and /finger wave at the hovfcfcl for 5 rupees. •• feank^ybu^iptes off
to Burma a^pdinher with the girls^ and Miss &#afyi|||      /Bjg^I'   /H A'      ';
Bis covered  Br.   Warner is next door  to me so  Introduced -'myself, ;j    Obtained
■some useful  information,   including the  confirms tion of the- request for '
two nurses   for  the  Irwin from  the  Colombo Plan.     Point W-J48#eque^;
fonr nursf/^t for Indiac^fflf e wim.be thffSenior and will IfffiM Miss
SdranvalaMn thejpublic Mealth''p^ectC^.    Br.  Warner says -iiiat Miss A.
state* she Is  so  concerned with'thth* nursing education tii'at she, hag no
time for/ the p#h.nfg aspects In relation to the village 'jpifogatanu'   This
nuse will also  co-ordinated the work of the other "three riurses, each of; which ■
will Mr placed iiippe of ^hi^SfaBee village progr#s b^i^& underl|ken Sby '
Point -|||a The team in wae^^ffeject wS^l censis^ef a ddcter,'salutary' *
engineer, health j^ueatorjitmd^A nurse.
 iiiili      sb   ms
-Ww^parner seem^^K shareoar generaVfl^.&ern about imposing methods
Cf tralnix from other *©untries into  thisws^xatica^^/She feels that the
ot^pe C;ft|r^Ining giv^p at.l^^e'College Is needed but Is not the answer to
M^ie Immecifede probleiW.    Shelalse agrees thailthey need .falcon tempi at ed
|§||f3t gradste public,- :heal«nur sing course^^^tn cid en tally she said that
one of ti^KiZ. nurses hajpbeen'asked to. teach it*    Where does this put
Miss Bavistfi Sh^^eelC^iliat for the village level some simple training;
shouldo^tegi^en t«the Milage- worker who  can squat down with the mother
'"■:asd do:»meys^tolc teaming in health*!'Itifeighi^fev^ to-be pretty didactic
^e^chii^j^Plo^^ie primary uni*^which would consist offll|ree or more
^|llage^^phfe'^^^>uld be a   Bady Health Visitors    She #C$Ld supervise the
village corkier So ',;{Por this  reason she feels  support which' they are asking
fo:i||^ thi^iSecondary ttalt ,which will have
several primary i^^fsi^accoidlng to the Bhoj^gRe|^rt which has been j
'adoptedg^^fce^he ; Pigling .Commission j and, which" ts;- being tieM' as the basis for
planning}    -there should be the public health nurse. g|||
There' "}ias been a! co-ordinating, committee  formed and just as soon as
Br. Man!  £&:■ available*' there will be another meeting.     This should help*
Bon't kha'w ton what ex! tent nursing can- be represented but will^investigate.
pplaof uri|*erl|^^ to £ush it or not however*■ |^ori'w^thInk Bor|j§|
^ft; gom^^^pfflbe. g^id<sj4 by s^yi^irslng policy other than hj$£ on^K
ftsftm^ the';   Pet||elssue p§ the Indi|§ Kurslng Jouras§||ft
Has  an excellent editorial.   Seems  to me  there must be* a group here one
could||^^ Br.  Warnea|-als^:'" gets Isola^ipd requests
■ forlndi|^^ Physiology toff ill a f es^wthat
Spas toeed^ljicant fo* fb/nrVpe|^^gt Shi||*considers thes#iitralght service reqtM@^(
and;||tiey afe^-not jsii^c^te^^Wany plan.^^^be does not\want to  fill tliem any
more  than we',; do,   at least from H.Q*     This is the same situation as  the
request fot'/fc pediatric .nurs^'"ln MadrasMp. thln^^^M^ard Boris say &h)^t
this pla$ would be kriwetft iwnext week and sen^pfor signature I   i»B§!g
I& relation t#f|he ^iefing^f Miss Gray a$d Miss fitherspoenjj,  I.think
these^tast two days Shi^^e^patcomplete waste^M^The^ire thoroughly sick
'.Of reading and say thp^pann^-:take In another tiling,     .'"There has b#en ijg!^
professional nursingI;^^^||j^ions whatever'.    Miss Witherspoon has no|||talked
with PR.Mettpop. %pai^^w hea|i|ts j^st not be^fflikKtereste^;    Bvenlthough
- he' dees; notgknow the'details" ofMfee. Thailaan^^^|iatIon as yet her pgg been
long enough|^!;;WHD  a^\siviMCH4\AdMsor- to give some general prlncijle^.!
-fflffl;My:fflt. ■'■ rgWgO:    - •/       . y-^pl^I fflffllffflUV;
Feb.3.    Discission with Mr."; Pales who has been a WHO  consultant In Vital
statistics if this Region -Mr, the past 6 months.||J*e alMgis impressed with
the need f (Improper planning,, going slowl^iana^^iningv^personnjel for
village wor/k,    -He satsffl§|.title .but thinks a lot. .a^otaffil Geneva to-o*^row
feo this goes with h^k»     ISP "   SEE TOSflnP
Raining to-day/ and according to' Dr.  Tytier Hl&rje wiilgR;a   month
of cold- feather.    Tir^ytXex did n|t- agree with Mr.fflf al«|»--'.Kany-of the
points Zmour dis cession which appear to me to be iadameiiip*    ^he spaeifcalized
app?o^;h\again.   .m& - ».    Ifflffllfflffl
 18.
i'eb.   4th.       Appointment with Br*     Marii  with ^orls.     Very pleasant and
welcomed me  to  the Region.    Biscussed Burma*^Bot favorably disposed
i© Ingram returning there but it w*ill be O.K.   if they request.
Meeting with Br*   feenbas   (P.H.Advisor who has Burma on his list)
Br.  Mettrop and toris re Burma*J||Br.  Mettrop had a long document from
Bnrma requesting^more personnel  and  supplies.     Want equipment    for
about 80 or more maternal and  child herllth centres.  wfhe preparation
of mid wives, is essential, for this"*    Bedded  that nothing would be done
about this gdtor thftfc next Exec.  Board of -UKIGEF and   that Br.  Mettrop
would visit Burma soon*     If he  can work out  the  situation  with,  the
Mediaal  Supt.  of the Bufferin  then we will need  to  assist In/the
midwifery  training... At least one midwifery tutor.    Br*. Veenbas  a little
disposed  to  favor scattering of personnel although he .gives llpe  service
to  the other principle.     I  think he  is good and will have some  talks
wi the him &   \ v' ' |...
Lunch with Mrn  Brouland  in his' hutment which he has redecorated
Very nicely.     Also  at lunch Doris,   Miss BrIksson,   Mr*   White,   and
Mr* Beger.     With'tegaxd  to Miss Br Iks son  the decision i to. ask her  to
accept Patna was ijnade  on  Friday morning.     She  was  asked  to come over  to
see-Boris yesterdky and sat in her office for several'hours and was
finally asfed.to   ireturn   to-morrow  at  9  A.M. . Hot  very good  for, someone
who has. had  an  anxiety  state  to  be  put off like  this and kept w,/.onder-
^^ng what her disposition is  to Be. gffifc    '
Staff meeting  in   tho   afternoon   to  hear BiwFalesi repot*     D:a f o r t tai at sly
it is most diffxciilt  to understand him because of hi'feenunciation.    He
was giving a eouf'se, and  I  ponder ho?, much the foreign /students really
understood of .?hit heap 'had 'to  say*    following Br.  Man I gave a very interesting repott of/; the meetings  In Geneva.    He told' of the meeting with
Bfn   Sinai  a^ad  thje new  type  of  survey re coma ended by him*     He agreed with
the need for      tiiias but  could not quite  see ho?;  the one man could develop
the liealth pis#n \   Go-ordination now the  responsibility of the Region.
Bid not get  the ;' \attitude  from 'Dr.  ^m:i  that "Point  4  and  Colombo  Plan
are waiting  ta; tsjfae over .from WHO  as --I had gathered from someone else.
'-Going to have ; WHO ^repres e'n tat I ve in each coun try.     Then he said that    . b
this would mak.e  the positions of  two  of the  three P.H.Advisors  in    the
Regional Office  superfluous--they would have to-, be placed in one  country,
I  think  thisywas-the first indieation of the■ change  that  they had had   .
judging by  the- look  on   the  faces "of" DR.Veenb^riwaM^fllliams.   Told
also  of  the  meeting with/the Policy Board. Need for loyalty and  acceptance
of the policies  agreed u#on by the majority aven  though they might not
be ones personally in agreement with.     Savings of jlf 300,000 last year.../
Must avoid ' ttiis year and  all asked to give an eajt-lyf' estimate of
anticipated  savings*    '"^his  should be an o  portion!ty Ifevr nursing to
work up   something really worth-while  as  there iljll Beg a lot of savings
in   the  nursing budget  for  this  country.  Asked  to, sort "• out projects  into
certain^  end doubtfuicS; He health  edueators:,    Br* \Maii\i  said Ted had
asked 'him about Mrsi" Kelly and- Indonesia.'    It s'eeW?  th&t that pro jest  is
not developing in  pi||^ no\t want. her.     Said
he.was.||ot susceptible  to he rath eduaatiors but" he was impressed with
Mrs.  li/blly and he thought she had"^-'mos^practical Wpro^ch.-   Bid not
see  haw'he  could Use  a health educator  sitting  arounff  in   the Regional
Office^ but wondered  if she- aould be used   in  Terai.    Possibly -'will  explore
'  placing-.- her  there^ on  the budget ling  for  the, entomologist.   • This- is
probably the $ee&~ way Marty can get hiiati^osee tjl|e value of  Health  .
Education*     Unfortunately Mr., Bickman  is not furthering the  eau$e*
Transport  comes  for. him  to  the hotel  every/'morn ing*     Br.   Ty tl eir; I s  al so
picked up but the blame for ordering the.;transport seems  to beppla ced o: .
poor Mr.  Bickman.     He  Is  the only one here1, this  vieek for  it.     It  is a
nice  waWc end I decided, it would be better to have my morning cojis^titutioi;
al for more reasons  than one* To return  to;' Terai,   if a Health Ed*   Is
placed  there  then we might well  consider the.second nurse,    Boris  Is
quite determined  that there will be one qnd  friljl -want to  transfer
Miss Heafy th.ere  if New Belhi  folds up.     Must g$  to  Terai before "I
make any statement on .-the/, matter. -. •   1 It t
Binner1 with Miss Pentz and Miss Craig.    Br * Yo ul ir o.kai^en ■¥^^BCieTe
for thetmeaM&ut had.-t^^iave early.    Afterj^|hcr disctissea th^^ceds of
 that the type of
.t>~going
' £ffer.
yto*Bd<Waiib vWs^giaater 8*s«l»-stKfeed £&«r i 8HMSd c%»ii&|iit th
Qttfta&ftMf&^v* ^^W^^sii^^C u^pliitf^t^^sn i
r£!C W "Sw^My ,^c^^o^^B3a«*S3::^^«^w -foams tty,
- .ftpMPv. that pTAev-  nre; *ao f 0»Ari" + - 'nOnna*00'*-^-{4-£-J
firap& M^Sss d2oi^lH?%H
Oie plans
rtii    - -a   *-'■..    .
Uts%^%rs^
lftdb!3i§af§
are go©
*Se^i DPJjj
tit!
for te&eiix*.to
ii|ss
cff§Ph
o^gystem
'w
it*
iieh h
B|P#Pf@P& Says
ts°iisthf SStfii®1*®^ i
-raining for oircyeajfii.
>«£©«*«$! v^uM Wf ldel)fevAh±«B tfieatlse dl^Sfe* fe-PX%13 ifh<I^O«a:i f h
g* a'i'jgfei «' ftS^ifcefre t«i&in®; a^ufaicB^mmtelkm fiBffBittee
fis Mrfefl^is^ ■ tttsSgXorfUB? M&^IP^li^.fNB^bf^^^i^eeta
hDgft- il^ <ftot&LMn&s£tM"eytliat, this  curriott^P^^^l^^j^Snnecl
*P1
>thing ,evevr done- about  it*,    fhe  c]
W$ir MtcW)r^ <^^ u**d  to 1
l||n;ttae
gdtgutfr
:rom »w
Ld I   ternatidnKL  and has also ha. -t -course Hi FuBlTc
•afcrfeW,
. T)lameK^lm|fflon ; Br*
Orkney?]
ii."covered for the xlinlc ad for.home
*ggT?4,     000 people but this  can. only be a guess.
s'"they 'fee 'able  to  visit all  the  infants once a month,    ^ays
lA^^ffiw®^^K^ allj§* Willi* H toa registered.  ,.
fee' that  theyng^c/'60>  of  the  preiiiatals.      Would doubt  this. >
Itnderfs h.-veffielid work at ^ajafenrh fox: one month,     ihey have.
iwc!l^^^^^^^©fihool 1|S they g«#^^f f0^ °^!l^XH^ith
"Ip'osed-'^. do. the deliveries fefhe district'and th^ealth
feL^itpht be onAl(M^^*^eh she Is given thfn-
ss  Craig* lyThe  emphasis  at the school aoes  seem
visiting *e
illSBffl-Kp-raii
they- gei-a
Says alsoj
hese
These dais '4-5e 'syx
VI si tor supeyvies
a11itude  ref'&Efced
|h| m
to he- pretffc
Lunch; -^{Itll!
/Brief>dis£u
Have nra^p»
with herbS
Lng sic
L]io.f|p5r* Mettrop/!|&d Djwb.'
,- ,-fir^nn^  pbatflRroiect planning but did not-get far.
i     n^noon ^w ,« ^rlttV full but perhaps by being
i Itinerary which is pretty i^ y^ *        v a* mm~^£*W&
iWdWm there fill be H opportunity to discuss.
Tea atfl with
d Dr. 2#dos followed by drinks *t tfi.
| -Rr-mic-ht Doris back to  the hotel for
Meettjro.p6<!   at Qon$tltuti'pu House,    i*rougnt wnb
d&xm^v^mM        Afbaffl Ua
 Feb.6.»Spent all day l|8the offlce'ii^tartM';Out wit^imore or less
general discussion with Boris regarding^lndsj|f nursing•programi^^^ils
"arose ou#|pf the proposed^,Isi:^^p,IiUbliana.    I-j^s:i«Btf' that this Is a
mission hospital partly subsidised- ^^he!%vf t.    There Is also a
Heal^litSchool ther€fe^ftBor^;.;seems very, uncer^^n as toywhether or lilfjl
^^p-fce.:.ls anurse i|§charge In this  state.     She says'Mil&^&ranvala has
said that tills project is':Jpstlfled.    When 1 questioned it Boris
naturally'^&ked whatlap; would propose*;^ When I mentioned courses.:'for
sister!tt^^sl'the H.Q. poll^^f not giving intrnal f^^owships^ was
brought up«|^?olnted^^^itha^i'hey had already* brokeaJ§£lmt policy.eand
H^^^5 thought that the gj||lcy would, change. b( 1 strc|hgl^^^commend
that JPf|'be |chang^^llt:^|a^^^^^-t pressing need -and Ip-: is foolish tp- ■
think only I In terms of sendingj^ese people abroad.    O^ly a selected
|||§w should go abroad.   Jfhis is^^^^^blicy'^pp''Warmer is working on
iand th:ere!.^e:plenty^|f Bo in t-4 fund d|p> awa3||^
to  eoursejy-sponsered' by tip Govlj| with WHO:^Bsista^c#';^^^gh '-pfirs^^Sl*')
Boris ^^^p^^^^^^^^^M project and it seemte^|:be the bestiifclicy
!^|^p|.!.t!^j|^ppind sea.toge^er. '  fortunately I shaljg^have an opportunity
jg|p|talk wm> Kiss 4dr8nval0|ftrit. |§|||
^ia^^Bt^^P nice d^fi&ssion ?/ith Br*  Tuli who'll^
^^^Adiai^^p Afghan is tan ^^ksk^vhim how-he thougi|||^
theh|j^ flrstv^iorlty Is for; courses
ffffla existikj^Meacher^lf^^rpm these ^election j^i%rtud^4S|brcad migkt
laterlbepfetoe^.^extffl'^i; Importance^' refresher: c." curses :i^r those \
nurses already ;trained;^^;.help Improve the service and the ciinlcak-t
fie]^:forShe presen^&tuu^^ts.    He-"feels there needs^o b$||k nursing
jSpM.. gr9f||| 'trained.' /"-Bmphasize^the ne-^!f6r- t^^hteg^Plon ' of pubiic I
healthmfi mentioned the Galc^^p.and Bombay.^-projel^peither os whl«^fe
. conta^ga p.h.n.  among^e personnel.:! He sal^^^^^^had stressed^ft^^
need /jn<J indicat*||that" 4|§"we rem^ bep^eve_^^fciis we should see kthat
^^^isllon is made for^^^lln  the' proje^|i|:;Sugg0^idpthat' one Cf the   .|||
bi^e^^^a^e public .^^ith ij&ddifflp^^^ her^khe^^peciflc qualific^l^^^
^kjw|a^*omething to watettfjp| in selection,   i^ow 'i^^$Bzf®Ty. me to get:!
Br. ^^p^ln on discussions ;w|^^^ris.h;i||haveua/f#§§Ling thatvtixe p.h.
advij^rs rare not brought into ;^Sf-.:,-nursing plans early'enough.^'Br.  Tuli
;;ha^>;^bieiast given lip-service- approval  to  the policys we have been
trying to \ put over.,
Br .Mettrop gave m^Lthe Jan.  Report for Lahore td||preadj|l Seems, tp be a
:;wc>;rth^wh'ile project anj^mpii-'of thebsecrets!.,o^^^^DeBs.ls mo doubt the-'
Coordination Committed. ;^M^i Me#j||^''-thlnks:>^|^|re should ..be provision
for this^pkpevery-^plan'w^perations^l- He Is .6fl|h^ opinion that the
^prgt...plart.: should befflra/the'r general and  that thfnspecifie aspects
should biBlevelopedvb^^e:' team^jeader. on the||rpot an^feeforethe project
act&Lly starts.        ISS
.-•Selection's Committedllpgpbe afternoon^pDr.  Chellopah the Chairman...
fflPersonnelMffleer ^^^^^^^S^K^^H depending on the positions for
i^i^ll^^R^^^W^f^^^^p^^ made.  San' see the need for references being
obtained T^f^^lca^ida^^jloug^ up to Seiectidi^^Qommittee.  Ifaink
that a. from f^^- we/ahpii^te^btain '■'-.referents on^^^:.cant^dates who look
as thougj^phey mfiffi la sent to the
Region.   --Self;erendw'"^;3#h:-;I kna.w we have sei^flswere not attached to the;.;
m^$^ being 4e4&ehed-&nd filed-elsewhere.
Suggest aliso  th^ifor th^l Region we should make soma specif3|| recommend*
ationj^^elspeci^ily for leadership positions.
• B||j^ go in 6::{^-weeks before the rest of
j|be te^^^K^o^^fsure if thla JlangtlioOf taSeyiB most desirable, but
itherekJf|k^^ be1'a shoj^t, perlodlB     /'/.   -w
Binner^Hle^tah "Hc/usfefth Boris and the WHO group/there,    ifter went to
ffliheJ|»^j^ ;Prof and Mr^-Bividas;.were having
odinn^^Mcelebrlte th^b^ithday^fflof; Iheir gro)wn 'm^twp'7 Oreec^ft
{So^^#ils;K"'Had been caiic Aed due .to  the. dea^6p-/King Cieorgp..;   Special
evening! wd^tion ot thd/ p^per put ;out and Gov11 "#^lc«lclosed todmorro^f
WHOJn^fol(^sing which/se^msia little is trange||^^i /OTj agency hastily
phoning jv^ee what t^ie other was! go ing to/do.-. ^p
 21 jgXf
Regarding Afghanistan, Br. full seemed to be fairly/well satisfied with
the project. He was pleased with the start of p^^Sa^iwIf^ry schooX*»{f|br
^^a^.15 places they hai^p^'applicants.     2 were daughtersfbf > th^■■ Prime
Minister and naturally the^were accepted and thls^tias hatji a makked
influence on the.-co-operation which is being,jjlyw in regard to any
fflre$uests*f||^ the domiciliary aspects 9|, the tr*aiwning
and to develop this they are requesting a district midwife^ She mty&t also
■hai^:pubtlclhealtlu.   Biscussed the nead fJjf^a nu^sin^peadiier of jfcjfis
^pl^p^.l^ptd not; think he agreed mt first'but    ||/the tad ke did.    Saljp
he.thought the nutsing/instru^.to;^^>uldibe the Ifftgicalipersci}£tv ^he    idea
•a:meetings for discussion *i|s a hai^ point to gei^veai^ Br^pmi;seemed
^^^^^:tate wheft^^psaidtthe nursing leader woul^^ee^jl^wve meeMngs w/
with all the nutses to-;^-ordlnate all the nursing ^pecMl'but that this
;dic^»t mean they would§^| also-be tespoi^pblehto/Ihe $Hrtor In charge
i||f the particular speciality. ^^^P  ^^^^i
Personnel going to Afghanistan should be mad em: full ji pfwjate tof the difficult
living conditions so 'that J^^will be man tally $repa6relljif| (%ay should
:iali^pealize the need for complete team-work and/ the' nefed tot make
adjtistment^fcfhey shotlftd take with them plenty ^ofw^phing {for both
warm and cold weather, |f|smei|-es,  linen,   and we iutliry.   ^f^H
Feb^*^ftlb Hajafgarh with Br.   Warner and;Br.Met|i4p)./j Ipt Br* ^Lluo*  at *
Bh^tfRest House.    During the brief discussion.ther$ itiwas obvious why,
•this-project has'been- not been more^uecessi^p^ As DJr. Warner!Wid when
we lefti/^flie most disturbing tlxjtafe t^^^pr^entai-attitude.w Sj^e\is
insecureJ-JB^ shoi^^fiings buft viBnot wiM|
Takes aikegdlfcive^"^^ Has i^bt madji. any effor^ra^^
have. Health-Committees cr|||- bring in the loc^peopl^.for Pl^nning^^^
Was impressed wltS^fthe area possibilities,    '4lka new primary unit bu'i^ihg
which will'soon^e completedj^^dithe s.tiid(^^^ro^ramf^ltho\igh the:  f|l^
latter has been largely limited'to nursing groups. l!?he College of
yflursii^ have their ownbseparate.projecJ^ln Ghairla viM-age and are very
•TBtic||^ vid&itlng Miss Heafy n$xt week so will
give* more§||bmplete detail^tate^^    After lunch^iscuflsed possibilities
of '^prelopmani^^pfe.  Warner Is veJ^b enthusiasti^suid »' is very obvious
that she wants to £ring Point 4 Into  theuplcture^:Onip^e way home she
suggested that she  ,  Br. Mettrop,   and I meet informally next week to
discuss further.    Br.Mettrfe hesitant at first but finally agreed ♦
The need for a Health Educator and Sanitary:'Engineer/on the team is
obvious. It would be a shame for WHO to fir aw ot^^^fthis area but %think
they might well give up the little dabbles in BelhSltself.    Br. Y.  spends
-•three days a week In Belhifand only 2^ at tla^afgarni^iChe latter might
well* be expanded inton'-a^salth Bemonstration projec^^S^
Feb* i8/    With Mlsjpavis at Sufdaj||pig Hospital0P.B^In A.M*    Startup
on Beir.4 the Colieg|||f nursing students hav^pKD exppf^ence.    In the
second year they      are tci^btave two wee^ifln medicine anKfesurgery concurrently with their ward exjH^ence whief|they also 'reeieveppfc thifts hospital.
And inhtlie -thlrdylprar they ri^^re two weeks ||lperienceuJ|tn the gj«j||§PB.
^his latter-has been given for about a year but:li^:Tmd|mffl.any direiflf
supervision from the College.    The OPD has from^49€lSati^nts daily.
. There lsp|ne staff nurse wh|||has unt^^fecently' been xji&at&d every month.
With Miss Bavis there is as matching nurset?)  a Miss jStitsij|^pPrem the
College of Nursing. pShe is-'^^|^staff of the^bllege an|ps a graduate
cf. Veliore^^^he does notseem too effe^ilye^at none of the$ are- as
agressive as they should be to feet the job we see to be done,done*
Perhaps it is befeter that they be as they are.    Miss Paris hslpapparently
mdde many ggod changes in the clinic,     *>he assigns the -'^tudent^^hi^ii
duties and encourages them to  tak^|lresponsibIlity» 'iXpp&rentl^^^r^
students in their evaluation ^^^^^M^^^^M hav® saipi;he^^^^^he
OPB because they are allowed to dj^thlngs on their own. j(0her$ fere||lsa
student dressers aad compounders.    Miss Baviis is arranging to have ^Re
classes with them and will use this oppdrtunity for the students to
have some teaching experiencc^Because of the  crowds at the OPB there
is little opportunity for the students do do much Individual teaching.
Miss-BaviSptries to stimulate their Interest in the social aspects of
thecases.     Twice a week she holdaj|a conference    with thep on mme
special conditions*    The^udents havelyto discuss some of thel^pro
cases. ! llii
 \\ 22. HH
This seems to havttngen a worth-while contribution .'/but do not think it
justifies the conmnua^e ol a WB^tUrse full time much longer*    I*1 the
afternoons    Miss £avis intends microbiology lectures twice a week and
then arranges certain field work.    On theS|j*.ther afternoons apart from
attending a symposium with tha students,  she just f il§p:-in time*    She
is not-satisfied herself and wan tj|a frank 'critafism JHF her work and
relationships if there is anything which seems iftbe not s&tisgdictory
from Miss .'Craig1 s polntfwf view. ■;:! repeat agaittS^at: I like hef attitude
and fcink'^^hat if she were permitted to sheygou^ .;eontrlb-
utionffl^f1 the educational program. W$$
Met Miss Faria|phe Matron.     Very efficiousi.    Hospital" has about
200 bedst^prHas-^- staff' of 6 sis||£rs and 24'p^taf||j5i fboM^Kon to herself.
. tihey^bviausly weldome j||e students for the -serv#™ ^9^Sive«^^tee
students come from. 7 to iSjfiad "their supervisors <a6me|9nw^them from the
cflllaj^^^Jn this hospitap?they have'their expediences i^^^^Ucine,
suggery and 0«R#    The -haspltal,;pbes not:" have a ||>hooll of \^w>oi«^
Bach ward has 28-30 patients and has 2 staff nurses ^dLa.otrderlies*
|||poffice .in;;'llf terho'oni^Bat opposite'Boris fottWhiXel*    Pan^pseem to
get down to-o.^ky con^^^p^ive work or discusslm!^^^;bher#f ■ tftii^ftting she
wants me - to.»" isyp go over-the planepsr:^ jd^se^fcl
Madrid,/the ^raft'ef whichMhe has not1 yet...deii^^t wou^d jg^^Kij^g on
it myself enA^t that 1 db^S^/thlnk it is ^S^^jUi of raoJ^^B^iathwe
want and l-'^oiuld like to have a discussion.-with Miss -;M%a]Mji^
Bi s cuss ion saalways get off^n tangents I I app^ciate BoriOTWpei%bnal ' B|
quallties^she is ve^l^tendly and:is agood ml^^'lHL a gr%i|L^^Kr
greatest'k-'^akness from thejyffice administration angi^J&fji l^cjk o^sSt'/.
planning.^ her work.    It could be dol|§ in ^^$* of yt|K
Had a"'chat with Br.  Williams | who is the P. HfAd visor for'^fejrlon |||
and Thailand.    A weakling! ly/  , lilf '^^S/      ^§IS§
■ We were supposed to go|f|o a Variety Show f^lthe College of parsing :|g|
to-night^|-All official functions were cancelled .but this was ^l|||
Boris was very much opposed j0$ff$& although I felt we should go on
account of Miss Craig•tJjNto hp^; tha^^|||Ctoeing wsg'ihave i^M^~-
a tactical err^^^t.am surefihe King would not:^&ye mindedl -   ^^p
Miss Eriksson is changing her mind every ether day.    Am gol^j^Sg
to try tc pwrsuade theryl^^''^^eotly home and see Br. Sundry f^rj|p
urefereal to -a psychiatrist. |s| ^'k^mj^^
Mr* Biekam is stilf^tere.':'He has,been"#itting iu the llbrajp^l^
^^yding a book called *Husiiii Fertility*!    After having seen the f«ij^|
need for a Health Edueajlr at Majafgarh^wou^l certainly put hi^^^^
wcrk if I were the Regiona^pirector.    Mr. Bickman is,, joining   I^gorie
Hudson and I to gbfio thelllj Mahalpto-morro w^'Another mm wl^^mint
his;|^|b:..coming.    Glad Ii am going    —may get- a better perspectifC^te
things . ^^^^^8
Feb. 9-10.    A very nice trlpi^Mr.Rohauser-tii^second man—f rom/^tf «/
where he is a civil engineer||| Has||gom.e over here'to work with dp
Indian engineers and  to'advise ..them on dam construction projecflpe      gf|
is no expense involved with the Indian Government and It is IndiJSp
which is. to  construct theJfUtms.  Here ^M^te^^^j^^^^^^^fe^^
^ftVe'It over WHO.    Even though   .it may not be- the wise#fei>llcy^i
end countries ate not going to request advice when they cfin get
elsewhere for nothing.    Something more wiliphave'to be do&e re|r
the providing of accommodation problem. Ipl
We reached Agra about 11 and booked in at the Imperii! He
comfortable.    Before lunch visited Akbar's %owb and after.Iven
Pet^pur Sikri which is the abandoned village built by Akbkr
Palaces and|j||her buildlngs^^f marble aodlred' sandstone.   \/
marble tomb to  the priest whom A^bar consulted because heir
Obviously he later had/ one 1    Saved the Taj   to  sefglfey moo^|l
certainly should se itj for the first time them.  It has a 1
and is very beauflfu^   It is lovely in the daytime also
I  tended to reg^Klit/more as another marble building .o|§|i
great difficulty iby many thousands of miserable workers
cost sould have been aso much more usefully employed.    A
Fort at Agr^ffljMore marble and sandstone.    On the way horu^
 23.
find a new Hindu Temple which Is supposed to    be very interacting.    We
were misdirected and found|purse!bes in aur big |||ymouth car going down the
narrow bazaar street of Mutr^rThe usual  crowds milling about and it
seemed to us that it would be i||ite impossible ^ avoid killing a through
unless our driver were more careful4|§|Littie" di|py shops on eitherrslde-|||
people lying sleeping covered^with dirty blanke^^to keep off the swarms
of ffl|pLies--.sacred cows,     tongas, .feed to  e^ifbeing made in the street.    Afpp
Mri^ohauser said it was something one could nof|§describe in a letter anf|f
it would not be believed anyway.a    After about a mil© of this we turned
around and retraced our steps without f ind Ing l^pf; temple^ All this
sertainly gives one* foa||Hfor thought.    The otJ^ifltay at Majafgarh Br. Y.
in j^xoost discouraged voice said,   **But we'll not gettthat for-. 100 l^ars.*
I am sure it wiiStake moreythanflpO years -to get what we. think should
be a modest publi^health development for the vast majority of the people
of ffll||ls country.y^hey ar.|||^:poor and.hungry! |||| the same time Miss
Hudson tells me that the mismanagement of government officials has ^|Lot
to do with poor-distribution.  -f|he Hed Crossl||bd to construct a special
building as a storehousfi^or food which was sent air freifgt by the
Ame^ycan Red Gross to.!fael|^itnwthe famine.   :Great stacks/of it are still in
s  torage*
One|||ncident~-on our way out on Sat morning we came across a big car-al&most
a limousine  type,  which w&||sitting at right angles t^pfehe road and extendec
half way across.    All/traffic was ^ing.^oundpr   Our driver said tfc^||.itb
was;k^^S" car and-stopped. inhere was a flatp^ireij^tl- other damage to the
car which had apparently ll§pn ,hit^i:Two^^en were asleep inside and:cr||i^^^
out.    Last night when we returned the car waj|f#till   |§a the same posiften
and one man ,was asleep inside.   -Supposedly^pie second^ad gone for help
which will no doubfe be along in a few days I
Feb.l:^^:-Td Hajafgarh. Miss Korah came in ..the car with me.    To a schoc|i§J
where the children were^taving IpeT. Ban cing around lno||he dust of" the yard.
2id some -special son&s. and advances.  :i3^p: ^o ing'school medicals.    Two student
health visitors ax^-their supervisor there.  Walk^,.^th^agh the torajp||fi
Najafgarh and saw mi o||| health; centre which will be abandoned when the
new!^llding is complet|j|    Met-lppe-'.^staff Health Visitor|j|A very nif|||f
^personljfand who: is qui Incapable. -^otdSlhave^een a matching nurse but
fhe does 4^t'v"like .to' -t^^; the^esponsibill^.ande^efers a district of
^rilHK^isIted many kf|*tes of the sweeper '<s3^b and other lf|asse#\ in
K^yafgarkp^d twd^the:^^^tlages.    Bvent|^poorest';-,h0me had beds, *jfme
bedt^iotfilrig,   clothes an^fquite, a supply of poking utensils.|B-.--Befinitely
more" thamihe Egyptian;^ all had mud floors bj*t these were
usual^;eprept clean :a^^^^ rooms were tidy. W$$|t to one where there
was ae^fcSay old bat^i^he Health Visitor was preparing to bathe the
baby*' -ita^-a simple but adequate set-up^:;        'wfM
Zn>w» afternoon^lpted Chawla Centre irh^Bs the centre where the
-:Colieg^|m;KursIng Ip^fats are located, -^r s^Kfcudents they have there
iS^ addi^bn a^ithi^D.entre there-is 'the
HealtHl^'l^l'taff public' health nurse*    No placf^tli the world can students
be so- ovp^pipervIsed^p;iThey just d|||lot ge^^feclugh ^gportunity i©|f&o things
§ on   :the3#;^W^Mlsstiphlllips stated that^o^-o-l* ten\ home visits at least
five wo^idhte*.. supervised-^; They have two months pbereMoirards the end of
the fowth year and. aft^^fehis rural experience '^^^^fi^ave tw0 months in
an url^tt-icenti^e where #i|^:are apparently equally^^^^s^ervise(l*    The
gir^m^-^re very alett a^Jintelligentf|l Most are'ciS^cn^larshipe given by
t.Belh^fednKll therefore have.to work in Belhi ti^mio^eaxs after g^Luat-
in^^t*^it from':'^^feentre to see an Exhibit J>u|t/oj| by\the .a^ard of
Bdueatjioh.     The nurses had asked to h^i^ta part \in the; exhibit and theirs
§was  thW-only part!except;n^.r a few rather u^l^^fe^sting ^rloulautal
posterife written in English which few ol||the vlll^ers wou^d understand*
Inder Ijss ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^H PrePared a
set uffefor a■ hon^confInement, diet during pregnancy,, the baby's diet,
the babyfs bath,   ^ndidhil^tren's toys.     Thes|p|fee^^^re expt#nii*8 to a
crowd of interested spectators as Indian music blared fortft,fo*om the loud
speaker of the'van about 20 yards distant. ^I^^^^^B WMmM
To  tea at the Health Visitors h|kse—pre-fab building cb the grounds of j|H|:
Health Centre. Miss Korah,   the supervisor who M a graduate frefp Veliore
and five ^studenta.y^pry vivacious ^d; verymn teres ted \ in the^^ork.
his country certainly has some good    materia;! to work, with.     r^g
%
 24.
It/seems  to me that Miss Heafy has done a good job.    She is well
liked by the staff with whom she workd and itw&s quite evident as we    w
walked  througi|§phe .villages that she is well know to  the people and liked.
"The difificult^ms 'been that s|| has net had a matching nurse.    Had there -
been one her position would n^l^avehto-*e continued in the project.    %l|l|
\:are many of!these girls whom, had they been working with her for a f#l§l
months,  would have been quite capable of carrying onlfAs It is now she
is really in the position    of administrating and supervising the public
- health nursing and midwifery program of the district,  and no-one is. trained
to  take over j irfjjj$S
Had a long talk with her at lunch about her own.-future In WHO.    East
Sept.-l&e applied for'^lpudy leave nd she has:J|een more or less counting
on  it*     Has not  been  able  to get any satisfaction out of the  Regional
Office    however.  Recall 'that a.bou*-las*    we suggested from II.-Q.   thst
•although she was not an  a five year  contract that.; a test!case be mdde
nof^^rs^gbut apparently. they have not made any- such attempt.  She had a
^^|ter. from Br*  Chellopah dated Jan. 31st to: the .effect-that they ...did
notptfcnow If they wouldj^e able to renue her contact,which e xpires the
end of April,  because of Ijjfie possibility that the;^oject might not be
: continued.'    Promised tc&>$£Jt her know def Inltelyr^rt;^h#- end -of *eb#
Miss Heafy wants to  go home the end of April and she* .wants very much to
spend six months  taking refresher courses and observation work  in both
public "health, and midwifery.     She would be willing topdo this on her ol|iJ|
but hefg^ro^her has be|p|;y^ry ill and in sBzni^0t^^^^me and she has. had
!!to; meet a considerable amount of  these  casts ^|vphe \^els also  that she'
cannot g6  through another summer at Hajafgarh.     Th$ dust is terrific--and
affec*^^^rftlnus. . .|^^i-'.' very hot,   there  Is no  fariv |||| the rest house
where'MWJsta^s ou4—-sis nights out oipeven,no runhlidg water,  only a
bore l^fflKatrine outside.     She is very, anxious  to' gta£ \ith WHO and If the
pr#|pffp w^r-e  continued,, woul^be willing to  come ."backfpp .llk^afgarh In;j^t.
for another year.  M^ss Heafy has  a lot of consideration "(due, to her in this.
Shales accepted  these diffiffelt conditions and has b^en veiy sincere In
:.'h^fyfforts: to -j4p:,-a ggod job,   iShe feels very keeipfly tjhe lack^of a matching
member because  if  there had been one  shefeels   that, they would have been
able;, to  C|arry on.    1 suggested -j|aat three years was ni||r really a very
long  time*  for  a project  especially  when as much spade  work had  to  be done,
andi tha tilt'" would not be so  good  to make another' change  in the WHO nursing
^-^tafi^e^pe.el^ly^:i^Br.Y.. is to leave.    She h^K^l little or no profession
al guidance.     I  gather  that Boris/has been out trwic^ buMalwajis with
Vlsltorsf. ,      ' K     bfflyp
Feb.l2*|Spent A.M*  with/Miss Hudson.    Home yl^lingi iiffDld Belhi with
Miss Hudson and- a male Health Visitor who hag been^p"--hi!|. present position
for 9 yttfjjTBV    A specialised T.B. Health Visitors ^^rseljr eight months,
talsy.pfouipe has r©cent^^'en revised and the #§3^ g^^Nursing is now
giving f^fr^tudents spend four months in the'clI^K^  ^Iffi^
Impossible to describe M^errltile .living conditions.   |fWt through the
bazaar/^rea and down through narrow winding corrldo^«-wxe living
'p^^^^^W^^M TB»ea|^irstaand last visit&er^^^fehe homes of
the  cobblers.     These  s'eem  to be one  cast*     1'hey live  andMwork as a
a community.  - Bach has ojde separate room Wm^i^^^^^m%^^^^^^ e&ch
there may--.^e fr">m any#ierSfehree tb-seven-mildreh\aC-J^llUs adults,
he tirst plaeewmas rh^mHm^ad but;  the last; was the ■^rs'^p;f>elhi,   so
l was  told.     The\fl^| waMjndescribablel*    W^men mixing gr^at Mlea'of cow
dung_jus»insi(|e 'the en4ran..^e.V bullocks Infffche co'rh^^^hii^ren\in rags
and dirtyyfiiep,  ^nd all/th> rest.    These po^pedpleXwh^: siake shoes by
piece pr^:cle^r^nlpal^«4ffl-annasM  6j|ents) m emi^^Mt §| shoes. .
xney hav^no fl^ptrloltfm^ their quarters anWhW problem
upermos.t  In  their minds-when  the H*V.  wanted pern to W'inifd^r X*Ray.
Promised to -^Kpo'- do s/omiihing about it if they w^M^\pfe#§^    case
had gone  to  the village and had died a few days previously]*'    ?hey $o  this
xrequently apparently*,;    Are afraid ithat if thfcy stay  In! the  o&ty that they
will die.;iMr|fci thosefietjpMilive A'such- terrfele - conditions they ire very .
friendly.    Y<ju sense/this as they crowd'aroun^gV^m^h^e is & fueling
of hostility; and  th$r are  very receptie to   teaching I    After thft first shock
is over the nu^ss f/^e^||iiw and are encouraged *oi.s^: 03^S*tlK^¥^^0X** "
ihe second' Wait was ,to  a .'case,  an 18 year: oiB^lfei of a" 40 ye$J: old tonga
driver.n  She \was setting oh-her charooy with h>er year .0ld\ba^'|l^*BpIng;
beside her*    fcjhe t^.s a far-advanced  case and 'wks doing a M o§ teoughing.
Mlhwas,rathf!r a: fetter.home*     It was  clean,   ftund  ?^4sted^ room ^rth
 25.
with an open porch of about the same side.Jfzln a corner of this porch there
was what I thought should be a^ore-hole latrine. j^Kt was not,   simply two"
seats with i||ly the floor underneath*     The  sweeper woman,   the lowest of
theS||stouchables would come and^J&lean away the night soil.  Beside the  case
and her baby, and husband,   there was her mother,-father and sister in  this:
home.   Some  instruction^: for lsolation«were giv^^^and^ form" wa^;left to
be completed for admission to hospital.     ?his  they would getpsomeone who
.could write to:phelp.^ptem with or if;they.}t30uld notg|find anyone /the H.V*
would do it on :theynextovisIt^fflfee'H.V. -had j^^^^tum:. c^:-to ^ive the -
patient*   (Use  cigarett^rats. )^fcb is "beneath hj^^Lgnity ^ffl©§trry .suchr. -
but Miss Hudson- is, tidings|||-- ge|||kim to alway^c.arr^.one«^e/' other .'d^p/
She had about four ddjtgfc^ somewhere*   . %iey '^ar^Hn^two
bundles.    Sheplcke<$|fj?p o^;."and asked him. to ntake thewo^epr. Only after
a lot of persuasion and her example would she do  if|    With^egar^&f|
possibility f^^^mis^^^^o-^^akes at least 18 month^^fr-yie end ft which
time mos# are dead as  this girlwill be*    :ihere are  two and 1 halfh|dllion
known cased of' fB in, Xnfla,  l|p|pO Saif^eds^.andl^O^ .0^ kn#wn deaths per
yearfrom TBj£*Every minutfepf the-day one pe^^nr.is/dyi3nyg ffffra TS in
India.11 was; thjfeir slogan fte^^ampaign/^pt: yea^gdA^|he .^lt;eoff one
ff ightp b^»tatj^jwe climbed  thexir was a great heap of garbage*^3fhe famil^p
upstairf had tkromn it/down,    ElEone will take a||r responsibility to see
that it.'is  cl^«^^d -awa^^^aw t^th. adults andpChlldren voidii|jttand -
defecating in :the narrow g^&^;i|^lhe alley-wayk§'MBM one of Me best
dairies dn the 'town-licensed, by the'Health Befit*/ Consisted ".j^fcj-llt^^p
out-door ^^^^^^^Hy a shelf,  m which, squatti^plhe: dairyman bei^L^d a
gweat copper/bowl of boiled milk.     People  came wlt^phetr containers'  to
buy..-'    They boil  their milt  so  much  that all  the nutrients   are destroyed
as well as .the germs.     The germs get in again in  the  containers 1
Miss Hudson;;goes  with the H«V.fs and students about twice a week onf-^eir
home visita§^|he understands  enough of-|§ke language to get the S/Cnse 0$/
what: the'people are saying; and wh^^h^^V*l^^^ying; to. teach*^^he s%ts:t
the H.f. have a list of eight points;||hat theytry^: ^^^&v^^J Unless ;
she watches  they will do  all  thifchon  thefirst; vis:l|fiand the people become
hostile because it seems so  impractical.    She i^fe|^ing^> get/the E^^M-
ffl.to do better-'teaching. J|p    !#!      Wm
Wentback t$||he T.B.Centre where Dj^tlckend ia theijtireckor ^fid project
leader.    H#f||s an Indian and "very go#MS^He refuse|ptd  op tip matching
member to any international so  this  team neve^kad%n international
leader Iqj the usual way.     ^he'ee-.who  are there ,%^^^^rse, /fepidemlologistj
X*Ray technician,   and -^p^&nk lab-technician, .are feting W advisers.^S*!
seems  to..have wo iked very well./Miss Hudson has dlfee  a gl?©d jo^Ir She has
a very definite way of getting things she wants anl/of getting around the
Br*  who wa.-sa very diffi^t at first.    Shejlluld; l;||^iil^ivthing ftgKthe
first six months|||Seems -to have been able since' t^eny"'i®j|afluence quite .
a f ew .||. the policie^^^ has | |fe|^^^^^Sl^m^&™    Rathert
weak.    Jt; will be a^pity if Mis^tudson leaves whei^^^pLi^&)ject is
finishe^.!ln Sept*i^^KaSickahd apparently recogni.2;^s-itkll#^/l;Mia^ Adranvala
is alsltaware of *|«'and i|||wondering if Miss Sudsd]@W|^Wot carry on..
here!and;^/the saie time|pnitiate an affillation..3||^bw:. ia^the Silver
Jublli^^anatoriim   . The.^ttertis where t|f| ^oraei$S% is to
be andjjp^heat^^ team*pp^^
vala dfp-not iqjp of%this-^roject*}    If the. condition^|&e jbufflmble,   as
they ar# reported to be, thi* would seem to be a logicalll^^op^ent*    Miss
Hudson could  ytien give some" guidance  to Miss Thomas e^^^^e Cpnt3C^^
They seem to nkve a good student program.    Have Brs.  talcing theJtwMiploma
in TB work, Jljey also go--out with Miss. Hudson||§ Talked HMh som^J||^ them
and  they wei^ijvery enthusiastic abtfUit these visits^KMl|^^^Ksaid^sfoa ;.
of f ered-l^^ffiear tal^epSiera but,Br*/Sickend; woul^h|-i^g|one of itnp
With  this/group he  came  and' asked,  if  she  would  take 'them,.,,   Take    College
of Kursi^gT^&idents Mso.^fpne morning Miss Hudson carae/'I^5«ie c®ntre ||®S^
foundV^^ouplp stand/Lng waiting v/ith a note from Miss Craig saying that!
they were to Zfeave  two weeks /in" the .Centrei.-end ,o^linin^/ whathj^is to be
given^Miss ;^lxidson;let!:this go on for awhile a0 theighad i^pjat..    She
also circumvented Miss Craigfg mo^.to put^^ theirpow^ supervisor as they
have done elsfewhe^i^p-Misfs":Craig |p-a-. very diff icu^;!pferson. ..apparently. '
From what I gMh«B.she has- met her match in the Hew &ealanders.
The T.B| Hsaljb^isitor students^^f which there are t0n,   come "j^rom all over
India.;|g5ollege takes  them forthe first  two months.  W|ll get deftails later.
Planning now :for anorhef group pf WHO Fellowship nursds-jrSix.    Course In
 26. \
for three months.      Piefj|work has.- been given 2j| Social  ^ork students and
to  the students in the H*Vfs eeu^e=e and Midwives; refresher courses.
Students from Lady Reading will be coming in the future^ Miss I£orah
was not anxious for!^i&ibut Miss LakshmiBBevi has kid&t her on and she is
now-going to'sendtth^jW   .
Appointment with, Miss Adranvala at 2130 P.M*    Seemed strong® to bee
her in a western sul^^pShe has just returned from accompanying Elizabeth
to several centres. |f.We talked genrally forthe most part.    Probably I should
have had Boris along but will forthe future discussions.    Miss A.  would
?/elcome having more active part in the actuatL planning of projects.|||Asked
her to come tjo Ludhiana with us and she will try to come fir at least the
second of thi twc^tays&iThere are three centres for P.G^&prk, Belhi,
Vellore,  and Madras^ She has just been to  the latter a^d/ftnot at tSL^Z
haPP7 about Jpeir program ."is Says the two  i^^H^I^^^^^^^K^^
subjects Inwroing they^ucjationalaones.      0^e;o|||the  two ha^s been to
England wher$ Whe took, the H.V.fxs cfgurse.    Miss A,  not' surellthat they
would want a^^B||elp however.    Thinks  It is more needed thaife t|ie pediatric
nurse. W^ A.  feels that there^s a real jr^eed for
refreshej^pou^ses.    The-4^|lan be developed by./the teams in tll^wasic schools.
' Is ia eojijilptje ^greeme^ abouf|f|he integration of p.h.     Is afr0Jra.;that
if veiftWany;fe:$e si&ter tutors were produe^^bhey -would, not ^^%ble to
absort^hem^di«:"to budgets*    It would seem that^he development otf a certain
numbei^€ bisicjf schools, with WHO assistance and .; that these be censes ftijggg
staff educatlioi| and refresher courses would be the best planning. /This
should be wmt.ien  into  tiplplan of operations.    Miss A.  liked the idea of
the leader going In first and working out the details with the local group.
Feels that t(iere has.^h4ftl>een enough Involvei^t!pOf  ti|f local nurses.    E.G.
Miss Toy wa||ptit Into  tg?ye Irwin and no discussion with the Matron,  Miss
Baird.        Milpt.^ does no^^ink we'.can. ^kitkffi^;b^nlcal experience' of
the stud-,enl«H^:selected ward^l^at.she does fP^^vthat some wards ciild be
selected fo^^pie initial!"■'■t'Pdjehingj^JChese could b'^flUss crowded,  bett||||
staffed,  a^^^tteraequ!pped.^E.G.  she feels thaty|J: Bombay 100 beds could
be set asid/feWor thi*-purpose. wM
GueslMo/k,!|.nner,Miss Adranvala,  Mis||:Lakshmi ^W^K^d Miss Borabji,  and
Bori^^^i^s. fl^^ Association.
hl%<'haMmbeen in existence since 1929.    Bach schodl $pins as a unit.   ,
thejft. Imve^S units ou^^&VpossIble of some 200. ■ apr the'^rst time this
year'Jme students'selecjte^l|ffleers. i^Mtll^p
:•-.-;-apr-' :ea7u• ■ fflaeseooeffl-a-  -V-^^pt-o
Feb.im Spint air morning! iHgla dliffiussion meeting wl$£ %.. Earner,  Br.
Mettrop aijfd    Boris in Br;"1 Warner*fjfrf^at discussing Kajafjfarh.    Br. Warner
had to spend the first||Sjj«-In giving Djs* Mettrop jl' background of the
Point 4 program inOtodM^an^ther details affiflf which s%e has given both
individually and colle^^y. to Dr. Mani, Br.  Ch«&lopa^l\ftnd> Br,. Tuli.
Hot discussed in W.H.0.  rapthat ell staff wouldM''Informed apparently.
It was a most interesting jj|scussion and I certainly feelvlhat "WHO is
lucky in having Dr. farnephere. Dr.  Warner has» double ptifltion here;
Health Advisor to ;ffife.(^'-4Point 4) program and ^onsult'suA-t .on Public
Health Administra4ij0a"'te^p|me Indian Govern^entMeTh^T.C.iSl^avc
150,000,000 for In|ia whijff muft&.be committed befl"w June ^|»2. ^en
there ar$vthe .;pi«erpar^indian funds of abour-5ip0C|,00^p|fces.a These
two mims«re ifeOpoolZih a bankj|*he $ arejjargely u$tli2^d ej||||. capital
expenditures dti&h as. supplies, necessary construction*- mtw TheM will be
50 connfcdmratjBVelopme^>'jreaB in^Hpla,   at lea# oneffl.M e%dh:.©|»he
28 State^^^^'immediatfif.^urpos^si'  these is to in crease j^^'-prod^tion and
they wil^^^pelected |»y the Planning ^ommissielfcon tlt<^^^i^Bimenda:i^>n of
the States  on that bastirOfflBach development area will'cons^i^of som^|00
villages^l^his will correspond to the Secondary apt it area?\of .theBhoH^^^
Repori^JXBr.  Warner feels ' tfyat lajafgarh will certainl' . M|\selected ab °«^M
of th«^'T^om.muntiles. Aie-.ael^-^^e discussed the enlargement of ^his for the
he a^^^pject/'^^neljide^all lie 70 villages-~ati€*u^feobo pep^pand
dismissed/possible: staffpj|peded.    Br.    Warner is -^ery keea';^pbai ^ew Inter-.
uat.^jaal -and as many national as possible*    It was. agreed/|hat there should
b£fM-public health administsator,   if possible loci^-a^erepshould be a
^ sanitary | insJ>ectoft|n the  centre and two more onpthe staff •»These might
SlllSi iSSllli 26f«i°l^i nurBing st^f:f should be ln.reased to one supervising
 public health nurse and an assistant nurse with midwifery as her speciality.
?he^|. would need, to ;be;ppur to five'more heal^T". visitors arid more midwives,
depending on .the number located in the additional, -villages*
W.H.O.M.C«H#^p^uld provide one social -.pediatrician and one public health
nurse midT/ife. ■ Br.  Mettrop and *oris will pull for a second district mid.
supervisor (with P.H.) but Br.  Warner and I persuaded  them to- wait to  see
what local per«^ will be much better with only
one W.H.O I aB^Knvineed^SSo mention was made of Heal th -Educator un til the
meeting was abo;ut  to difelband'-and Tf\  Warner■ said-/*! wish Ted Butterwcrth
would come out, h$r.e.     How .can  it.be managed. * - She was .going to ask the
Indian Government to ask Br. hlani.     It was., suggested bji the others that
it would he befejt to, akk Br. Man I first -and not to men tion any specific
name;" Hf, mentioned Mrs;. ' Kelly and what had/.been.|^Lld in  the  staff meet-ing
As  there; was  t(iin€j;  before lunch '1 went back and- had a further Chat with
■Br.  Warner.-     If W..H.O*  does 'not put in ^Health Ed.   they will.     She has -
already .'asked'fordone  as  Advisor  to heJ^feBjfie;'has  told Br*     Man I  of Ail
the staff- she has requested including nursing. $fc£
»'nftfc""    w& Wm^mWm^ml^F^i      VsBF" wan        jpp mHBym
In aftpjrnoow went tp   College of \Iursii$g.  Mies  Gralg had lined'up a program fo
fordme ifehleh gave -m'f only a halii .hour wi.th several peoMe,     1 had specif icall
ally lasked for fffll^vas^Kme* wi toiler first*       '*»he  gave me so-me of the
general .background -off  the College  and some pr ill ted  Information,     they
admit 24 math year,  lcouIdjp||t. take mfre because of accommodation.     They.
have nowdinlthe  f£aro|b Tour years  24—17—17—151 ^ Totaly93.   She,'spoke of
their o^wsuperviso^ being with    them In  the hospital and in-'"the village
btkt^^ time was no,tB|)portune to go further IntAhthe |uh*  field work
aspei^K^   Next met ^iiss Clifford j||tes.    She i^nfte of  the d^fficul^g^
Demand^ N.Z*  etanclar'j&s of these girls and puts a-.]^^at deal of emphasis
en ^^hniques.      Comjplains of the poorness ofo|^Klocal -ptpervisorsiand
justifjles-t-hehnumber^        them on this basii^^p[ext"'-J|hisked along *^?^^^^
Miss $S*bell wl^lsore-spon^ble--f^^ihe po^'cer^^|ate group and.str#8|^
me as. being, a very capable and understanding perso;^St?he best of,the     j|||
three.  They now have|||wo post c||ffcificate couraM^^t^^in hospital
administration-In whii«^^heredare'a8' WMMM fe^^KSl'tutor1 s t^w-hich ther
athe^.atepl^?: Hot-all:.these people will go bacl^o assume the positions
for which they are trained,    rtext yea.r going to  combine this course..
Could take 30 In all*- This presenifnumber is mere  jthaii they have had
before as; there 'has;^pen no one definitely res-^lqi^ibipFjbg'-He^t year||^|
because of their weak background,  30 to 50 hours ^nureing^'procedures
will be included.    As.ked about the necfr for 'mor^ftpti»|p- give such
-courses.     lhey should T^-limlted £||pause not enough goodfmaterial for
them.    Perhaps later centrea could be develo-^twat Calcutta and Bombay*
The present group-are having g<ff|l experience/^^^pe i^ac^l^g of Miss
Hudson's T#B#H.V.  grou|||l      ®®Z§* Miss Kent-JohnsW1 *h^p'^'responsible
for nursing arts.    A nice girl,  who Is very dis<^^ag^k^^B,thecpoor
"teaching facilities  in^^#^war^*  Peels that they»^ed\^"*w!^e more
responsibility and; tha^|%hey;need the Shole 24 ho^pshMTt ;f|hgive thi^jp
Hext saw Br.yBavadas ^^/fceaches nutrition.    She gltes ^bVfi^Sractlcal
course but Wlis very hani' £e^ them to carry out^f^e te^chlng-abecause of
...the low income of the families.      E.G.*  a peon getis|»
rupees a month.  80 wiil^^;'spent: c^food end eloping, -,fu«B,etc% He san
-buy wheat, to give hi9b§^^fealorles. for 3 annas;|j^ MflP
with the remaining M-bai^^i:his diet.     Tendency v/ill    b^L^^^mmimore -
wheat as  this  Is fi|ling|    "^!Ch^saw    Miss B^^^. Miss ;^ai^^a@'definitely, asked he^||iw.takeb%^|p0St certificate S^^^^^^^fcl^^^^
about July.u Asged/abo^piie possibili^of    getting ^^ot^mW^BBheT
course but Miss Ba^is did not think she could*     She  Is!, not one tha*-  -san be
rushed. ^f|5    £^S#    s nlfi: i feffe   l||al
Stayed for dinner- at the  College.    Kiss Bavis,   the thr^e N.Z'smiji
Miss Pentz who  sjhb'Wed/her Kodachrome of  the Kashmir.    I nice holiday spot.
 28.
3?eb.  14 JJtLn office||i discussion with Mr.  Sundaram,  Personnel Officer.
Suggested that rhen      we review and classify the files—personnel
histories a- at H.-Q#||piat it||buld be helpfuljtf we entered "0m  classification in  the space on  the top right hand corner where it^rtates,
f,Bo not write inol^^pspace.;t!    Think this would be^apr^ry g^od idea.:'.He -
further(suggested  tht we might Indicate the'particular position or
project'would recommend for.     This would not be praetical  in - * the
majority of cases.j;   They feel here that they do not haves \euough
information about /the progress of re etui tin en t.     Suggested that we send
copies of the letters  that -we send to  the individuals selected so that
they will  have  tjf&is   Information.     Mr.   S.   says  that when recruitment!  is
done Within tl^^gljim'that copies of lette^»r#, sentfh|b H.Q.";«is
nightjp© discussed -wi;|h' Mr. Patterson. «ertainiy( the,re Seeds t tM^e
eaarMer »«fic^ttion;^^fe*rival of %&c^
-.yesterday —v10.j. [notified -here yet.    Miss Van^por^recta^^pfT^d last
Sunday end   the  ^ableiwas Wcie'ved" just at closing Sioe on .'Sat.!
Mr. ^>^^5phaslz|sd ' t|ft^heed%pr revision of    the tPersonnel History forp.
Would very* much; like  to  have photographs  so -that  they §'could j-fudge
personality^I Bjointed out' the danger of  thfes  and  the-difficulty in
get'ting  exitra pihotographs. {   We\ might however- sen4an^ of the photographs
we recie.vejif. tte  think" there might be a selection made.ffeMr.   S* vjaiso ^'
pointedgouM information ondependents which would  accompany
personnel.i^he|r neednthl's  information early in order to make  the;
necessary; ar; an^emen.ts  wi^J'thu^^iintry regarding; accommodation.  •
Biscussed brl€fi(rig..-' He promised to have a meeting of^ff  committee
before I gQ^pMin^^there Is duplication din t^MiTing ot informa^on-
re leave,-.i'ii^u#an^:bf  etC'^B'l agree ^nd. think wegpnj&uld ohets|£ at H.Q.
|l|?gsee thatf;;«BUr^s $ef init-ii^.givenVand not-'just i^efp?|o' Ipk- individual
from the Staff' /gules.     Refer to Mr.  Wright.    Mr^^^»-thinkS;t^ilu
informatafe  sra&id ^l-give^ at H.Q. |pd that^^^^t™/particul««Jtains
which ha,^^P^^ cleared ;-;i^e.. should Be di*cuss|$& ^nd question^K
answered^pl^pys  th^taour briefing book,i'.whl6M' personnel r^p#re,
have; errorsMIthe li^raof Regional Office Per^&iel and the &gg^|l§l
chart ^fi^f^pujp to da^||p   l:^suggestedi^nd^^^no^to Mr. Irigi^S
when .^iJ^^^ena-'-Mgapts very hard fox H.q.   to 'keep up w&th the
chances <;   Perhaps w4 should not be -giving such a a complete list j!frem
H#%^^^l^lile top officeri^bhe Personnel Qltlce^ and the pasticular
afi^^||J|;ffl|||g ;i.pk •• hlSs? Iptf
n#«'^panti^ipated when Br*- Mettrop wrote uph'the ^S&e^ing of the previous
day^wKth l%v Wamer|pa-':put -§|ton tha||§two interSfcioi^al nursesgw^juld-
be r^uired.    Mo amount 'of persuasion on my pai?!^Wottld make cipher he
or ^^fepfifelent.     rafj a difference in;pi>ncept, InsVtead of goihfe in .sand
workltag'/pth what i^^here,   th||. want :M.pu^^ standards oag^^them
as quickly as they can. j||j gglj ||§| ^K
^en^p^h Miss Bavis i^fche afternoon -t^&ee .-^^^ovf%-Gard^n^    Very
^TTelj«formal gardens,^which always leave me c^d)  whf\ch were a rl|||g■-.-b-
of c^lbie»(iuite a contrastb^uthe streets of Old Belhi  and pice for «|ig|
peopljLtfito haveii- Miss Bavis  is a very lonely peilon and|jft think must
get /very homesick at times,    lent '■ b'.- \   :;;Mfl
a-oluoa-- e. teaafflfflbbB-
Went 'With Miss.Hudson  toita refugee settlement in Belhi  w'here it had
been arranged  to have a group of mothers  together to discos  the
organization of a Baby^inl^    Miss Hudsonfs purpose%ras ^fentually to
have them all X*Rayed.||A nice group but I could not;^iayffl^^^fae  whole
session. ^^^^^^
Binner at Miss Adranvalla* s. '<    ^g
Feb. 15|felt office ii&.M. .•■ Boris too busy for any discussiWsi^;^^*
tine making an outlMeef^ttinformatlon needed frim Ludhiana. | Offix^t
closed in afternoon J^fi|pfliit time with Boris, in her room go ing;. over #-.
the Bombay project ?md her draft plan of operaiions for Madra^   pedi^trlc^
On our return from/ludhiana there will be timeet^ discuss thejs$ In
relation/ to an ovejr~all program    in nursing forl^ndia with Br^ ifuli
and fiiss AdranvaldL.    Biscussion was very plaasant—hope I go tj oyer some
points*    Plans hafe me a bit stimied*    Can11 honestly see howj detail
can be worked ou# except by the leader to her first survey. Wb do need
to get into the cirlgirial plan the matter of staff education and refresher
courses. iKl -::T\.       ._.*»»«"*
 ! 25* I flji
Feb.  16-18*    Beft at SKSS s&t A.M.-for ath*';ferai^
not go.'   Met at Rampur by Br.  Iseris"ag!|Kfamily and Mi^-s ^ane^i^^fwroceeded
' back t« their H.Q.  at Haldwani via Gader Pur and Bajspui^pAt'-^^^PM^
two, places there are so c&lied ellnlesa. %ch one room |nd v^rj|^JKpriy
equipped with erer^ping but -recoils* -Mo less than ten:.%^ books
for them to record in*    Mtss Banes left a long monthly report jrorm to
be .completed which would take Mrs. Pandit,  the H.V.  in}£&$ Pijbrjj   all day
to read^p- am sure.    Afraid Miss Banesbis another example^pf \fyM recruit
direct from I.R.O*    ^^^^^^^^^^^^§^mtM Mr®. p^^»»r* *>* &
- trained dai. Apparently In thlp^part of India thef|^
btrained dai is one who has had soise training^^roba^i^dne llf^^^^:^16
Indigenous dai has Jjad no  training.   .In  the Madras area„,  ^e|rc||^ig to
Miss Banes-,- there are nfe|mtraine|L ones*    I think there ar^wl^
are not given any ^Mgnl^^|' because there,  -is a hIghe^^^TOmliM%f
midwives there.'.   Mrs.  Pandit'"has 17 -villages in her area and t, there '%re
untrained'dai si in eacl^fe -        ^P^P^k.^
Sister Angela is at Bawppi^^a-.^e has had isome nursing trainirp bkit J^lgl
not fully registered*1^p|l hasf||3 villages. |jin Bazpitr,jfchere |i8^p^^lned
midwife and a dai Iip^raii^Sg.   - $4ster Angela l^rery good,  4d^i%Ing-J^i
Miss Pepper hand got l@t#:pf slides each month. vfgPO£ -Of Miss fleppe^1 s - ti»e
.'s^ent-onv th#/i^ been ^sntrolled and |he sl|de
surveys are not to bj©/continued,    ^rilf Iseris planning to develop .ppbllc
■, health In the area ;mboun& Haldwaiilt.    15fQOO'"|#^|andil30 villipgestpp^e
could not give me a^r;^^pJsfactory plan that •wou|^^^ustIfy %m seesria
nurse which he wan Ik-   Mjyp^epper 'iftB^irmed: that. ..this afterippn. Says
§|§||: need;-, for a seco^Aii^^^^^r. ']^^^&an is to etart|fr&th tiie school
children^ Nat gofl^^^p'-Miss P*:j^rs.htheseu^Liages ax#reii swall and
she does not think |the plan would wo^ti^ Personally I think Ip.Vl is-|§ist |
looking around f^jBbmet3^kg::'^: Justlj^:his staying nora^hat thW malafcia
has been controll^$|gp ^^fm fai^
plfcsterday A.M.bwenj^o see ^i^^^linic' in Haldwani.    H^l^iphad. go^e...
Miss' Pepper says they ar^|good^/lJhen wen|plfce Ranlkhet«^Pa>w HisjaiWas.
Binner at Mainatol on .|§turl|$:   A lovel^lay^^&ef^hls A.M^at »5Q»
Back at noon.   . ?o«@&ce' for fareweligparty for Hx^Vhite^ ^^^
low off to Ludhima»l: a|i ' |lf|   Sfi
Feb. •2#»ArriV(^p^Mana at|i§A .M.    Met by ®t. l^leen %ow, Principal
Christian Medical^M^lege^p^htis is an ^terdominatonal mission -|nd was
the first colle^lb^be e&tablishedlpr ^wom^in Ind|||§I?Founded 1894.
"The, Cathoii^a§ba|& dd|||p^ it has j
g^t:.been foundtmseito actppt Catholic stiidenti^^;ThisWiould b<^&;urna
In mind if rah^Snternatlonal^ersonnel are sentg&ertejg ^aken tot. the
^^mpoimd and gi^en tea'and ;|^te; After breakfas^f-^| in\|?r.  Snow* s office
witheBr.%i-gamffi?},  who ii Qeireral ^uperintendea^^tf the\leiaorlal Hospital
which is in c^|t'ection *0m^* College, ^^p^thjSpblk'eVf Pathologist,
..Miss ^ennis,  M/p,tronE3t c^lfout in conversation tha#Br.yBergsiaa did not
know anything about ■ttr-y^quej^it.^^p'r"-two nurses from VmdOm    Ahis was
one of Br.  WiijliamsbydreamsL  probably arrising outflif ^1|^P@SS less
casual conversation :wi^:.OT.  %ow and Jig. Snow had oliirl^u»iy(3p4 discussed
this with Br. jBergsma. Mpowlng this dlscus^ktt^^aftjH
the hospital .^acilitieii^^Sfter lunch we went f|J|" an hoim^tel the H^psth
-.;Schooi whii^^^also ui^^Kheui^
a-^harge.    '7}xM\ we^site#|^^^f the tliree.-Sealth'-oontres | ifithe.p«Q
^^ich .are opfe^ated .l*om/^&hHg|^ anliare l^l-as - tr^^i^i^KBlds
the the |pi|^^ mi^wiv^fvgnd ^^^A^^wIbo
the medica^Mttdents.    ^mW%»00j2 deliveri^h^^year^o^elMI^
adpne In the hope by;theseu#dvps.  Jjj^ get good domiciliary e^^bfienCe.
*e had tea/'W$/^^the.nurs?|pig skisters and staff nwsesy'-'-and ^^^^fe^a^^p
followed by a idiscussion 'with  the  same group that we had start^fc^pt-with
in the morning. ^^^^^^^^^^^^^^^^^^^« needs strengtP^p^here.
Miss ^ei^kiii a dear olitftady and would be eo-*opemtiv§ but ha* h<^t
much id^tof/^hursing eduction,  or of admltt^traf^Uh.  rhey/is'een^^^be
ffirly well".s-t|affed and.'-'|fet Inhere is not t.Is^^to giv;e tie flftu|4en{i)B^pre
than one da^ of f :&. month lort^a reduce their night du$y to la^s tjb.«Mj^^t
12 honrs;^i:^j^qi;ais no-st^ff education.    *he sister iutor^gltiss| ^^eny
is of ^^K03^ ''^^^W^y^m<    shs".;does :part tlme^§lity^:n theb^ar^ls.Sh^
does no.^^eemi^. -have an^Mlan for -:the educ^^onal program. 1 co'ltd n#
produce/ the honrs give tp tia'ch course or any definite oj^tlin(fe. #g
 30.
Br|gp5now and her colleagues are genuinely interested In having some
assistance in nursing and are anxilous to  introduce the p.h.  aspects.
Mhey are especially keen on this because Br.  Carl Tajpor,  one of their
mission people lef returning this Fall and is enxiousfpodo some village
work- and some research Jll This -would .i^;laifine .opportimi^fto'get some
information on the real health needs of the people.    Br.  Taylor has
just recieved his M.A.  in PubliltHealth at Harvard with honorif|and is
going to  take his doctorate as well. , They recognise his need of nursing
support in his work bj*t are agreed that the basic program should be
started first.  They liked the idea of a well prepared nurse coming to
help them In planning for such a-program.J9^ was left with them to
discuss together and tjltlet us know If .th^. would like suefes|assistance.
Briefly some of the faifls. gathered are:
Present hospital 310 beds.
New hospital planned-for^^^^t>eds^|-Half-the funds tinfee suppli*l§f
by the Mission ai^^lhe:;^mainder to-be supplied by the Punjab
Gov't and the-Centrp;; Gov'tJfc This is a 10 yeai^lan and tt is
hoped that #ie first unit will be completed next year.
Up to 1948 this has been a wonen's hSlgital.^fhere are still only
a limited number^f male4||eds but-these are to... be extended.
• There Is n^'separate pediatric unit b&ff this also^s planned.
-A casualty unit and a ||||B. uni^! are In^^e plans for^|he
future and a T.Bi^^^icbln the tAwn ii^pust-riow being taken
iover by the hospitipg
The OPB is a veiy gd&d one.    Has plantyj|f space and there
should be goo^copportunities for teaching.
Nursing staff of Hospita^K S§«|
Matron;
1 sister tutor  (Miss Alien)  who l|||only'%art time.     ,he does
ypome ward work.    Is a fulip^ualifled tii^c^j
1 fully qualified nurse-midwife w^has^^Ki" had the Truby
| King courseMc(Miss Livingstone of K«Z«^|g||$
.Mother ward sisters,  3 of whom are Indian. W^ ward si£|prs
hare away on furlough. ^Bp^^'
.  8 staff nurses  (Indian) :    \ '^j§§
4 staff nurses doing male training as  they^Wve^^^jffeviously
g.. ;    had ,this  in their training. ffi^^
^Phould have i4fstaff nurses—6 short. "-Can't get^cau^of
lowi'salary and-.also because several havp^gone bacto|^ Pakistan.
'•'^tliarry staff condld^^^ 8 ■ t|f 10 '^^^^^Las.    Ai^i^tWeeper^gl
/Mo others.  The nurse dais have been give*^|f|p years^ftai^^g*
ll^hey admitted with 6th s^^^ and are taught in titty|e:>^Pnlax.;
^^he^.':areg® nurse dais..,in training.,-' f^^^^^b -
^R-^here are alsObf|0 midwiies In training-^murse is 18 months,    "^n||||
K|'Most of-the midwives who hate matric g(^^^^'-the Heal thj\ Visitors-
course.      ./ SIP wwl
uThere are 58 #p         nurses:                                                   / ■ "I^B
I 1st-- yeai^fel 4                                    e i          ,.,              ^M^
2nd   * -fl 8 i   mam
3rd.     § ~~8 u flPSft
4th    2   ||14 ffli|g .   «
About 50$ of the ^Student nurses have thfljr matric.    ^^m^^^i
admitted in ^j|l a^fr^tober. SB Sp p|#
This  Is  the last-year that;students, caft^lter medical^|^m. with
matrie only,   bfhis may make more availabi^for. nursing mlmmi
bmatric standari^^torfflthe Punjab' there .arl|pn .High^bhoolii^
-204,000 bo^^nd^ly 19,000 glrl^l
Student J^jj^weapactty::!* now 64.egHoweve.^feould take more than
this  if a^b^wn^;^;.. nurse-dais group and |aldwivesf
Working Upixrp fo^*x^|ts | 7:30 to 12^4' to i*jm2 hours on'-
night duty fhd.sft 6 one month period^pf Ihls.    Only one day
off per month' andBtongefi 'flfurs on Sunday.
Staff nurses have \ full half day a week off and one day per
month.'- aaSfii gn:h
 Living accommodation is good. Bach student has a single room.
Nurses accommodation same as for medical students.
Incidentally the missita staff all paid the ^ame wage, regardless
of iualificatl^&-^nurses aame as doctors.M^ll must be very
ipw. '0^^
Of the 310 hospital beds, 64 ate for maternity. Baily average
number of patients 180-to :190.'^pul«|gud^^that this will be
increased.  SshJI
Planning to send one nurse down  to Belhi to take the sister
^utor course next year. Also considering ^additional sister
tutor from Bngland and two.more Ward Sisters^"These' would all
however have to' spehipabout the first year in language study.
Visited Health School—Miss  Sen. Have 19 studentsL- capacity 25 but
would be very crowded. Have an area with the ^ealth] Centes for
praciisfe field. Bo clinical work in A.M^and have threoy in aftenoon.
Visited! two Af the Centres. .Jpieseghave good posslMLitles for
development. Too much clerical work. Little Individual teaching.
Have one month field work In agvillage. j.. .,;
Zh^z    IBiafegi        ilili        hffllSSiolw WmM
Have thjBi  impression $$!£% 'this would be a    good time tol\ start a project
-here,    jnhfe hospital facilities are to be expanded.   -the medical staff
.are anxious : for - improvemei^K^p, tWie Aursin^Mucation programi^Sxpans-
i^a^pjbeing planned ii^j^p^. rural field.    They arm interested in
the Risibility of refresher^urses in .'the-'-future^pp^tneir policy is
to replace the forgigh personnel/with Xtiplan personnel. ||§f
Left a(Mx   I P.M. -Ill
jBe|^23).    Rajinj^i Br_^^hisholm arrived.     Spoke  to  staff.    Te^, party
at the Presidents Residence put on by the Rajkumari. - llfel
Feb^ML. More ra^^^Increased crop yield already by lOjflj* !Sn office
.,to-da|ri. drafting,;plaa^«^|«for Ludhiana project.-" **ood expe|rieh<^%nd
hoped'! have7'notsbee3|?^^^^pirealis^c in the: suggestions*!; Br. **anl
recl^eved 0#B.f^fe^t»i to-day and called me "in immediately as he is
golnjg away forjw|^^ti|toe. *as very nice and asked me my ^pinion of
B.P,j ,Had:r:^^lll hi® j:that I did ^ffl^ithlnk he was getting p,s good
nursing ^dvi^e; as h^ttiould be—that the planning was not very good
butj§|iat/a:l^ of the planning in W.H..0. had- been (spotty and .
thai it:^^^i^ot^''jfeir. to-dr^:cize undul^^^ilo have a talk with
Bori>s arid, .thejjn,' see/Br. Manl again if he is back before. I'leave.
Tl/iA %rls-;ShoulMp>e given an ®port||slty tflj^how what she can do
p&anathei1 year bxM! thi||c shfelihoiyad not-.b^^ffioutaged to stay beyong
tha;tt  time*    Heeid, to-night that Kiss %reman  is a very good person.     Is
takllng midwifery jijji Edinburgh and Nancy Boas^fsays she is interested |p
W*r^ well a^igtfi^.^'p^ Indian peopl^and
shfe also speatks flie language.    She might be a possibility for a
Regional Advisor /»'iMz^M^Bz ISaa■ .,   pS
Had Nanj£y Bo&se iahdllfier husband to dinner,    phe picked a honey!
BiscussM, Madras/ pe4l#tric nurse project with Br.  tuli.    He agreed that
it was ^potty biAt. Mgrlew of the fact that-Madras i* a centre in whic|||
afurthd^evelopqients are likely .Retake plipfr >skedl2that we let i% go
. throug^vnow.^|#;-a^ %^phellopah "fee: thr^gh the pian-eps and each
have t\\elr}.9jih/ pe|»uliar-likes and dislikesM^t is .difficult for
Boris ,And #||^ if ^afesr Ml thr^e could sit down
together pi^t6pd of foris at a time^Apparehtiy It is (not done that
way here/gu.     g   -    \[      , ^83^ -V.
Feb.22/ Interview with- Mr. ^avies of U1U.CLF yesterday'. As ^orls
says,^^# big'^dj^ctato^^^One would think heiwas the h£g planner
for gj&i the inTO^ft.ati*ns3L aide which is pouritfg into  this country.
 32.
Went with Miss 'Adrai^la J:'the^llver ^fcili^^dnatorium for T..B.
Br. Krishaa the Superintendent and    MlsMlfasiJI^the Ma|3?on.    168 b5ds I
and in two years pianu^:expand "to at lefeLsf^JO^ >edsJ§Only 14 itaff
nurses at present.    Mlsf|Adranwala and;5»,^I^hna/isOP^rery ke^n to
start an affiliation fol^ student nutsesff# he'*tB Afesomation had.some
flands given;So  them; which has been ear-marked ^to/provme atarater-tutor
for three/ye ar^^phe difficulty. Is to ge't C^^n^. Ba^tirtWyrlsn
interested, nd willing; to  co-operate andf%i|%et tie hc>l!pOT^PId-to- gfbe
the studesfts theu^^^^ftdea is .'to- gq»*- re#ept^^»,the^^ntinuation of
Miss Hudson: so  that shigpould work with tM^ionasiswr-tutor and
also  at the Clinic. b:^l Krishna does' noto^plilk ;^^&anwTide har time
but she ccfuld easily wa^^phat out.     This had ri^^ss^^teies and
would'be a valuable  con^Ib&tion from W.H.cL  b<fc$$se off^^V&ct .that so
much interest has be^stliipLated which ||ll t^^:W^th^^pif^^^fc t^
to  concolidate and giv^|the most lasting r^^^^^K»
Tp the T.l|»A*I.  and int^feLewawith Miss Lakshmi^'ite^        Miss Berabje.
To belong fto   the T.K.Atl. nurses must be ful«r^ffl^er|ed. »1 Staltt
syllabi Ǥ- gecognized except the- Oov't group;S^kdras|.  fpK| se$e  ^tate
Branches Parting.n^^i   tJ^A.I. meets pn^^^'^yeailtand pie'Him is. twice
y«arly^^S|ive Midwivesyl|iion,  Health Tisi^jr§p%|i^©,   ^^|j«udent
^^s4tes association as  gssociate Member&J|| There\Jtr|EJ 5f8 full members
f^ra; of $n estimate^9-1^000 nurses  In la^ia.'^^h^r/^ari jfigu^soelates
111 midwives, 85 H. V.f s and 3,101  students,     the ic.H.A.1. 'h'ai organised
a few three day refresher courses,  . They seem  to.Jbe  very hampered by
efficient office administration.    Miss L&kshmi M&Vi hafe to  Write out
all letters herself-^o-Sne to dictate to.      :^^^r" r'i^mH"^m*^^
Through Miss Bakshmi^evi," Col.   S.L.Bhatia,   iBs^ect^jSl^
;an|l Htai% Services,   Is asking about ®^»siblMty ^f «f .O^ssistance
in developing a post graduate course for pitjhre^^
MisJ^rtdranvala is encotffaging this... ^b^hi 111   ^.A^^P
Went to;^ollefee to  s^p-demonstration of pract^^pnu^ritioh $ta$ on by
-the T.B. 'h*#Skith. VisitoMstudenta^;^pouchIng to  seljpOw much the1^
students have app^gciai^u^iis period at the '-^llege. W$$     W$0   W^
Cocktails J$t Br>    ^anif s for the B.S^ollowed. by big^«tUo\ reception
at Patialia House.    Feet.desperately tire#||f Accordian 'Maying ivp^z
library af/ter in honor of Jack White and dinner at the «%|§b after 10.
*23* Meeting in AJ^dte office re »ajafgarh<r   Ms.  Chellopi^^tlft
»ettrog,  ^oris and I.    Agff§|d that W.H.O*  shol^d  continue.with Hajafgarh
if whold area included and adequate national staff^M^vi^ed opinions
on wha^bhould be done in urban area with Br,Wuli:md I holding^r the
go slow policy.    Br.  ^hellopah and Br, Mettrop seemeMippxlous to -include
She whfl* of the New Belhi area as faf|as M.C.H.tfonicernef.!
In afternoon went to Ghandi Chowk with Miss $fafy and Mislifavi^Later
to party celebrating George Washington's birthday at] theg^y'lean
Embassy.     The most gorgeous saris—the wellMlressed les tern *omen looked
mo s.'^n in t e r e s t ingibes ide them. ||§|§      |||
Tea with Miss HudsenJKpp has dee^ated he%|^^m in JKotajf fti&Ee most
attractively.    Has r^^f adjusted well to  thi£ sitjialtion.       £pB|
i
 33.
Feb. 24j| Sunday.    Boris§|rame at 10:30 and we talked till lunch time
when Miss Broe joined us.^gylscussed her futurei, "professional guidance'.
of the staaff, briefing,  planning and country programs.     It is difficult
to get down to the really professional problems wiijfc her.    The negative
fPI&tltude seems '^gporop up- continually.    Have-fir ied to/pbelieve that
this could be overcome and  that I could find the qualities which would
enable me  to encourage her to  consider some further study so that she
could continue in this position.    Bid suggest further &w3y but it did
||§§^ recieve any particular comment either one wa||hOr thej»ther.     She has
I her contract, in New Zealand wxtended for one year. JKe shiplndicated
that she really did n#^ihav#ftime to discuss'this matter, at any length
when in Geneva 1 asked ^^HK.give some thoughthlb the letters and that
.wo would have further discussion before seeing B^#-Mani.|^^
In discussion of the planning emphasized the nee^: to bring Miss Adr an val a
more into   the picture both in the  initial plannll^ and $n the making
'of the. pi an-ops.  In relation to briefing trli^ap brlng-Mit the need
I to  avoid over-lapping and the personnel and administrative aspects
being handled by the respective-officers rather than taking her time.
{  Re briefing—have be|||:talking to  the girls herejjlrid iaye' fftlt that
we might well cut down^p^l, Geneva period to ene '-weelcS^- %t6>y: f eei: t hey
have been;.talked at a. lot and  thatthey have  a lo.t to  reed.     'When  they
come here, there  is more  talking and more reading.     It'is necessary for
they to- stay/here., oigl^fthe week because ap.paxen^^^ffl.th^.^i^^ bas to'
be given sis days notice, off their arrivals-       IIP9gj
^oris Indicated that^|^^ Man! haspfot restrlj|bed \their^«aveij^fshe has
not yet been tSAfghahistan and "only on.ee to  In don e a I a *in , a fl s It which
was cut veiry short, 0thls would^eem to be%artlp her?^^\pO0i\i)lanning.
She has nqli'tereally ac4ej>ted the idea of a ^^K|leadW Will th^% nursing
projects J^rollring|/s^veral nursesi^pan not, i|^; whatXa' leader ^^feld have ■
accomplished  in Colombo  when the members are  so  s cattered•'* - Had p||a
insist|$|»t this rslup't be our policy and that Br.  Marii agreed  to fpl^|
^Iscusse<3^pie pos^ibili^^^; a working conference in 195'4hai| a folloW j
-4pon th^Regionap. basj^ofthe forthcoming conference in 6er|eva.^^aldbfflb-:
Dr. Man#i would nql^&gr^'    Suggested we-discuss %/t with him v^o-gether
and- t^li^iwould/prepare a justlficatif^^^il^ft discuss wi\th he*
before' leavingS^he;/is; just unable to^ see.'/that.,.*\conference^ould be a
good thing in th|&se' countries. ^^^^^P ' fill
Miss Broe enthu^laastic about her stilly.     s^e^^^SfaYe workei|b^up a
good plan.     Tea/at the College, gg pl|§ '£$W-
Feb.25. Meeting ix| Br.  Raja's office re Najafgat^. jW ^aja, yhairman^
Br. Pandit, Br.  Barkart Syrian,  ^r&ulandi  (K/a^.Neibit Dr. warner,
Miss Adranvala,  Miss Q*aig,       Miss u-lifford-3^aes,^^»,G^llopah,     I
Br.  Tuli,  Brf Metirop,  $aris an<@. Br.  Raja openedo^^;the noto that the
main purpose §1 tl|R! centre was to be for tBainingt    f ont^l^d to say that
no "one group should:'carve out the tr: own area.'.i^iss :,0rai|^|aior *oalc
exception to thi3 and ||4ed to explain that fc|e reason ^P^HM^^K
own supervisors was -that they were|||rying to/'||^telop somethxi^^ia little
beyond what-already exists itt-y'Ji^^:8nd;ihat^p|»refore ^aT^MJ^*^?'vf a
better type of supervision thaj^^^l regular st^ff could proT-^'^|^^*n
the main emphasis?, in tha un||| has been on M#6..-Hf. ~and they wanmiBk.*^
produce, a more g^nerallzetfitypo of experienced■ Both of these\^oin'^|
well taken but" 1/am afraid Miss Craig does nop-tell the' whole.^^^S^fe
of the situation? an|gt$ie ■ truth pHfiffl
meeting ^r. Raj^--calJ|:«iKii 7%$, Warner t^utli|ie her. ideas whic\ha,sh«
did very well  along the lines we had presriouily discussed*u^he/a^s©
put in a^plug for heM|h education and that fl/health educator ^jighW be
added not ,ju3l||tor ■ t^ visual glides but from the/'-j^i^p^f
view of commiinity organization.-a,      rhe meeting\went on and o^jwith §if||l
getting down/ to principles.    ^m^^^S&^^^^^i want I.H.Of-feassistance.
A committee unde^(thi chairmanship of Dj^ Warner is to meet hejrt Wed.
to consider plaahing^l^rganization,  and the required staff te for a
field training/^rograms&-On the -committeo>^fch^ be Miss Adranvila,
Br. Kulandl, %. Mettr^^ Miss Clifford-Jones^ Br. Pandit and §oris.
Br.  Warner wiSl be hur, 'p$Lvatlon. |g|p; x
/.'.//p..;       •   ffl/tg        i    -'g--■ a
Binner to-night fir Miss Broe and off to Cailik^ta to-morrow A#M.
 34.
Feb*26.-   Left on 7 A.M .flight foi^plcutta. Jjrive from airport .JS* city
not as bad as Mexpected from reports bjit prit'^terrible nevertheless.
Reminded me of Rangoiin but there the povertydoes not appear quiteijmvi
extensive.   -More bullocks^^n the streets here thal|kn New ^elhi||: More
men: in •'nationSress:here* 's&j^gM
Mrs. Mitter came after^mch and we chatted ab*ut things in general.
'-^e^^^plitlined- a nice prograai^Br Thurs. at J|he hospital, flffe-morrow
:go to Institute and|ping\i^|-    At "about 5 1 was wakehod by a pou&dlng on the
\MiM—flm, Laksbmanan.    Br.' Grzegorzewski ic^m^ also|pv nice
|ilii:^|e|l| ... '."' ISli        Jl
Elizabeth ^nd Br.Ander^i||§rrived from Bacca ^t^^p^fir*  &.|&lned us
for dinifkr*'   |*ike Br|||te^ the Indians
since.h|%a s bom herifand more ot lesilfms ident|tfled hinetHL with
■ this coUntry.    Re. lajafgarh,  ha has a lot -n||tsympl^ifiy with Baa&art Syrian*
Says thakjthe latter,'even when Rockefeller s^artedliiqyever want#|Rthe
Health'Mlt". therei^Then apparaatly W.H.O. went in! \again^g'hi^^Hfess.
Brt^p»ieisis to think a lot of B*H*fs ability.      ^S5 ^^S
.Talked^ until nearly one with Elizabeth* ^jphe finds] the nur8in^n|^ern
here largely- a diluted Iritish^^Says the British |maWons^;i^i^mtributed
a lox|  specially, in Ireferenee|||e the hospital hou|sekeepJUij^^^pfe$ias
imygms^'us bot|^/ In mostsch^ks "sh|| has seen t&£|Hk has, been only one
'■^^er/mtor and n^4/'P.TS^t.   Much emp&asis o^^xamIh^ions.rJMore-students
f&^fehto get thrdug^ffl;and^i^ey- writfc-and re-write examination's.    Intone
plfeLM^apiey repeat everything in the year they fail*." \ Elizabeth qui"f||^
inpfessM with Vellolpand will probsbly give a Felloe-hip therej|liShe
is'^sWe impressed wltm^he possibilities atu^ravancore^  and is entertaining the idea of giving assistance there. -/.Apparentl^^h^re lira fal£^|
pgo'od s^afftalreadj^pad^'^^^^^wou^ send in someone like %ss Hohl ||o work
it ujN^ln the~futu||femigh^ Schf^^^zt  n^izabeth thinks
there is n^4|oom ^^i^^^^^^^^S^^^^^^^^^^^^^^^^^^^^^:)i^&^ th$n the two,  in
India for some-time ^etisR Sheikas quite impressed withj Bombay.  Says i§||
they w^nt to -integrate the p.*f||  there    aand are hoping/the W.H.O^i^esin   gll
will/:h|ave a p.h.n^fl^w^ Wig      ffe .;.'■''
Feb^7.   Visited til Adia Institute of Hygiene and Public Health with
Brt^^^SiFw^ <^ief,||ui^ti^ns of the Institutte ate teaching an&^ research.
-fhey'^'give a ^iploma/^|irse and a Certificate course toffee lldfcnciates
in bo^n Public Heal^,;and M*^^^Also-glvewa^urse^intiPtiblie'^ealth
Engi^ejering^X'fhe/latter are placed,   out for a periodgijf Internship
fo r al perl*dp^f/'6 n}k t^fjine year.    Most-of 'the- students arjr-^sponsored
and;®ime from positions to which they %!!!"'be retiirnlngL«#^g. out of
60 ^udents i|y't#^p^|obably 55 will 'be spons||r-ed.    Have practical
fiei^work.-« area and|||, the Heal^Centre aVSihgur which is
opem"t^d im(^p::t^fe di^ectiohio;f'..the Institute^phis Is the o&ly place in
Ind^a'wertf^^K'in fNjj|^c Health may be o|l||ned.    Madras and Bombay
giv^iabstaatt^i^ of ^.teppin:-theit medical J|p>lege.    Salaries arelow.
A^prof^s^oi^pits fr^la;-fflp|00toa500drupees ^qfnnnth*^ private physician
would/:/e|aJrn u£ni* ^Owt^0esi l^^^M iSlP    38 8
Under. th^Mposed^ifC.B. project^th. WHO^MplF there afre planus to
^^'de^Wp an u^ba^^.eldl^rainingwarea|if   '.'^8 BE
;|3^^akshm^^ plans" to  take;;^ver:^^M;;the wards? of tha\ city
.Mwhlchiheri xare go|lt homes md'p^oj^industries, schools,  ete*;|«
'^p^re ifJty.:tye]klttiL ln~|pe are^^pphofed m plans for th|||g
'"'''buildlng»^!st4rey. "^Prnvides spa^:^fe^::Such specialized ^mj&
services ;a»^CyH.> Sdfel,  T*B., »l||#^-*tei^jphere is alSor s^aci^p
^^p^of the^mlni^atlve staff lait-;^pthl^t^!^ ttiere; is no
^^^^provis^h tf^A riN^rse.    Br* ©. g^vMse'^od eupport in B»y plea   Jig
^gjf^r wt^t he p^ferroef a 'Head Hurse4MiIn j^he spe.cialez sections there
was ip»ist^V^^ butzjmst^f-pi a room with, the clerical
^fe;(ptafrt^^fcis''going i^;: be: .hardi^ this in a country where
^Smrsing/ha^ n*t found its l^^^i^&^^^^^^tt *hi-s    ixi|tance
^|ldwfbien^ th^ ^^^f the building iswmi^.ti4igiso' rapidly. now|§| 4here
l'"i!i.;ia«t/ad provision^^^group'.teaching or for. teaching of
^Pliff^.Ll|rlnif quarters for the staf#arl^acluded in the plan*
wS^ttaff-ffr the-  Institute which; will;##l^e Awo public health
mmxLTBb^ P.H.M. wiil^p^d^r^bth#:;B Kw;
Mm M.C*H* '^Sbpcted to thls^/but again is «ot at a;stage_when it can
beta..fteparto|4t on Its^own^iAls^BinceJ this is UNI8SF m^ney it
probablyahasb;^stax't ^ut in/ this way.
y- >z :
 35.
-^P^^ir5t~riUt^'e
an' .purses in
pips should
oilIties.    Students
|ftthe Instltutdlll
yents_ths ataff the-beginningsof March fi53~and~ the: students to  come the
Tlrs:t~of:Tj"uii6r^ "Say^Tl^:im^ii^e™agtittie work on the, syllabus^   !■ did .. I
not- have, a chance; to follow-this up.  wSuggested th*aj£ I
comg -even earlier -so  that she could work with the
the -^preparation ftf1 the -syllabus*   'Miss -Adr an vala; an$ :
lyW00l do wn|je&r e"^r%on j    lilt fMMMf^^f^^^^^M mm
le: •" Sxpar^ion'of ■ Slngur through- provision of hoste|||F
. Hire put there,,  at pisesSnt..in. tents. % J"j
4;: ..Provision/of~ expanded hostel facilities next jtoo*
/^jltffli?new,'floor €ll-£ith^pnst|^'te*^ ^''^^aSnftWS giga
QS evidence that the commencement of building-operations are to   -
start-In the' near future although Col. Lakslu"snsn{i fcept mentioning
the fir|t of AptiM    anfilili! ^"^I^Mfc  SBBSBP^i^
lUter about^^feple '^ll^ his|§efice. &a»8ttsiM&aii teljlt mf§^
•^heblnstitutemd w^et;|^»;^f hls:-staf#- Inprfcrteil jttth tkj^npp
quality;of  fihewstaff and the fe'any, interesting reaesxc^ projects of
.-particular importance to  theh- Indian and the local] si teat xo^ri' A very
hicewspMl%!-#ongathf^       th^y &||&&eea |plike Bf./3ipsa^an very   much.
—£&e In statute, ,is directly und^r the  Central GnvVt.j / • /.•     eg     -
Vi s 1ted ^fpgurv In theafternooh.    Mrs. Bitter, with u». j Ab^i "one hour
-each "-he.y'ht e$H    R*^ *ver" t'he last portion/ only ^©^6tedl about foiir
Singur Ajcfea comprises ~ f^tir Union,'^iloarts and 'c^mpx*ls6& ia pop.,'^f s^w „
the institute,'p^^^esponsible f~ri teaching and r'easearcii and1, ihe Bovft
">f bengal fori'the seSv*^.  There ere two parallel staflT-s. w gainer ~
ineffectual/ Bf>   explained^tk^~^^UjLip#    M.C.H.  ladv doci^r thrfr^L also  as
.well as the Chief Health Visitor- wh* sept-very much in thf bbxflCTnttnft*
; -A ;^^^5ft|i^^^pi§| associated^ Herluthe^u*^^
eitt;-from;^he axjeas noj^erved/by the ^entre;!^
doi&icilliry jpidwifery apparently onlJKthree sm^ll^mtotri^^are served
froHpaef'centre,.    In Singur building a cliipi^i held^^W^eek.    &nly
about fJG atjtend. ' fhere are two~or three <^||p^^i^^Lnl*e^p» 1;r^^8" Presumably
^pi«rattendance at" these would n^t be so la3?ge>asdat Singu^^s far as
I -Could telk,"» addition to  the Chief HealK ^^it^l^^^ffJw^* a
nurse bteg-ifuld like t#~iake her general training  th#si^ S*f|rfs
4 mldwives jandtl tr^ine&dlas.  These again all iM undler^M&^^pi
±here are 4po tmbe wells in the area and .jHltallato
about 50$ areg»use/^^;2.5^ fe^ mi^jdayl
The literacy reate asi«ng womesris aboi|t 4% end mmng 'mm ab4>^iL2^.
A great-deal ^health ...education" advice is ind'lcaf ed;^dgii|if b^^ie
tesching sr  aterial in" the form df posters display^d/^or:*W^   ;a/public
which, IA, so; illiterateV^fhls area needs^a JL**- ^r^/Aeve^pme^ - 'to make
It into  m effedtlve teaching area.     Again  stresseid't^^ need;?V?:f ^
oyer-all publ^pheal.th nurse.    B^tt l.  agieea.   .      j\;l   a-^' 'dJ\-
To dinner at ftr\ >, Lakshmanan's home.     7/1 Loudon Sjt* .iC^n^ral. Calkutta,.
Very charming.'   Bf,ughter,nieces,  husbands,  and sis;!terV5ivii^^"—^^^—a^^—-^
a lErs^ f^w gathering.   .Br. L.   is a BrakMn.    He itoiiil
a goo4' ch^t'et- f^r the H.B.  ^f this Hegi^n*
 36,
Feb.28.    To Medical College Hospital,  Calcutta,    ^irst had interview with
^Ifl* B.G.Chakravarti,  Principal *f the College* Then"-he, Mrs|l|tewisf
thew ^atron*  and Misi|Bela Majumder^  fissistantu^atron,  with Mrs. Pettier
accompanied me aroung the h^spital^^spltal supposed to have slightly
p^fer 800 beds but, patient load ah^t^300/more.    §ome wards not sowcrowd«iQ
but In the majority there was great;i^er-cr^wding*^pfards in the original
building,"117 years *ld,  which were meant for|||6 patients, have28.
Medical |pllege has ^er" 1300 medical students.    Only a little over 100
§^et;.3rom€a^ . 3tatisticsJ|fer number of staffs sstudenti*  etc. on attached
she^^testatistics/for Wes:t Bengal^lir^ nn attache^^K^^
Wards, were ineat and clean#^?All beds had two sheeteJ|iSome children
mixed.-w3|ft! adults^ al though ;there is a- separ^te^ pediatric ward^ Sisters
havie charg^ of bl^cki irhich may^e anywhere^p^m S^to 'wfl^^Ter 100
bfcds.    Stajtf. nurses on indlTldual wards.  ~ Completely dependent on ellidents
fo'r/service^f^metimes'the students cann<*^Lea*e for^tneir lectures.
One fairly large Classroom but inadequate demonstration,   teaching material,
and"text-$*oke.    Eo la^rat^rjS^^o P.T.S^Mi^s Johniwi,  the &ister
Tutor*    ^ok her-Sister Tutor1 s Certlficai^pn ffew Belhi l$46~47wand has
just rett|rned~from taking Hospltalk.'AdminI^ratI» atbJfhe Royal College
Mt Nursing. Would judge she^'do-^:-very didafet|ptteaching.    Admits thip
students/ have to memorize fof||;exams but does no|||&<p much wrong with
that,    idmit student^P^ree times a' year-*Janr^^:i^e,  and Sov*--'..Exa^-; in
Feb.i/aij4l Aug. Allugouon to^iiidw^^ry,  eomp^lsory M-this hospital.*;
13 st^dpnts were tlsken in this    month;:4 of tlese 'already have midwifery.
Admitsihn/jqualifIcatifbs matricuiatl4^^f.. failed malric.    Have a $lsn
f^r;j^^^;when .WHO nurses come*-   Were not!l|on#idermg aany ward $xp*
Mrs^([etiier had z plan to include the students fromipte. oth^r two 'Mm
Ca^utta!.Hospitals-'^yfflthis and make a Centres. P.T^J'^ll probably not -
lip this Vith the-first bateta^Ehere ate n&w three nurees taking their
"Sister-fflfitor1 s courstffi^fjBelhC who^iii be assignedgas fhe matching
nurses-M|4hey are Miss fhommyii; Miss Areng,  &nd Miss Beyig A pediatric
sisteri/s taking tho ped4a*ap4e administration oeirse^ipi Madras and will
be refilling so^nlj^plere doils not seem/pto be any provision for fellowships in our pr^jeeffp Why?". jllf    I        |fipf      «S WM
Assistant UaXvm haA^kd Hospital Administration  (or Slstefe Tutors)
lf|t^ England*    She is not
being "Used properlj^^^^pparen^r just allowed |gj|* what Mpf£a Lewis
tells her to<
the latter is a dictator.
Jil^feilitjr^at ppesffl
Spoke\'|p> Mrs. Me tiler about
Majumder might he usM^rap#h#  aspects.
Lunch with Mrs/Lewis -anl&thers after seeing th^Matters being constructed f^r W*it.0*J|ersonnel.    Each will hate [^mtmmm md a 8BS
room Mjoining#$here will be three lavatories ^d two baths between
the/four4^/feachpt,wl&hat«oa bearer•jpTheyg,^^*^>«lng their «v
linen,  IncdLw^-bedii^eW- If necessary the\hospltai will l^an some
ate first.''ftolture/and»^lery will    be l^^ft*^d|^#Jvw^
After lunch'the Ward Sisters earne for a meetinf»:#out"8 of the®.
They certainly have no Mme fo^eaching although *pe of them expressed
interest «:it*#0f the/gi#ip,  three never said5\one.fwnra.    others were
•quite interested andil^^a fair amount f| sagm? ^#^f their time is
i.toyentip^ 1^es&\   procedures
establ^feed:^Jlach-one -|f|es an sh%^pemembers being flight*
i^wfmB|.bBas^l^gM^i^ ;|i|i^p;|- ' g    1 '        BBj
Mr«alewis::^uld Mke,^a' leader of the WHO nu^se^ at le^ft a ^nth
if w4 linger, ,b$f*r# the rest *f tha team.  wW*\uld\be foo& if others
could krrive ti^fl|^/of May ..to get ready fo^the'\new eia^s*
 37.
yeb*2f^Left $reat Eastern* Hotel at SJ15 ^.M.'-^^p'ways India ai&d
thence to Bum Bum Airp&tt. S^ggy.    Shall no^fforget th*se streets "very
quickly, fplf, tantless people sleeping $~n the pavement with only a    sheet
over them. Like dead with    shrouds*    CoW^ and bullocks grupping in the
refua«» Heally every rickshaw had lt& owner sleeping, in or undn^^^g
1Calcutta^ populatl^lliSrer 3i:Jnlll^^|)S'iee flight.-^, Madras making
one stop a*t ■ Yizagapatam.    Very warm h#r«#      Met at"41rpo'rt by Br*w
Hajamannikam,t^ief of Maternal and Child Healtp#*a^the State*    |he
really came to meet Br*^^rdon but he was not on the    plane*    Approached
me with the request for a WHO    publiO health nurse to he&|> in the preparation #f 3K*V*s.wReally did not hare ©u€%^fa *f what she wanted except
that it be somefine ^help herein the nursing activities and'thiols
^;|Ettderstandable^1She and her ^hlef came along toa's.^^ris *0§uat $:30*
^they resl^y ate desperately'AiSdinig trained persoi^^^^^t'/on^^f the
difficulti'e®..^ffl^tting reci^ts for ,thewEMr#,s.^^gsewis the^l^t'J^at
-H*"V^^i:,a^ppaid ^tkl^^s 6#f|>er   teonth. Woi^^-^iice someone to organize
theii^urse and would be prepared tit acci^p:||hanges in the currle^iiB* '
Thl^can]W;S part-1 of the over-all^lannii^>"*hich is to  take place with
yliadras i^ficialfi^'Suggested that If thij^ispect wire undertaken it
mighp^W wel^^^Jhav^ a second nurse ^1^^^u§^in t^jjH "field worlfe aspect.
Madras Mas, Jjust ajibro^e^an assistant ndrse ^o^g||^pljiey have"trained
$haftthey mmnnt place beeauere of laeltMf sancti^ned:r^sltlons
tfM€r^GMftP^0ti^ Hof§£?|g#:L€3ji^ imafieted
S^ope^a wp*h    a little Indi&a #btMnl|^^t is amazing haw ,$|| Is
that fhe"'ftude^p;is therei^p glw service*.S^er^^ittle
given to tiB^..education* f^^
Ms^M^l^^^^fc au'-h^k^s taxi ride around Madras before"/leaving ^ir the
,^irpo^^.   A,/very a.i$0jf$&ye el^wlth lovely buildings'and    a nice ■
/T^nghwater-fr^ azi^':';the people look better .fed.-   .. As ;
||^||4ax| drtye|||^ are christians.f    Lotts of christian
clairtJhes.   /it certafip^pbas made awdifference if that is a contributing
factor.  This Is one v^pythe mosit progressive States^piiHas a population of
4#€ - 56 million.    ?h$ highes^.itera^>a;t^^^orls says that 70$ of tfte
nurses in/India are ^hristians^The problem with attBacting the better
class gi|flL.;ls that she has never been taught^ dojlnything in the home*
Afld tiWifthe non-chrisftlan at any rate it is quite %neath her dignity
Ip,. do genial tasks.1 itMfwill takeifelme to o ver oftfee 'thi #f||    ^^^p
Left airport a^^lM|gvla Aii^lndia.      Smfi^l;ane 1^%&# comgorta ble.
one ,st#p; where, wet had lu^ch*.^^rive^|||l4iaio at 3:4M' Very attractive
lT«m mpHR^ %* 1|PUl*s Ellas,. Miss %tW^Miss *%ith and. Miss
Macnemah^nawh^;-^^r^d #gth^rand .OriefftMJ^tel:M^iO.H*^rltfa us for
tea.     Alien' went' to .GallfePace^for a_ delightful and 'ref jesting 0«£jS@|
Ma3^K^MlnrA*M#spen^a couple of hours a1888Colombo. Ixhibi^on*
■*£*WjieM *nly for||he pavilllons of ttaeiJfiH^us
oouTO^^^^fcK# an(|^i#nesia -'the bestii^ricetralia mJ||^
U.^»3B^^t ri^l/i^^^KCthe ll^^pp^^^^^^^^^M^^^^N  A W$ $*i
ph^gjraphs ^itl^'^^^^mk rather fine printing*^E*Ift#P;# the"only sectipft .
that Resorted w^eliy^^^^p; We./Jbought that this wHjuld be our one and j
onl^;;J|eit but fir. a^:f^r>5 .panuadin who came in forSadeink with us
in ^revening^sti«Nld nn taking Us to a   Chinese mbal which was
devious and|pen b&|flfcgto.the achibitinn V   seelft at^nlght*    It real^f^
wa^lery:attrfctiwS tinySight 'bulbs which
g^^the^. tA;^pp.^ar^n^e of being^vered wljpiwcotiflowers. ' Wewtfent
^to^sdei tlM^ly^^IMxis^riai, aid Health Srf^bitS whichJfrere ^ery good.
Sometini^p?heref/ was Mention of "the assistance of thej^lombo Plan
bui^P|a-»freq^entl^asvit deserved^am sure*    Great ftew industries
;.are' |nderSnst^cti/4n now and are projected .:n« tha future*   /fhls is
^^^^^^^^^^^^^l^^^^p coimtry faeom    Indi^^S ^^B
In thebafte^on wf -hVd &'  meeting with"the nurses at'MtpLavlnia       |   ^;|
Hotel»' beautiful"s^>»*^pibthe shore about ten, ©lie*i**V»*e nurlfees'all j
tave mk a ^rlef back/gtound of what they have be$n ^oing and plan to do.
he d^iaJ^s of fhl*"/will be recorded in thi accoun»f the visits whicli
we-wiliM makingst^%hem individually. Th*ses~m#ser se^ej to get .
along viry well to^etiier and they have a good»nc^ptlon og xne n**Wm
 ,38.
mMS^^BM
prepare Ceylonese nurses to take over from them,    ^he question of having
matching tturs*ikJh)4s beeh a difficulty apparently  %ere^Js much
evidence of pofe origlh&l planning—an inheritance from the rushed MGH
projests*    There iswal^bevidence that"a leader of the^nursing group
was much needed.    9*w mm wpuld think otherwise is"beyoiid me.    For example
when^Miss Pr4&ser/the flas^ arrival,"came. Bhe did not know wha^.shewwas
■ tx do.w She followed''Miss''Wilson around for awhile and then1' carved out    a
job*  for herself when she saw that the r&st of thfc hospital was being
neglected.    She app||*ently"&centrated on the tw#tfiremaihlng pediatric
wards where the Swa^asha^^^enacular girls were being trained*fpthese
girls are given experience    IdNpedlatrics at the Lady Kidgeway and in
women4 s medicine did surgery at\the Lady Havellck* Originally the course
was t*i be for 18 An tils .-and theyXwere to be an tesiatantr-ij^
|J|lurse was exten##d\to:,three years and they apparently graduate as. .B
grade nura.es*X^^^>have *ne tutor/ with whom.-Mi^s Prosser works*^|?he
also has an tdaderstudy whonrshe is no?/ trying to  give more pediatric '
experiente toy   ,uhe plans t* work her in to  take ^ver the" clinical
Instruction;-In' pediatries  to .these Swabasha girlg andwalso  to  take" '
o^er theiediatrle lectures to.;Jphem from the tutor"wfa§)fwIll then continue
- to give"their. general mm:sing.    ...9h^Js planning nowjlln the request of
the tutor*   to write'fut the pediatric lectures and thewtutorwwill give
them.    A bery queationable^procedurB.    Mrs. Kleppe also Is working
only with t 1b   venacular group*    she is at the Castle which is apparently
a fairly new institution end has a Matron very muel|J||  interested in
training*.   Miss Macnem&ain iipfct theBeSoyga which has a very unstable
matr^n^  is very ivercrowded and is njglpgood for- training.' - Very J|i|f^ii
rotation^Here the nurses who are" taking midwifery are trained as w&ll
as the Swabash% girls^ She has 30 of the "Sagllsh speaking nurses who
do 12 months mldwif^r^^^I» Ceyloh they downot do midwifery immediately
after nursing and somTe *f these haVe bfeen"out for a long tiiae.    They
- are trying t#' have i'tj.- compulso^'lttow to dn^-t af tei&   The venUcula^6f|
girls spenci 18 months^^g months of which ls;*pi the .institution* -'|pt'6     fp
months at th% end im^^mt^ domiciliary ifldwifer^: experience which th^y
get at the health. ceh/tres.^iMrs/ Januadin i^J'J^ charge of  this aspect.
She seems-to be inichlarge 1||ga. npuber^of thinfc£j?J||
March 3*-|&n MisswSmlifts transport |1| oil fjAf^Br. Laird.    He has.
hia office in a, c'omerlfjf the m&le .clinic*^|b^ female clinic where"
Miss"rmith concentratie^tes at some-distance, il^; Laird feels 'that on^p
one of ^'trngthree object^^F/^f the pr*3eetf||e ami to be realized
after being in fhegfiel$ f*r over 8    months--t^^rwt^inic i;which the$
are expecting |p|||%V6 l$to next-gfreejg|li The Flfxl Program has n^t even been
Started ind seemsm^peless.    the training program which la ithe prime
abjectly^ has been a   disappointment* He feel4HN^ tJli^ is because theiflj.
is a sim^aiitt^eS^»^r#B. and ifxat the dr®*.|^Pe afr*f4 th&t if they
take anfr specl^traitjiiitg at.all they will fee%p^sted^ anlputpost
f*r e^l|^|^^jr | .^^i^bject to staff meeting^ on, the. same grounds—..
afraifW W^> be^nxia/ered as||peclali zed" t|^ining^:Perhaps »»*
Lairf lj$ wf*rng in no-i •■|pproacting this j£& a"*^Wvgeneralized gjth*-.
bas^i^l/iflve the feci ing that neither he or -"Jl£»s Smith, have seen th»
ful3^po;#^ thinking of 44    V.B^ak anything but a Bpecializec
servient Miss ^mitfi has iWk been^traln-ing" aa^auiwes except the ottes
ln ^h*S^ we 3*?||l|^^ not followed
through'.on-the isuggestion B*ris made  t^ 'have  the general nursing
studipnM^tat0 tlUR^Utf    However there has W«n s«m excuse" be cause the
sP^^^Ft T^beeifh B* crowded*    M&bb Smith seemij^^^ateVpent teo'dt .ojfiper
timW^m^mif^S ^urveyj^^ghe problem" of V*B*^«^pil nottb^eeiawto be an
extrei^y|MeutW'one Mi   $% In pregnant mfcthjl^j' 5^wi% P^ftleej 1~2#
in th#|^y^0ut of] Mi3 att^students onl^^t^^al^posillive.   ;
*ltMtfP&&¥&1m the stWffing^ the'-clinl^f-l^ha^'no.t beek veryM ||||
sa^^ifif#f*JBFi    Wany^re workers^,The CNv^t^say^ thfey wil«^mploywmore
if ./fe)^^^an^^|' psuafLm- \Miss %ith suggested social woWcerftM^ut from
wh^P|;:ca»7#I|f;cmve^ thebe are:no trained ones:p|^i:f^ ^^
■.'.aa'!.-;:-- ', UUffl - ffl i/O - .ffl -.--ffl fflffl ffl-gffl;: •   Oj'•'afflffl-.:-/ .•a^^-fflbw7' / a ffl ffl/U
HeaK^er^ ;thr^ugl^V|i{|;iady Ridgeway Mnd th^|p^fHaveIn<sk Mth Miss
MuttaKanij   the Matr^a,  ■ she Lady Hereinck Is irhne4's and is fxW medieal,
end swt-glfeai; eases m^dlpr whltth are gyn*::« kfrg^h&l beds* .;jfMitdi»al#
5 pa^lafe a&tientuf ^y'KH fi*«r pfttientsi^l.'n.sliady RidgeW is
ffsr pedi^trics-MPheret-i^-a^ld pnrti'Mi and'p-new puildiilg "P*5^Jl *ua%
nve^yiar ag<# Theffli»ldl pnrti^n is very crowded #»d An one t*^ ^ino.r
 mm    §§p        i§§p
...there lire'.IB ttases mm^mf which are fljir cases. 'Mien there m W^rd 5
which is supposedly for the convalescent*    . Xt t.akel^^e overflow after
the new admissions which take place on regular days. /^^^has 48 beds bu ■
will-have anywhere; from 80wto 9^?atients.    Th^^»e*^fl^or patients^is
not nearly as bad &§ Ij^j-^ounds siiaee th@s& people are"q*lte used .3$$*
sleeping >&t the floor and without any pillow. k| was^more disturbed by
the big crow which fleww about taking bits ^fl^p^d from the plates*
The-main psprt *f the hospital linked fairlyiwell equipped and--clean.
Bed-linen wa|/n«t"always *ell laundered howev^|SfoparentIy there has
been a grea;||kmprovement ^ver Becember*wTher^Ss a^al.^feof teaching
materiai^--Ma^y nephrite and maln^ritlon^^^yerm'^slajs^ified as EH
m&iignant mal^utrItl<t|pK:3Che Matron is a timijl^^^
staff educat^^^or her staff nurses«lM3ayll^^ interested.
^^,ther f r^iSsomerbhing said' by MisS Crawf^pR^^fe/ th$t perhaps jjQftr j
nurses are ;w4 impatlefit and have no to tried •ft;;bu^|^ttSbthe^ security ^M
the matron./"Miss Mls4||| has 71 general training hur|4's~^some- are in
pediatrics to^i*feeg^ months and some for 3/isonth»|;- fhpe |.st-the first
time there pasrbeen any teaching in clinical peifiiatrle^
This "has b<Jen/j||§/a"selected ward baslj^T^^etiHrs givewlectures once &
week and M|ss Wilso^^^lows with tutorial|| Mls^Vllson kl&\ gives some
lectures tlijhe medicai^|ppLents*'^fiaey ari hiding th&t i|l^^ULsonfs
understudy! can Stake |§he sister" tu'^^^T^urs^Ln Vellore |starMttg in
Juljr*n-a^ pei^^S;'of 'Ipree months;'vWhen|lherfe ^illSot be
my student* frW tl^dgenersl.. course becau^e^||b,-.erifc^wf; yonS: ^asslshor,^^
Miss .Wilson wKna\ered what"she... could best do during ^Mlfil pie^l^^pc Suggested
staff" edification S^nd mentioned: this teptfie %t§j*n*w AiM.sp^te f»\ Miss -
CrawfordJ who ..thinks the best contribu^^lthat^|Sould |be ma^de ft«pid be
. t**t.assisjt the sisters withffthe adminiSt!rt3^
nev&r h^td ' any ^^^b^^pl&i- ;Mis«^^^"sser®is working! with-^^^
girls, who incidentall^^pl^tter prepared than' thei .pigllsW; speaking
girl**./'   heymust have their S.S*G* which~is eqU%^:^it t« ^atric.
*h^-fit^ere on^ have Jyj||^^^#quivalent t^^rad'^ldi^AlsH the Ihgllrag
understanding is veriglimited. ~ Apparenstly:^P^hexl#jt two yefrs they
StUM#er again in Snjglish all the subjjects the^r !hSf e taken previously
in f^galese* gj^e ejftjrtatffe'i-ff teachers Isffery ,^reft|t and the l&u&llty of
spmX$$^& entering    HiJ|wSchool is of greati^ee^bt|p^e iklu*atiHnal j
1m^ •thiswjfc th^^^^*- group *f
l3Ms^0m nurses*   'Whe|n they started it waj^^^^^^^R©onth cours<||g
On fje^mmen<tatinn§ '"mkm^UXBB Crawford anipr- staff"tiey h&vejfev&sed the
cur^cUlum and ar4 supposed J|* be"saactlon^^|it^e'' «p^e for,. 3' years.jfK
They fcet trining in tjne-i General Hospital ^add^iio^^ the Lady Haveleek
and"Li^dy Ridgeway. . ^one^pt their^tutors i^weve^fere^^ined and.-this        ;
is *nji||f the blgge;itg;|>roblems---to feet tutorjKtrained^^^ can sp^ak i
the Cingalese .language*    Pre^puslj* also ti^^kipiWg ^'Is*1*8 group
and the Engli^, g^ot^^^s beett quite separate. $hd w I^'gMsh speaking-;}
studekthas always./fel'^&iperl^^io the «thetm!Q
ward^^at least' 0} s«M® '"^#iem, Miss Cfrawf*w^a^
them/jwork together* w^.        ^lEgd        ;'g-^fg/     ^^^^^^^^^^^pl^fei
Br.:/of|e Siivaha^ be^rfeaving Miss Wilson and Miwl .^^^e^^W^^Sle
^^^M^^^^^^^^^^^^^^^ ?heri they ^^T'weiito\and^^\JK^re the-
-infants, ^^^^^^^^^^f^l^^i^^^p^^^^ ^ncej^i^^^^^»|^# dSSi
MisMJrawford feels -/ve^ikeenlyiS^tai therew s^^^^K^t' ^^S^^P^;^H
the W.H.o. nur^e»^itp^he 8ehiii^   She w^u^Vp#ially i^^^P^aye tthl
understudies ^^ix^^^^-the strength *^the; t^laalng] ^l#l^^^^^^^^
iclinlcal eupe$i^^ w;Ho cSuldoihei^psib^
about*-^Por $*me reason Boris seems m oppose this^^^airi ^how$|^^^^^^^^
original plajfuiin^^?^^     "dgai |;^i     :;/e;bi; |;|||| tMM
Sext wenC^^Hthe^Be fio^sa Hospital*    Matr^^-' M^ss"Ralc|a||akse wh^Sfas        h
on the staf^ff ^he G^e^al Hospital Training School'.^whas had|||fer
"Sister ~T00?t*s ^onraenfromb-Vellore.    She appeals tdkbie^yery nervous
persoii a^i|"a little ^^ecurft^ 0ur;-vlsltwwa6'U^
had t^teend^ns'fme. t ike. wi thla visiting doctornj^st- after. «purrlvlld and
seemed ^5l;t|i'ffl upset 4bout .something.    We saw thriughv^0ie o^jthe hospital.
It hasMYerMdo beds but many more patients* ' fi^yabmxt 500 dteliveriSs a
monthi-^^spital seemKyery w^ll equipped*    Thei^egis a widwileiy tutffr
but she is^^traineSg^id not meet he^fe Misa Ma!cnemanin ca$e ^th us.
"?he relationship between the two dldwnttpbseefii tt^n^^f the happiest.
xfftmetimes -seamed %&e differences of opinion.    Unfortunately th#re e*
 wasipit en opportunity to sit down and talk with tie   ^atron. |™|
Miss Macneman has 30 general trained nurses" who are do ing"their 12 months
"in midwifery*    It has ^t been nesessary for the ntfcrse to take midwifery
on graduation" and many *f these have beeft out f^-some time*    lhat they
are irking to fiatr is Wjlnfel$de three monthgMbsJ  in the. general course an
and then h&ve them take |»- months in midwifery"almost immediately*w thej|||
chief reason being thatv^requ^ntly the nurse on graduatiil^ gets pested to
"anjprtpost hospital and finds herself in charge of-the"maternity ward and
other wards as wfcll^^fhereis'also  the venaeular gr*up #f"midwlve^ who'take'
the 18 monthp-* ;   Also tskes;||he general training nurses for two "months
/•^Pl^^as srganized. .tw«^feremature"tmits^si Has two ^derstudies*
Miss Macnemanin and Mr|||&leppe working on t$e midwlfery^irriculum,^P
^^She afternoon visiteliCastle Street Maternitytl^iere Mrs. Eleppe works*
Matron is Miss:Be Silvaga trained si&ter tutor who^^^/on the general
H8$p I tai Training Sjj^nl- staff for/18 y&ars.    A Well"prepared person with
good^deaS*    Wants to g*f|on a 6 months observati^jjb totiip|r§n her own*' Is
thinking .^|N.2^because lj||ls closM*    this is a frery nlcei^2 bedded
•hHepltal*-«tike all the maternity hospitals many patients are' .takett '!&
fttr anywhe^e^iip to,3 months before dell very.w P^itical^ Staff consist ts
of thef^atr#tt*i 2 Sisters, Mrs* Kleppe who confineS^rielf largely t$
the L-%bot§|j Eoom, 10 midwivest  5 staff nurses,  otte of whom is a midwife,
and 65 vehicular pttpiXijSldwive**    Thftre are also T]m£-the general |
train ing^fcitses who "are; do ing their obs*i:    Mraf&Rleppe is responsible for
these ^ She has two tto&erstudies*    Has set upaa premature unit of which
they areiep^ery proujU    This iB;|§ splend||t. hospital and they are
endeavoring to work tllCup as a'; good .teaching unl^/f^oris Complains
that Mrs. Kleppe is"not a trained midwlfer^t^^^:and is more interested
in the administration.--j|§Che place does have an alr^Kj;Butch cleanliness
and tidyness^l^ut I feel sure Mrs. Eleppe is an excellent practical
teacher.    The Matron give«|:the venacular students"their general nursing
procedures as.-she feels iffhey must, hav^feiis.    .l,4f^|d imagine that the
venacjilar'-iiSdents^in the BeSoysa get very 11ttlej|^*   hE this*
(LateriiMi^ Crav^ford speaksfrery highl^^f? Mrs. Klepp%gend especially
in--.her relationships, with peoflLe*} !^^ llll
Met the'P^incipal Matr^ MisS Somerasinghe. %he hm ju^t returned from
a year;»;*tudy 'diS^observati^i. in;^^^^iaiaiy ^i f$stew Kesferve. k^
undersl^p^that s^f Is l|t~a ve^" strong person l^^the .wfeltlon;  was
given -tfipfier onllthe basis'aw' senility. ■;   ggi
lip iiiia .. t HIS    ' gig : ijiiiilii Mr-1
Went ^Indonesian. {Ba3|^Snd Sumatran dancing at jlkh4 ***#&! ^Jgtllege
Hall*    ^ery fine.   %nner fefter^t the Fountain Cafe with the nurses*
■March 4.    Spent^A.M* 'kt;'^|/Murses "Training Sehlli «n£ G^^pl Hospital.
Miss Crawfo^and Mj^^^^^land leave In^£^^^^kef%llW are not.
sending any'.more.    Mi^s M$as to take. *ve|fK^(liearne^-.-ilat|r that the
Qovft haV^oa Idea'tofi a$toelgh nurse taing ^Mr arid «rtll% laterfrrom
Miss Massey that the^fe id&yfebeen several hinllpthat- she d*\\*e*    #he was
terrified thatg^ tH^&lgnra 16 wmldwb.e fatal
of course for a f||?eigh person to be brought $M wh&i ^heee..gW^^ese girls
have been prepare^ and 4r% ready"to take res^isibility;^H§¥here ls I
Miss Bl-tfleld.ffl^the .B.si^lw w^/ will be back In Jul^^f^11 m
Misfip Ellas1  assistant and~laterymight take ovvei&andy#  \%#hhVve one_
tutor in training at' Y^idfte who returns in %^> One indi^ ^rse las
beeil here e.r^pp and id e^-a. contract "for tw^pore- yearish^ ii\ a goHd
tutnr^;-'^ Mr§p^omazr Ml^sj|passey§* m^r-.g^^^Well^re
on a^vf^l^iarshipi afe^wo such p^ffided^eveKyear; ^^tlmes
they h^-e 1»slgn;:,a-cont^H^ tremealn in .thea'poslti^ fo3^^ph^L<^
J4X^^wained W as mu«^ Iftlfears*   -Miss    H*PeSiiva"i$J|o reipngfc*
'm^ VAore-atethe en«^^prli and might then work el^g^tfe''^Jjjfc,
^slasse^:0choai is. supp^M"K,have - a streng^^f 8 Instr^ct^rs*,,i^^^3?^g
l^lK^^fci^f three ■ i^nt^^^ing whitth' time the mttidents dr n^m^^^^
.".the Wfi^^ph- fhen they ;^jfc?fallowed through for at least the ftlret eM^
. ;three.^nths of e^|iirrwe^K1^perience gby the instructors*    ^missj^sffiil
are:'e^ptw5e -sti^teltte,t*^^;j^sx0y*    Miss^rawfor^oping- tha4 in 'Eaii^r?
ttiey will,not have!^, adi^TB^rea.-than ^nce awyaai^^^i» expressed thjfe
hope that:.-/it woul4 be- twicel a yearias have more^control oyer,/ tKe   WfMffi
students*^Ganft leegfche j^WuHiw^wSil^     W&S^- &$& SSSNHffll ^ii^H^^
There Is an Idvtsfry Board f^r the Training Schools    Members ax^e the
 ShI    PP        Pf 41* lli     '■■■-'      "*.■-. HMSi
appropriate"government officials and hospital officials,   the Matrons,
|gfed thrtejfamm the Nurses^Training Sehoox|l Whcprit comes ^:Mrainin g
question^ Miss jSrawford does n^;hayl|t* 'got to  the Medical Supt. of the
hospital .^ut y£^-..^^ BiM.sS In the Kandy pro jest there
need&|||f %^ safeguard fiiffrelation to. fcho will ha^^^ie say in nursing
education*": Miss CraWford^nly has til/supply .abfirta^/^
The^;.have^yer the course of time been able to select /the wards "ill which
• they mil gogibad they can Mntr^^theiSr time ^ere*fe/frylng§|o get aif'f g
Modelj Ward -^^whithntheBy ,-ean demonstrate what Me nurse can"reallywdo*
Wiiplftake aw4©from the atteftdante the htirslngwdu?tie«gthey n^w perform.
Late^j lea rned^hat. Br|§§Barlow has taken'half o-^phl* ward for thoracic
surges®    HJ^S^ specIpList here from- fiaglanlf whoi|pu& been making
':Bome/^fi re<|h.^en4ation^ be" send! abroad
immediate^i^S batches 40s 20 j£p^rainlngf fd %Um  every thirracic j
^surgery:|^tlen»^ a stainless ste^.^^idf^ablneyp^     §£&
School hakKvpr-^^^tudents including BjgM$M
Adranval^/iiss ^kwford/fftinks there is ^^^mffm^^T mTe s*^d€B*
n-firies £m^%is ^W^^y^^S '-^^^ffl^P       ^^^^K
^^#aW>Le^jp^t gra4uataj^urses are given* '■.■■■'4J^|e'r graduation &e nurse
must ser\je for three years.     She  then  t&kes her midwifery an fid .--then  takes
the p*g. 'Wp||rtetlce^ .
is no org/feni&ed instruction*    Miss. Crawford. Says tne^. will organize some
eventualiJy*     With Regard t^"Sister tutor's course,  fcii^s' 0*  f^els  that if .
two  can\kjKe-is^ Velloref  this should be sVlfiicienjt tfor the
time being«^K^£^^S^^^§E |g||i ^^^^^^^^^^^ft
Mon^pa^ng ward^-^'fe^e hospital"are run by the Cathoii^/ sisters.     They
seem to-' be finji people £n& are mostly Aeerifcan and Iwi^
under verfpdlf^ic^Lt- poslpt*ns. - Beds ift^S^
uBuall^^ftpo./'ijpto  the SJyfpo*pltalf  whlc^^t^^Sit^to^ 12lbed ward
i^^^p^M^^^^^^m^^^^^^i patietps. ^^S^^8 WSs
In afte^omgreturned t||tScho-ol for .teai^Miss : Crawfo|^|^ad ^ssh^Upierland
^lnvitw^-th^ #*^^Rhurses,dMIss Kragh and M$*s||Hlcko
als^nt^ie'%tro^s, 'and staff of the -^|o.o^^aReturne<^P^ A^|^^^^|r|^'',^^^Q
■■W»HO ^Urjseswah^ Miss d^ayler. /Had raeetlng#l^Discusse^|L de%l*pMh\|^^
thl^pro0tam—e^haBized the need-to work s&fewly and gitef#^E' Ceyl|p Aurxes
.thi^fee^ixtity.'they"need. B'lsctissed Genev|§;£fcnfer^nce and^ chimgel a\b |j[+Q«
Sfacoittr&gedathem m have follow up dis cuss ioRs^^felly a^td tggtfo e^ry-thing'
possiMe.^ get t^a nursei|l^^
After/ dinner M^ss Wilson  and M^ss"  Prosser wanted some  suggestions  aB to
their program*  ~Asked what they would suggest themselvesy   ."Klss Wilson
;Wotq^like..to ;d-o/ soiiathinj^o help the staff nur^esaand ih^Islsters In
the-^ard administration prob||p&* ..'-'JBtressed t||^ n^d fo.r|th»\ understudies
t* ev^ltuall^^ placl^fe School stafgfc WHOls p^ro:gram»i unfortunately
no^^^^|fg^o^&xampl^|n this respe^^Si&c^urage4, them \to dl|cuss;. their
plans ?vith Mi-ate  Crawfprd,   and after she  is gone»:with Miss, ^^jp^SPl
March*5#    tfsandy with Eisi^iimerasinghe-and ijfli&f** Si|lM«^bAU* 70Jgi
miles,  very^auti^p^mt^? Hosfital ^^^^%^' %'the^idiaf a hill
and is built kin teip^acei^^iftsequently thera are' '^piy"iptairsm^ cN|imb.-
Beds-500,  patient* (-.average 1,000 dally now.   ;>^caWipie ^l»^rc^owd^--
T.B. maie^lS bsdsjy 52-patients;  female■ 15bbed'i^pp patifntsjeve tardS
20.beds -aid 4 mtnHp:patient; maternity wa||i% -ward# ||3 beds#; S|||i^lent
Gr^Gom^ IM the Miical 8u|?t.    Has only:-"f*^^ftthls position for 6^^
weeks.   yihsfcital %& divided intowtwo partsM^e^U^trw1* \^ thej Religious
Sisters^ *W^he   M^tron is a Ceylon^se, Mis^^l^andM'ft jnas an assistant
who'i^l^\Ceyl^hese. fShe hai^febout 400 iw^Waie N^nd fwale taedi^al g
and^psur^ical^'AB.H* which is;^ small. i*$^ l«w wav from
the main ^ection^ chronic medical and surglcal^wl^^ **>
open- buildings ^fith^tin to^fs and extrem^y-..-.j^r^fad^litlf*^       f»B.  In
sa similar typ^^ftbullding#^and a   PlanterWM^m^h^ \B ^i^V^
pati.en^«ther| ar«l Religious Sistsx4 of t?)«;^^*-|tn^li w
Orderi^^en are'jnurs'^p and„a2^iall well/preparoi^J|rem American axMlitf
Canadian ^Schooife#    Man^iavW their M#A^^The^.gter Superior is MadJIleine
Maria ;ajM:her assls'wi-t^ irtio was in concen^^i^^1 :camplM the Phi|lipines,
througho*p%he    war «Ni£tett Brigitin^fe-^iinadi^a Sifter; Is^in ^harge
of the   Hddiatrlcs *#d and one took midwife^r after" sb«Lcasie here iana xs
responsible for the midwifery students^ Tha pellgious Asters na^|e
  HI 4%
March ,6i^Left..Colombo at 7:30 A.M.^Iice flight-to Madras.    Immediately
after lunch    went" to Madra* General Hospital to "meet Miss Sverat.       n
Biscussed plans f^v pediatric unit with Professor Achar who later showed
us the. existing- facilities for pedftatricsipaBr. Achar ,1s a very. tathu*lajf|fi
tic pediatriciar"who has taken P*G* work in Boston and, in Toronto and     IBB
who want*to introduce" the treatments -etc.* w*ileh he saw there.    He want* p^
make the General a good pediatric teaching centre*    At present there
are 30 beds for children who have infections diseases,  including diphtheria
^pi^p^^^^^^^^^^^^^ll^^ a^e 20 beds for typhoid cases* These are
along one sisie of a big ward and on the other side there are female e^'e*#
typhoid, |||think* The ma£^pediatric"ward has 22 beds';|^ffl;a^i^ta b^/the
larger, beds, have been'replaced'by^ots atid "with ha^vii&grome ^mlhe
floor they take 43:patients*;^fhe top floo^of thewhospltaJ^pMh|^^^P
nurses quarters but"h'ow that||hey are fin the new h^stele^Ptii^^Mi" been
vacated.    Adult*-:-wl^^re ^^.^the accommodation    adjoHiing thl,fweseht
pediatric ward.;aS^i:^f^Kbe moved Up and the vacated rmiyk rei^leled for
children♦■S'^his has not started j*et"and Br* Aeher thlnks^K,sIk^ ready
in abou*^^hree months^ESr."Acher going on- ^Lidajlpln M||^^^«^pw
garters will give 60 bed§^^P^>ediatrics. 'Whes^| will lp; medio^/case*
only.    I^^^^her does:||o;t have anything toldo witMthe l&^gicaSeases.
-;lnJ|M Wortens and- Qhildrens M^ta^lhere a^:^^^^l^tr4» bedlp' ^^12
Ach^. alslfhas ^ese^^^i^^^ity^^^he molgi^iii^com^^cid !m^m^ least.
during tj®;daytimewwith the. children, ojffee wards Appeared ^jeWVM^thiK^^
was :more evidence of- special-treatments and nursinfe c*|re th^|^p^ny    MM
sueh^h^pitals*ffl - ?h^Sistir^ in charge'seemed||i^ a^d'^fe'te\rested.-
ire-do not too*, if she i§ithe one"who Iftfip go awayfli ?e^fewShglp t«^ft'think
n^# There was a. great varletywof cases. Many nutritional ^d^*a*.^^^^|
chirossl^weie* There is a Blood Bsnk adjaceut^j^whe pediatric var^^HH
many Blood 'Transfusions are-giveajjl W^Mf^^^mi      ^^^0  W^S^L^
Br» Acher sees the duties of.-the WH^^nurse;a* the fcliowlngl^^P^each
premature, nursing care techniques'^  teach^^&llBh «& cetture* a* 'Ip
Blood Tra^sfus^ns,  ^ntinuous Brlp,  Siibctttaneou#v|^Ip|  Cfelleetl«n^oj^^
urine fropNtefants,   eystograms, formula,"^om^^%t^&-Bhe w*uld also give
Sediatric lectures"and clinical instruction in jjed^atiile to the students,
either IB given no*^Sr*|^5har w^uld like to^n|va^/ntirse froif Toronto
or from Boston^eMight write to Miss Mastoti,^^P&l also speak"tf^pi,adys
Sharp* and Ruth Si^eper^whe^tp^hey are in Toront^^^mfe seems .-'to -remember
a"Miss I el son-in Toronf^    Might iniuir&ep^t w^^^e/eertainly be a-,
wrtnderful: experience-.;J^' any nurse becaus*f>they' woM*| .s,ee cae#gJVJhey
Wottld rarely if ever see at home*flfJ think this-ttol^t'Jbje. a woirto^whil^
project even if" no thing further.|pvelops in MadraeSpPe{fhaps I was too?
critical and t^o, hasty in condem&lng it as a^^^^t^^r&jectj^
This hospitalwhas 887 beds, divided as fAlln^g-B^^ll 252,  surgical 381,
Children..54-^?thi^a;.280#    Thff|lally avera^feiumber\'m? Willdrsn in the
, childrenfs ward Is' 40 at present.  *he daily^aiiw
children r new casein 100^.-^ e^ploki^Sn the mlldren1*
••ardtj4, trained, „fepnpilsjfvday and nlghtrduty^a||^upjia,ii W&M     In th*
Out-patleht Bept*Monthly aberage number of admissions A the -XeKlatlpIg
Ward,' 129i/monthl^pyerage^ niimbiBi^' deaths ligj|m4 ward^|^^.Irttal
nursing staff ;^lu^erin tend en t SB£      M^^^^^^Sf
Assistant-" Superintendent*   "2   W^t:^M^, ;i^»^^ I   ISp
Xur*ing futors   jj||gp«(  Two for the *$ip^maw?^r^
■(;'b: GefiSral ^Stei|e &idt otte%nnnthe
BloM Bank*i3|| ^^Iro^
Head Hurses ..    14 ^H ;   V ) [ V' e ,
'Hfurees     '8/7 -^^W«?     ; ' x ^>
a:        ftipil Sursies •    1721 , t;|o.:       ^S^^K
The ^Sdy. Hope School   HppKursing is the Central 'Prell^laiary-/,^S^^^ ,
School, f^r.-the general a^lfl Stanley Hospitals*^ifhere a*re twc nurMi#;o ;
tutors for this jisch*^^^and 50 students,   -fhis-pa be^dK for sl^»^the <^m
but in the-future will ;^^pbly ;;only be;three and stude^A* wil^M admitted'
four times a ye^* . fheriare 60 male Students in the General S^se* It
was said that §0 everymhree female one male student is ltw@® ihere zre   ..
many more applicants thp. can be accepted* ^j||| .   *^g , "• i,   '     ^    ^^
Interviewed tiyb tm* tutf*£frr thei^iplpia ^ourse^ in Kjjr|ll%."Shi\ tw^w
tutors-fo^'the; general^^oi^se were'also present^d^he ^l^lakaf course ^£uld
seemwt^ be rather a po«ftk:i|wf,w#    Ihere areA8 students at preseht,  5 pe^^S
the Ulster TulorVs and 3; taking hospital Mmlnistratlon^ feg
 j eg IpllllS
- •--!£, - /     ;--ffl ibbr       ^w>#'-*     idr-j./b
;he senior tuto||ffl   Miss ^adjaline tekches"Psych^gy# general,  social,  and
tducatlnnaljgg^ and"Supervision; Principles m
Education; Metft^ds ^^i^hing^'F^sin^ Schooimdmlnistration; Ethics;
Professional |l|p^^ like al| .thejnt^r»#, at* a graduate
P this J|apita|p^ teaching: ^#t"lflcate here*    %e
• has not much idea r,£\ tpal education.    Her asxist8nt> Mis* CSiarkrapanl^g
^^h^^^pbad h<jflg|^ &he tfjj/ipl l*llege»  l*>p& better*^!
She teaches Hlato^ of Nursling;"pursing from thi public health point of
view;' aud; gives M&t *f the \tut?rials of thifc^imt*^
i&el$ra Fyyisimf Chemistry, .Anatomy ani^^
Bs®te|M BioMgy. Cp^^^jH **$
the present clfesa but', 6 failed the first preliminary  tfst whi oh ife given at
&he end \*f e*&; week's i:   It is |- given  in the basic acienjbe* taught Mr
the doctoro,h^fter 'about 2 1 features in each.    Mies Ad^l^ne could jrtipt see
that this w&sTnot acceptable;'! end the right way lf;o"do jlt»ftb?he maximum
number ' fcs  that pan  'toe" taken" is 20,  10 from ^fe i 10
external* /f*here<ls supprtsecX to be some practical expari^ca In teaching.
^ ?yrj^me ^tervation   Visits in Mand G.g.  cim&tow     \\ [\
Foiinf/iag 'these #ntej;rview*, we 'attended the formal opening of the »$wr *
no^tei,;V(,|5yhKer Highness, tjie ^laharini Saheba of /BhavnR^ar.    S4e. attached
March;'7.  ' ifceft i Conn em ar a H« tel  at 7 A.M*     Af^'er two  stUp* dnd: a 'tfcabpv
fligh^^^^d^in i^fe[iii 3;4p       f|§       gig \ 'w^HF    \ ^
Elizabeth caneii at T'fori dinner with    Boris at/ff||   She lis at ''the same     L
stage n'oW as <'l  am;i very) eonfuad about it all/and finding"it iliffi^ult^^^
y&Bmw-mW and where 1 a*he &iid Bi^BatKn have worked   |1|1
out a s.'|^9^j^^j^ ebs tag^^^^XB the Bracks tt-* "Watson plan fo^-- nursing, education.
&lfifcabet||^^ midwifery ar^public he%th"c5n Jbeiput
into thr^f yea^f^pils is likely what they wlljgbe trying-out in p
Travanffl^^. 7eelS$ that publlj^^^ealth nurses will be^lB"demdnd v*ry    |
*«^- ^fel the.f ealth Visitor group are no*'gaining- enoughfi^port to
continue fo«iong|| Most centres are., apparently not getting enough
candidtted^^|hey are wanting Something which gives "them m^re. After dlzuil^|
Br^^arneraS'at •at"our.;.^Bble dor: a few minutes.-||Piscussed this with
her and said we would li^ffco see the Lady Reading here offer public
health" rather than a H*?#  course.^pr. Warner also is agreeing tha^ffche
H*¥.  course is n^iadequate.    This~is a slight change in hea\ view.    §he
thinks--^ make the change.    Jt^Va$&er also
told us that HazSl portal could not be released in time to #<me to
India with the^ Poin^^and that Lillian Bishoff is coming almost"        Hp
^-Immediately^Between B^|^4 and *#H*5* we might get something g&lng .Ifl
repla.ce the presentipralning at the Lady Reading* rap
a/k^ae zZzzMZ hbeb; :bgb      bi**bb
Miss"Roberts here. ..HasOsized upi|||e Delhi. ^puatinn:||uite wellW*»a iJfSl
of confusion and a l*tJpp||^.ople dabbling iniSe same thlngs.s^S
March B,|||lntervifcw wlf|rafci¥i* to start-«i|^»ee:^^ftMani- at 12.
Gave ffl^r^Ls an ^ppnrtunit^p:fejBpeak t^the'^^uaiti^t0«B.*s letter but
she would; n«t|j|1Chis lfAJ^yf:i*ie unsatisfa||pythings^-thaf she ttill;
not bac^pipwher ^TO',CwS'iieti«nsw«.r give an ^pj^ptunity .fo.r..dl,fi:ouesioB.
Asl:edi|^^;inng she0^ta|#'-'i*ah-t|^: stay-wltbfflW.H»o# and/if she wanted te
stay-l*nj|e:fc than nne yMr w«uld she consider tsijpig s««ae frxlt in Nursing
Bducati«^r.-. Said ,sfc||pw%dd. n«.t;'iran111« stay iaHrr' tha«iwn ujnre years in
any ease todfflthat sh^^iWiid probably liKe'ta dri-^me 'fcidyihg but n«t
f^r futthfer w-nlc In.^^pif-it wotild be .l^-w«3^M^ewffl**ealand and she
definitely-wanted t-«  Return  therse  Later in interrle. with Dr* Mani
and with iNris preseyppj'repeatedthis statement. ! It .was agreed fthat
at press^ptthe .e^Mralei ri^ltld-- be renewed f^r.pie yearpi^d fflDr. Mani made
a n^t^^B^ll6■~■^^/&•^^, 8^.1«tttis£ "He mention was made about Grade and.^
th«ught£»>«uld /be Is wek-1- n«t M -bring it up*    ' |§I
Wi,fcil zp^Xd I dlsCussled pl/^nning f^r 1954.^|ftie easpsessed s^me little
dissatiisf^ctlon |th^Kk.hf4d-tj^t been able j§»- help.'her with this*    Prev-
iouslyy she had thld ipe^pat the planning was d*»e,l||; June and^July and
that they hfed a«je4dWi«4fra|^estiAned whether J w^uld c-«>roe then t« h.lp
with that ^r n^w|»    afc aftreed that I needed ti see things first and that
»«*rth»as not tipe tmr mzre-«^ However I have been able, to plan with her
 45.
f*r the Ludhiana projecVand do?|*ome tentative plans for the forking
Gonference*  Making a memo of our discussion for planning.      ||p     I
Had a nice Interview with M. Manie    Discussed Burma and he does not
^ilnk. Ingram should go back there.    Perhaps he" is right and' as nursinj|ff
educators are diffi suit to fing perhaps we"should let her $* to
Bnmbay^|§lle saiaBfae w%l« dictate abetter €SwMr*»>ung San notlfylng^her
that we were goiiig^bput in a/replacement forfi^gr&mr  that we did not- ■
i|p^ngk"it fairfp-"the .team there n*tJ|* have ai^eniorj^erson and that we
were not giving:the best seisflce without this pfit fllled*^Bbis^  as
Dr. Manft saidf  *o^i|d be a Country lursing Adviser iU disguise* He agreed
to P 5.       Incidentally Dr. Malii said,   in relation to planning,   that he
had hoped that dach ^ have a liursing advisor and that after
she had been there fir akjtjjdit a year shfe w*pl& make-recomme&Aatlonsffor /||§
the^rogram plpnning^^^^^g.   ||espoke abJiii;e;theaneedwfor suehwa pers^^
In Afghanistan and C^ylo^^E^ris s&ys../thatb|^Mfuli ,took"this p"st
"*utblast^ar^;!^ rllationi|o';.eeylon'^l^po^abo^wthe possibility
||| a; request-Coming tkr W.H.O.  tc put a&jneone in~Miss^?rawfordfs pl&ce. 'f|j§
-then thai reason fftfr-JuF. a withdrawing wag given-he agreed that we"shoUl^^|ft
and a.sk|^p^ris Ito «.t'thls ">n record so tha0:|there would be a note of
It whe^rrequests a^^processed^-To return !,^^P^maf Dr. Mani was signing
the 6 ^n^evalua^io^^^^uaid^  Davis,   and" Willlamson*|§%Laid hasi'Jbad.
hfer PrS^^i^naxy jpe^^d -extended for three month*.„andda l*tter has gone
t^. he^ppiainraBfe the';^easo^^prraham      and DaviS have had'- their a^htract
*^^^^^^^^^^^^^%i^. |||fc$.he felt tl^^recommendation Was inconsists
ent with the"content -of thig^epoj^a^lt-was suggested^that tlahSm, Davis|
and dp^id sho,ulp[not have their contract e*tended^|^^Mffl the tw^|pears.
/Dr^ M^nl a litllte heslta^^aboUt-J^^llng.P&vie^^K of Mandaiay*    Says if.
S^^^^ave any fetiidents we cannot/, li^^hem down*J^fiu|Eg^s.ted to Dr. Mani
tha^|hereawa«:a|limii to  the s|^er^^|Nj^ets w%V4ftPl& carry In
;ftSp*sing afid 0||^^^fehdught we"had plafined abopt all we could manage in
fiJii* Reglon:|W th.fet farther projects, would b^^p^natural developments^
from /these*i»|(a[e agree^^dthis.-   Then bro.ugl;^|ipathe matter of a"RegJ^^_
Working Conjt^iren^e w^emlnaf*  . Sbcplained what-^^i/wanted inaa fallow
up from th^lfflen^ smiled and^thii^sked If itttig^ibe
possible ^agf^lt ^i^^^^A.B^and^askedl^ffl^Slf she e^uld w^rk.it up
t*r 1952M  Wei said th^would beb^p^ssible anc^that we had tSughpof it
^f,,13fji b\3piconld"do ;£t inj|py$3^p'- "He-saidJ^tegre^tbM» the principle
md ^K' 'ahe^d* |p*rls w^^^eed"a Mti^^^plp'wl^ this as I do a no: t think
she h%& Jbhe :tnggiem$lM Iplg* abouV^|p&Dr. Mani had the
ide^jLmia|ediateiy about^orklng-lt up/.throughj^rre^p'^lence andwfinding
HgV' whatL-the group would want .to'; discuss^fSsuggesto^, write unofficially
^pih.../7terna White imme4lately and f.ing out if she i^tMd be available
next; yfar and when*) W^^^^^fS^ fliPw    \ - i i
^-fflfflaa: <■ w : ee^y'we/poffloffl     ^.zyzyi^yzzZyZzz.z
Went ^tresentatioj^fe'o^the Elorshde Nightingale Medai'-to MissflMothy
Davis^iWrineipal Matr«i^^?the &rffiy -lursing ae|F^ee. Slresentation
made JM the President*|*Berrific lot of color,   .pompqjfaind ceremony.
 .    .// "46.
Harch'Kp Sunday.:    Worked in A#M.    Doris: invited severaj^i  the Club
foriluri\che ! Jneluded Dr.  Pandit^'Miss AdrattvalaM. the NewwZealanderfs
Miss Heafy and~Miss/^vie* J>r+ Pandit seton Health Tis^pps*    W^may
have- tor^giveik-s^ine help to #j^p^ady Reading and gradually^Change oyer*'
After lunch Miss Adr an val a arid p4««^"Doris came to my ^om for discussion.
Told Miss Adr an val a about my^pkeern ;^er the Calcutta s#t-up in';
relatlSp;to public'health nursing in thebAil India Ihatitute* ^P^B
IAsb A&ranVala. Is all^^pbgetting public -healfe;^ptoathe" basic." Mil., so
strong, on t^xeP.CJ.*s -^^^.H.i^ut when we pointed:out that   we 'thought
these wouldlpe essential  to give those out n*w p.h*;'and-.^^t:-- they' couj||§|
gradually replace the H.Y.  she agreed.     ln ogir nursing project in Calcutta
if Mi&s ®faki^y has ti&t accepted as-: the pediatric nu^se we should t^^|^^
get someone J||^i~~with, & p.h. nursintg backgr^todfflials^^plffe must watch
for this (Ln ;al^|:our projects*- 'Miss Adranvala'^/^thinks that one nurse*
should bebin the Institute/at least a year ^before taking in any p*h.
students .•■feo-'work upi||yhe" field program^SoAgree. W^SB
Discussed .posSlbilitle^^'f refresher courses planned for 1952 budget.
Wil^iry. to work ixi publ|^;health nursing this VsAJJ^L in coneetion   Jgg
with' the P*G* ;Coursi^p:M|ss Broe has bfeen working- with, the  College on
a. corg curriculum f^^^th'4 Administration,  Teaching, and P.H. groups.
Miss ^avlfe wi/£l"have some teaching to do  and the field work for the^*G.fSe
?be refreJBher/agurfif.e migh^be worked in with this^SMrS^^ioase Is   ^N
willing tjoagifVe.' ™»refresher..-course ill pfediatrlceibefore^she goes J||^
leave in jbct^erif^^ work to^m^pow and will do  this on a:-
;voluntee^f ba^ls. :^pi.stead^f a midwifery refresher -Mis* Adran vala;|||
thinkslf^p)#Mt<ff ty& better to have -,^.refresher^^^^fcif or Sister Tutor1 s.
This thel^lle^^Wll^be^Esfed to give*     The M^^Mb fresher is to^start veae
very s*o/jji|§   Initiation t^:Mlss Hudson; Miss fl is very anxious to have
hhr sont^c^(^r(8newed- for a year;;^J;work witb^he'paffiliates,  -if they
can bj^^talned^^n^ was agreed that Mlms Hudson should be approached
to Bf/mBrnt.d^he'^^ulid; be willing ;^p^*^e back~after--:h^me-.leave. /.-.:If so,||j|
the/^p/ece^sary negotiations for a request would'%e made.    If"Miss Hudson
was nV't filling jf^o; Return it was felt that we should not encourage any
requea-fSs s^dmulch ^L^rends on- the knowledge she|pa,s already gained.
MlsSAdr^Vaia^pyji/.th^^^fian Nursing wouncil ||F asking the Medical
Rese-^rcli %uncil for &&;Btance In studying the/^§esential nursing
procedures.    Th'is information arose *ut of my^asl^^g what"could be"
done a^utVthe^lard '-{jp^igps having to spend so $uch time on inventories.
Miss  A#   thinks  a central   supply would help*        ^®
March AO* •'% ?fficdK^mnf erences wlth"Dr."Tulii-Dr^  Chel^pah, Dr.
Veenbas,  and ■i»Mettr^^  Brought up s^e *f the-   points ^oris and I a
have "'been discussing/ inll$spect to  the various countries*   %   \A .     ;.
Indonesia has jtyltii^aito its request for Nursing -Mis^gthe  ^ister    utor,
and the addit^nall-:tw|/p.h.nfs f*r the mi^^^^^^^^#W SFS lj
will be 2,3,oi4'year&^ef^re Indonesia is. ready ,^^p^rjei^i personnel.
E.C.A*  is"siting |a^ii^»-tutor and Miss Murray 11?-fur & ing; Adviser.
Dr. Mettrop feels^m^w&a^embarrasesd with' all-^e^rp/blems left by
Dr.   teilliamsf.  ^Lat^M^a^ series of .refresher ;e^'#s& in' pediatrics.
He is trying to mauk ^^&noSt o||a difficult situatiok so we Should
give hira evfry sup^ort^Mfibl^ He recognizes-^at jme proposal put
up is not Joy any m/eans^d^al^'Hope we can havef||jer pediatric nurses in
place flfflj|t* ^^S^^^^E ' ^xBp   '   *
Lunch wi/th Miss Hudson 11 the Gymkhana Club. •' ^   -bl /'
 47.
Meeting ^& afternoon re briefing with uM $r«utand/1*r.  Sundarham    and
Bnris.     following points brought outi       OfflfflfflObeoe: *
1.     SuKKest  that all arrangements  re finank^s hZ.'MnAe. •*«  D'ilO»tv.. 4.1
2«
3.
fuggfst thati; a11 arrangements re finances he ikade in H.0. rather than
in Seneya. ;.- ■      &§$&$&!£ ®l^^|^^F^^lS^ -W. Wm
Idea ^^aving. lmformati^n..^^ountr^H^^m"po8t Reports favora bly
recieveds    B.o. planning- a letter to bfpient ®, - each individual
giving more specific information re salary|allowances,  country
information,   etc.     A 'personalized'  letter.   ' fuggestdd this be     HP
cleared"fr*a Geneva-'and that it might be'.sent t<i~tlie individual from
there  fn'avoid any over-tapping or the giving «£ conflicting
inforssnatiruu    riuggeeted it might be sent t-  Geneva at the same time
as  MIC   81, JaS .0'- a        J     -
H "j..  plan  t* hAve a    Briefiftg Sect   «y wifeM tw&onths. B.S.  will
have- a check list for all -people seen and if or all Itwms discussed*
{'w^^L&tt9r might be a-good idea for H.Cj.)  ffl   -/
S^p»;//'ill send 'minutes Of  committee meetings PttfeenevaO
4.Suggest send letterJH  or rather  co-oies,   re  recruits  eat soOR.O.  kept
ujM-t$fadate. . h3:iu eea|ili|i
[S;aafl§t &f^*ip|i^|0a|^ly re dependentsO-    -. ajBj|_ a
6.   ~'%gget in letters  to  candidates who plan .to  take''families that
•J^emily c$Sp la#er*||| :i0z yilizMZZZ   fflOffl
^^,new regulation that linen,   crockery,   cutlery'1 not provided by
I     ' 'G's' 't.    Better to buy thi& equipment o^lJI^'sbbf-j  except might take"
fflsoae line^i^juipment a^|l«*wancef||p given, and  also  30 day installation ■
p«j^sdieiB» -J|p§ %£0?*.     §P& c       S^fiB
Pieals* dopant send people to arrive in Mew Delhi on Sat;  Trying
to  close fiffice on  Sat.,   at least during  th® summer.     Notice of  their
arrival to be"sejtit asiearly a|||poSsible.       Otifffli        Ifflfvilb
W-mld like" two  copies  *f minutes of Geneva Brief iag-Commit We
Meetings  so ham-Wn^j file ahd *ne for circulation. ,
Suggest thati# briefing book do not inclttd#4R#0»hart; iff list *>f
names/until they-get.more stabilized.    Probably should not give more
names- than that of R.B.,B.R.D., *k.&F.,  personnel, ■ and    pecial
Advisor,    lllSlill        llll I^SpI
IP
10.
Sfaaer with Br. and Mrs Williams and their daughter,
Pilauw at the  tlolg&».ffl|l|-,.,-   ...   -   O .      . fflffl.
Belicious chieken
March-11.  Reviewed personnel histories with #^§lj*.    Made selections '
and notes for furiher' foiiow-u.p froft Geneva.*    Jigffl mMM
Luno$J'at the RaJkuina*frH'  Miss Broe, Miss taylor, Miss *dranvala,
and the three New "'ealandert^^OT}l'>mbo Plan very much in favor.
Conference wl«-MisS-.jpaigj»»ri8, Miss ^avis at~J|P.M.    Miss vraig
i«f$ti he known that slewed heard from various eottraes that W*ii.Wfc-
nat satisfied.:with mk&m-W- th© ??ay she was using Miss Bavis.    J*"*? on
t* talk about the P.HJ post certificate course and stated Miss i>avis
If be in charge of tha Public Health students who would be = ta   ™g   |g
some work with the wh-fWgroup.    f&ere will be a lot mt things V; Jje
ironedd«#/as thdy gZ$L-.ng.    Miss Batis understands t?1«3BK1.hXL*2
tea a^erV    the seemed-'relieved to know that we aP*feeiaI*l^* ™Sl
would be difficulties01 in discussion"wiih Miss Oraig said|j|dici n«i
thinkbwe Should wnWy aW*l» the la«k*f a matching nurse th^ ^ar.     *ne
bud^eMihe is there arid-perhaps someone can-be selected fr^fc the xirsx
class  to kave'&jyWai-*Experience and then go abroad<-for st\^r*^fe
agreed that it ^uiiW^ss^^Z%n\ce five years tWgeally geS^is on its
M'i'ss Roberts  to "BalpgZn  tomorrow and I  to Bombay.        , SR
 Tv
Pip-' / jtlltl ^etor unablcT;^ $he hsdolfe^ attand
^ayx4 /meeting is Balhi* bJ^feiief t a planned pr*grafts for ®e:gm~ At
a c^t'  to  the Matronfs  office H th* J.J.t*r*up of Hnspitftls.
KMi^4 Mrs.eiine*  end ^glo-Indian who has had a P*G*  in Hoirpit&l
^snistr&tion at the ^yal^illege and impressed me as /being about the
^at effluent Matr'^pl have ®#t $ft, this: trip* .   Interview with Dr* -
S&thna the Medical Superintendent who al^ seemed very nice*    They a^^fe
looking forward to having the W*H*0*  team and were pleased with the
suggestion that the leader might"'Come earlier than the rest^'Want"
senio^^Jeopie becaiii|p^hey are locking forward tobtheib'devel^p^ent. of
a B#SCi program•    ^reelpthat this was f^r the futur#4p"Saw someof    j§|b|
the representative wards a&&; th^se which will he used for  teaching*    fhey
ar^M^eparted to/use    selected wards which are better staffed and better
equipped*  See attached f^r statistics re beds and  staff* mLwM
Me-ta^e-^i^ter tutors in"the l&rge and fairly well equipped class-ro^m*
Sister P^pa:.is the senior*    Took    the Sister Tutor's cotubs^atthe
Hoyal^ ofoliege 1947-48* Her assistant is Miss Chandkar who took fite
sam^^ours.ev>'1944--45*  A Hiss Punn*^se"is afe present '."acting as Understudy
ahd-^anslfc take the sister Tut^r Cotarse in^Delhi this* ^all*  There ia   jl
now one -in;-3D.elhi'- talcing :Jpe co^urse.JlJt is hoped that,, kheuwlll b$ back on
the te&chjingb staffsbut the difficulty is that      there are only two §gj
san^i^ned posts l|P the echini.*      '0%k pig llll
Re*salaries; lister    Tutor~-l£#x§~t* 20^xS^to  250 per mo.
Wm WWard' Asters 125x5 to 150x10 to  200*
ra     b^taff nurses 80x5 t* 100 |j|
ISp Sp^Hudents    flret'^ifeu 10 plus allowances~**26*
lj * |fil first yr*   20    * * 36
/      ;.'|!        J 2nd,   3rd,     end  *id.-   §§pg 46*
/     :#ll get maintenance^and uniform allowance*
/        ttb : a®*:'
there'^Me tB; Health-Visitors *n the-staff*    0ne works in the pediatric
:6:*P#I^E;App|arently do-f^some follow-up in t^.e"homes*:-^jtaL^ other  is in thie
p&$e~niatla 'clinie&V --;!/€'- is said that, she £oilows-upb^iythe. mothers
discharged frott:hospit^^pObvioully'.-itbis impossible to do this asw
there/j are.-10 t* • IS births daily and:moat are discharged at the  end of
.4 or/5 days* .. /.      '  . Wm       |g|||       !!§£?
■^he^eafee-'many ..An^^iui^B^e andpB^ia^EuropeSns on tKfe staff *|§tPraetically
-.all wear western firess«:^ea;SiBi^ps ear'European    fo~od and lt:ls
expected5^ tsess with them. w?5ier€^pls a two
:r0ome<tt^ttage-"next ^r^e^tiurees^^ost^l    where    tqo can  st^y and . tf§|i
-;W'th^jtwo w^tild^ha^^^^ptooms. in the hostel. ;All nurses are/supplied
wit|||^ necessary to take linen*
At Iff30| set ftDiksMW^e anrgeon General.    He~also very friendly.    Said
':h«'k-few«»en talking wi^pr,.,Ra^a ahout"the project.      It is Signed n~ow
ift lhjsib^jM the/ matter which has beenthoidingfft up is the provision
for.:^Siesttrrying;«^^^Plhe project after W.H.0. withdraws,    whieh
j^anWfflS|t|in^ sanctien^f>rwmore pos&|ivn ttee teaching,.staff,    fhis they
are t^|n|g'j^fflnake/pro'visioH^r.    *hey were a'4lso hesitating over the
^^pl^^P^pP^p^^^^^^^^^^l^^l  ^..assured him th&t we Wbuldgl
not ^^^^^m^^^^0X^^^^&^^^^^$^^^k^^^m would he hrough|p^|
the  co^iritry.       -p:a- ■   .,- ' . .    WSm. •- A'
gppA.     .;-;!e'p'iu..a:ev   ipfeaaa f '    inie ipi'.e .a ,
To^k hu*! f-r eii^rt  at  2; 30 P.M.   fro a  the  Taj-Hotel*  "Jiene left at.,-
^p  om^| 14 passengers      Suid  2 hahies  so had lots j of .,ro'oa. ^d'
Tn- Gairo'r 27/00 miles,   1? hours less 20 minutes,    -^pry'/differfen^ ■
atm-sphelre/'iat Cairo  th^i  in Jan .Ho  pniice  to  esco.rt.-hs,.    O^a^'b*
to  G«a®yal^00 railes,  flying tine 8    hours.    Av.ppJOitud^u»^,0
Plew around Alps    which were beautifule    Fiekedp>ut p>h^-e^^d'-    ^j
Mt.   B^|sai,   a d  then Mte 'Blanc     which .WS    flew' m8jA
Time Miter wee Geneyjbto Delh3^4lr hours.      W-
 0_ &8S llll ^^Jteaaagy     ^^^^
FIELD TRIP—  SOUTH-EAST ASIA RE6FI6N
I   sWw*' m
fcWand^   %tel,   Rangoon*     I have  tc lock twice at the date to
belJSi^it*   V Muat be at least 80 degrees oMeide* ^prrived yesterday
about threeb^*M»  afte^r an uneventfu^irip*    A let of waiting arOfioad in
London where aj nearly fre&e and did not really get warm until Cairo*
Was in a doubl^:. seat-with very nice travelling companions—an Inglishman
and his wife ^d four year old son who were going back to Hong-Kong after
a visit home»»fever $%w 3 better\xyo'uhgst«r\^ja\ a--trlp^    Every bump in the
air was a hugf jok^^^nsequently the only rough part of the flight which
^^.^tm^trom Ba#a t0 ^arachi,   was a lot of fun* |||~At Cairo the military
atmosph^:'^frevaded*     We were  told that we binst wait  in  the plane until
the alacrities boarded and  that probably  they would  spray.     However  the
lit* M man esrying the bomb never got beyond- the ifo:^^^fcthe stair-way
1^^ we were  spared  that unpleasantness*     Probably  thejfc Were celebrating
^^ror the new Prince.    We were eseorte||thethe restaurant h^ at least five ■
g^'policeman and  the miriads -of others..'who hang about*     They swarmed around
the plane and I praye&||hat there was some good supervisiC&J      In Basra
and Karachi-also  there werAafjpfcs &f do-nothings aroimd'^buf^pt the same
military atmosphercj^jlt was a delight to.gat-off at-O^^tta and meet
btfae friendly and efficiei^;atmosphere ^bre*.^fhe airport attendants
neatly uniformed arid  eve^one most courteous.
I was met here by Dr* Hu^jl«|(who  is the assistant to Mrs*  Atoig-San5
understudy for Dr.MacPhail end apparently lots cf|^ther things which no
doubt I shall l^ar^ln due #urse) and Miss Grahaja*    Apoligies from
Miss   -Pedersen,who was aftthat moment meeting with,Mrs.  Aung-^aryr about
the nursing personnel to be sent to Burma!    As a matter of fact all^phe
girls wanted t||§come t^jpoeet me but there is ia petrol shortage--the o|l
companj^^» strike*    T$a at the hotel where po" were j&ined by Miss Q#aid,
Miss ficlpl;-, Biff,   MacPhail-,   and Dr*  Kimballt Da Team)     %en I was asked
to join a special party which had been arranged at^he swimming club*     Tired
as I was I  thought I had better g^^J^arned ou^^^'-h-e an qut-doe|||oinema
at thebforeigners clpb—a mostfflterrlbl^|icture'of the Hollywood kind*..
And lots of people in evening dress—thej*Koll me that||g| is a good
idea as it keeps  the mosquitos away.MEverybody seemed b^-.g* bitten but
me so probably I donH need  to go formal!
The reason X'havo.it lme for thi|^long introduction is that ||||kegged :cff
the first engagement this morning which was at &.A.M.  to see jsome schaclc/#i^#V
opened,   and now at 9:50    Iss pedersen is having anfH||ppointment with Miss
Cjjuaid*       By the way reoms are very scarse here and apparently a wable
rent to Delhi,  and may or may not have been relayed t® Geneva,   toiling
\ \e not to Mome on that account!    Anyway Miss pedersen is O^igwith lie
rah^m   .'(who .did-not go  toj tlrapartyO and I am occupying bthe spare bed i^S^
tss Quaid1 s room.      At 131; 30 there is to be a meeting wl^the nurses,
b Vd at 11:30 Up until about 12 we meet Mrs^^ing-Sang and a whole raft of
Qiers  in succession,  according tc Miss Podarsen.
4>.M«  this is quite a situatiohJllnPirst there was a briwf meeting this
^fining withithe nurses*    The need for nursing leadNii^^ttp: is most ^ffirious^-■;
le tutor group and the public health groug oa#i goMM|helr own way.
Dois herself refers to ^e division in the teaja add spes|| of nursing
edition    as apart from public health.    Miss #«$rSn was ^avoidably late
andtdck very little part in the discussion whichbin effect was really
boU discussion.    It was a little scolding from tho Nursing Advisor on
thai not working as a team and on their behavior.   ^ was embarrassed for
tfaei  sake that 1 was present.      Miss Scott made a plea for fitaff meetings
80 tiafe she could get tc* know of the work and plans ^^|he others*    Miss
*avi& seems to think that they aTe co-operating very well when they ask
the ptblic health nurses to give lectures to the studasps*    So ;4oo«£g ,
&isS iraham—Miss Davies seems to be the spokesman fo^phe two*    fortunately
there Vas less than an hour for  this meeting and  we are to have a longflj
'^fptfijbuss pursing?
mr
 f
2»
Then Dr*    MacPhail, Jforis and X went to pay the official call on
Mes.  Aung- San*     This was very friendly and no business,    but she asked me
to: lunch with her at her home.    Wo then called on Dr.  Tha Gyaw, director
|i||bfiealth. Servicei^:;Xt.'ls under him that nursing service is administered.
flfhe training and the servicO are still "under separate departments although
I  was sure  that .in  a report  in &eneva_recently 5^|iad_that  they were now
under oneM: Wishful thinkingJ|JWe spoke    very briefly to him but there
therf^was time for him tc get in    a dig about difficulties in accommodation
which is  a very sore question here now.    We also  saw Mr. Barnabas,  Chief
of" the CKIGEF Mission in Burma.    He is having a get together of all \M
people in Burma next thurMay and invited |oris and I.
^^fhen lunch with Irs. Aung-SajQ^at her rather-delightful>&mo»X%^^
lasted nearly two hours and ^certainly heard her side of the story*  It
would seem that the difficulties stem from the fact that when Miss traham m
and Miss Davies first came they were shown the two  rooms  in the hospital    lj
which were allotted td|Khem and refused totike them until* there wero some
major alterations made.p?fhis would have been very costly: and BO thoy
were ;§rat in the HotOl.    When Mrs. Aung -Ban* returned fm^ Geneva she found
them there.    she was very upset,   fundamentally because she $oes not like
hotel,.life for..nurses, and does not like_the  example  set to jBurmese    girls.
I  certabiniy' mould ftgree witlTher.     Jor  the "last  two months  these girls have
boon in tho hospital i^^fenslg^^. on a private' bath: whi awl has-been mado for/
them a||foonsiderable expense ipr Ac cord ing to Mrs Aung*~San* thy wanted folding -
beds and several other commoditees which could"-not be provide#^M:shall see
for myself and ge..tbtheift|de pf-the story.      Apparent!^;there has been
some talk of moving Miss Quaid. Mrs.  A-S says that is not -the way to
handli the situation,   that the mistake should be corrected wi|h her*    She
apparently Is ver^higi^anded with Dr*  Mwtf&m* Miss Baird went to live
at the hostel .when there was a room ready-.*:^thero wao|||r second for   Miss
. Quaid at that time but fcl^refused  to go.    Miss Baird does a lot of her
Sown work and  apparel tly has  the Burmese just eating from'her hand*     Am
going there for dinnerfso will be able to judge for myself*
XpOhould  imagine that Dr. Mac^hail  is not a leader but he is being
put in a very'difficult position , and It is not fair to expecifeim/^ be
j   the 1*?^®!^ majojf part;%sbEursin^.
They  certainly do not  want  any more nurses  until  the accommodation
^situation is oorreeted.CThe hotel has not recieved a cent yet!)      thero is
opposition to*    a Mursing Advisor but chiefly because of the accommodation
and also because they are afraid of the kind of person they will' get.lieXt
seems to me know that a solution might be to re-write the present project,
making it t^o—a nursing,   and an M.C.H*,   and to put in  a good leader  of
the nursing team who woull have the same advisory responsibilities as
though a separate project were made of tho lursing Advisor position.
jGf course this  is one side of the story andfjfpis quit^alfcfevious that ono
[|of the major difficulties  is  the fact ttiatjars>^.A-4*ai is herself a' nurse
fand takes''responsibility    for  too many de tails"* t-
An interesting side-lightsthe nurses expressed the opinion    thit the
reason Iss Dickman,   tho,._atron of tho/-hospital ^fmoes no* have norosSp
authority in hor own hands is because- she is AngloBurmes^, Mrs. A*~8
expressed the pinion that the reason the fi^aurses df not pay as much
respect and courtesy to Miss Dickman is because they pa?obabiy consider her
j as only-.Angl6-BiarmeseI §J1§
Delightful dinner at Miss Baird1s|§|aShe is on very friendly terms     «
with Dr. Huffman,  which may or may not be good,  and Br. Huff*oh^a cools
prepares Miss Bairdrs meals and her bearer goes fo»hem on &is bicycle.
She has a room iag&jbo hostel and has fixed it very hieely having fought
some furniture horself.     It is on the ground fioor and has had to have
special wire screening on the doors and windows becauiff of f|ie danger
of docoitersM In the same building there are about fdgy health visitors
whom Miss Baird teaches.    «he partitions are very thiitad their laughter
and singing were clearly audible all evening.    Later ■ tt>oy did some
Burmese dancing for us.    All are a very happy and wholosoino. lookigg,
group ofwomen^nd girls*     I had the feeling that ^^^^A
with them , that she really liked them and they ware very fond of hofljra^
Miss Baird has  two dogs,  one of which will-produc||more any day!
 ^an 22. Just back from a most delightful three day trip up country*
4-oft Rangoon via Bfcrmese airways, with aJJ the local passengers and
freight, at 8*30 |unday A.MR Our party consisted of Dr. MacPhail,
Dr.. Huff^to, loriB and Ijpp v\/e were very fortunate to get permits to go,
Local E.G.A. people cannot go up unless on business to the other E.C.AJ
team at Taunggyi, the capital of tho Shan States. Our destination
was Taunggyi.  we reached Heho airstrip after about two hours flight
and were met by the civil surgeon of Taunggyi and an armed guard of
about five soldiers who travelled in a big lorry behind us* There are
feoth insurgents and deeoiters in this area and of course it is quite
a responsibility to the Gov11 to have for&lgh pe&ple travellung abo$t.
^ho 22 mile drive wax through beautiful hilly country with all ser%of
flowering trees in blossom. 1>he most attractive aras the flamo of the
forest, and when we got J||Saunggyi itself the iprry trees were in
bloom*  It Is a fair sized town and the health facilities we Visited
|| were a 20 bed maternity home and a^lSO bed hospital* It is to the latter
1 place that 'there was a proposal to' si end'" a W.H.O. sister tutor*
The Maternity Home seems .to be run by a group of volunteer women-.
It is poorly equipped*^JSr the wards thereyare-.,oniy wooden beds,; and a
delapidated bedside cabinet beside each. ;^eAof ^ wards .is for free
patients to whom the faulty brings in fqoM fhere were 8 patients at
the time of our visit. In an adjacent building Jhere. |^^^M^|
one a very small one for class-room purposes, and the, other *frffw
5th about a  dozen beds for the student aidwives.  ttkff consists of
SfflS;2»«Wi«s, 5 .Idwives .« » *W« «s = ,tle
learned later that the l.O.A. nurse was working with \these)'«* J-jL,*.
trainees* ^trainees spend about two ^^^^^M ^e nurses
to get much accurate informationgfct seem* that tho**, like the nurses
in the hospital weSLvisIted next were the people formerly 'trained* Iqg&g
Dr* Seagreaves nnd when h&s place was IM they were brought here for
'proper' training.  Incidentally Dr. Seagreaves has returned and will
probably be--rf^s-ta^ting his work.
Our next visit was to. the hosplti^. Maximum capacity 157, now
140 patients♦ ftafj^ Matron, 6 staff nurses, 1 sister tutor (not
teaching full time) 2 .ward teachers, 12 etudents in third year and four
l:.i^S%he second yea:fc|g'; There ate none Iiiiithe first yearfjV|When asked
about this they said none had been taken because of a stated policy
by the government that all training of nurses was to be cantrallied In
Rangoon.  This policy is now being re- con side red*  The' "sister "tujbon
was one who took the course in Rangoon but who did very poorly and
Did not pass the examinations* There are no lectures given by doctors.
The civil surgeon, obviously looks on student nurses simply as people
to:|lelp him look after the patients. He says: that he and the tfcree
other doctors woulf have no ..time for teaching* aghe nurses home consists
'-.of a bamboo hut of one -large^ room and rows of beds do mi either dido..
It is definitely very cold at nights in this part and this is not very
good accommodation.  The hospital is across the road. Rather a pa or
set-up.  Absolutely^out as a jgjLace to. send a WK.O. nurse.  The sister
I tutor showedflls^^ sup^x^^p^PKIGEf. .
In the evening the l.O.A. people came to see us.. These were .Dr. j
and Mrs Hutt (the latter is a nurse and assists tha E.G.A. nurse in
some teaching) Miss Mortvedt, the nurse, and Mr, S—?—""., Health
Educator*  The latter Is-ere ally stationed in Rangoon but visits the
group here.-.-'The EGA program is tjuite extensive and in health feature^
malaria and M'.O.H* Incidentally the W*H*Q* malaria team have not been
in contact with tthe EGA malaria people* Dr. MacPhail says that is
not their fault (W.H.0.fs) as it was brought up at the co^ox^dination
meeting andJD.Allen_ ^&^ dlA^i^^iif^M^^
There does seem to have been one major oversight however on the part of
our group.  The Shan State* do not consider themselves as part of
Burma and they do seem to have some laws unto themselves. The Health
Officer in the Shan States has apparently not met our malaria team nor
had he been contacted re arrangements*      lllfll
Miss Mortvedt is trying to do something w&th the nurse isidwivea
and is teaching the five who are-.- taking the refresher course, something
about publi.b health. K.0#A.: program in M.G.H. "is to set up 10 centres
and also to; have a mobile teaia. As I understood It there would be
i
 4   .
a midwife and a lady health visitor An each centre.    Miss Mortvedt    was
therefore cehc&rned with getting some people ready fo|f;this program.
She did not know about the p.H.N* course in^angoon.    Asked about the
possibility of sending some to Bein|^:  f.CUA. has fellowships not used*
She is also working ti^pthebriurses in the,»ipltal on job definition
and on proTOdures§|'Told har about what the ^^^ group are doing on
procedures*     She is comix^|tO;: Rangoon in Feb^t^d \illl see our nurses
Hope they will work ou^omething to-gether so that various groups of
the Burmese nurses will have a part  in these procedures which are being
prepared for them.
On Monday morning we left early,  with our escor^ftahd called s^t a
very colorful-local bazaar on our way tp^he air-poTfflfe';All kinds &&
interesting fruits and vegetables.b^The Burmese diet contain&ea lot of
these along with .rice and vej^^ftttlehsweets^^yaad^,^ng wait at thaniirport
as we had been given wrong infromqtion about plane times.    While waiting
had-Sitoe delicious Burmese food served in rather ^uesmonable surroun&Ings
as faxja^T sanitation was ..^^cerned.      After 35 minutes;i®Light'arrived ,r
in Mandalay where we were met by Miss  Williasson, Mi.ss Davies.,.' Bt9 Lyan,
Medisal Superintendent--g^tthe Hospital,   and M46sJ§Daw.Tin Hlaing,   the
Matro^S    Taken to. Dr^iyan^s home for luncS|. He and 1\is wife are Ohine&e
Got^jshock when I saw the primitive bathroom facilities and realized
that these people probably think us most unreasonable when we ;^rk for
thosoptrhings which we consider as minimum for comfort.
After lunch went first to tho nurses quasars of the hospital*    ?he
girls-each have a smalleroom.' Miss Wfs serves also as a dining! -rolp|ff
and an offico«|^They have:g|$ust acquired a kerosene stove andbf|rtend to
do a little cooking. ^They have their own bearer who buys,rthelr    food
which-is  cooked and- served separatel5^p:The. remainder pt the firetyfloor
isbcrccupied by the trained staJgX^   It is for thi|fcgrou^' that anew
residence was to have /been built thus releasing this space for more
students^_J|ven by. putting 3 to  a room however, it would only provide
for ^J^ft^^o^ stairs are the students rooms and a sitting room for all
nurses.    Also the small elass-*room which will not accommodate any more
than they have at presentj^O In all,   9 being In the second 18 month
period and 11 In the first half.    Is    There are three ^tudents to a room
but there is  fairly generous  space for clothing and personal arti|||es.
We visited a few of the wards of the hospital all of which are vary
crowded and patients  in. every corridor*:»Chereffl are;||35 patients 'and ti^p
staff consists of the Matron,(rather weak and inefficient)^4 sisters^
6 staff nurses,  6 graduat^|aursoa(those in bond for two years after'lpiey
write their examination)  and the 20 students*    When Miss Williamson came
she was told by Dr^Lyan that the two most pressing problems were clean^ines
orrrather the lack of it and poor discipline.     Consequently instead of
being able i^start on midwifery aa had    been planned she set about wii|R
a will on the general sidei|| There were no  sheets and very few towels and
face ;01othes|g|t.low these are provided but I tgjke it the sheets are not
always laundered between patients*  The vermin were thiok<^PEhare has been
running water only since the last month and even now this is only to  the
door of the    maternity ward*     The labor room at the far end has none*     Ther
were three cases going on in this room when we visited*.  Babies are on tho
verandah may from their mothers.
When Miss Davies came she took over the general side but Miss Williams
still continues to do a certain amount of ward work and wants  to do this*
Miss W. now has two midwifery students.    SS^gives two leetureo a week.^|&
these and they have two medical lectures.    There should be 20 midwifery
students but the; prospects of getting them and also  the increased nursing
students do noMseem very graet at the moment.    This to be gone into
with   Mrs.  A#-S.  who does all the selection.    In addition to this Miss. W.
gives some supervision to  the midwlves in the two maternity shelters  (about
10 beds each)  and to the one clinic.    In these there are three igidwives,
two of them being lady health visitors.    One is hopeless&t-MSr" -there are
Italy si& trined mid wives in the city and Miss f«  is planning to contact
them    and arrange some type of refresher course^ #The incentive to bring
thorn in may be the DII CEP bags which apparently are Very much needed in
this countrji|^ 100 are coming t^^xrma and I beliege there has been some
simplification of Ipem. § i^i-
mU^B Davies started her first P.T.B^||lass mjan. Think there are
Only six in it an* this time they came iti a group*    Previously they came
< dLrXXj^ZUmd   Z
 n
Mrs^ A-S complainm|& me about the nurses  insisting that they coma as a
group.    The matching nurse for Mise D# has just returned from taking the
course^in Rangoon and a holiia$|f   She 1* Miss Keeley and is working with
Miss, h.   She observes^the latter giving the lectures and then helps with
the demonstrations,.    *or the next class Miss D.  plan$e|§ havo her take
ove£ mor^f the teaching|||All teaching ia in English,    fhere is apparently
thi^S^oit|^  which i^bne^^^^o^factors i^recr^itment.J^However the major
is accommodation.    T^pbj/a: werO supposed toe^a60';students,  or at least *
that was  t$xe promise wh^fthe agreement was made with W«,H.O.      here Is no
possibility that s^h will b^^roVided withinwfehe next year and probably
not within-, the next two years which'j|Kthe extent of the project.
We discussed the question-"ft;; the .additional W*H*0« nurse.    Thereof!!©
no accommodation foa^hir-ffl^' certainl^three could not share tho typ^of
bathroom fajflpitiex pro^lpid and there ff.-no olher^^jom-fflBor a bed-room. -
Even apartffom the accommodation she is no^ieeded with- the present
■ studeni^.6ad^;Miss  ^illiamson fe&|||>she can do  the midwifery and the j
supervision^ of the present staff of ladyfihealth b^s 1 tors and outside
midwives'iMs^here apparently-are -no others *|||She wants-also to  continue with
some of btlfe: -general*^^he question oi^bhe aAdition^tnurse being a ilff^-eaL
inatructowfas' ai^|ydiscussed but ruled out on  the  same basis.
Mls-s ^'avies does 3np t know how many students  are  com Ing  in April
and needstthis ffllnforma^fen for .planning*/ As far as she knows only one
application has  gone down to Raangoon*    Miss Davies  Is  a very mature
person, and goes about her work-in; an assured" and "quiet manner*    Our opinion
of.. he„r..Xrom H.:Q.   contact has,, I  think,   been  confirmed,,     Had she be en"'
here, in Raw n go on  she  could have been  pppointed  aa  the  team leader .but it.
would: have been toughrt^Jherl    whe has started a committee on procedures.
•^he Matron  is  Chairman and .in addition to  the  tw#^|f^'them ;ei^8latii-.'of-
one oisterv  the slater tutor,, an||pthree  staff nurses*ffl|^iajB^t.all.^volunt^
-eer^d*    low they are working out the basic fundamentals■ fsSfthe requisites for pro cedures .^S.Gv for temperature taking what are the basic number
of tfi^rmometers needed,    Kow considering the  same principles for macintosh
sheetir|g..^^hey are really starting at the:^indamentals*    .fiuggested'^fcat
MissjDavies have an opportunity to  come down  to Rangoon to discuss with
the girls here at some  stage..:
From W.H^G.'spoint of view this has been a costly project in Mandalay.
However the girls have Ifertainly done a good job and have laid a foundation for something.    How long it would  continue would be difficult to
sayl^vihejc certainly are at the stage now then they    need more students
to adequately justif^btheir continuanco^^g
Jan^p3..    Visited some of|^h.e ante-natal,  materni^;. and  clinical
ficill^ies in Rangoon which are visited and supervised by Miss Baird and
Miss Quaid.;^&rstwto Tower    Dane which'Is a tte&~ seventy bed or f|^|
maternity shelte^? It is staffed by midwives,  lady health visitors and
so .called..probationers.M?hese laa^HRaro just girls taken in and employed until  the mext mide^wifery class starts at the Dufferin. incidentally
I gave up yesterday irj^g;etc get figures ^tstaff,  patient liad ate.
j|t is quite obvious that there is understaffing in al^ltheae places and
that^^p^umber of patients per doctor in the clinics is far more than
can be given any adequate teaching because of time and physical facilities.
Miss Baird uses Tower Lane for teaching purposes; for the five p.h.n.
students.     They do group and individual  teaching with  the probationers
and with the patients*       In spite of the fa<^^fehat the attendants all
wear masks and that the babies are fed on schedule TowOr *ane strike*
me as being a      good show.
Uexf went to Sand with Road where an infant clinic wasppn progress*
Miss Quaid theral^This used as training field for L*H*f*s ans f.H.»*t:s
Their district is m^ch too small and the families are visited mor$h
frequently oven than every oOther day.:^This very crowded but I have no
doubt that, this and also all "the other places are much improved since
our people'came.    Again I wonder about the effe ctiveness of tha approach
however*    I felt in this place as well as at the ante-natal clinic that
we visited  in the afternoon with Miss ;Quaid^that this was a W#H.Q#
activity and that the changes made had not been developed as a reault
%£ TftTZ %#g^Mnlffig °^ the part °f *h* local WHSS^ ^gh^m.^rong
 |3g!§ - -J||        ~ ' 6.
in this but  certainly I had  the  impression  that Miss  Quaid did not give
nearly enough responsibility to  the loeal nurse in charge in showing
. us\the oliniesm^f,
Later in the afternoon we visited briefly the Har|ourt Butler
Jnstitut^ Dr.-h:Suiv|-:'^||i;^ot. in however and we will return.    Miss Baird
■'was ^laying a conference".with her students'and, a class weJs  in' session for
let he JitH^s. -   The -latter .are all  taught by the Burmese in the native
.language. ' Our people help them develop the lessons.     We;then went over
to Kiss Baird1 s which is near-by for an hour's discussio^whieh was alls
too short and is-|^ be ij^pntinued. *SH^,$<uJjn.^^
:    There has been  a new•eurripulum drattton up for the preparation of
Pul3lic health nurses*     t he coram! ttee  consisted of Dr.-  $uvi,  Dr. I Huff ton,
Dr.MacPhail,  Miss Oliaan' (E.G.A.)  and MipsUBaird  and Wid.    Learned
later from Miss, plman  that she had teak en very little/part.      -'*hJe plan is
not- to7^ain -an|fbL*H..?4^ffl any more anMthe program iiil^tftlpreparation
of P.H.N'. *,$• is  to   consist of  the. following: ,\J .   -.,
I a* j f^A"   . J 3g^onths pre-hospitai at the Harcourt Institute,
^^^Sfi       f^|,|ft mldw|^ofy athte SuffM^I    ii^Jllpi ^IPNP
r-T^ a  { j/   6 months pediatrics and general nursing     HV^   /y^^JS^^
Wal|iSi| 3 months publi^^health administration. |§§f feel
Miaoussec»y^|^pachlng responsibilities:-of Miss ,Baird and Miss  Quaid.
-It  is' quite obvious   that  there are  real difficulties. '     Miss  Quaid
carries on     as, 'at home.     She  teaches Personal Hygiene-but it was rather
difficult  to  find out exactly what  that contained.     As Miss Baird has a
course in which their own health is discttssedi|j^
[must be muefr'over-lapping- and' thet while -the one ip^heoro^jal  y#he other
is  quite practical.    Miss Bai'd also  teaches a course  she  epulis Health'
Education.,,,// ;he has brought into  this Mr* Ryerson,  Health Educator of
E.G.A.  amfi&r.  Wrightfield,     Audio-Visual Expert of E.GiA*    jftnqre is a
course on? Mental Hygiene given by a well prepared Burmese/^^^^^T^M
course oji Community Hygiene ttW given by Miss Bairetain diseusaing "
these courses one had  the feeling that M'isx Baird was doing some very
practical  teaching applied  to  the  situation here.  • Ser.partbofgthe field
work p-rbgram  is' well-planned by pre  and  poet  fionferences  with jfcW:/'v_
group afcfd apparently their;powers of observaWbn as •'^fewhat -i»|ig^^
-and wrong are very acute.    . Miss Baird wears a uniform—seer-a^oker.
ll   Mifjf^ade.ra;Oh^saysb,that ttr»'A#8#, has complained ab||ft MJkMBj^g^§^
i   appearan€^,;;^he do ea|f|p^^
Had a very nice disfl|jissIon with Doris a^ter lunch.    There certainly
■gfajave been, difficulties wS$jM\ thiaftOam whiOhb'started even before ar^vqql j
in Delhi according-to her^On arrival- there it wasr:v^ryb'hOt and ..f^fetho
first few days there were tears and protestationsrithat they could not
live in their quarters at Constitution House. fhefirst point Doris
brought tip was the need for ceefuluseleetion of personnel,   and hew |||ght
she is.    I am more than evejliimpressed with the need for our personnel
fitting intpthe cultural pattern of the country even at groat personal
sacrifice to  themselveo-^;;.Some of this team have notg^no that.    ?or
examp^fjbMr.  Af'S«  is .'.trying to. get: the Burmese :s&|sOi to wear unifona
and no jewelery.    Apparently Miss  Graham  at*..   Mi so Davies were not
wearing uniform, and were wearing rings  and bracelets on duty.    Miss   .
.  Graham stated in Delhi  that she was  in W.H.6. only for the salary.
The behavior of threebofp,thi^|.o:am  ihas been  criticized.     Miss Navies
apparenly went around with a married man while his wife was  in Englaij^l
Thi4 was probabl^liuita i*1 order but;;toJiu^'a-It was Questioned beca,use
I     of the cultural background.    They have al&. matf; a bid for Dr* Mac Phail!s
favod|| all go to him individually,   and he has not had the strength
to upoify them a^M team and appoint a spokesman for them in relation
L to  their nursing program,     *hls has  certainly not boh entirely his fault
\ and it is going to be very difficult for anyone to bring_ about much
jlunity^Muchato my surprise, Doris suggested that perhaps if Ruth Ingram
||came back she. could do  it.     I had not mentioned "her irme ^^^0.
* ^capacity. *     Shows   the  ad van ta: ge  of biding time I
4   9^> |' b   - IS       i-fflgfflki
\£*t!heck  should be made with our  finance department.     The girls  should
probably have more than: half tha ir salary -Jwat to  them at first when
fthey go out on field assignments.    It is during the first two months of
?/so  that expenses are heavy and tho installation grants are always a long
time in coming.    Also,   above all,   they must ^^^^^^S«
them from 'Geneva in Swiss Francs*    Miss Pressor did this and it was,.
 ;■
with great difficulty that she got them changed,   in spite of the fact
that we^are  told ei\t the bank -that they ate good  anywhere.    Also wHdhtw^^
regard to personnel selection,  we must give serious consideration to
more reliable methods of selection and  to  tho possibility of more
individual Interviews.    This team probably got more than its share of
problem^s bt*t there are Certainly three who are no.tf:||ally hare ,£$«!
the purpose bfgthe professional development of Burmese nurses and are
not pulling th§ir weight.
Had a very helpful interview with Dr||Allen the leader of the 3§*|||^';
I Health Mission.    He asked immediately when we. were going' to- get the. ■
nursing advisor and said this was now the most urgent need,  with which
| I heartily agreed.    Thoy have asked for a Senior Nurse but have delayed
pushing it as  they■recoghize that tt really should bo our appointmentJCl
I hope before we leave we can return to Dr.  Allen and report soma
suscess on this quest! on.|l|If not tho only hope I can see is to appoint
a spokesman for our nursing gr&up from among the present members*  and
to urge E.G. A.  to get a Senior person.    Lat er If alt out Miss Glman
on Miss    Ingram.    Reaction not so good at first but after further j
discussion af the many factors concerned she agreed that it might bo the
best move*    Serf Irst objection was that Ruth did riot have public
health and that she did not represent American nursing.     I was very
Impressed with Dr.    Allen and with Dr. L.$|j|d. whom we met there also
and who had just returned from a visit ti the W*H.O« malaria team.
Dr. Laird IS the- E.C.A* malaria man/b.ao at last local contact tftas been
4~made*     Said the W.H.O#i-malaria show was-very good an^Kthat.Dr*  Weeks
had some good training started*(lncidentally therfthave been lots of
hints about nursed on malaria teams and Doris was questioning Dr. Laird
very much about: who ^arrl^.'oui^llie health' education:^; connection
with malaria in^the^eproject.ffl^J: have, not§|§ald :a. word*     1,".shall have
my turn and  it is interesting;^ note haw much Miss lohrVs health
education work''.has bom-" praised by- Dorl^and ;-^t;-ahe. kept emp&asizing
to ujb her. lack of public health^J^l^i -"'return- to (fi;. 'Allen,  I am quite
convinced tha||g|here' can>.'bt^fce fullest c^j^er^Xon. on the local
level^fyfte* Kohn is heregnow also and he has' bo^|^:greatly impressed with
E.C#A.  personnel and work.?    Yesterday therewas a great to-do in the
paper about Burma not signing M.S*A*  To||Lay there is a little statement
to  the affeoti.'thl^^7 "the Gov|^tagdiscussing it with f^S.  representativea
*wlth a view to operating£]p&ii: said.-4^^; in Burma willput material#||
affecting this Oountry1 s^clared foreign policy.'^I feel fsorry for
the professional group of the U.S.F..H.S..  who have been drawn into
this polltical wrangle.     Thoy are certtoly most sincere ^ thoir offorts
here to do a good profossional^ob.    According to,Br* Kohn thoy have
done a great bdeal^^^the medical Allege^jgvjHave two or'^ee professors
:there.'i^E§
*{Xa^ OjljX^ juj
vd*Jx£Z
ti>
^yf^M^
<x~&
^4^W^ La*A
 1 ffan*   24»       *en* through some of- the wards- of  the Rangoon General Hospital.
Was  agreeably surprised  with  the  tldyness  aad  cleanliness.       Although
it is a 500 bed hospital  and  the  census yesterday was more than 850
it did not have  the appearance of  this much over-crowding.    Most of'their
equipment was  taken by the.5ape and  they are o&Jry gradually building it up
afeain.p They are in great need    of more but Dr* MacPhail  tells me they
misusev what  they have and naed a lot of advise along this line.
We were accompanied by    Miss Dickman  the Matron.   '"She  ii Anglo-Burmese
and obviously is rather Insecure in her position for that reason and also
professionally.     She  is not a very alert  arid   intelligent appearing
person*     Saw the P.T.S.   where  a class was   in  session  and being taught by
one of the local  tutors.    Unfortunately Dr* Huff/ton joined us  in the
middle of our tour and stuck to   the very end which rather spoiled our
opportunity for discussion    with Miss Dickman re liH^p-.. nursing relationships.   ;Mlss Dickman [did  speak of  the   clinical   supervision  which had
been  started and  seemed   to   think  it was a good procedure.     She was
definitely much moreton  the defensive  after Dr.H.   joined us.
Next went  to   V.D.  Glinic where W.H.Q. wteam  are  working.     They are just
moved  to .new quarterns  and' feava-^ua* are getting  them- prepared*     Miss
Scott seems  to  have ./very good relationships with  the  Ipcal nurses.     The
Outside  investigations  are done by untrained  workers who  are political
appointees.     However  she aays  they are beginning to  respond  to training.
The Fellowship nu.rs.fee    who  will return, in one year is tt© leave for Wash*
on Sat.    -The  team were, very upset because  the Burmese Ijroygft- have not
sent the Itelagrarail^hey^ji^a.'.'required tp  send »notif5jwf her arrival*
To be  sure   that  she  would be met  at  the  airport '"I   sent 'la cable  to  Agnes
Ghagas.   Dr,   Tucker   Is making  the plans  dtor  the  extension of  the program
and  in a month or so  the  team hope  to  go  to Mandalay.     The Tuckers have
been doing a lomof complaining about accommodation.     They saWd at first
they did' not wajj/t a house.    Now they are most dissa^tlsfiW and  complain
abou^%xp#ns.#S;^f;ifficulty'of getting food for  the baby oto^h A lot of
this   complain Ing is unreasonable. j|gra|
Lunch with Miss Baird and Miss Sawyer of Voice of America.
Interview with Dr.   Suivi,  Director of the Harcoutt Butifr Institute.
He says he who pes ./to have a public health nursing course next year but
only if he can get enough suitable recruits.   Otherwise he wi% have the
L.H^l^s coursf/oniy^ Apparently the course I outlined previously is
for^H.vfe aid not for P.H.KVs.    According!!© Drl^Suivi the bourse
for the latt^i^ould consist of the three yeaars general training, followed
by nine mont&f;ofl midwifery and nine months of ptillic hoallwfe.;.Juried to
inject the i$#a o-Mputting soma public health into  the basi^&lit^mthink
it fell on bi^renbground.    Did not get much help.;Jrom Doris $n; this'i^^ha
blunders om|-.Perhaps it is  too much to  expect an acceptance Of this
idea in thes^^oiaiitries where every minute of the student1 s fi^a is needled for seryicef^»B" any--rata it certainly shows -the need of ai^wraing
Advisor M^jB^P^^^^^^M^ all  the-time and will use eve-ftopportunity
to bring about tf^o /gradual  cl^ge.    Have a feeling that Dr.  $uivi does
too muoh 'M the :planninj|gon his own wi^out consulting nursin^^
To  tea at/$R. 'Barnabas *sa     About 30 present of which about 26 were
actually U.N.   epplo'yeed people working: here in Rangoon..    There1 were
2 Technical Assistance,   2 F.A.O.,   t aa^iOfflCEF and  t£e rest ,W.H.O.
It was decided,.;to  folrm an informal association.       he    uckers Iput the
aiipftasis on    the negative side—to air their complaints.    Dr* MacPhail
spoke up and  skid  tj&e objective should be to get to-gether to! taaow what
each agency i^fdol^g and to be better able to  co-ordinate activities
and plan formha 'ratal program.    He made several good contrlb|itions to
the diacussf|#a anrfbMr. Barnabas gave excellent leadership.    A|©ommittee
was  fdrmedl   on whi/tih each of  the agencies has  a representatives.     W.H.O.
has  two,  Dr.  MacP.j, ;and Mjss Baird. ; ,
ffli-'-.-yspffl-t;     sanefflffl.abg      '-^c^t
WanV i^^pa^ ^i^Laca to see the future accommodation.    They will ceraialy
be adequate1 and  codfortable*     1?he rooms me small  and I  ca&n fprsee a lot
of complain ing.     Especially        since  the hotel rates are going up and *
nothing hasb^imj^|pFiiii:eJ^ settled with thw GovH as to  their con^^utior*
Stippo'^edlyl^^^wi^^pot be ribre than 10. rupees||||^
 "9.
Schultz and Miss Grassmo ff the B.C.G. Team ?/ho are already housed there.
They are very happy in their work. -^oinewhat hampered in their movements
for B«G.G.  Work due t& present polltic^ftconditions.
'Forgot 1I; add  in reference to Dr.  Suivifs plans that he has a pipe-
dream of' a  central P.T.S. tor  the whole;of Rangoon   ,   or rather Burma, :1|||
be in Rangoon. , _ -Aboti^^^Ktudents. -'Plans ."tj^akep,t^^present "P«H.Ha a
students; for the  teachers*^  Pointed out the fallacy of this and  the
unwleldiness of such a acMtfj^ Bfot much',hal|&a?om ^(^^---here either who
said we would:fclke to-fflh€^^\ln  this  In provision -.of- international nurse
tutors and  she had  to  get'ideas now f or  the 1954 budget*;^ Wouldn't
dream of touching anotheg^p^bsing project here until a Nursing Advisor
hasibeen on the  spo^Ktt^o^.: time*::' wl|w yfy
Jan.   25* Met for three hours  In^$he morning with JKlss l%raham and Miss ||1
Davis.   This was I- thought a fairly good meeting and we were able to get
a number of. points, ^iBai^&k^ Miss Graham  started out by describing their
program.    At'first..tmdf^.Miss Ingram1s direction thej^fave lectures to all.
classes.    At that tlme§||here were only tw^fpurmese S*&Jjer Tutors and they
had no understudy. f||owrthere are four Burmese and they^ave taught    thejgft
^^take most of the ''lectu3?oa|^r  the. P.T.&||' The W.H.O* Curses supervise
and discuss the lectures :-fi^^hem.    Also hel^'-them withllheir lesson
plans.     Am not su^^ t^^-axe doing enough of .this and SrO perhaps
relinquishing thei^g£opon4^^pities a little.:jp>o  quuiJfcly.^^hen diseussai£
the next -sister tu|brf sffl^^f^^npried to-, bring out|afte poinvthat one
of them should bi^pie respohsil^5'-person but here met;|I stone vwall.    $in.B$i$
presented-the  ideatthat Mrs.  Mclntyre,   whomis  the  senior of thO^Burmese
grou$ and: is appar^^p5r:;very good,  might be responsible end the NW.H.O*||||
, act as hor advisorsi^M       *iMk ';<...■■
A clinical'Instruction program has been introdt^pd*    Through no apparen
-fault of ;thaWHO nurijOjk tSJTMatron was, ordere||;hby Mr^pA^.S.- to: put this
Into  effe^p immediately ^/Consequently the sister tutors themsrselves were
not prepared^^Kf:this nor we^. the ward sisters*    However it seems to
b"p smoothing out 3^jm^
Aaked about pl^ps for  the futur^     These were lifted by Miss Davis as
theeJ^Oliowing;   ||||   ' .- '^M
el.    devalopme4|EOf more adaptable student accomplishment records.
2.    clinical :f||aching ward program.
!||3.    BurmaMB^jmoya-^tti  take over    mor^fjjiasses so that they w*ll be
well Iprtftblished  in tips before WHO finished.
4. '-compi«ibi6n JK 'a comprehensi^o^rll.abus with a fairly wide content.
(  Jli discuasion of this the inclusion of public health did not
; feature.    More of this later.) jag
5. try towhe3# improve tha;^^hoja^?of nursing record^|
6. get sor^fel^rinformation on the number yijjr girls graduating,   the
number altering nursing and the numb||:- going to other professions.
Discuss^Kheir procedure committeOi^Dor^'had already discussed
this at lengt^j^^ this was no% gone intaffully. ^jtoa had the impression
that there  if not nearly enough involvement of local nursea.    *here
have been some difficulties with Miss Dickman who apparently resented tha
fact that one meeting was cancelled because some: of the sister tutors wore
ilot present*-^Sfiss Dickman is reported to have felt that since she waa
there it shox^^fiave :been continued*-^irs.  A.S. Jpld me of this also.
Anothe^lnc^leiiS which was reported l^eGov11 was that Miss Davis on meeting
bojbh Dr0 Huff ton and Miss Dickman together said g&eod-morning" and not
^Good-morning MatrOh*.     This was apparently discussed at the, Co-ordinating
meeting and aim told to me by Mrs. A*S*      Thimseems to be gel a ted to
Miss Dickman1 sbiSgii^urity as an Anglo-Burmese,    g .
When discussed inclusion of piiblic health ^et a blank in Miss Graham.
She is not convinced. osfflfct of this grew aa expression of personality
feelings ad a definit^^t^tement of the unco-operativeness of Miss Graham
and Miss Scottjilj can say most Objectlvelly tha^thasa latt^k^mm are
the only maturC^women oribthe team,  both professl^aally and socially.
Miss QTmqummaAe the statement that they have never been given a worip
of praise.   jfei^'sJBWar   _l|$ld comment on the good lob dontMvfth%|^as
asked for a^Kr-i^te^ interview.
 10.
M
w
It discussed the means by which we  could bring about some unity in
the nursing program*-1- emphasized the need for -thfc  consideration of
a program in nursing.and not the two separate parts?,  of  fsick nursing*
and public health nuts ing.     They suggested meetings  ar|d we listed a
number of things bO be brought up to-mojffrow* M^o-dky^^ I write having
watched a beautiful Rangoon sunrise and had my iom^ng tea*.).    In the
course of  the luncheon  conversation we were  able   to if eel  them out on
Miss Ingram.  I  think she would be acceptable^Mj am moke than ever
convinced that Miss Ingram is the only one^H&oan da£f||e job.    A now
person would be floored at  the outset*     Wegfed previbuslft discussed  ttee
need of a nursing leader to  which they had^gree4.     le stressed that
those here must be a united group before..she-a^m;^^'        ||||
I was  feeling quite pleased  about this "meeting until an evening
dinner  to  which! had  invited  all bthe' nurses.     I  hg^J^ien willing to
thliil:. that they were really making a reasonable professional effort and
that perhaps Doris might have  had, a little  too   strict■ moMti"'code' *     That
was shattered.    Doris  is right,     Ahere aw re three ^^|mia team whose
primary objectiveliin being im W.H.O'Var'o based on/fig^i'a,.instincts and
are not related t(pprofesslonal nursing.     They ar^^H^br a, man*     The
talk at dinner was mainly about clubs and  clothes,   and parties and boy
friends*    I hand It to Doris,   she reilly kept a conversation going
around her.     I  could not compete with  the loud piano music and**I wae^
tired*had only-had one small^tink.     For which I  shall no doubt be :p|f
considered a pride.      I have just been jg.an,j&ing at Mr. KeenyVs monthly
report for December.    ©n page 7 he listslppme very good: qualifications
for international personnel, tfjtis  statement in relation to  the frequenting
of clubs  is! partieularily applicable here*    Miss Davis and Miss Graham
belong to  three.Although only one has a colOr bar few Burmese go  to
fee others. JaJJf
At 4.  we had a meeting with Miss (fchsham and Miss  Quaidb«   It was
most uncomfortable with Miss Quaid starting out with the.flat statement
that we must be loyal to ea,ch other.     She accused Miss GflSipm of not
accepting her social invi tat ions etc.     She  is most plausible-band §Jtf0£l
difficultU^ Ml convinced that Miss. Ingram1 s ^Statements.were'^rre^^
It is. so difficult #o prove. JJjr- think:.ii^^oontra^'"should not be confirmed
beyohd the probationary y:0'ar.      Were able to^p^ng out-^hat one person
'should be responsibl|^i^fc the public health spring aspect ofgpie^
program  and Miss..Quaid verbally agreed  that  it  should.be Mism'
understand she is reported to have  said  that: she .should be .<^";-ta'am'
leader since she has hadnilven years of interna^onal experience.    I
strongly recommend that we <^%_ot;J»ka an^^^heryurses ^^^^ft^«
I.RfQ.     shey must get'rexperiehce  in  a feneralIzed program  at first.
Apparently 'there are some real difficulties with Miss Roufflaaon who also
came straigla^from I.R^&|| flllS
Doris  and... I have -prepared, our agendas  for discussion on  Saat*- with
Dr. MacPhail and- then with all the nursfes a<§ a group. Xpj   ||S£;
Doria and I: call^Rf.or. a half hour at Dr. Papanicolaou*^. T.JJf^y.-
show.    A fine one on paper|§aad statistically*     ?hera are ei^ht Burmese
nurses '.-e^MidoIng a-.specialized follow u^llrograj^a How mu^^^tter ft
these nurses  could have  taken  the p.h.n.   course and a gener4i"|tza^|t
program tyeen developejfjp-lt could have J||een done but of course this is
beyodfl trig  interest.piSpeaking of M. Pfs conversation toplcs^m am
told he&has only two;   tuberculosis and one which I cannot Writ^ enren in
this .personal diaryl hP
 ■Bf
IB     111     " lli«B
.♦26.  flp'ri* ai^jl met with Dr. MacP.fat 8|3^^Q; ha^^Ied to keep
im tovoypd in all-jp^thia and aware of our discussions with ; the' rmt^^M
ie is ag^^^lon th^pped %gjjp a nursing leader azip agrees -that Miss  I
Ingram:jfl$»ift Ibe 'a^^^aohoic^  We discussed Miss %aii and how we cou||6!
improve relatl&n^|lp%with the public health nursing giroup^Decided
that, ye prObabl^»^p:not do  anything about Mis|^uaid at the moment*:'1
We a^e agreed ths$hpfcrhaps; the best solution would b^^'fputfin a third
Q'W^gto'work .cl|&,oly with Mies Baird^^td i^g^B .'rO'spo^sible fore a good
educational. |f&^d work program with the prfbl.J^:heaitl^ursing students.
*e ^f^^^M^-4J^a'Pl^^t  A*s*lfi reactions are m' this*^^K^ftbto: do a lot
of tkpcin^^^^^'^jt^ pufppver to Doris »$b:con^
Mjp^ »*M*Q* public health ntirsihg attedents edgp
If thfiSj^^ia^fifcie-- to give some guidance to -the L*H*j^^^fe;f|&a nof| sure
that I .have   convinced her yet but I believe  the others] and    Dr. Mac^K
agree.
At Ml mM®et wit^jall the nurses.^. I 4nt#edtt«e&r      started wit|||
a bit o%gthe^tstorypO-f^)w nursing started in WHO and rotated' that to
the  sfkrftirrg »of  the Burma, teem project which has a large 'nursing aspect.
JtirophasIzed,'> our responsibilities- as nurses in  the whole WHO program.
Then' threy tije meeting- open for discussion...    It.want very will with the
auggestlcpgvj^ staff meetings for the discussion of nursing matters.
Sj ^W^f/oold'ed to ha^^^Btotating chairman ;ahd Miss lavis  is  to bob the
first c-Jnd.  call^a meeting next  Saturday.    Miss Graha^f expressed her
doubts/ that  thejc meetings would be of any valuel^^^aimOpseegthe
aontr^ibution of p.h.n. #lMiss Scott was moat helpj^.^ln the discussion.
To 7iy  surprise Doris did' not  think  the discussion j we^»well*;b'Bonf t
to^w^what she expected._   It was^eallybftary good.' -There was time left
^^'tOXffiabout s-om'OfH^^bactivitieste-. Doris was ^havje- told /about the
Sxpert;.Conimittee an^^dvisor^s meeting sti^fat tend ed tbttt she shirked thfta*J»
and {B^Q-pludedd^'t briefl^Ral .am afraid that if I had'not been hare
thlsSpeeting to  try- to, unify the group would not have %aken place and
theaS^ woul&lliave b#eh eio discus slop about W.H.O*'.a<|t:ivi\ties in general.
I would have  liked'much more  and have  thought oflots of things since
that tjfc^y should have bben told but the personnel^problems haven taken
I the  time  which should have been devoted by H.G.   and Regional people  to
policy .'matters  and planning.       We now have to get Miss Baird,  Miss
Quaid md Miss Scott together to  formally 'get them going on th*^;^h.ntg
aspHPraK ^^y have left Miss Scott out completely and have considered
her^@ily\in relation  to'aV.D.f||lJhe told Doris  that she h^fsnever been ip|
such av situation before and wans very worried fey the lack of professionalism the behavior and  the  continual gripping.    Dr.  Kimball,   who  is Mf^
grand p^rfeo^^^old her very wisely.that the onlylihing f^^^^pfco &#%as
to  show themythat  she was bigger then  they were.
Had run du with the'Belgian. PAO man and his wife.     They are a mO(|j£j|
vivacious'^tipimand it was a joy to hear the mixing|fOf the French and th$
English ag^in.      \
At  4;30%a<S k tea for^ie 1#H.Q* nurses and  their matching members.
Very;.impresse(ifflwili|fflMrs.  Maclntyre,   the senior tutor.vf^piero were 14 of us
At 7:30 went to dinner at Mrs.  A*Sfs.-bPresent in addition *o
Doris and I was MraSreen,  wife of Dr.  Green ISA orthopedic surgeon
at the Medical College;   a Mr. Miller who  turned out to be the manager
of Nestled here, ^bachelor,   and a frightful boroJ^Another Britis»^|
who  spoke Burmese  fluently  and lives up near Mandalay.    Had a nice
Burmese dinner—which J do not fing as palatable as Chinese food*
 Ipl 12#
Jan.  27^     Sunday.|jib Shwe »agofeagoda with Miss Scott,   a,it.  withihom
she,works ,and the Dr's mt|her wh^Ms an ardent Buddist.f; Tery intereafing
but  a .-very strange faith.^Complelily individualisti^e^id-/everything
seems to be done by thpindividual to gain'-morl^- I^poms a bit out
of place to  spiall the gold and precious fetones  in theae pagodas when
there are so many||oor and money i^m much needed! to rebuild  the country.
And the millions being poured in from .outsid||p |||§
Lunch at Dr.Huffton^^^A delicious W^^^^^^£m^^^^^^
discussion with Rev^Huffton who  1b Principal of a^ge boy*s  schoo^P
Have 1100.     Teach English from thekfeeginnihg although ii$«he Gov't
school^^K'is not aow sta**ted until  the *5thNhStandard.^r.  H.   s&ys there
■-isgincro-aaing.recognition^illf the.need ftf:.English andj|hat there is a
movement  to   start  l^the-'^p^gatandarA*; §P^P!
Quich swim with Miss Seott before going to ;t^^^rst birthday?^^»^
for 'Valerie Jean  Tuvker at  the Strand. ^^^^fe
Dinner ihr'the|» witfc^^e- T.B* :Teaja^/Bioob^Oplo#-'  Dr. Pjjglj'   '
has: recently been to HongKong and has brought soma»3T tlie most gorgeous
brocades and  ivory .carving.    Hot very-lmpr^l^^^^ththim.
^sn^  28.§;^ent to  see the EGA Aung San Myo Demonstration Health Centre
beyondgjCnseii^ and about 15 miles outaide  the  cityy^^Are building a more
or; less'--model Health Centre' hand are. planning to am-corporate t.ho;:a'-
surrounding villageajl; "Wi^ serve about 5000 pef^e.    Miss Gltohiphe
nurse in charge,  has Jhree lady^^althevisittf^^ Going to  take the
student p.h.n* ^"for fielfffwork in  another montKw   This whole^jjbntre
is being set up f^'.'thje^|urpose of providing .supervised field worls:
train ing f or all  categories of public health and related workersj||Other
stated objectives  are   wto demonstrate proven and established health
practices not yet universally accepted  In Burma and yet known to be
capable of  contributing irjaterlally  to  the health and welfare of the
citizens of Burma**,  and,'"■* t<r^pr#yide an opportunity for experimentation
and research in  the field pf public health practices,   selecting problems fsmm Ithe many areas o^ public he all-in which satisfactory preventive
?rocedurea have not been      developed or in which significant improvement
s an ever present possibility."
Mr. •■ Carl ay,  Environmental Sanitatieii|gis  the' senior member .of pm.
team and most-kindly; showed us aroung and gave -t|j| a lot of his-tome.
So "did SCSj'Reirsc^i  Heai:lp^dueatioiiS^     ^hey aafe handicapped at present
duetto lack of matching p^^onnel^^The^k are n^satching Drs*: fofe^le
two EGA men. Mr.  Carle^f|£s m$j&b anxlous.A^k-deve^|w.thQ...'moat practical
and 'ecoho'rgicp;-ways of^ making the village'a more, healthful" place In .
which %o live.    Ppi; examp^fjie abbwed ua^^^tle prinking ^cups fflaw.,of
bamboo gwhieh theyffiope tho'--cbild3r^;.wlllpbe abl^to make themaelMa and
which will-repM^ce, the'h^ommon drinking cup In  school^"^hey havo^xper-
imented witht he making of a bamboo  crib for babies'-.-',sp that the mothers
will be encouragedgnotj-^bhave the baby besidp|ii^em oi^he floor as they
sleep.    Mr.gRierson hasga very practical approa^Bo;.Health Education.-
(See program outline attached)      The personnel hire hopehthaflj.* wAjH|?|
national^lnternationar,   and private health,   and; bocial programs apon so rod
by the government shoIp.d consider establishing: arid co~#jrdinating
their projects at the Centre.11   "J4-  think we have made a stepgyoward a
better co-ordination: in^^ Por some reason thi^pas lagged and
Miss 01 ton has nofSbeen brought In-to meetIngs/,latelyM; Miss Bairft--
plans tog:g#tbtogethei|;ifflth her.    Doris and 1 ar^ meeting the p.h.n.'a-
to-morrow-and' will makehjlef inite Jlans for thlsl^K
We discussed evaluation--they are planning: a^ourf-day working
conference very soon t#^consider what they had when theyi started,  what
progress they have ma4^. and how their objectives. shouM^^:re-defined in
th^pight of experienci^^ibdate. p|;§ ^^^
Entertaining Mrs. , A.S.,  Miss Dickman,   and Matron Molly fof  the
Dufferin for- dinneriSjCook some time off thlsbaft'^rnod'n' ^fp1 little '
personal shopping^ Beautiful lacquer wori^and-*many jpvely precious
stoaei.    Burma is apparently famous for its rallies bt£t I di^ ^ot indulge*
 13.
Jan.29.     To Dufferin Hospital  at 9 A.M.     Shown  every bed  in  it by the
Matron,   Sitter M^liyi     208 beds,   325 patients.     Staff insists of the
Matron,   who   took midwifeery in. England  in .1925 and has been  In  this
position ever , since;; a sister tutor who  is  supposedly full  time but for
She last  two months  she has been  the||ister in  charge of the Infectious
section,   (she retumedfrom -W^Lg aMttor1^ coursB in Sagland three
months  ago);   6 nursing sisteip  24  trained nUrsesr   (these and  the nursing
sisters are all  trained midwives and nurses;   the trained nutses  are
filling their compulsory two yars)}  and 145  students. -There are  two  away
now on British Council fellowships  In England*    At least one of them is
taking her C.iJ.B.     Ulster M0lly was not sure what  the other one was doing.
Supposedly when  they return     they  are  to  assist with'^le  teaching.
At present  the  edueational program  is nihl.     The students are taken
|Sft directly from scho^ft^and other*
have had anything up to  three months-as   *probationers*  at Tower Lane.(see
previous notes)  For th* first three months  they get one hour*s lecture a
day on  general nursing.     %hihs  apparently is  given  In   the  ewenlng-anf in
the day  time  they ate an  the wards,   some of  them even having as  their
first introdution service  in  the, labour room*     Sister Mwlly said that
some who  were  coming directly from High School were leaving.     Shouldthi^k
the reasons  would be obvious|ff'After this first three months  they are
given  two medical lectures per week.     To til.: 1 ec.tures—100 hours,     The
regular course |s 18 months,   for graduate nurses vit.1,6; 6 monthsl^phis  six
months  is  taken'witi^jhe last six months group of  thefllegular course*
When these people finish they usually take  the L.H.V*   course.
I did not see bfhi Director of the K0spital who  is -supposedly
against foreign personnel. Dr.  Green Arm it age who had been here under £ he
auspices of  the British    Council for  the last  ten days, has been doing
a series of gjm.   operations and one was  going on* in  the 0.H. Doris
apparently already had  a meeting with Bister Myliy,   the Director,   and
Mrs.-  A.S.   and  she  said  that  the director does not  want an  international
sister  tutor.     Said   that  with 'the-present one  and   the   two   who  are
returning; "Trcem England  they  could manage.     There  is no doubt but  that
some assistance  is needed but  there  is no point in forcing someone on
them*     And I am  still of the opinion  that nothing should be done t^S^y
to  persuade  them until  we have  a nursing  aadvisor.     The midwifery  aspect*
are neglected^   and; should be  strengthened by a preliminary course in
general nursing and an organized midwifery  course.     Discussed the  inclusion
of some  experience  in domiciliary midwifery with Sister Molly "bjrt she waa
mmare interested  in I having some advice on how to prevent linen losses*
This: was given I
At  2; 30 we went for our appointment with Mrs*  A4S. but slue had been
call ed to  t he Prime Minister on very  short notice* .  Hope  the one now
scheduled for 11  to-morrow comes off.
Met with.the p.H*Kfs  at  tea-time and discussed their getting together, to discuss   theuP*H*M*g aspect^of  the program.     They  are keen  to
do  this and responsibility for the  co-ordination has been given to
Miss Baird.     They will' soon bring in Miss jjflt®®*^ (E.C*A.}   and .'will., also
Include the B.G.G* nurses.     I urged  two  things;     *hat 'theyg consider t
p.h.n'g- only as a part :of  the  total nursing plan,   and  that  they not
forget  that what they decided in  their meetings waa not to be  considered
as  the plan  for Burma,- the Burmese nurses must be brought  In  fo^^li^^
Met Bliss Graham for private  interview at _ 6130.     Imagine my
surprise when her request was to know ihj* possibilits^r'g^hging to
another project at the  end of a yearpere^.,1 gave her to'mid erst and
that  this  would not be-an  acceptable request from the organisation1 s
point of view*     In discussion  it  caiae out  that  she readily does not like
nursing,   she likes 'office work';     Therefore she  Is -definitely. a "poor
selection  for a tf.H.O* nursing position.     I wonder  If    -we had our
applicants  write  in  a narrative  state merit  if this  situation  would have
been discovered before recruitment.     Her reason for wanting/a change is
that Rangoon  Is> so dull ./and  there are no 'social outlets.    Later' we had
a group dinner  and  I  was  sitting beside Mrs.  Msslegaard,   the young
Norwegian wife of  the leader of   the B.G.G*   Team.     **he Hares jhe re at
hotel  and I  askjed her how she put  in her day.     i:he time- flies, for:,ftw
She writes lettjers,  reads,  saws, knits, does her own washing.!   A,%,
 14.
Of being able to make an individual  adjustment*
Jan.   30*|pFust before doing the above I watched from  the balcony a most
beautiful sunrise.    And I wish I could describe the many varieties of
interesting costumes worn by the people as they passed by on the street'
below^Many of them seemed to be hurrying to get some milk or other
provisions  in their little tin cana#   some fat Burmese in Western costume
with their  tennis racquets,  women and men in loungyivs,   very poor
in ragSj  Indians  In their native dress.
Went with Miss Baird tf foodliffe mobile clinic*     fhli-is not a mobile
clinic in the true W^kse -of^ie word.    "ghe. equipment fie taken out once
a week and a general  clin^Jis set up in a basha hut1     Dr.  Huffton and
Miss Baird go  and one lady healfh visitor*      There f^ a voluntary group
of theiocal people who^Jaelp.    ^he community consists of 6-800 basha
huts housing up to  2000 people,  many of whom are f^fugees from the
insurgent areas.    All are labourera and there are many cottage Indus tafias.     The leader of the voluntary group is a man w$||f apparently has
some private means and apparently has a genuine interest in the welfare
of the people.     *hay have regular meetings and they even have a M*C«H*
committer*    ?hay are' planning to hlpjLd a permanent clinic.   "Shis is a
real  'grass roots.<^pproach: and,l| would hazard a -gums that it will
outlast the E.G.A* project we saw the other day#jpl    went around the -
village and observe* the cleanly swept mud str*fto♦    Every so often thara
was a pump around which there would be a group iff 'adults and children
having their bati&doing their washing and abllecting their water.
They are a very clean people and  throughout the c44fey outskirts of the
city one observes this public bathlghg goi^; oni^^the children are
usually naked and  the mother pours dippers of water over  them,    -fhe
adults are very clev^jl in bathing themselves hinga wet loungyi and then
changing to a dry one.    Went In to  two..or thrii^^homes^^^e bas^ha, hut
homes may have dirt flo^ffs or they may be bui|p;:up on stilts and have
wooddBn floors^^lhere may be one or two .chairs but usually^Kae people
squat on a    mat and eat from a lowiiable.    They also sleep on a mat
stretched out on the floor.    Went to  the |chool^iich is;one great
open-air^pom and had over- 200 children.     *hay were having their ...opening
prayers ^nd alSpjrere reciting in unison with thJlr palms together in
front, of.their face* Toot loti^f plctj^os*    Pongyis everywhere with
their bagging $#ts.
M|ji   ?h;^^lffera.realbp^ssibilitles for field work and H^ssg^aird Is-"
very ■kej^S^on developing it but|||t must be done slowljftjf   Mrs.  A*S.  in
her characteristic fashion had just sent jou^§-word  that it was to" be
developjed:.;for domiciliary midwifery*z$jj^^^
At  2:30 met with   ^rs.   A..S.     A Nursing Advisor  as  such  Is njt acceptable.
On reading,: the  project write-up I  could understand  tha  t.      rhey  feel  that
they cten gjet on. very well with the. planning themselves  and': that they
do not\zivm need a National Advisor until  they have produced about
8,   0®6| nurses which-they- now have on paper as  their need.     A nursing
leader to.)co-ordinate  the WHO nursing team and help us do  the most for
Burma,'recieved attention and a note was made when Miss  Ingram's name
was m/entibned.       Mrs.   A.S.  promised  to discuss  this  and  let us know.
Before bringing FP the question of a Nursing Advisor or a leader wens*
ironilim^d: we msked about  the third p.h.n.   te replace Miss Hohr.     fhe
question ! of accommodation was mentioned  as  a difficulty but it was-
agreed ttfiat  this nurse was needed and  should  come.     I  suggested  that we
would not~k;send her" until-we had Mrs.A.8* s answe^^ega.rding the leader
as  it wojuld make  it  easier on all  sides  If they  could  co^ie  to-gether or
if the leader, could  come a little ahead. ^^M
lent  in/ the  afteanoon   to   try  to   see   the Minister  and his  **ec±e;tary.
All  in /Weetings  so  could only, leave: cards. |ip
Br.  Huffton   palled  to   say good-bye.     *>he  says she thinks  that the  idaa of
a leader and:Miss Ingram will be acceptable.    Mrs.  A.S.  has already
told  thd Minister that -they do not want a Uursing Advisor and  therefore
she  cannot Inverse her decision.
Saw DrfiAlljisii and  told him of out  suggestions.     He w£ll hold off bringing
Miss Gardiner,!-if hex can,  until the decision: is made^n  case  it woui*
spoiia'bup crfanices of having a/, loader appointed.-' ||p
aflfeHfeirnort at 8:20    P.M.     Stopped; twice on (read by police.    /
 15.
HEW DELHI
«*an.  31*J§Arrived at 5 A.M.    Met by Marjoiie Hudson, Kancy BoasJ§l
and Oorrine Eriksson.    Had leis for us.    Came to the Ambassador Bfctel
■ and af tori-an attempt at: rest went down t^preakfai^^^^hiere forud
Dr.  S In cl air-Lout it who- Is just in from Cairo.    H#^^ a narrow escape
In lai^gSaturday^loo-ting: and bumiiig^^ alX
his baggagffilneluding his.Passport andjma Laisse2^Passer^;Tho way
hd fi^m^f- -g$t out., of the country was'lttigfet a -|§ilt .from the British.
. Counsafe-which^s sometlmea feIven to 'drunken British aailora to get them
out ofl^the country.. ^fef
Met; the-off iol^taf^l^and spend the da^g§n observing what goes on.
• Dori# gets; lo^^^f..-interruptions.-"■-'! havek,%e. feelin^phat things- are
looked, at qiffibkly an^-.ation taken without |^^^thought..a ■ She spent-..
somMtime with Mis&;|||ray and Miss Withers;^p^&ut going over a lot of
administrative thinga^hich I am sure have i^been don|pp,t H*Qtf  and whi^h
theye have in theii^pagf rules anyway. :'^^»:-:ll;ttla':'-itg^the professional
aspects touched 5^^^Mr.4ipundarham ■ hieui^st3|d ntheym that as they were
on af one var contract they woul^be entitl^^^^ home leave at :thl|tbnd of
"the &ear^i^ extended*i|p went in on this conference
Inland was able togiorrect Mr.Sundarham in hiKihterpretation*    Had remembere 1
lithe oxperienca^p.th Miss Massey.     Why was; MiaKiWitherspoon only given
[la one year^lln^rac^i maybe we should be morm careftjSvln checking efcfais
K# lip;    :M&M    ii
Hadb*§ brla^Mhat with Dr. Mettrop*     s&tM $a ia^new^persoj^tt^ce
■heac^effl:^2f^p^h|^pelhi p^goot is under discission ^cjwi|§ Talk -d$S
fnO:tacoi3^piuing -Wcause the Gov't have not metf |||air^^llgations. -. -Also
the Soiyege of Nursing haiQ^thelr own field work areafe-I wonder
originally iftwhawxtent Miss.eCraig was drawn into: the making of the
plana'ffl^^r this project^I get: the impression from tl^plffice that
Point-^Snd.the-Colombo, arc hovering around like vultures; waiting :f^|
WHO tb;fflJ^'ap->-6-ut s^fthat:e^iey can swoop in. gj&aw Miss. Davis.    She o-aaems
to ha-^^been-tpushed^ around a;||pit -but is no^^omplaining.'^Bhe may n<|labe
a very for^ef^S^person bti^J liked her attitude tojjthe, situation.
J3ab3-1 / TQ-o££4«e
Feb* 1.    Made offical  contacts with Indian group so  could see the
projects and facilllgpa. in India.  Went first^to ligg Banchandani who
is  the liason officer for India with W.H.O.    He  took ujjl-to-meet Dr.  Raja,
Dr.  tishwanathan,  one of the Deputies,   and Dr. Pandl^MKoticed Br.
Warner's office next door to Dr.  Ranchandani.^in conversation the
lack of space was mentioned and the fact that one of Dr*\ R&nchandanl1 s
;jp*^ Dr.  Warner. ^^$1
Th^gwent through Old Delhi ^ meet Dr.   (Col) Bha&kat Byran,
'Director-of Medical  SeS^LceSffl-:for Deip.. Bi^a.: somewhat" difficult and
I gather that relationships with WHO personnel have not always been too
goo^d. yp
Appointment with DrfMcWheeney to discuss the disposal of Miss Eriksso*
Patna seemagthebbnly possible assignment^ Suggested Doris write to
H.Q.  explaining the situation so  th^Miss Harris might be warned that
when she-.a3M^es here, she will be asked  to -gteo BankokWffl Discussed
briefing with 3>r. MacWheeney|p;The administrative aspecta seem to be the
ones which loom iargos»t in their minds hero and presumably this is
based on difficulties  they have had.     Shgg^sted that each person have
a slip setting out clearly the salary,  pension,  what entitled to by
the Govft,p4^ diem,lite*    The per diem item could only be completed by
the Region s|nce &j*Q« would not have that information.    Suggest that
such a slip be prepared ^ partly completed at H.Q.,   aAgthe rest be
completed at flegioh* Ssff
With Miss Hudson to the Pounder's 8ay of the Mew Delhi School of
Social Wotk.    Met some  interesting people.    Miss Moses gave the Amnual
Report and this was;followed By a apeech by Mrs. Bowles,  wife of tha
America Ambassador. #n befcalf of the U.S.Gov't she presented 300 boots
to  the achooli^ftiis is very much a* American school*|» to have dinner
with Deborah Pentz on M0nday sd will learn more about h$w they have
adapted for the I-dian  scene* .   ; J       -m  k.,/^
Dinner with Hiss Gray who was entertaining Mr.  and Mrs. Br*t«Wi^
 - .   %       li.
leb.2.     With Nancy Boase   to   Irwin Hospital.     Through a misunderstanding'
the Matron was no^previously warned of my visitj| Doris feels this to
be serious and just anoth$||straw to make suclpcon tacts more difficult in
the-future!    Miss Aleard is theMatroj^b%er^p|f''on:e full time Sister
Tutor who last^|ar^ok a,course' In -Administration in Kew Zealand.    Don1!
think she was ve^^su^cessfui.;fi#-s    ^ie hospital has 355 beds and over
400 'fati-ent^p:^ome of tha child ten have been moved ^tde^l- new pediatric
unit which haK been very well equipped by UNICEF.     %me        o^^Khe
equipment is still  stored^ thai isolation cubicle as it mu^tA^ on display
ffjgRrs until the.building is #|£fl.ciallj* opene<|gly KeruS^e^^r^^32u
patients  in the new unit and 40 in the old ward.    The staff^onelsts of
one sister,   2 staff nursea^fe' students from. ™^Jrwih ahj^V^-College .'^;|
Eyrsing;;students.   The latter come fromJ|gj&o liKly and a^Knot therebfor
several;:.months'after Marct||b A'Siste:i|^ them from the
College*  . She  just completed her course lasti|par and h^^^ai. no- real
experience herself^ Miss Toy has worked with her and w§|fch the two groups
of students^;There have:-been-three;differ-&nt;^ she
has been here*    She: sayil|f§hei.College: girls ar^^fery pr^pdted but that,
there -I-s:hOh-doubt but tha^thej^iave a batt'^Bpbieoret^^l background*'
Becauff^pf:-.the difference ^background she hasg||0' take ||§he two'^Wwya
or students separately for;teaching.    Another^aiff;^Sisia^pB com Jl^ back fron
;af:C0ur:^K|^ Englandbin ga;pon,^^:r ..so.    She w ilSj|/taki||fecharge of^^R. whole
xmitg-:a^-l^';^tha;-t time -^^^: expected J&at the t^p;,floor will be '\mf^^
making abed;eapaeity*-|||: 92.Jp|!here is a small medlcaSlb.P.B*  attached.
Maney says the ward sisters have very l|||^le-^J^
are responsible-A for'^l equipment,  linen,   etc^^and have ]»|flpke up many
losses;*M'Consequentl5^^^^^of their time ia  spent In checking and other
minor'administrative details, which sh^^g^S:done liy someone els&|||liancy
p^Leavlng in March.     She wants  to ;^ae bac^Jand work par^timogoaga volunteer basis. ^She woulcf^p^o be willing to ..teach^^iotherg^pf^Ilgraduate^pedlat-
?l|l^^urse. on-thfei basi|||if asked.1     Sh|iJ^^Khever hadf| matching member*
So tbubt WHO here would want her replaced o$ a full timf|ca|pacity however
on acoou&t of all the MICEf equipment kthe use of whi^Jfcneads  in many
cases;to be taught and wupervised.    However apparently thO^S^lombo Plan
have gb£en asked to  supply two nurses-^^p;th4i-;hoppital*   (This was later
confirmed by ..D^p^arner*v.}o|^^parently-;this request was.; made by Miss
Adranvala without any conifi.tation with WHO as  it was apparently a
'surprise-to all \eoncBmt%ii& a feek. or so- ago^-t^' can't
understand this lack o-^Oo-ordinscil.onS  h ~zM:
To  sum up, p would say t^^;-Man:cy has mad||§ja good}^>ntribution here,
'throug^ier1 teacjilag,he^|art- in the planning, f<a|^the ne%^i,^kid
her supervision and Ins^^ctionf^p, the use Of unfamiliar equipment.:^Her
eontributio^S^uld h^^been mucho'more|^fe;^^ptand -laipilng.^gshe had
had-"a matching; nurse who ;would carry onk|^^pinstructIon^She heraelf
foels^^at perha^Bfh^ffl-hasbbeen able' togchange aotaeiattJMdas ^i^fj||
regariSo pedlatrio^rsing,   thait the a|^al techn;g§ues w$ll; be ^tiokly
forgotton when  they go on:||^pbher- 'ser^^s- -where ^0^Mz§kno auupervision.
Already in. the'^il^ward mmy^ilngs are allowed wh||j| she .pre^^aly had
'the girls -'-trained ;|j|;- do iothf^iw-.. ;
Lunch at ;the^Glubbwlth Dorl^pJisses, ^^^^^^^^^^^^^^^^^^^B
and Mancy. '^fi'^m
Shamp<|||and finger wave ..at the hotel ^^^^^^^^fl^^^^l no*^*^P:f
to ^Srma and dinner wi^ftthe girlagaiS|;-;MissfflHeafy.
Discovered' Dr.  Warner, is-- hail^^^^o me ao .introduced myself^ Obtained
some useful information, Jpoluding t||p confirmation of th^Mjqueat for
two nurses/jfor --.the Irwlnifrom the Colombo Plan.    Point |};^^galso requesting;
four nurses for India#:M91^e will be the Senior and|fwill wor% with Miss
Sdranvala, on the public health aspects.    Dr.  Warner sayajpiat Miss A.
j^^^^p_'^^ra|i  s|m von earned withththw nursing wducatlon tjMt sh^has no
■time fo2^^fep.h.intg aspects.in r||ation to the village;^feogram^:^bis
&use id^^^p^^l^^^^^^^^ work'^^lthe other^hree i^aes !^^h;;^ which
will "^fflplaced l^^^pe of the tjbaee village programs beiiyj imdei^^Jiin by
Pointw*^   hfeia teelm ii^wachbpro;|^t Willi consist of a docto^sanjftary
engineer, I health leducator and a nurse* ;
 m
i^^^^^^^^1^^^^^^^^1®^^^^^ s3hia,3r» h. ocix- gen oral concern about imposing ma thoda
of tr:^^l^^pco^^^ter' »un tries  into. this, situttion^. She feels that the
type °lfflBp^lnS Sivtef^gthaiCollege is neaded gbutwi^iot the answer to
the immoi&ade problems JpShe also agrees that they need^^^ contemplated
post graduate public heali^ursing cdurs'^^(:itf^Ld en tally 'she said that
•°Mfi§f the'%&.-nu£sM'':haE^ Whe^does this'put'
Misa Davis^^fShe feel^ghat fifths village-level|^ma simple training
should be giyen tot the village worker who  can squat down with the mother
and do-^ppe simple teaching I^^^^^^^^^^^^^^^S^^^^K^^^^^|| didactic
te aching ^#Warg||he primary :*mit,  which; would consist of'lffirae or more
villagea^fither^^hould be a ^ady Health Visitor*     She would supervise the
^^Llage.;. workers.^HgPoif this reason she feels support; whit^fthOy are asking
£^|r t^L.H^^^^I^Ustifiad)    ?or the    Secondary ttai.t^plch wiir,h|^|
several :primai^:^fit'S,   {according to  the Bhore Report which has beeif||g!
adopted by the Planning Gommlssion and which is being used as the basis for
planning)    there should be the publlKhealthbnurse^
Tho3^i^as been a co-ordinating committee formed and just as soon as
Dr. Man!  ig^vailatolap there will be another meeJ^ftg.     This should help.
Don't l^owfc^whatp extent nursing can-be represented but will investigate.
Am of ^lertain mihd'^^atQp^p. push^jj&'or not howeve|§||tJ don^tthink Doris
is going to be guidei by any nursingi||blicy other ^an her ownt
Haiqi&ust be^ngreading the. J?eb.'  issue,-. of^M^^dii;.Nursing Journal,
lias an excailenj^ffi^torial«Seems.'to. me there-i^^^.; be a group here one
^uldg^ally . work witl|^ j Warn^^^alao gets | Isolated requests
for ^ptdividuala*w Such as a Prifessor of physiology to fill a post that^i
has been vacant |^^^^^^^^^|^^^^^^^^^^^^^^^^^^P^^^^p^^^i^^^^^^^^^^^P service reqikets
and||^y are, hot supported by any..'plan.  ;,;S^i^;does, not want to  flll.atham;'any
more.;;than we-do,   at least froK-Ji.^^S^ft^^^the same situation as  the
request fori|gpediabfc gKeardgDoris say that
this plaj^lS^ould be written up next week and sen^for signature I
Ingfifeiat ion  to   the bri e f ing of Miss Gray ?&.& Miss .Wi.ther spoon,. I  think
I the s e last" "tvo  days  have  been  a_ complete  wa.ste.     They  are  thoroughly  sick
of 'reading" and   say  they -cannot  take   In 'another  thing,       There has been no  .
professional ftursing di|ipussions whatever, b Miss Witherspoon has no ^talked
wi^lDR.Mettrbp;. te^^^^^^^^^^l^^^^^^^^^l^^^^^^^^^ft    -iyen thougf||l
bha. does not know-thaf|&tails of^ie Thaila^^f.altuation as yet hejfc has been
lonp|enough is WO as an MGH Advisor to gi^^ some general principles.
Feb*3.    Discussion with Mr.  Fales  who has been a WHO  consultant in vital
statistics ipllthis Region for the past 6 mont|$§.    He also  is impressed with
the need.af^pproper plaajfmg,  going slowly^ |u^
village work.. c:Ba. -says' 1 Itt^Kbut,thinks a l^^Mf's 6°tog to Geneva to-mOgro.i
so this goes with him*
Raining to-day and acc^tlng to -;Dr.' Tytle^|there- will-be afe^onth j
of cold weather*    Jfr*J^ on many-of the
points ?i^fbur discussion which appear to me to* be iSndamehtalJ^^j5fiie  spaefcallj^
||§jproach again*.
 18.     ,
'Feb.   4tt§|||   Appointment with Dr. I Mani wi%^porIs*g   Very pleasant and
welcomed me  to, the Region.    Discussed Burma.    Mot favorably disposed
&o Ingram returning there but it wwill be mK.  if they request.
Meeting with Dgf Veenbas   (P.H.Advisor Wit has Burma on his list)
Dr. Mettrop and;"aorta re Burma.    Dr.  Mettr^^had a long document from
Burma requ.estinig toore personnel and  supplies^?,Want equipment    for
about 80., or mofe Maternal  and; child herllth cWtrei^B. %^preparatIon
of midwlvesb^sgos^ntial for this.-   Decided ^HflEibthing would be done
^^Sut this fcd^^ihfc* next Exec.''Board of IMICEFh&nd  that Ipr-. Mettrop
would 'visit Burma soon.     If he  $an work out  the .situation  with  the
Mediea]||Supt«,of  the-puffer in ..then we will|§eed £0  assist" in'-.the t
midwifery   training.     At  least  one midwifery  tutor.     Dr.   Veenbas  a little.
|^n|^K^K^i^^^f9 scattering of personnel although he gives lip$ service
to  the other1principle.     I  think he  is good  and "will have  some, talks
with hi|a.      ;%:SaBpP f
Lunch wi-mMr.  Brouland  in his hutment which he has redecorated
very ^^ely'^^A%so afelunch Doris,  Miss :.ErIkssoi^Mr.  White,   and
Mr.  Leg^||l§ ' li||ra-]Keg^d 'to Miss Eriksson the decision to  ask her to
accept Pi|§l&. was^-^adegon friday morning*     She was  asked  to  cosfe over to
see Dori^ljfesterday Sd sat in her office for several Jhburs and was
flnallyi-5iKed ;t|^X^t^^^^fcmorrow at'9 A.M*    Ko-tbvery good for someone
who has, b.ad an mxiet^%tatexto  be put off like  this and kept wponder-
ing whfflKlher: diipc^&tlon  is  to, be.
St^ff meeting gjfi|the aftestnoon to |p&ar DR.Pales repot.    Unfortunately
It is:||$4t difficiS^^o'undiestand- him because of his ^enunciation.    He
was giving a course  and I  wonder how much the  foreign  students really
understood of s^fe.t he& had  tp  say.     following Dr..  Mani. gave a very  inter-*
esting report jojf  the  meetings, in  Geneva^ He  told .of the meeting with; ■
Df.   Slnaik%id  t||0 new type, of survey recommended b^hlm.    He agreed with
jj*§pA need f(^te|^ffi^i but could hj^^fttiite see how the one man could develop
th^pl^ now the responsibility of the Region.
Did not g'e%  th^'attitiidai^^t Dr.^ani  that Point  4 and Colombo Plan
are waiting to; ts^e over-from WHO as  I had gathered from someone else.
Going to Wve/WHO  Representative  in  each  country.     Then he  said that
this wouldgm©;ke thfe positions of  two of the Jlree P.H.Advisors  in    the
Regional CNffi.ce superfluousj^hey would have toaelbe placed in one country.
I  think thi>»as  the. firstnlndieation of the change  that they had had
judging,^fethe l£ok on  th^facesw^DR^Veenbas, and Dr.   Williams.   Told
also ofyth^^^eting wl^;th^olloy Board:J||eedgfor loyalty and  acceptance
Of the V|^|'eiea agreediipon by^^^majority?:^en  though they might nog
be ones^^rson^lly Ii)K^^ementl^^^^^Saving^of # 30p,0OO:.hlast year.
Must  avoid   tnis year and  all  asked  to  give  an  early, estimate  of
anticipated  savings/^ph£s sho|i|^ be an ofportunitit^for nursing to.
work,-ia'p  something really  worth-while  as  there will  be  a-lot of  savings
in Mil nursing bqdgeirfojr this  country.  Asked to  sort out projects  into
certains' and dd]yibtfu^^S: Re health. edueators|| Dr. .Man^L said Ted had
asked'him about^rs^^^lly and  ^^ffi^^^^P^^^^^^^P^I^^^fe^^^ is
not developing J»^Pa' ^^ieipateA^^mp^and they will !*$# want her.    Said
he was *rio.t susceptible, tb-'h^alt^pduaiktlors'but'he was impressed with
Mrs.  Kelly and h|J|hought- she:had-?^%ost;practical approach.-  Did not
':saoi^w;'he coii^^^eft health educator sittin4^pun<ff in  the Regional
Officii^ ^ouldj^kused  In ,f§rai|j|Possibly will ..explore
placing her thdre on Ae budget ling for the; entomologist.     This; Is
probably the aiea*- way U^gty, can get him to see the value of Health
Educatioi|f§y U^fortuii£teiy ^if^Bickman lSfflnot:fprthering the  caus%B.
TransportrcoMm'forjwfc»~to  the hotel every morning.    Dr.  Tytlar is also
picked up 'J^^&ie] jblame; forl^rdering the transport seems  to bOj plaiced on
poor lm^^ week for it.     I'lfnP a
nice walk's^yLde^ld'ei^It wpuld be better An have my morning constitutional for more'^4a)s94s  thin on^^^^jfa. return to|uferai,   if a. Health Ed^   is
placed ther|^hj^.Twa might well consider the  second nurse.    Doris is
quite determined  tjhat  there will be one %nd wil^want to  transfer
Miss Heafy :Mj're  If Hew D^eihl folds up.    Must g|j*o Terai before 'I -
make any s-tdf&ment'on  the/matter.
a::Wfflt|W:b'fflk:; 'ZyZZz
Dinncjftwith Miss !p*&*z.and Miss Craig |R Dr. Youl^rokainen also, there
for the^^Slaut had toffl lfflfeate earlyjjl After dinner discussed the needs of
 PH 19.
India for village workersf^Sfay are qult||^phviheed that the type of
people thdy are each turn Ing -but now |^^^^^ft^^fe?l^fi^^^^^| going
^M^Ye tt^immedlate pr|§lems.    O^^She Docial Work^mde Missa^ents-
fee^.that the village worker shutld pfc trained  in community organisation
in ag:i^ftiltur5f^^n nut^tionft;:Could no^puite get Miss Craig to!i^|ma:
doMtrthe needs, on the health side.     Said we would have the dais for
a longtime and that wehshould gi^^-them: some  trainiftj^;.   Then toldI
about the presenlfL.H.¥rs*   apparently thayspi not do      anything for the
patient,  just aag^&ov $hey arel^prt ^|^^iing.     fhinks this is the
attitude given|ite them      in thgp£ trailing.     Sitedgpj&veral Inetanees
|^p|provebher.'pap3tt*:   She and Miss Adra^tvala have discussed at'length the
preparation bf an assistant type who would be giv^pkboi^ nine months
in basicgand home nursing,   and ii^hia perio^;they w&]4 be taught haw
to meet the needs of the family for^rsing jggg& accojpling to  tha disease
|||^f*dit^^ wouifd' have midwifel^^ppublic health
would be in|^rated^^&gho^| and t^|:.cou1^^^oul^^two years.    IhSse
ggfpLong with th¥ dais would be the ^^fi^lge workerf||§
.     Mfss Craig obviouily t|Ss^fe%^^^^A^^^^a neither does
Miss;; Pentz..^fw. have ^imtl from, a remark' dropped^th^pMiss- Craig did
not know, Mifi^avis was gfming.     Wi^gget-ttiShe pettom of all this
if. po a sibling    Miss- Craig  li probably a'^rong minded and difficult
person to hork wl^;.howevo]^f
m^5^^■>ady«Saading Health School  in the A.M.    Shown around by
Miss Korah-thi^upervisor and Met D»(Mr^&agal - Who%%sked that her
regarda »givefi to Miss Pohek.^School ■-hs^^batudents,   which is  the
present .capacity,   and ,th|j|are adalt^gii two' tii^^»year.-i^urse is
18 months*;;  Se*> admission standardsb.ahd^agulsti^^^^*^d.  The students
come from algover India but they do hot encourage phem from Stated which -h-
have their :own , Health Schoo^"" This' Schoolasupport^bbyv^ie- Rod Cross
::^^^pi*y:sO^^I-t is axpa^wppat^g will be t^en^^ri|^bihe Gov^^i)
I There  are  plans  underfoot  through UNICIF and WHO  aid  to double  the
capaclty^^^is'S;.Kor^^statafi(^bat th^*"wan^^KrevJp^Qhe syllabus to
include basic nursing and midwifery and . to  integrate  the public health
throughout.      the bourse wouldb^p.11 be  three years.--allonf t know if this
is the same, tiling MIss^jMaig was .talking about•ef5ft^:;currlctiixim  committee
consisted of Eiss Adranvala,  Miss Korah, Miss Heal {R.F*) Miss 'Norseman,..'
-and Si^Pandli^ Doria.a|lld m.e--$ater.k^iat .this curriculum has beta piann|||l|
for a long time but nothing ever done about i«&. The clinic facilities
are good bu^tt wcimldgs&em that they are not |pted to makimum eapacity§||^
Apparently only two  full  clinics a week are held.     The plans for teaching
seem very good and thaa^udents;.racieve goof superv^ion'|prom Mis'S-aKorah
and her two 'assistants^-'^ie twotJ^ve not hadgplf special''training^ Mis^
Korah #s an fid International! andg-!^a^i9^so: haft-a course in Public Health
Nursing Administration at  Toronto.     Thought I detected the Toronto  system
of record'kfiling but apparentiy^^Kas beenuJ^Bse-for some time.    Doris
blames,it on Dr. Orkney! ' The-area coveredi^rs.;the'-^iniipa^ for home
visiting contains  around  24,     000 people but  tnis. can  only be a guess.
Miss-Korah says  they are  able  to- visit all  the  Infants once a month.     Says
they gOf all  birth registrations  and  all   are  wupposed  to  be registered, j
Says  also  that they get 60$ ofl#*e prenatalsjg'Would doubt *hi0t«|
4hese students have field work at Hajafgarh for one month*    They have
two dais at  the Health School   to  whom   they give  training for oneyeax.
These dais are  supposed to do  the deliveries on  the district and the Health
Visitor supervise.     This might be one way in which shfe is given tne
attitude referred to by Miss Oraeig.     The emphasis at the school does  seem
to be pretty much on  the  telling side/
Lunch with Dr. Youlio.,  Dr. Mettrop and Doris.
Brief discussion iifefeternoon aboutffeojeet planning but did not get far.
Have mapped .out our Itinerary which Is pretty full but per^ps by Jeing
with her out of the Office there will be more opportunity to discuss.
TV*  at 5 with Kiss Davis  and Dr.  Davidos followed by drinks it the
5l!tt5op»-   at SoMtitStion House.    Brought Doris back to  the hotel for
dinner. >..
 20.
Peb.6.     Spent all day at the office^^^tarted out with a more or less
general discussion with 5oris regarding kinds of nursing programs,  'Ifhis
arose; out of the; proposed visit^p.;Lubli an a.    It .seems: that this isjlp
mission hospital partly subsidizedeby the Gov1t.    There is also  a
Health School ther.e4j»3Doris seems very uncertain, a^^^f^hether or not
there is ^urseb^^charge in. this  state*; .niShe says Miss Adranvala has
said that this projact is justified.    When I questioned it Doris
naturally saked what«fwould propose*Jl|tWhen I motioned; courses for
sister tutors the H.Q. pa-3^|p|f n^-giving intrnal fellowships'was
-^rciug^pj^^-   Pointed out that thoy had alread^broken;;:ftaat policy and
'that I thou||ht -that-.the.J^
that it b#|changed-.-^p;hid. jthe most;pressing:'.|0^d and 'M[ is foolish ||^§
thinlsa only jin terms ofiiendlng these pe^L;av;abroad*.-    Only, a selected
few should go abroad.     This  is the policy Di^^ Wafflrno^ is working on
and there are plenty of Eoint 4 funds  tc^war^intem^P'Fellowships
to  course^ffeponsered by the Gov*:|| with WHO assistance through personnel£f:b
Doris is qt|ite set on    this project and  it seems to be the bast policy
for'us to ^i^pnd see*-1^^atha^be; lortunately -'I a^^l:have an opportunity
to  talk with Miss Adran^la f&r&t.
Had'ajfH*ry nice ffldl:a^^ision with D^p^^teiWhO:^p-:the. P.H.Advisor
for'lBd*.a and. Afghan Is tan «|||Asked him hcfche taught; we  could '||n|p||
Atho^bestsSsistancebto  Indla.He sa4ldf;tha:i^p*st:-priority ;is forg«urses
for existilig teachers.g^-om these selection for study^ abroad might
latiS^beaBiad-e. Nextain-:Importance is^jpefresher'fj§§burses for those
nursejaealfeady trained-B^ help. lmprov|||the .servl^. and.the clinlest!
f.Idld  fb^phe presentbspftdents.  '.He feels  thej|| needs  to be a nursing
aide group trained. ^Emphasized the need for the integratioiQ^^ub^^i|a-
^§alth*. I mentioned  the Calcutta. and;^mbay project neither oi whl||lf:
eontaiiaaa p*h.n*- among tho;p.ers.onn^^^ae; said-that-he had stressed r^L^'S
need 'and indieate|||that if we real^t. b^psve. in.-this we should see th^f
provision is mad^^^;it &n ^ogpro:jec1^;Suggested -that one of tha~f|j|
team have public health|tin  addition  to her othar|^pecifio qualification.
this is something to watch for ln:!|p&l fee tion..     low It    Is for    ma to gc^S
Dr.   Tul/1 in on discussions with Do1^>    I have-a feeling that the p.h.
advisors ^re not brought into  the nursing plans early enough.    Dr.  Tull
has at least, given lip-service: .approT^gto.kptl^^blicys we have been
"trying to', put ovel^M
Dr.Mettrop gave me the Jan.  Report for Lahore  to readJ|LSeems to be a
worth whUe project andgpne of gthe secrets of ;.st^feess-^a mo doubt the
Coordination Committee.      Dr.  Mettrop thinks  t^fra should be provision
for this  in everyaplan pfg^perationa^ He Is of ^jhe opinion that the
first plan should be rather general:and  that the  specifia aspects
should be developed by the  team leader on tha^pot' an^fD'eforalthe project
actually s.tartl||j| ^^
Selectio&liS Committed in.; the af terh^pf*-' - Dr..--Chellop^; the'Chairman.
Personnel Offlc<||&and othei^^iffleers depending on t^gapositions 'for
B^which selections are to be made.  San seetheneed.:foi^eferences-;ba.lng
^obtained bofore candidate brought up t^ Selections Committee.  Think
^y Jg that fromst^* we should."o^ain references;'On^pfeicandldatas who look
as though they might be suitable before tt he hlrstory is sent to the
Region*     References which I know we..have sent..wer^^pi.^attaohad^ja the
file.     This would .prevent referOno^ being de4a,ched~and filed elsewhere.
Suggest e$jj&p th^ jg^pthls Region we should make some specific recommends,
ations,   espe^^ leadership^lpsitions.. .
Dr^^l.i thinks''leader-, should go  ln^p|fr 8 weeks before the rest of
the team, pa nopgp^sure lathis length of time is mo^^deslrable^'.but
there should at le^tpt be a short period.
Dinner atsKotah H0use with Doris  and the WHO group there.    After went ,p||
the T$5r'eMfJat the/Imperial where Prof and Mrs. Lividas* were having
dinner^^^felebraite th«(^lrthday of their grown mp daughter inGreece.
Ho musi$JI.Had been cancelled due to  the death of King George|p; Special
evening; edition of tha 4$bper put out and Gov*t offices closed to ©morrow.
WHO not;closing which seems a little strange.  Each UN; agency hastily
phoningbto  see what the other was going to do.      ^^-^
 21
^cS^^^^^^^I^^J^^^f^^^li to be fairly, well satisfied with
the projectT Ee was pleased, witj^hetipart of the midwifery, school.    Por
3#-&~ 1^-places theytpad 35 applicants. h-2'; Were daughters of   thm Prime
Minister and naturally they were accepted and this has had a makked
Influence on the "co-op er^^^n which is being given in regard to any
requests.^gChey want.'t^piclude ..the domiciliary aspec^:-in the trailing •--■
and to develop this they are requesting a district midwifes-She must also
h^^publ i c h e al th. \.- :©iscuHe3T the" ziead "for .'a nursing- l^y^^r-of - this   3H
group.      Did^not think he agreed mt first but    in the-|lnd J||F did.     Said
he thought the hutsing instructor would be thai{^gic^ person.     Tha    idaa
&/meetings for discussion is a hard point to get overph Dr.j^Tuli seemed
w hesitate when! said the nursing leader would neaf£ to have meetings
with all the nutsen-^^^Sdordinate all  the nursing aspects but that this
did not- meangthey would not also: be  tespoi^!^g^^^p&a doctor In charge'
of the particular speeialft||a^ ■
Personnel :goin||§to Afghan I step should be madog&fullji '^aretpr the difficult
living conditions  so that they will be mentally prep^ed^pilhay should
als^reallzie the need for complete;.team-work :to&:'' the ..haredt:^p.:make
adjiisitments^^They should;^ake. with them plenty ofi^^lpiing for both
vwarm and cold weather,   cosme^as,  linen,  and some dutlery.
Peb.7.fc^o Majafgarh wittfir.  Warner and" Dr.Metl^B'  ' Mat. Dr^liu^at *
the    Rest House.    During the brief discuasibn there it was obv^jus why
this project has been- nowbeen more  successful^ As Dr.  Warnersald when
we left,   ®The most disturbing thinfe Is the    mental attitude.*1 'Sl^^^B
insecure aadprobably realizes* herown short^mingfebult will not^dmlt.
Takes a negativeB^tti&ude  to suggestions.    Has ^t'ma0 any tffo:^^^S
have.} Health- ©l^iftttees^^--to bring ^^^ l^pl^
Was impressed wit^khe  area possibilities,    g^^^ew Wlmarf unit buif||bg
which will -sj|^^
latter has been lar^py limited to nursing groups.    ?He ^llege of
Kursing have their own separata project In Ghawla.^^feage and are very
muchao^er-supervis^i^'Wi^;be vld&iting Miss^eafy ntjxt week so wll|§g|
give more complete'd^ails later.    S^^^fe^SW^h discu|js|p pos^Ml||p#s..'
-Of i^^l^i#S4|^^ti^fe^^ Is vary, ent^aiastiob^nd^ is very ol&vio^p
that- she wants, to pring Pofirt 4 in$k. th#^^turo4^^pf the way homo she '
suggested: that she -3^^CM'ettrop,a:ahd: I- me4te^^^rmai|% next week to
discuss furthe^^^Dr.Me?i^p|h'hesitant.eat; f^stikli^lfflnally agreed .
The need for a Health Educator and Sanltar^hgine^^^te;thafflteam is
obvious.-:^^^uld:be a shame forWBQ; to draw o^y^^^Mig^area.but .^phink
they might well,'give Ujf|ihe l^pttta dabblatf||Ln D^p||fitself *    Dr.:.p^pends
-three days a week in Delhi andbonl^pl. at tMajafgarh.a^pie lattei^iiglij^
well be expanded into;a Heal||| Demonstration project.,
: Feb.B8/    With l^^^^^^^^^^^^tt iMpital -O.P*l^n A.lM Starting
on De«r.4 thei.Cfeliege"of nursing students havt^^PD experienced In the
second year they      are to have two weeks in medicine and aurgory concurrently with their ward experience whi^th^felso reclevo! at thlfts hospital*
And-in the third ywar thj^ffi^eviev|^wo: weeks aexperi en oogan tha gjm OPD.
.his latter has been given forTJ|p^
supervision frpmSth^ 3-4QC^itients dally..
There is one staff nurse whifRftas unt^gL recentlllpNen rotated every month|tl
With Miss Davis  there is as matching^^prse^?)  a Miss ,S$ushilk from  the
College of Kursing.     She is lfp3W &**d is & graduate
of Vellore.     She does not seem toJ||effective but nona.;of them are as
agressive as they should be to feet the job worses IflT-be done,done.
Perhaps it is better that they^e a^fchey are.    Miss Davis has apparently
mdde many ggod changes in the clihi^g^g ^hebassigns tha students their
duties and encouragesp:^^; to takewresponsIbility*|^^
students in their evaluation of the experienoa have said they like the
OPD because they are allowed to do things on their owiUgipfoere are also
student dressers and compounders tj^ffclss Dayiis is arranging to have soma
Classes with them and will use this opp&rtunity for tha  students to
have some teaching experience*^pecause of the |irowds a»the OPD there
is little opportunity for the students do^ much individual teaching*
Miss Davis tries to stimulate their interest^* the  social aspects of
the bases.    Twice a week she holds a confera^^Jwith them oh soma
special conditionsJf|The students;have to discuss some of their^^^
cases.
 Thisseems to hav||peen a worth-while contribution but:||0 not think it
justifies the conMnuance og a WHO nurse full time much tpnger.    I*  the
afternoons    Miss Davis attends microbiology lectures twice a week and
then arranges certainlpield worrap' On the    other afternoons apart from
attending a symposium with tha  students^|he just fills  in time*    She
is not satisfied herself and wants ^Jp*ank criticism of her work and
relationships if there is anything which seems t#|be not satisfactory
from Miss Craig's point of viewwJj^T repeat. again afha^^like her attitude
and think that if she were permitted to  shejlpsould    ftke a good    contribution to tha educational program*
Met Miss Faria the Matron|§  Very officious.     Hospital has about
200 beds*    Has a staff of 6 sisters and 24 Jstaff in addi^on to herself*
They obviously weldome the students for the service th^^Kjgive.     The
students come from 7  to 1 ao^their 'supervisors'- come i|^^Bthem from the
cdllege ^^fflln this hospital they have their axparienqii^^^padlclne, c/ H^*
suggery and Q.R«JtpThe hospital does not1 have :a'Scho^^pf =J||j| own."'.
Each, ward has  28-30^atientaand has 2 staff nurses {m^^ia^derllea.
To office In Afternoon.    Sat opposite Doris for^awhilai^Can^eSeem to
get down to  any constructive work or discussion with h^3^f The^hing she
wants me to do  Is to go oy^gthe planops fdr 'the' pediatric nWTm^^n
Madras,   the draft of whi oh she has not yet'done, '-'^ would ga-^m-in^ o||§|
it myself'except that I-do no t think it i||§the kind of ^|roj;^W:thaf :we
wan^Wd-^S^uld-'like f| hav*. a dtsoussibn:''|wlth Miss'Adranvali^irst.
bDis-cussions^lwaya'bget .offb.onbtangents-;|^^'appreciate .9p^#;fs personal
quailtiesv~fehais very friendly and Is agood mixer In a grop#*    Her
greatest weakness from the office administr^^fe^anglji is lack of
planning of her work*<||pt coulg|pj| donen3^ppl^|bf. the many tnteji^pp-
plpLons. . «. . pHS Jlt> ■
p Had a chat with Dr.  Williams who  is thfet-^p^Advis^ for Ceylon
J and Thailand.    A weaklingflgj J|p ©S^^^l
We were supposed to go^o afflJf&rlety Show atthe College of lursing
to-hlght.    All official functions ware cancelled but -this - was:#t. .'.
Doris was-very mucMftpposed ,to..-g;oin^^thoU^ibfelt we shoulf go on
account of Miss G#§ig.    I do hope /that in not going i^hhave no^pade
a tactical error|||.I am  suragt^XIng woul^ not^ava;«ndedf
Miss Briksson is changing her mihd every other day.    Am goi^gx
to try to pwrsuade ther to go direotly home and see Pr* Gundry for
referral to a psychiatrist. llllll
Mr. Biekam is still he«..H© has been sitting in the library
reading a book called ♦'Human Fertility• I bSPifcr having seen the great
need for a Health Educator at lajafgarh I would certainly put him to
work if I were the Regional Director®-' Mr.. Bickmaj^Si joining    Margorie
Hudson and I to go  to the Taj Mahal to-morrow.    Another man with-Point 4
is aXso coming.    .S^pl'I    &m -gbin^fe-may get ,a better perspective on
/things  .
Feb.9-10^^A very nice trip.    Mr.Rohauser the second man—from Denver
.where, he is  a civil engineesff; Has .comesovei^pre/^ work withbth^p
Ind ^engineers anigfeo : advise them onpdam.:c?^^tr^ction -projeoti^p:There
is no  expend involved with the Indian .Government rndflft IstIndian mdney
which is tojgib^ EGA and Point 4
have It-over WHO.    Ev^&though^it may .not ;-l|§ithe wisest poliOy in th||§j
end  countries ate not going to. request advice when  they can get it
elsewhere for nothing.    Something more will have  to be dohe regarding
the providing-, of .accommodation problem. i#^f;
We reached Agra about ll and booked in at the Imperial Hotel*  Very
comfortable*     Before lunch visited Akbar^B^omb and after -wes^ptb.
Fet*hpur SikrI whichls the abandoned village built by Akbar and Shahjahn*
Palaces  and other buildings    of marble  and red sandstoha*   :A beautiful
marble tomb  to  the priest whom Ajgbar consulted becauseha had bo  son*
Obvioully he later had oheJ    Saved the Taj   "to  see by i^oon-light. &)na
certainly should se^it for the first time  them.  It hasha magical quality
and Is very bbaufIfulv    It;is lovely in the daytime also bu/Kam afraid
I  tended "tl^pgard it moHp^as-ganothar-marble building constructed wit||j|
great difficutty by many thousands of miserable workers whence money It
cost aouldjhave been so mufeh more usefully employed*    Also visited the
Port at Ag^are More marble ^iraisand stone.    On the way |»me wa tried to'-
 23e
J^^^a-pnew Sindt|»mple "^^^^^^s^^aad-'.t^pbe very i^^resting.    We
were misdirected and found ourselbes  in aur big Plymouth car going down the
narrow bazaar street of Mutra. Wlgm wsual crowds milling about and it*.j§§|
seeme^^K^^s'V*llat: §11 '-woui^ba'^uite impossible;^, avoid killing a througfp
unl^Sk^our driva^ppsre m^^^fereful^^i'ttle dil^^hops on either aida-«i
^plple lying-sleeping .^yered with dirt^blanke^atOg keep offthe Swarms
^W||fiLies^:sacred cows,-   -taigas,   food to  eat being ma^piln; the strai^^I-As
M.r-^&.ha'jiaer'said; it was-'^imathlng one Could nofpdescrlbe in a:-letl|fer and-'
it would not be believed anyway*^    Af tar aboi^|. a milm'of this we turned
'aro\mdBmd.-rdtrace%^^r steps without ,f inding:^ie tempia^^All this
sertainly giveshone food for thought*     The other day at Majafgarh Br. Hpf
in a    most discouraged voice said,   ^But we'll not get that for 100 years."1
I  am sure it will  tak^fsiore .-than 100 years  to.'get wha||: we think whould
f^pp.a modest ,publi|ghealth development for the vast majority of thepeople
of  this- country. r^(^^^^e so-poor a^^tningrj?^ At:Sne same time MI^t||
Hudson tells me  that th^mismanagamei^-of government officials has Iffiot
f|^|v'do with poor dis^^.tmj^h. .bTl^felied Gross had to obustruct a special
building as  a storehouse1!^; food which was..Jaii^^|i'r freifgt by the
American Red Gross to helpgl^the fai^ie..^reat- .stacks of it "are'stil^uln
s  torsge.
One-Incident—onf|§|r way out on Sat morning we .came across a big ■ ca^paijmost
8^feimousine  type,  whld%|||as ijpbtingh4lferIg|jp<angles  to  the road and extended
■:Jpii*f way across.    AiJptraffic was |§§Ing around *b;||§ur driver said that it■;
was his car;and stopped,  ^here was  a flat tire anlf^ther damage to  the
$§§!' which had apparent!^ been hit.     Two men were asleep inside and crawled
||§tet»    Last night when we returned^|fi|i^^ was s|jp(^   in v|he same posi^bn
and one man was  asleep inside.    Supposedly the second||§ad gone for help
1^111 ch will no doubife be^long in a few day»f#|
Feb.11*     To Rajafgarh. Miss Korah came  in the  car with me..^To  a soptol
where, tfw%^^^.dren were^aving .K^'ia Banc Ing aa^und' in  the dust of the yai^^:
Did  some special son^s andf|&anca^^ medlcals.^^Two Jffetudent  '
health visitors and tho^isupervis^^^^^.  Walked ■tix^^j0. the "town of
^B|af garhfflahd ■ saw. an o^fflhealt^3ent3^; which* will beb^andoned when the
-new .-building Is.complet^J^^Met ipe staff, Heal^^ very nice
persox&ffland whobls |^^tf^fip^^^^|^^^^S boohi a matching -nuts a but...
she does notlptike  to  take  the resppnsibili^^:aiad pripf.ers a district of
hdr own.   Visited many homes of tti$jpRweeper.!class and ^her classes  in
Majafgarh and twb|g&ther;vlilagea.k^Syen  th^^brest h^pf^ad bads,   some
bed^LOthing,   clothes andSBlli^a suPPl|#^Sffaking Tj^fnsi^|«'    Definitely
more tha^bhe Egyptiang#$llahJ Hearly all had m^^^^&I^Ft these were
usually swept clean and^he rooms were tidal    Went to bne where there
was  anjpvday old baby^;:^K% HeaMffWisitor was preparing to;|bathe t^j|:|
bab^te-b'JSad a simple but adequate eS.et-^||g|
^K^^f^a afternoon vlsit^gChawla Centre which is jthe centre where'l^^
College/^^pBurslng Studen||;are locatadjg^^r s^|^uden^ they have  there
three fu5B^tlme'-sup^plsors*^^^-addltion ail^is  centr^^here is- tha
Healthe'i^^bataff public-health nurse*    Nq^laci^phethe world can students
be so ov^^ps^pervisei^^^^s^st do not get enough^ppo4|anIty to;:^|things
-onfj^iheiplpwn. -  Mls^Phillips statac|^hat ow|^^.f ten. home visits at least
five wouldabasupervlsecil^^hej^iave^wo months here towards  the end of
the fourth ye&r aifl|- af t^r^^pis;:3^ral  experience Jj|ll j have  two^onths  in
.an urban .bentj^pAiare th)(^M^re apparently equally over-supervisa^,   The
girist^re very alett qom^ given by
Delhi''and willtt^ierefo'f^have  to work  in Delh^pif twi||rears after graduating.       Went frombthe ;centr^|lo.ba^.an Exhibit -fcu,t oj\ byMhe Board:i||rb|
Eduaatloh*     The-: nurse^^^aski^^p|;have a part;^et^*"^hib^andp^el^g
was  t^.onlyapar"P^cf^t?|^;'.a few rath^uninteresting ^rioula^al
poste^ written iky%ngl^i^kyihiQh few of the vj^lagershould understand.
Inder Miss Heafy1s.dir^dtion the student Heal thiolsitors had prepared a
setkf|| for- agpbme (confln4men^:diet during pregnancy*  tl^^by's diet,
the baby's bath,   and £Mldrenfs toys.    These they ?#ere explaining to a
crowd of interested^^ctktors as Inn an musloi^ared fort|^^^;;the loud
speaker'ofethe van abo|ft'2;0 yards distant*, ^^^^m    '
To  tea at the, Healjfh ?isitj?rs house-^pr^ab building on the founds of  the
Health Geh-tra., MIsa Kbralh^he supervisor who 1^ graduate from Vellore
and five-stude^^^fj^w yi^acious;^d- veryglnteres^d  in their work.
This .country'.certainly has? some gobl^^^^rl^;; to woj^with*
Rill. lff        '^~ ' ...'      x. a b  A^kWS?
 24.
It seems  to. me-that Miss.Hoafy-has done a good job.   ' She Is well
liked by the  staff with whom she workd and  itjto&s  quite  evident as we
walked  through the villages  thai^shs is well know to  the people and liked.
The didficul&y has been  that she has not had a matching nurse.    Had there
been one her position would not have to be continued in the .project iWfher a
are many of these girl^^whom,  had|^ey been working with, her for a f awb.
months,  would have been ljuite capable o£g|arrying-on.  As it Is now she
is really  in  the position    of admjfeatrating and supervising the public
health nursing and midwifery prog^^^^p;:the district.,  and-'no-one is .trained -
, Z to .. tak e o ve r f •  I ■' tlilll
Had a long talk with her at Itijrich about her own  future  in WHO*    East
fSept.  she applied for study leave ^i she has been more or less  counting
Won t|||   Has not been able  to  get any satisfaction out of the  Regional
\l[ Office    however.   Recall  that afeQU^«4a®t    we .suggested, grom R.%.   th<ct
although she .was not an  a five year  contract  that  a test  case be.'mdde
of hers,   but apparently they have not made, any such  attempt.   She had a
letter from Dr.   Ghellopah dated Jan. 31st to Jfjg^ifteot that they did a
.not know if  tl^ey wouldffiaable t^l|lenue her contract,which expires  the
&\e*yLi?J^ ©j^^^r-possibility that the !project might not be
.ybq^ijn^ definitely'by the  end of *eb*J||§|
Miss Heafy wajnts to  go^ome-3|he end of April:;.a^|-she,--w^ants very much to ■-
spend six mon|^p taking refpasher courses and observation work in both
public healtjfcr and  midwifery.     She  would be willing to, do  this on her own
but her brother has been  very ill and  In  a nursina     home and she has. had
to  meet  a  considerable   amount  of   these   casts.   She  feels  also   that she
cannot go ethxjough another summer at Sfajafgarh.     The 'j^RS/t Is  terrific and
affects'.BwH»inus.    li'M^ very hot.,--there is no fai^^B;the rest house.
where sJ^i-tal^s 04^-'«p-.nightsgoutg'of seven,no- rui^ffixg water,   only a
bore l^^fe^-qrine outslda^;She :'l^^rery an^iousj^^^fe^ M.t£&1RiP  and  if the
project7weri;jcontin^ t#come backSp Haja^garh in Oct. a
'for an^har^par*^ M±ssj Heafy has  i^p?t.;;of consideration ;Mfe 1b her in this.
She .h^^ce^pted j these-i^f fi^gLt: - conditioha. -and^^^^^^e^pary sincere in
her efforts'to do  a ggod jobij" Sl^o^eels very^eenlfc-&#/Sack of a. matching
member because  If  ther||l|i^ would have been
able  to  carry on.     I  suggested  that  three years  was not really a vary
long time f|r a project especia!3^|wtien as much spade work had to be done,
and  thai^g^pDuld not be so, good  to make  anothe^aehange  ingthe WHO nursing
^EtaffMre8pe;bia.lly If Dr.T.   is  to le.,avej||gaShe has. had. little or no profession.
r^jp. guidance*     I  gather  that Doris  has-been, out twice but  always _with
VI sites!* eg'^a^ S|^f^p^Sw|^
Feb«12./g  Spient A.M.  with Miss  Hudson.     "Home  visiting  in Old Delhi with
•Miss Hudson [arid a male Health-Visitor who had been tin his present position
for 9 y|irs.^:A specialfkz^ T.B* He^^gH-sltors 8ourse of eight months,
^his  oMirsfi'has recentl^^^pan revise||;and the ^oltege of Nursing is now
glving-S^p; Students spmd four m'C^^^pin the clinic: -z
ImpossiblMyto j$ffi|^^ through the
bazaar areriv and down through narrow winding corridors to, the living
quarters oj^arious TB cas.es* Fir^^gd last^vigjts, wer|ito  the. homes of|||
■ the cobbArsi^These s*im^toe-b'e: on^^^|^sW^*?iey live ax^work as agg-
communit*^  Each has onre separate roosji for living quart^a.p.but In each
there mrdy be fr\>m any^ere^%5uthrJ8ue.;^^:seven children;a<|a|ell as adults.
*he first ,plaeevpsas nit so  bad but     tfye last was  the' ifpra ^^i Delhi,   so
I  wa$:/ told.     Thef f il th was~ indescribable.     W#men mixing great piles of  cow
dung jus^ylnsitfO^tl^fflienfer^^P^ bull^^.,.ln the bot*ar,  i^hildran| in rags
and diafty#fli^B|gi*B a^/thd-restf^/Sese poor peoplewh& make Sshoes by
piece work cle^^^piJLy abbi^t 4 annas .J36 cents)-on ea#h paii\of shoes.
They..have n$> almf^ anSethi#MaS:w ^biggest problem
upermost  in  their minds/ when- the H.V. [wanted  them  to  go  in- for X*$ay.
.Promised t^^kr to do  fcomij^hiag abo.u^^plif .they ^otf^^^^^me.M^ie case
had gone to '^i^ylllafMend'afeui died^ few days prevlouslyffg they do  this
j frequentl*^ap^arently^afera afraid th%t If they stayBfl tho ct&y that they
'■**&!■-diez such terrible conditions they are very
friendlyri^pm senswSi^s^^sthey- crowd arounf ::yN^fhere is;:^obfealing
of hostili^^pnd th^y are iery receptie to  teaching;.    After mofirst shock
is over |i|^ encouraged to g^^^pith ^ie work.
The second; Visit w*|s to ,a*Akaef  an 18 year old wife of a 40 year old tonga
drivejE^^P^e. was s*tt:tng c$/her charpoy wither yeqr Old babyBsieeping
beside her.,    ^he ims  a far-fedvanced  case and was doing a lot ofv^ughing.     a^.
^l£lh^^-./^h4r a :1^tter home.     It  was   clean, band  consisted    of one room W^
 ,25*
with an .open porch "of iabout the same side.     In -a corner of this porch there
! Kas' .what 1. thought .should ,be a bpre^holef^dtrine.'^p#^wa,s; apt,   simply two
- a eats" - wi th , only the -floor'underneath.    The sweeper woman,   tha lowest of
Lthe upL-touchables would-. come and clean away the night soil.. Besides the case
and her baby'-and husbejid,   there v*as her mother^; father and slater in this
|hOfflQ...Some   Instructions  for  isolation     were given   and' a form tas l|tft  to
bfe;'complete<I' for aarfils-slon   to.hospital.   -This   they would getySO-meone who.
cbuid wrlMli^ if they could not find anyone'the H.V.
I would do it Wthe..next visit. The H.V. had no sputum cup to give the -:
patient. "(Use cigarette-tins.) -It is beneath his dignity to carry such,
but Miss"Hudson   is'trying  to  get him  to  always   carry one.     The other day
(she"had'about foifr do sen  that she was taking somewhere*  /ttiey were in two
bundles*     She picked yp one had asked him to  take the oJ(her.  Only after
a lot of persuasion and her example would Jfc do  it.     With.regard  to
possibility for admission,   it takes at least 18 months' at the end of which
time most are dead, as this giriyill be.     %ere are two and a half million
known casedj&fytB iMlndia,  12,000 San beds,  and SOQfGOO knSwn deaths per
yearfrom TBi^pvery Minute of the day one person is dying fmmn H in
India.11 was- their  slogan  for a campaign last year*     At the foot od one
flight of staijrs we climbed theda was a greatjeap' of garbage, b The. families
upstairs haft thrown It; down.    Hoi One will  take any responsibility .'to see
that it is  cleared away.     Saw both adults  and children voiding, and
defecating Ih/the narrow gutter'of the alley-way.     Saw one of  the best
dairies te  th4 town-license^! by the Health Dep1t.    .Consisted of a -little
out-door sho$, .really-a shelf,   on which squatted the'dairyman behind a
gmeat coppef-fbowl of boiled milk.    People came with their containers to
buy.g They bpil  their mill- ao. uracil that -all  the nutrients are destroyed
as well as//$W, germs||| The germs get in again in the containers J
Miss Hudspiv goes with the H.-7. fs and students "about twice a week on their
home vis^imMBhe understands enough of the language to get the sense of
what the people are saying and what the H.V.  is trying to teach.     She says
the H.V. ml a list ofyeig^ftpoints that thoy try to get over.    Unless
she watc^|JjKay -will-dci| all  thi*/on  the first visit and the people become
■■hostile/Ve^ipse it seems so  impractical.     She is  tryingpo get the H.Y.fS
to do ,better teaching. ff^fy
Wentbaclr  to  theT.B.Centre where Dr.  Sickend  ia the Director end project
leader.    He, is an Indian-and very good.    He refused to be  the matching'
member to  '?hy international so  this  team never had' an international
leader igj /the usual way* , -Miaee who are there  ,   the nurs4,   epidemiologist,
X*Ray technician,   and !  think lab-technician,   are  acting as advisors.     It
seems to have worked  very weiUMiss Hudson has done a good job.    She haa
a very d'^lnite way of. getting things she wants and of getting around the
Dr.  who yfus very difficult at first-.     She could    not do a| thing for tha
first six months.    Seetfs to have been able since then  to  influence quite
a few ofje policies, gp^ has | matching nurse,    Miss Thdfmas.    Rather
weak.     Bg^ill be ^j/ityfWt Miss Hudson leaves when  this project is
finished |n Sept. \i>jt.  £i£kend apparently recoghi^eS; this* »iiss Adranvala
is also , aware of it; 'and  i/s  wondering If Miss. Hudson  could not carry on..
here and iat the sape  time   initiate  an affiliatifi;^i«^am a1f the Silver
Jubileeg»anatoriujpA.     JJiKlWtter Is where  the Thoracic  Surgery Project  is  to
be and a; theatra/fsistei»sa wamted for that team.   (\ 'Incidentally Miss Adranvala did/ not kn^w of this - pro j eat*.) _ If-the^eond i fJ rt^Wrft ati^kable,   as
they awwreported to bi^Mhl* would seeifipp2^s a logl^ailmavelopm.ent.   "Hiss
Hudson Mould tfien give 'jao.me.'guidancehto Miss Thomas ^p"-Mie Centrfei-
They sepm to jkfave a goj$dn#tudent program*    Have Dra--.s^k|ug their diploma
in TD:-wc|\rk. Jfhjey also '.feo, out with Miss Hudson.     Talked wi.th some of them
andr they wej|iy|very eh|/husias tic about these visitSiffi--:Mi^a\y8[^  said she
Offered IfflGjb.-^par tOMake'phem but Dr.  Sickend would'^^K%one of it*
Wlthythis^^^ojip he cajfne and, asked if she would take  them,.    .Take    College
of Nursing mudenta^so(*^'One morning Miss Hudson came to  the Centre and
found f couple  standing waiting with a note from Miss, Craig paying that
I they >ere' to' have t\p weeks!' in-, the Centre end outlining what\was to be-
glveii.    Miss Hudson''let this go on for awhile and then had it out*     She
ais^?ircumvapted|Mss SrM&'g move to put in ,t^»oin supervisor as they
have done elsiewhercjf.    Mis& Craig is a very difficult parson, apparently.
From what 1: gather/she hap met her match in the New SJealanders.
The T.B.  Hmalt.Visitor students,   of which there are  tm?   come from all over
India* . College takes  them- ff o,rthe first two months.  Will get details later.
Planning now fdjr anorher gr^up pf WHO Fellowship nurad(S--six. ^oursa is
 for three months.       Fl elf'-work has been given  to Social  ^ork students and
to  the students in the H*?f^ eo4»-se and Mid wives refresher courses.
Students from I*ady Reading will be coming in the futuraMattlss Korah
was|&et anxious  for this but Miss LakshmiBDevi has kiddd her on arid she  is
now going to send them.
.Appointment with: Miss1 Adr an vala at 2**30 P.M.     Seemed Strang^ to bee
her :in a, western suit,     ^he has just returned from accompanying Elizabeth
III several centres.     We talked g^nrally forthe most part.    Probably I 8houljp&'
have had Doris  along but will forthe  future discusaions.|t-Miss A.  would   Jp
welcome having more active part in  the actual planning o^j^ojeots*.^:Asked
-her t$%come  to Ludhiana with us and she will try,.;|M; com|^fOr a^tleastathe
second pf the  two days.  There are  three centres fo^fP*&f.g work, Delhij
Vellore,  and .Madras-..    She has|^ust been  to  the latter and isft not at A'{|3s
happy about  their program.     Says   the  two   tutors   th^re   teach  all  the
subjects  including  the  educational ones.       O^e of  the ..ti^piaa-bOen-fflW
England wherw-whe took, the H«V.fxs  course.    Miss. A.  ndjtsurffi|;hat they
would want Ijb-V help however.    Thinks  it is more needed thail tfte pediatric
nurse,    l^^yaid-tfeat.       Miss, A.  feels, that there Is a real Inked■ for
refreshernjs^urses.    These can be: developed by the teams  in tie-e|>asic. schools.
Is  In complet.0  agreement about the  lntegratioi||of p-^^S:'Js  afraid  that
if-very/many more si&tiig^^ not W$8$le  to
absorb them \due/ to budgets. Mt wo ulje.se em thatfflh^ a certain
numbe^ybf basic, schools with WHO as aj||;t an Q^and0pm$^^ese be ^bntrasfor
staff education and refresher courses would be .the'abest plannj^i^^e^is
sho^K be written into ythey^ idea of
the leader going in fiaggSt, and working^uth;^^ the; loca||^roup*
Feels  that there . hasf^^^^pan; e^jagh involvement: o^l^ito^^^^^^tiBuL■.nxax-a«l.^^^^pl|^ife§
Miss Toy wasAputblhto  th;oi^p?in and;no--.discussIo^tWit^^^ Matron*-;tMissba-
Baird. ■     Miss A.  does nj^^^fiik- wejgan l|^^gthaj|ilnieal expedience o|||||
the student^^^^^selected wards but she does foa^that' some wardsboould be
selected foaPthe initial ete^feng^jM:These could \b€^es^;^owded^Mett^^
staffed,   an^better equipped.    S.G.  she feels;^^^^B^>mbaJ 100 ^eds eoti£|||
be set aside for thi & purpose.;: ^^S.fiS §31
Guest) toldlnner;Miss Adranvala,  Miss Lakshmii^^^f ana. Miss |?erabjl,   and
DorisJ^^iiss Borabji  is Secretaty of the Students bursas Association.
^his'has^^een In existence since 1929..    Each s^ool-'^
they hjgLve 98 units out of apossible of soma 200.   "^^S^ha first time this
year the students .selected officers. ^^S ^S^R     T
Feb.13.  Sp§nt all morning in a discussion meeting with Sr./Earner,  Dr.
Mettrop and    Doris in Dr.   Warner's flat discussing^Majafgarh«l>r. Warner
had  toyspend  the first hour In giving Dr. Mettrop a bao)£^pxind\ °? *he
Point'fJ:^rogram in India and othe|||de tails all ofjjj which .A^hajp given both
indivi#iai:ly and  collectively to Dr. Mani-Sfe#, Ch#l'lopa^|^<|^r.  Tuli.
Hot discussed  in W.Ht'i^so  that all staff wrould blpUiferri^ a^p^rently.
It wasM most  interesting discussion and I::-:d^^ain-^f^fi| mh^^llHD. is
lucky in having Dr.  Warner, here. Dr.   Warner has aB& here; I
'Heal thgM visor to th=a:T.C.A. \(Point 4)  program fg§|^ fons^^ah^ e&l\Publie
Health Administration  to   th^Indian Governgientj^Tha T• C*a2| kavO \
#50,0OO,lii: f^llndia whi^gmu|^be. commltta^ 'Then
there agpthe toounterpar^&^^u funds of abou1^^^^^06^fnipeei.^.Thase
two sums are 1$ a pool ;|&, a^oehk.     fhe I .are, larg^iy^tiliMed raS dapitai
expenditures  su^hasa supplies, necessary construc'tioi^||p^^ Them will. be
50 community ^development ffcTeas In^ndia,   at leases one jf^eachftf1 the
28 States.The^t®m^iate purpose of these  Is  to  increase \o^% production  and
they wil^pe selected iy the Planning Comaissi0n^on the^^^commehdation of
the StateSfflbh  that basis.  E&Ob development W^^^^^^^W^^^^SM ^°^^S
village^fhfts will-Correspond tc^pie Secondar]^&[It are^jo^ the Bhore
Repor^uPo^prarnar feels  that Majafgarh will car|ainly be selected as one
of th^coramunities.;^g-ea€h'   We discussed the enlargement f:^&is for. tha
he alth project t^itncljidel'all  the 70 villages—^b;out 67,000 $»p#  and
discussed; possible staff .needed.'   Dr|g§; Warnei|^p|rery keen; on a* §ew. Inter- -
national and as manjr national as possible.     It ^as \agreed:ftmt  there should
be a public health administrator,   if possibl^^:c^;*;;T'Therashould ba a
sanitary iinspec tor in the  centre and two. mor||;on btne staff.    These might
8iillS-iMSlfe-2lil«i2|aJ nursing staff should be d.h^rea^ed1;o ono supervising
 i
public .^^t^purseTar^d an ass^tan.^mrse.. with midwifery as' her speciality,
al^are would;|feed to! be four pafigp more health visitors and 'more midwives,
depending on the numl^J^ocated lnf|he additional villages*
W.H*||*M#C*H«  would provide one social pediatrician and one public health
nurse midwife. Dr.  Mettrop. and ^oris will pull for a second district mid*
supervisor (with, P. H.||&ut Dr.  Warner and I persuaded  them to wait to  see
what local personn^l^will ;^e avail able. :MX t    will be much betterywith on||l§
one W.H.O  I. am Jfi|»vineaK>   No mention was made c*|kHealth Educator untlrathe
meeting was about toAlsband and Diy*  Warner, said *I wish Ted Hutterworth
would come -Itl herein How can it be managed.»|||j She was going to ask the m.-.
Indian GoveJnent to ask Dr.  Mani^gjpLt was suggested bj* the others that
-222^ ^K-lr.,'Mani first and not  to mention any specific
name.      i'Mentioned. Mrs*'   '^a^y: and what had been saidi In the a staff meellplng.
As  ther^^^^^|tig^ before ;4AiCfe^s went back-and had a further chat wit^l
Dr. .%rne^p^f4 W.H.O«  dbes-bi^|^&it in a Health Ed.  they will.-    she has
already w^^^pf^^pxe- as Mv£^l|^^ to^^P&r. /'. ikanihof alib
the st^f/f slip hastrequoted Including nursing*; -
:|*| aftffl^rnoon' weht|||p Coilege;^a\SursiKig.  Miss Craig had lined upa program -ftr
for Wff^ with;:several^|reople.^^ had specifioall
ally^ asked foSSpll  the^ime/|iith her'/first.-      %e  gave me  some %f the
^heral background of thte College and some printed  imformatlon.     They
admit %A each year, v^fld:dgn^Kst'ake- more becauseaif ao^^modationM-; They
have-ni^j, in : th^e f4*a&: four yea*|||24—17—17^-151    Total*93»   She  spoke of
th^r' own superviso^^|ing' with    them in. the hospital and in the village
h4tj|praime was no1^pportus|§wto go fufcther int&I\the p.h.  field work
aspects. ;   Bekt met Miss Clifford Jonef||:    She  Is one 6f,the  difficulties.
Demands- M.Z^*tandarps-- oftthasoiglrlMland pu||ba great deal of emphasis
on techniqu^^g   Complain^Of  the poorneSa||f  thegloeal supervisors;.d^^
justifies  the numbers ^^them <|lI;this, basis.    Hext whisked along to@i||
Miss Grbellt who  is responsiblek|^t;t^p©^^^^^icate group and struck
me .^^eingl^very. capable a^ understand Ing person.    %jglbest of the
three*  They now have two post certificate coursei^afce in hospital gp
admlnist3?ationbin wl||^j^P^o. araM:'and one for sisto^tutor1 s of w hich ther
there ate vt^J'Ha^^fel-these^ people willego back to  a%ume ;||te positions
for wh^oh.-they area-trained*!-,: Hext year j^ing,:^ comb ins ;^^| course*
Coui^pake 30 in all.  This present number Is mare than they have had
before as there has been no one definitely responsible.    Mext year,
because of their weak background/f|o to  50 hours i£ nursing procedures
will be included^,Asnked'abou^|he need for pore centres to give^ su|l||
courses. \gfhey shouj^be^ limited because not enough good material for
them.    Perhaps later, centres could be develefffi at Calcutta and Bombay.
The present group are having good experience in  the teaching of Miss
Hudson1s T.B«H#T. . grouJOSg Mext. Miss Kent-Johnston whep^is responsible
for nursing arts.    A nice" girl,  who  is very discouraged ova^ the poor
teaching facilities  in |heywards.  Feels that they need to haye more
responsibility and tha^^phfy nee^^ie fihole 24 hour shift to give  this.
Mext saw Dr.bl)avadas whc^ teaches nutrltioi^-Sfca gives a very practical
course but M is very hard for them to carry out tnhe teaching because of
the low incbijie of the families.      E.G.  a peon gets an average of 60-90
rupees a moilth.  80 willl^e spent on food and clothing,  fuaji  etc*    He aan
buy wheat to   give him 12(00 calories for 3 annas a day.    IhK^an^ha get
with the^niaining tp---balance his dietj|~ Tendency will    be to addbmore
wheat as  thJLs  is filing/      Then  saw    Miss Dajgjs.    Miss Crai^hiaji^laf in Italy asked he^to  takjk t^ppost |^||s§^^
about July. fpAsted /aboffhthe possibility of    getting in an$£har refresher
course but kiss Da^is dj^ hot think she could.     She is notpH thas^ean be
rushed.    -    \ / .      ":-/ ... \ .  . Ssfilfi
Stayedy^tfldinnei&t t£e .-College.; Miss Davis,   the three Ktj&'sand
Miss Vpi%tjk'who  showed/her.Kodachrome of the Kashmir*     A nice holiday spot.
 z,
a   ML
y    28.    ,'   . §8*1^
Feb.  14*}   In office,    .discussion with MrfiftSundaram,  Pwrsohnel ..J^^Icar.
Suggested ;that wheii-     we review and  classifylphe files—personnel
historieje a-  af B.Q* ■ that It'would beVhelpfu|||If we entered th©  classif-
ica^p In  the apace oi||gf;he  top. right handfiorner where it states,
wDo Mt/write .in this space.'*    Think thlse';^^^bfe' a very good idaa.    He
furth^feufgeste(^^L4 we might- IndlWteythe.pa^^ or
^^I^^^ffl^uld reoffend for.   ."This wof||d nc^'be practical -In : the
^ajOe^^g:of  caseSiM'Theyjfeel^ere that they do ^Jra^ive^icnough
information about;ma^ progress;of rectultment^Sugg^tediteiat we send
copies Jof Ithe letrj^^Khat '.way* and  to  the individuals selected so. that'
■ they -ipe«have:.this1 information.    Mrp^U ■ says f tha^feien. recruitment! is
a°^^ph^n thegtegiohw-that copies of letters are senftto H.Q.    Ihla
mi^1M|^a d\lscuss-#d wi.Jh"'Mr*;PaAtersonS,Certaihly the/a needs  to* be
eaa^i$rn^ 11^ Geneva
^^^^^^^P^^^gl^^^^j yet^Miss Van/^rqfe^^^rived last
Sunday/and ffl the  cable  was  recleved just- aty^pfSlng;^pm.e on Sat^"
^R; ^r..-^^femplliasized the ^ed\fpr revision of. !-"^^^^ei*sonnel History forip*
Ip   w°uld-|||^ icould judge
person^lIty^I;Djbintefeout tnSt-danger of^iJssiy^^^fehe\l^gficulty in
getting ,. e^£:||fr however SUnd ena^fif the photographs
we recie^^^ffi;*|e thihjkathere .mS|ght be a selection ma^O^^^Mr.  S.yalso
»^ pointed ^ufe»^ need for'Information on^ependents whldfe would accompany
|||| personnel^.l.Whe|r need ;f^^iI^o3%Jation early InMrder || make  the
^^^^ecessary^^^a^emeh^ with l||p  fcpuntry regar^hg accommodation.
J   -$iscussed'\brl^ingj^;.He promised  yjp have a meeting o'^^S. committee
K{ hefore I go.Cjhin]/s  t|pfre is duplication 'iij^pba givlpg pt information
ffi re leav^i^^^^rari^^^^^lfl  agree %ndtM|.ink we should check at H.Q.
pg; to see  tha^fe^^^^p def inlt^i' givei\ and not justblei^pto tha individual
raj from the Bf^$^^lem   Refer to Mr.   %ighty ^>-^^^aks this
j^fito be giv^n at "H.Q.  and that^^^^^gparticular itemp|
if  j which; hayen^be cleare^e^^^|shou||. be;|^p8ussn^ and questions
mm answerfd^^^fi:says that our brieflng;|book,  whic h per|pnnel recieve,
111 have^^pHft^K'; the list of Regional Off ice Personnel and J||e ©ggan.-
P'^char^M n^piigip: to :^^^|g|    I  suggestednffte drop a no'll^^fflMr. Wrigf^.'b
B:^an tfhl^Htefipans as lM^^^>ery^hard f^;|^Q.  to keej^g^'w&th the
chan^^^^e,rhapsffl we. should, nojkfbe givlngffiuqh a complete list-from
I^^^^^K^ft^6 iPjP officers:,   the Personnel Of^^er,  and;..the "particular
,ffi-.$ :^^Lbi.pated when Dr*- Mettrop wro?£gK up the meeting of the previous
day'^|pth D$r.  Warner he put down that two  international nurses would
be requir^di^;Sq amount of-persuasion on my part would make eitherp||i§|
or Dorlsi relen^:; I'^^^fe 'different in concept,   in^ead of. going in and
working with wh&t is.^^^^^they want'^o push our st^d.arda;;on togthem
as  quickly -as  they ca^jjira : a f|l||
Went with Miss/Davis ;ih*-T-the afternoon to see the .Ge||t Garden^?'Veryvp'
lovely formal gardens-yCwhich always'a|^ave me cold) whjlpi were JSE- rlOmfe
of color*||^ and nice f^^the
people  ta'havetf-^lss Davis  is  a ver^Ionely:|^rson andt^^think must
get Jfpry heroesIck; at- t^^i*     lent
Went'with Miss Mdson t^^irefugee se'i|lement;. InaDelhi wherl^^piad
been, arranged  to/have a grou^of mothers  together t|ffl;discus^^hei;
organizatlon^^fflpa Baby -01hic.    Miss' Hudsonfs purpose was  eyahtually to
have them aO^^MRayed.^^ nice group but^^psfeuld not stay f^T the  whole
session.   '^^^sSSf.        IflN
%nner at-^l^/JAdranva^l.a1 s. ;    iSp
^eh.  154^^^Rice in aM    Doris  too busy for any discussions..- Spent
ti»e making/^n 0utlino9^r infoimation needed f rora; Ludhiania*^ff ice
closed in^ter:hoon^:Spent: time with Doris  in her room j .going ;0*f|Kg!
the Bomba^/projiect and h^r draft plan of Operations fpr'Madras    pediatriCi
On our.^^purn Jf-Jrom Liidhiana there will bo time toadiscuss thea^ In
relatio^S) an <&ver-a3§f program    in nursing foralndl^iw^th Dr« .'Tuli.
and Mip//'Adranval^.    Discussion was very pleasant—ho pep got over some
pointsfl Plans   hate me a bit stlmled*    Canlt ho^atly s^e how detail
can be "forked JHwaxcapt by th%.leader to her'first surfey.
to getjmtp  thaPfllginal plan the matter of staff education
cours«f*fc1    \ r
coursedi
fe do need
tion and refres*
 ■.-.g    Ug,       ffl     -   -: ..in.. „   ,.z';:     a    ■ .-
29.
Feb* 16-18.    Left at 6:30 on Sat A.M.  for    the feral.    Mr.  Siegel did
not go>    Met at Rampur by Dr.  Iseris and family and Miss ^anes*    Proceeded
back to  their H*;Q«>  at Haldwani via Gader Pur'.and Bazpu2^|§|At ;$||r latter
two places there areai^cllled clinicsa.  ^ach one room and very poorly
equipped with everything but records.    Edifiess than ter^eparate books
for them to record in*    Mtss Danes left a long mont&ly report ierin to
be completed which would take Mrs* Pandit,  the H.l^in Gap Pur#  all day
to raail," I am sura.    Afraid Miss Danes is another example of the recruit
direst from I«EU0*    In ^adae ?ur,   In addition to Mrs. Pandffi there is a
^5^ihad dai. Apparently in |Rlfe part of India the so called trained
^|i^nii,Tdai is one who has had some tralnlngf.-:--probabl^pne ^P^%,    ?he
indigenous dai has gad no  training*     In  the Madras area„,  according to
Miss Danes.,- there are no untrained ones*d||: I  think there arw^ut^hey
■"-are not. given any reijogniti^ because there j 1st,a higher propO^^^:Of
midwives' there.'. Mrs* Pandit has,,;^^^lages:^glier area and ethers are
un trainee   dais  in each|||p ^ .   :1||§
Sister Angela is at "'Bazpu^nffla^ie has had somefltursing training but is
not fully registered.*    She has 33 villages.    In Bazpur there ils a trained
midwife band a dai  Injp3palning.    i&ster Angela is very good,  according to
Miss Pepper and got lots of slides each mont^^^O^ of Miss Pepperfa ti»e
spent on Jfae malaria aspects^"^is has. been .-^j|ntrolled and ,:$he slide
surveys arp net to l^|^ptinuedS| Dr.^Iseris planning to-'develop public
health in [the area around Haldwan^^pt5»®P0 popifand 130 villages.    He
Could net feive me anp;satisfact^y plan.^iat would; ju^ify the second
nurse whicjl he want||    Miss Pepper confirBied^hat this afternoon.  Say||||
no need'for a second nurse.;'-:'TDr.;..^|aplan is p^^art with the.school
children^kK^t gooda|§%h.' Miss ^^says these villages are very small and
she does hfot think the plan would work.    Personally I think Dr. p| is just
looking around for something to $^j0j$l$ his staying now thfif;tha malai^gj
I has been jj con troll ed^h
^esterday A*M*|||rent .to see the^Linic In Haldwani^^^^lf.f s had gone.
Miss Pepper says t|i|i^  to Ranikhet.wbg|5aw Himalayas*
Dinner'at Hainatofion return^ A lovely.:day• J§E*eft this A.M*at 6:5^5
Back at noon*     To Office for farewell party d^| Mr. White,
low off to Dudhiana*
Feb.   20.    Arrived;LJ2dhiana at 5 A .M.    Mefby .^!]^Blleen Snow, {SHsoipal
Christian Medical foilege*M;ThIs is an interdomlnatipnal mission and was
the first college to be establlshii^por "women in Ind 1^,.    Founded 1894.
The Catholic -Chura^does. Aot contribute and fi|p.various reasons it has
not been found wise  to  accept Catholic students^S^Thl^^hould be bourne
in mind If any international personnel are sent^^ra^^a'akOTt- tol the
compound and given tea and bed^tf After breakfas||?Met inllir.  Snowfs office
with Dr.Bergsma (?),^^^^Is Vomeral Superintendent of the Memorial Hospital
which is in .-^inectlonyf||to-the College, Dr.  ^orothy Volkea^Path©logiiS|i
Miss ^ennis,  Matron.  It cam^^^r' in tjpQversation  that Dr*  Bergsm§ did n@f||
know;.anything about the requ^|A:il^^pfor two nurses.from W*H»0^|s&'?hi8 was
one of Dr.  Williams dreami^g^robably arising out of a morebor less
casual conversation with DR.  Snow aad^Bi, s*aow had obviouily not discussed
this with Dr.yBergsma* -FieSowIng thlj^discussion we saw pie Collage and
the hospital facilities.    Afte^|Lunch we went for an hour to the Health
School which Is  also under the direction of the :|pllege*    Miss Sen in
charge,   Jperpwe visited two of the three health centres  i&nthe town
which are operated from titeHel,th Dch||el and are used as training fields
the the %alth Visitor students and the mi^dwives and nursa-daia^hAlso
the medical students.    Of the 2,00fi deliveries last year overJ|)alfi were
done in the homo by these groups.  */\ll geffggood domiciliary experience*
We had tea with the nursing sisters and staff nt^ies,   and this was
followed by a discussion with the same group that we had started out with
in the morning*  It Is obvious  that the nursing needs strengthening here.
Miss ^ennis  Is a dear old lady and would be co-operativg but has not       H
much Idea of nursing education,  or of administrarion*     <hey see^etb be
fairly well staffed and Jret there is not time to give the students more
than one day off a month or to reduce their night duty to lass■_ tfxan
12 hoursM*here is no  staff education|^*he sister tutor*    Miss! ^llen,
Is of the old school type|l; She dees part time duty o:f|' the wardfeShe
does np|;seem to have any plan for the educational program.    Could not
produce;/the hours.give to  eaoKftourse or any definite outline.
 30.
|SP;. Snow ^d her', colleagues are genuinely int^estefSIln having some
assistance in nursing and ar^fbtnxilousbto ;i^^
*hey are especially teen on this because Dr*  Carl Taylor,  one of'their
mission peopie||hs returning this Fall and is anxio^eto \do some village
work and some research^SfflThis would "be:~ a f ina^^ortunity'^^etisome
information on the real heal^needs of the people*^Dr*  Taylor has
just relieved his M.A.  in Publ-3^iH§alth at.Harvard wlj^g^nors and is
going'^^g^ake his dooi|^^^ as wellif    They recognixe hia^p^, of nursing
suPI^^tin his work bj*t are agreed that the basic program should ba
;staS^d first.-|^iey liked the idea of'. a;-wf^^Aepared nursS|bming:,to:ffl
helpwthem in.'planning f^g^^^aa program*  /fjj|t was left wit^Mtiem to
discuss  together end./l^pLet us.||ptow if they, would like sucl^%s si stance.
Briefly some, of the facts gathered are; !^^^^^
Present hospital   "3.10 beds...-: mfi^'--'
Hew hospital planned for 500 beds.    Half they|pQnds iwbe supplied
by the Mission and i^^ remainder to be supplied by thanP^n|:ab
Gov't and thf-b^intral Gov*t.    ^w;is ajl^iyear:plan stnd-^t.t is
-hoped that-^^^irst :unIt will be compleded next yeai^
Up ifi 19^pthtsh|^pbeen. a women1 sihosp^al.-^^paere are stJ^^^nly
a limltedk number^P ma^ beds but||hese are  m be extduded^^^
There is no  solvate pedia^^W::.unt^pfut-lihtsj-'^lpo- Is planned. ?§Jk£
A casualty un it ai*a S*B.  x^l^^^pe .Jl^the'^ans for the
future and a T.B^Siin^in th^^4wn^pr'. justip^w being taken
overhbyv the -:hospi±alVpk IpiSi
The OPD is a very good one*.    Has'pieia||y of nspaoi^^^there v
should be good:r^poi|^iitl,e.aX^r teao^ng. >       \
Nursing stafffof Hospital:
Matron ?^Slf
1  sister tutor  (Miss Ali||||f wht^^onljr^^^t time* tj^hja does
.some ward work.    Is a fully qu^ifia^^^ory ||||
^^^ui^fcqualifi^a nurse-mldwlfa^io hasj^^^' had^he %Uby
King coursai||(Mlss Livingstone'of N.Z.)     -t^^^^B    W^S^-
6 other ward sisters,  3 of who^arei^^^^^^S^ard slsfefe^te
a,re away. o%J^orloug^|p ffSIB HRS -
Braff'lpirses  (Indian) W$m       iSlf
staff nurses doing male;training as  they havfia^t previously
had;this' in th^r training. r^^fel lllf
Should hav«h^ staff ^^^es-«^- short*!!'' Can|Jt\ get be§aU^ of
;-low salary.-ari^^li^^pecause sever^^pj^ gonO. bacl|^^fciPakijBtanr^g
AHtliariyastaf&condists of 6;-^^K|iurse-dias.    A^^»^ee^|a*B:
No otheraMThe ipjlpfe dais ha^Bbe^^;givehe|S© year^l^^inihg.
?hey admitted witl^p^k standardbah^are taugh|||In thej»Bnactila^^
There are 70 nuri^^als:;in training.        iW$^
*here are also  30 midwives  In  training—cows a is
Most of the midwives who hadSmatric go^n t^ythe
course^
'There are  58 stud^if|forsess
ls.f%ea*jfl^4   g^HQ Hm^L^^m^^M
8
4
MKmohths^^^
He aSasSiV Vi s t tor s.
2nd |
3rd.
4 th
Thenar e
About 50$ of the student nurses have their matrio|
admitted in April an^Octobeffflg m
This Is  the last yeai|Khat;8t^ with
matric only* ;':f|p:is may make mb^aayallabl^Pf^^rsJ^ig witf||
mat|pc standard.     InlthO^ S°^^B^
264,000:,boya.Tand only life 000 girls. |pg Wm
Student nurse'capacity is now l|||f^
.this  if etrt down on nurse-dais tgroup an^^ldwiveat:.%|^ ||||E flip
Working hours-for-students 7*30 to ;12it^Ko'. Tz^^m. hours «Hm
night duty and 5 or 6 one mont^|^eriod^R'b|ihis. Only one day
off per nion||| andMongefi hours on SxandaS   \
Staff nurses: have a full half day a week off  and one day p«rp
months bgiyygp  ;«£&»
 \ 31-
Living accommodation is good.    Each student has  a    single room,
lurses accommodation same as fo||f medical students.
. •Incid&tally; theamissidn-^laff-.all pal||the same wage,   regardless,
of qualifications—nurses^lame as doctors*    All must be very
g^pw*
Of the 310 hospital beds, 64 ate for maternity.^Daily average
number of patients 180 toC^^Sv ^ould judge that this will be
increased. :-.-.;
yflshning to send^ne nurse down      to Delhi  to take tha sister
feutO|AourseTne3^year. Also consIder^g:;an additional ..sister
tutor from England and two more Ward Sistersp^hase would all
however hav«gfto spend about the first year in language study.
Visited Health School—Miss Sen.    Have 191 students;,   capacity 25 but
would be very crowded. Have an area with the ^ealthgGentes for
practise field.  Do clinical work In A^M^^pnd have threoy in aftenoon.
Visited two df  the Centres.     These have good posslilities for
de.velo|^en|^p-^p'^m^^ clerical work.    Little individual  teaching.
Hai^|one month field work ixjjpt village* j
Have.-the  Impress!on'Vtha^^||t.a : wou^;be a ;^^if^ime to, start atpro^aG^^
.here. .'.|£fc-e gospitaI||K sta^p|
are anstiou^ffior imp|||yement;ip   tldie itursing aducatlon; program.    Expans-
ion;i|||^ fi6^pSlhey are interested in
thopoasibllity of refresher courses  in. .i|^ futur^and their policy is
^pgreplace ti|e foreign personnel with Indianapersonnel.   '
Left .-at 11    W*y-*
HsSSrajte^ t - a'
Bep^teB.     Ra|in||i Dr*|Jlhisholm arrived*     Spoke  to  staff.     Tea party
aty^fe Presidents Residence put on by  the Rajkumari.
Feb^^l.    Mojre ral4*     Increased crop yield already by 10$. t^n office
:to^n|ay drafting plan-ops for Ludhiana proj^^^l^ood experience and
hoP^p havejnot beeipstoo unrea^stic in the suggestions^Dr* teani
;-re#I^ved Q^B.f s;>lettjj^:-to-day and called me in immediately as he is
6°i|^awa^xorbsa)me ffme. *as ■very'-nice and asked me my opinion of
B.P.f   \Hafe^Ktell him  Ilbat I did notu^'hln^J^fWas getting as good
ll^aihg a^vl^p as'hal^ioUld ber|||hat the planning was not very good
but that /afJ^eifgEll i^pit of the planning in W.H.OIjf, had been spotty and
that i.^pMp.d hoV^ imdulj^^^plhave a .talk, with
Doris arii^feiep ere^w^ Man!-again if he is back before I leave*
Think ^o^^a^|^u^Kbe given an :;^|portunlt3So  show what she can <||gt
;^^^P^^K^ft| b^fcl^iink sheg should ;n|^p>e encouraged to stay beyong
^pKr.tim£^Kea3rd. tip-night that Miss foreman is a very good person*:,   Is
taking midwlitery i^adinburgh and Hancy Boase says she is interested In
W.H.O.    Appaibntl^M^S;;va^ well; accepted ^l-the Indian people and
she also speaks the language.     She mlghj;be .^possibility for a    *
Regional'. M^f^Wi !  ■ fill
Had Nancy Bo?*ise md^^r 'husband todinner^She picked a honey I
Discussed Madras? pe&if.tric nurse project with Dr.. fu^l^fla agreed  th||§
itwa^|pott^ but ;i^^riew of; the fact that Madras  is a centre In whid§||
furthei^^Ove/lopipents are likely to take place asked that we let it go
through jiow^^q ari^^^^Chellopah feo  through the plan-ops and each
have theflfcjown peculiar likes and dislikesV    It is difficult for
Doris and$fi£t would b^so much easier if only all three could sit down
together Mate ad of one at a tlm0yj|; Apparently it is not done that
way here/i   .
Feb.22M|feerview wit^Mr. ®avles of OTICEF yesterday^^s ^oris
says,^^f|big dletato^* One would think he was the big planner
for ^I^S^'international aide which Is pouring Into  this  country.
 .     32.
Went with.Miss Adranvala to  the *iiver Jubilee Sanatorium for T*B.
Dr.^&rlshaa the Superintendent  and    Miss;,Mas.^;the Matron*     168 bids
Und * in ..two -years plan _ to  expand  to at least 300 beds*'   Only 14 "staff
nurs.es at present.   bliss Adrdnvala and ^r.,.Krishna ar^ very keen to
s tart:,; an .af fill at I oil for student nutsasT     *he TB Association had some
funds given to  them which has been ear-marked to provide a, sister-tutor
for  three.1 years. -  *he difficulty is  to get Oolohel Bark art Myrian
interested! nd willing to  co-operate and  to get the hospitals  to gttre
the-studenl'ts  the  time.    Idea is  to get a request for  the Continuation of
Missn.Hudfeq'n' so that she5 could work'• frith'rad national sisipr~tutor and
alsStttv4»e' eiinic^b.:^prKrishnadoes not «i^ppfe#an dliflda'her time
but»&^duld easily work-. thj§| out.    This ,pkBraalcp0ssIbil\ties and
wou$i§*e "'3: valuable contribution from W.H.ig^fpfee of the ?Caot that so
much- interest has been stimulated which will teltfe.-another yea^r ptr two
to  cod col Mate and give, the 'most lasting results. ■   y
Tp th# T*N!.A.I.  and^ Interview with Miss Lakshi|||^ Dorabje.
To bejongjra the T.K.aIi* nu^as must be fullj|reg^
syllabi "aire gecognized IP#|^^ B^me <3tate
Branches Starting nojj|    T.N.A.I. meets- pnei|jg year anip^the Council twice
yearly.    i;4ave midwives-.Union,  Health Vlsl^dra%D^aguaK|ind gtudent-
Kur§;#s association as   us so date Members./   There >.re2J:568 full members I
ouf^m anttatimated.a'9-lb>tO-0 nurses In ^dla.    ^^^^^^^^ as&gpsoei&tes
111 .^idwiire^,! 85 H.V.'s-and  3,101  students*  ' The T.M*|Ll.  has organised
a few threegday refresher courses.    They seem to be very hampered' by
efficient' 'draloe administration.-    Miss Lakshmi ^evi h&f i to w^lleout
■alljfla.ttjferaT'Herself—no-dme to dictate Wm i|ftS    1111
Through'Ml$s Lakshm^evtp^ol^B.L.Bhatia,   Ins^ecWm^^eraiMt Medical
and Health Services,V$s asking about the possibility of ftH.O^ssistance
in developing a post graduate course for p.h*  nurses in Hyderabad *
Miss A^banv^a is encouraging thla*;:. IRSI
Went to P*oll«^e to see demonstration of practical nutrition P^^^Kby ■
the .T.B^ he|al|th Visitor'students.     Touching- toysee how mum these    • *
student^ hsive1 appreciated this period at the College.      fffijl!
Cocktails at Dr* j^ani*® for the D*G.  followed by big ijpW reception
at PatIklM House*    Feet desperately tiredl    Accordian pliaylrag in
libra^?|11er in honor of Jac]c ihite mid dinner at the Clfib a^ter; |||§|
t'kjk/ffl ifflpfflaCk ighp        !■§&'
Feb  2 iIHfe ■       -kffl-kffl-;.:ffl:-;:i-: fflfflha---.;.-:   eelae fflsbaptbgn
W   u  %a|ting In A.M.  In office, re Bajafgar||   3)8s-..,.0hallop8^«ili,
^ettrr^,. toofIs and 1^ Agreed that W.H.O.  should pmntinueJ/witi^^afgarh
if wh0Wmr|a included and adequate national staffip^lvlled oplMpns '
on wb^^hotlld bedone ^^*ban area with. Dr'^ff^li and I hold^ngl^Sltha
go ^Jo.^ and Dr^ Meti^p: seemed anxious \ tot ih^luda.
She^]^^ New Delhi area as far as M.^R.  e|^
In mtfefihoon went. tO'-Ohandi ;Gh^wk with MisalKeafy and Miaraj^a^Is|||-Later
to/^xty celebrating Qeorge *ashtag;tgj^^
^bjg^^pta-^^: B30st. gorgeous saris-—the wall dossed Jleatefjn *omen l^ked
mo^^ra^iinteraating beside -them. 811^ ^^^S'f
Tea^^g: Miss; Hiidson^^fea has decorated her room in :Ko,^p:H<||iaa most
attraelpvelyv'   Has.really adjusted well;Mr-:;thI.ib;sltFatIon^   §|§|'h
 \s
/' »     i 33.
Feb. 24.     Sunday. J D0ris  came at 10130 and we talked  till lunch time
when Miss Broe jrlined us.    ^i a cussed her future,  professional guidance
of the sta-Mff,  bijLefing,   planning and  country programs.     It is difficult
3§i get down  t^^hife really professional problems with her.     the negative
aattitude  seems Jjf crop up continually.    Have tried  to believe  that
this  could be overcome and  that  I could find  the qualities whl^ch would
enable me  to  encourage her to  consider some further study so  that she
could  continue  In  this pojfltlon* pbflld suggest further study but itflld
not recieve any partlculafcgcomment  either one way or thaSthanp. She has
her- con tract, in Mew Zealand '-wx tended f^:ohe: year* lfg> sheyIndicated
that she really did not have  time  to discuss  this matter at any length
when in Oeneva I  asked her to  give some/thought  to  the let#^a| and that
we would have further discussion before seeing Dr. Manli|g
In discussion of the planning emphasized  the need  to bring Miss Adranvala
more  Into   the picture bot^in  the  initial planning and  in  the ma^cifg
of  the plan-ops*  In rela;t^n  t^^riefing tried- togbringWkt- the heed"
to  avoid over-lapping and  the personnel and administrative aspjj^t&qy    a
being handled by the respective'off leers  rather than  ta^pg h^||-:tJ^^^
(.Re briefing—have been .Jpiking -^nthe girls here and have ffclfewhat;^^
we might well  cut,down  the Geneva period, to one.wee^. They feei| t hey
have been  talked  at a lot and  thatthey have  allot to; read.     %enS§hey
come here  there  is more  talking and more-reading..    Itgis- necessa^v for
they to  stay here pv&fc* the week beeaeuse apparently the country has  to
be given  six days .hoticflfof  their arrival) ||PI lllf?
^oris  indicated that Dr. Man! has not restricted  their gravel--shefiias
not.yet been  t^Afghanistan and only onee  to. Indonesia to. a ^.ait-jwhi^^
was cut very sh^rt.    This would seem t^jpe partly her o^n poor planning.
She has not really accepted  the  idea of a team leader «S1m^  the nursing
projects Involylbg several nurses.     Can no||gsee what a leader 3§|uld have
accompllshednih Colombo  ?dnen  the. members are  so  scat tared .^l^tad 'tola-
insistnthat;^Is mustgbe our policy andjjjp^fe Br.. Mani ag^eafd t& it.
^Iscussedpthe possibility of a working conference  in 19.5,||a?  a follow-
up on thegBegion^aJbasis offthe forthcoming conference in Ge^eva^ Said
Dr.  Mani would no||§agree.     Suggested  we discuss  it with!him.-^to-gether
and  that, I  would prepare a^ustification for it  to discuss with her
before leaving,    ^he is just unable to see that a co'nference -would be a
good thing- in  the^e countries. fillip
Miss Broe  enthufla^stle about her study.^Seems  to have iworked\up a
good plan|||t Tea at the Allege, gift        P^B
Feb.25* Meeting in Dr.  Rajafs office re Kajafgarh. J>r. $aja,  Chairman,
Dr*  Pandit^ Dr. Barkart Syrian,  Jh^JCulandi^(U.C.H*Kelhi*|Dr. garner,
Miss Adranvala,  Mixs °faig,       Miss ^lifford-Jones,  ar. k%ellop^h.
Dr.  Tuli, ftrf  Mettrop, $oris and I. Dr.  Ra§#%^anedo^on tie note  that the
main purpose of. the  central was to be for  tBaining.^;ontinued' to\ say that
no one group should carve.pO|p|::their own'area*2jhl&iss Orai'gylater took
exception to  this and tried to  explain that the reason thMy needed their
own supervisors was that they were trying to develop somethihg ajmittie
beyond what already exists in India and that therefore hate to;havkvai^M
better type of supervision than the regular staff could provida.":^li^
the main emphasis; in the unit has been on M.G.H.   and theyewanted to
produce a more generalized type of experience.    Both of (phase points
well  taken hut^Sm afraid Miss Praig does not tell the whole truth
of the sltuati^Kipd theytruth she:does  tell is ■■ dialed•■ ;-Barw^Ln the
meeting #r.  Rajag^lled:'.on'Dr.  Warner;;^0utlinecher ideas whl^i^he
did' very weSg afi*ing^fee lines we hfe<j|S
put in a^^u^efor .health,- education and  that a health; edueata2*bmighi be
added not- justjibir the production o£ visual aides but froffif^^mpoint of
view of communityiorganizatlon. • he meeting, went on and.;pj^^|lthbO.Ut
getting down  to principles.     It is clear that thejr want W.H^eMLass'iataiice.
A committee m0~^^ *ed.
to  consider planningl^ferganlzation,   and the required staff'^mr a
field training progrkmN*SbOn  the committee is to beblflss Adranvala,,
Dr. Kulandi,  Dr. Mettrop, Miss Slifford-Joneg|- Dr.mmdii and goris.
Dr.  Warner wiH be our salvation,   c /mW' ^f
ifflggUy g'fygp       jgpr
Dinner to-night for Miss vfroe and off to Calcuttato-morr^w A*$I.
;a.p-v;:„.p,afflffl--i a zzim U    -'
.    .        b    ..an a ■  -$gm   g&Jr
■o
 mm asz
54* ^afaSffi^
Feh^,. .  £oft on 7 A#M. flight fo^Kalcutta.    Drive from airportl^^ city
nuot as bad as I expected from reports bpt prttty terrible nevertheless*
Reminded me of Rangoon but there the poverty does not appear quite so
extensive.    More bullocks    on the streets here than gin Kew ^elhi.    Moi||f
men in national dross here,  also*
Mrs* Mitter came after lunch and we chatted about things in general*
**he has outlined a nice program for Thurs*  at tha hospital* nfo-morrow
go to Institute and Si&gur*    At about 5 I was wakened by a pounding on the
^^^^^^^^^^^^^^^^^^  Orzegorzewskl coming to-morrdw also  so nice
ll^ngiy - ■ ggp
^flizabe^h and Dr.Anderson arrived from Dacca at 7:3Q^;Dr., 0.  joined us
for dinger.    Like Dr.  Amderson—qulet|||ls protective, of  the Indians
sinfea h4 wa s born here and more o± less-has identified himself with
this 'oettotry..   Re. Hajafgarh,  he has a lo^ftf sympathy with Barkart Kyrian,
Says tha^the latter,  even when Rockefellerstarted never wanted the
Health Pnjjn' thera^FThem apparently W.H«0* weipb in against his wishes.
Dr.  Atjgteems. to think a lot. of B*N«fs abill.1^^
Talked! until nearly one with .Elizabeth. 1f§phe f Inda sfehe nursing pattern
hero Tiargely,.a diluted Brltish^kSaya the British tekrons have contributed
alM  especially^ in reference"to tha hospital housekeeping which has
Impa^ssed us botl^dIn^^t|sohn>il-s she has seen the3s^i&s been only one.
siat0rgMtor and no4 P.T«,S#|tMuch emphasis on examii®tlons.-More students
falythan get through and/||*ey write and re-wr&te examinations.    In some
pla<ies;mhey repeat everything in the year they fail.^/Elizabeth quite
impressed with ;fel^re. and will probsbly give a Fellowship thare.^She
is ala||| impressed..:ii^t;;the:^ssibil^ies aC^avano^p^  and-la entertaining thej idea of giving assistancei;t.here4^5Apparentl^p^ira is a fairly
good staff already and J|hey would send/^e-som^jhe like Miss Nohli^^^ork
It up^fflln. thefuflare mightbbo?^|telversl^:Sch^L bul^^Lzabeth thinks
there is nh room fpr suoi|^prhools^p>,ir: rather aj^;mo,i®flhto the tw^^^^
India for some time yetaj§|" She wa.s quite Impressed with Bombay.  Says
they want to integrate the p.h.  there    aand are hoping the W#H.O* team
will have a p.h.n.
Feb*27»   Visited :JhLl..|»dia Institute Of Hygiene and Public Health with
Dr.  ®M^^ of the Institutte ate teaching and research.
Theyrglve a ^iplni^poo'urse :-snd' a' Ci|tificate c^urse.;t^»he lldenciates
in both Public Health and M.C«H« Als^-glve^a conrsa'^Mpublic Health*'
Engineerings||?he, latter are place^p^ut for atperiodyod internship
'•ffi-;j^p;:perI?vdw:of.^6 mft'.i^one year.    Most of tha -studentjs are sponsored
andjpae from positions to which/they will^bapreturning,.    e*g. out of
60 apudenis, ^^:^^ probably 55 will be sponsored.    Have practical
fie|jK,work in'   the urban area and in the He alt Centra at Siiigur which is
operated under the directlon^^ the Institute.  Thii^sth^ only place in
Ind^iwhere P.^||alni:5ubilc Health may be obtained.    Madras and Bombay
give a smattetng of p.h*   in theit medical college.    Salaries afe lew*
Awpr^fesb^l^ets fr^m    llOOto 1500 rupees fer month.    A private physician
would earn up to  4000 rupees^
Under the proposed M*C*B* project with WHO-piktIF there are plans 1^
1. develop an urban field training'area;
D^^5»akshmanan plans'to  take over one of the wards of tha city
ihtwhichftierO are good homes andg]^^,  industries,  schools,  eta*
y$&ere is^^gl^spit^^nwthe area* i^powad. us plans for tha
^H^ldIng*-|^atorey.Provides space f <>ry Such specialized^^
liyieahricea" is allf space
fof the^administrative staff but in this^piaea there la ho
provisi^^for -a-nurse.-: Dr. G* gave me good Import -lnt,^rp^ea
f*r what he termed a fHead KursevJj|In the speeialez sections there
was In mostjpapace for the nurse but mostly in a room with the clerical
gstaff<^Mjt Is'going to be hard to^Arercome this in a country where
nursing has not found Its feet and especiallyy in thia^aLnstance
when" the coat of tha building is~mounting so rapidly Sr#    there
Is not adequate provision for group teaching or for teaching of
staffM Lining quarters for the staff are  Included in the plan.
2.    Staff for the~   Institute which will include &wo public health
lurses. |She course~in P.H.I^will be under the Depart&ef&t of
M.C.H.p%ibjacted to this but again is not at a stage whan it can
be~ a Department on its'own*    Also since      this is UNIGEF\ m-ney it
probably has :$8k start out in this way. fflB
 much*
Wants/the staf^fchetKglnning^of March 1953wand" thf students to  com^tha
f irs:f||^ June^gfi Says he has d^he a little work onfphe syllabus^^^^ld
n^s^i-ave a chance .fSrMllotf|%his up*  ~Suggested tha^Sfe first nutse
||^ld, even earlier;a* that she could work-with the Indian $mrse& in
.the praparatlftm^f the sylilabua^fflMIss Adranvala &n§^J^oris should
'■'dome down f her e~eoon.    ^^^^^       §§f|l
fl    Expansion of Singur though pro vis i^. of-|^ Students
live put-there, , alupaesSht in tents«l;t; h ^^^S^K
^l^^provisiort^f^axpandad h^tal facilities next door -to. tha Institute
and a new f&oor on. tha;:inst^ttte."'--
lo evidence that the commencement iff buildInM^perations are to
start in the near';future;alt^^ mentioning
the flffajraf Ap£il*']B ^^%^^BfS^&
Aft^aboUct a cnuple||f hours' In his office Qf|k lia^hmanan too^ |ts over
the^hatituta- and: wa wjjjk-; maa|j||^^ with the-.-fine
qua3§|||> • 4^bhew staf f f a^p|ha'! ma^;intaresting research; pro j ect^K^
particull|fe ' ladlafc ^'d'-^ A irery
nieethspljbit am*ng||gbem' and^|^»y:^pLl :se#© to like Dj^E^shaaBatt .V*2hy;.mUG]
A g<w- leadi||p^^^ Delhi in Utff^j^i^B Br., '^^^^^laee#
The^sti^|e Is direct^aunder 'the  Central Gov* t* w ,     i^M^^^m^
Vis^pd-Singur in theaftornoon.    Mrs*  Mltter wit^r^a^^^^^^^^^b^ur
eac^jray By ca*jg| Road ovottthe last portion only e^m|^tad»|^|^P^p^i
months aga*kk^^d not have opportunity t^Vialt any'^pW^^^Llages but
apparently'tha." transportation facilities are ▼*ry;j^Mp'fS^^*   " jfj«g-
SIngur AreacMttprisea four Union-Boards ^^^^^^^^^1^^^^^^^^^^
75ffp^ These are id. 68. villages^lfOO Sq. milg^^
the- Institute aregrasponslble f*r teaching an^reasearch auj^jnt lo'vH
nf Benga^^S^r tthe service*  There are^sro parallel staff fa flk^$4W^f^^
ineffectual :-^^Bexplained the  set-up¥f M.C*B4|ia^^ as
well^i^--t^en#hi.af Hfealt^:Tlsitor wh*v kept'veryffl-muc^pn thoghao^^fcai* •
A 4 bed maternity h&me associatedi^^ero the"untrained dai& are brought
in from the areas not served by the ^entre-fo'f-i^^^p^training.^^^y
domiciliary midwifery apparently only three small districts are served
from the centre.   'In Singur building a cilj&ic is held^nce;^week*^Jpnly
abetii 50 attend^'V^her^are tw^^^thrae;.other cliniojcentrea^^ftesumably
the*attendance at those Would n^t ba^^^arge as alB^^
I c||Hd tellfi;   In addition to^ tha^iief Heal^lHaJ^^g^wh^|^^^^a
nurse b&t w^uld like tjfgtake har. general  training'^^^
4 midwives-and 3 trained dias*  these again' allkg^me: ^^^jSl^^g ^^fc
ftiere are 400 tube, wells, in the area and 240Q;«^^
abotit 50$ are in use. arft25-^ tafl^serve^ -
The^&teraey r&a,te among women" is-about 4$ and, amoSjf tt«oif^^^'; %2%.
A great &ea3«j£ health aducation"' advice Is iiiACcated judging by ^*^H
teaching m^, aterial inpthe form df poster-displayed"'1^
whloh is so  illiterate!^ This, area. needs';-j|M
It'-ll^K; an effective teaching areai-   Again stressed t%f need;|||| an' -
'oyo^^l. public l^^^^^^^^^^^l^^^^^ a8reed*;^P
'^^■i^'innar^^ Dr.    Lakshmananfs home.    7/f&oudon Stlf-Cen^^^^^outta*
Ve^^^harii|agi^^:aughter^nieces*  husbands,!'and sis-jter^jy^law.^^^^te
a larg^family gathering*    Dr* bL*  Is a Braiaftdn*    He m^RLd have^jleen
a S^^im^^^^e;':fhr -the R.D^ff^f this Region#
 Feb.28.    To Medical foliage Hospital,  Calcutta^'-^irs-t had interview with
Dr. D.O.Chakravarti^  Principal of the College^Then-he, Mrs. Lewis,
the~ *atron,   and Miss Bela Majumder,  Assistant Matron,  with Mrs. Pettier
accompanied me aroung the hospital* Hospital supposed to have slightly
over 800 beds but patient *^iad about"300 more,    fome wards not so"crowded
but in the majority there was great over-crowding.    Wards in the original
building,"117 years *!d,  which were meant for 16 patients,  have28.
-Madical,';^tXaga .has av^I300 medical att^i^i^jffl ®nly a little over 100
are women^.Statistics f^r-numberbof ...staff|^tudants,  etc., on attached
sheetjUbStatlstios'; for West Bengal alsn on &ttaehe|tifej |pil
Wards were neat and clean.MAll beds had.two. sheetsJpldpme children
mixed with adults"althoughthere is a separate"pediatric ward.    Slaters
al§|ve charge ^fiv"KLi%Oka which may..be anywhere"|||om 80 to. wel^^ver/100.g
bads.    Staff nurses on individual wards^b^Completely dependent on students
for servigai^J-Sometimes- the students■•.■oann^-^p.eawe f*r~their lectures.
One fairly"large classroom but inadequate demonstration,   teaching material,
and"text-b*nke.   -lo ;^^^at^ry*^So P.T.S:^Miss :.Jol|as^n,,. the ^ister
Tutor*'..-.-;^k her"Sister^^irfSpCertifIcate in New .JJ»lhl 1946-47wand has
just returned"from taking Hospital Administration a^ithedBnyal College
of Mursing. Would judge she^|fe,es Ye^Tdidatt^^tea«iiigf^ Admits the
student^ have to mem*r$£l^!^ see. much wrong wi^ft
• that*    jpdmit stud ants"-"three times a yaar-^ah^;JFuna,   and 8ov«||pfacams in
Feb||taBd -Aug-.. All go nikSto midwifery,   irompula^^^M /this hospitalpf;
TO ^t^fents wea^-taken in this    month^4§§^ thes^plready have midwifery.
Admission qualifications matrloulatio||^r failed maMrio.    Have a flan
.for p?.TUgp:when WHO nurses come..   Were notQ^niidering aaJly ward axp.
Mrs||pettief had > plan t^flSlnelude, the students fr«^^ia f*th*rpii|i^^p
CalcuttajHospi'^s in  this and make a Central, P*T.Sp||Ill probably not
do  this withathe"fir|p" batch^fhere ate ndw t^raa nurses taking tha^pl
Sister Tutn^fp^urs^In Delhi J0r> wifttbe assigned a#She matching
nursea^ig?hey;.are MillagThommy^i^ss Areng,. &nd UisB^^yz WM pediatric
sistoS^s  taking ^he ped4&4#4e administration course" in %draS and wtf||j
be returning,..so^i^:. There does not seemtt^^a any provision for fellowships in'our project. Why?"  ~:$[3m *&$&§     y§§| iSi       l^*ljie$
Assistant Matron has. hsrt^spltai Administration  (or Sister Tutors)
in England and als* Hea^h Visitor1 s Coursj^h England*    She is not
''being used prop^riy^, Ap^rentlyrist -allowed t* do what Mrs* Lewis j
tells, her t^pf'   $h£g latter ^^^^' die tato a ^possibility that fiss '
Majumder. might beJdiad. for jl^ about
this.. mki m^'^m V §J|       §11
iui»ih with Mrs Lewis anftjothers after seeing the quattera being const-
ructe^^prW.,H*0#,..personnel.    Each will have a bed-room and a sitting
room ad^olnlngi^^pare .will, be ^j&ree lavatoriOs and two baths between
tho ffiur^^ac^f wil$|tiave a bearer>'^i:Thay ahou»|ring, their^^1*^S
linen, J^oluding bed-lihen*    If necessary th* hospital will loan soma
at first.  F^irhiture and cr^cfery willj§|be provlded^^g
After lunch the Ward Sisters Came fgk a meetihgS Aboutw8 of them,
fhay certainly have^^^^Btme f^r teaching although s^me of them expressed
interest j^it.ypf the group,  three never said one \worft.    Others were
quite inlpfasted and had a fair amount :^;..sayjg|-Much of their ti«e is
inventories as theyaare responsible for any: 1^'sses-MSo procedures
establMied'^Sach- **ne does an she remembers being ^i^it#y
To dee'';Dr. Das Gupta inb'his office. gf|l
Mrsv^ewis would like the leader of the WHO nurses at la%^|»month
if not! Imagery before tha rest *f the team*  "Would be |oo4, if^thers
could iarrive the first <->f May t* get ready for the &ew class.
 37.
Feb.29.  "iieft Great Eastern Hotel at 5*15 b&.M.«rto Airways India and
thence to Dum Dum Airport* -foggy*    ^alliint forget those atreeti^pery
^uicklp.    Countless people sleeping 4~*i the pavement with onl^^Saheet
over^hem^tike daad^^th shrouds* GoWs and bullocks gru§4lng in the
rafuse^JSaatly every rickshaw had It£ <ftaer sleeping Hi ■ or under -.;5^i]
"Calcutta's papulation --^er '% milli***i.    lice fllgSlfc^ Madras maki&g
on^^piipgat Ylzagapatam.    Very warm here*-     Mat atv'^lrppip-t. "by Jbr,.L
Rajamannikam," Chief of UaterttaX and Child HOalth foP^tha i&tate.    She
really came to me.^|jPr*  Gordon but;||se was not.||H^ie   . plpne|||t Approached
ma with the request .J§§£ a WHjO    public health ntirsa to hei$ in the preparationmf H«>?*s*|Really did not havo mucfeidea of what she wanted except
that It be someSne ^hal^her^ln th^^^rsihg activities and this, is
understandablef^fe^^^^l" har|^hie^f4ama -ai^Sg t^usee £k*Tia and X at-fj^^
They reslly ate desperately nsedihg^.t^ of the  -
difficulties in getting recrui^/orJ^ the^fact that
Ht^^i' a^fjpald *i||f Rs 60 p^^^^ntl^(W^Tj^e^like..someone. 1»^r^ganize
tho|pmrs^ and wo-rafl be prepared to accep^fphanges in the curriculum.
fk^fpanj^ a' par^^^tha^per-all plannii^;whieh la, to take place W§th
Madras f-^if.lcIalaS: Suggested that. ...if this aspei§|-wire- uiid|&5atato^fflit
ml^ftjie| walla .|^hav^ aJ|aeond nurse ^|^pLf in. th shield wo.rkffl-ai^iact* :
Madras has, just approVei||an assistant nttrse course.:;^phey--havew.traiaMid.
l&ggkes mat they Cannot'-place beeauere r*f lack of s^itl^neil^bsitions
*j£fi| themj.       |^Elb|Iffl Pile        rl^:i0fflftb     WzM      . |:u:ti|||   bip^:
iflss Eyyrai^Matr^^cama' ta^the< . Hotel for dinneii^^
!lJ.CKy^ s^^^^k here in Madras.
{^hi^B^-J^opoa^ witl^l^r^little Indifen bln^t^)  It l^amazing haw It. la
'.'acoe^teit; that tkew student Is thereto give serriijj^^^Very little
att^tl^n giv^i t^  the education.
;..- i-; ..aaa zyz. ' n. ,'...'   ■  ' > -  'ffl ■
March""!.     Took anb^^1^ taxi ride aJ^imd MadraQ>afore...: leaving, for the
. Mrp^rffe' A, Very attractive city with:-Svely buildings and    a nice   ;js|j|f
i^ng;water-front*.' Much, cleaner anEn^he people ^^^better fad. . ..:. Aa:
the taxi driver remarked,   fThey;3^^ ;
churches4Mj?It certainly has isada a'dlfference if that is a contributing
factor^pfhis,..is nne of l^^^ost progressi^pitates^Has a population of
456    56 million.    ?hg highes^Literacy faM^^'i^ris says that 7«|§|»>f t&e
nurses  in^india aratghristians^The pr^Lem wi^'attracting the better
fjglpss gi^fis ^hattg^j^B' never|keen ta|^ht5^pj^|Bnything id" tha home.
Aftd Wlirathtf non-christian at any rate it Is quite 1|pneath her dignity
to p^menlal^feskay^^t will take tis^|o :i|^irc^me;Sis#'      §3rapi
Left airport a^ll;3^^Ia.;Mr;lndia.      Sm&^^lsne Xm^BTj eomgf^tS?ble*
OnO stop where we had lunch. ^l^rivedtSalombo atk^^^KrVea^;attractive
from tha ai^ M^P^.Mtss Elias,  Miss Wili^peMis®ffiith-.and Miss
Macnemanip 'wti^SMfiayad at the Grand Oriefft^|bp|tel ^U|).iH>)  with us for
tea^^he^ weat/^'l^1leFa^eJpfr a/delighaf^L and refyesking swim*.,
ttaroti^^^^"A.M^Bpen^a c*|fee of hours- aiMhe^fol*mbo Exhibition.
Faij^r wel-i-i'done. .    Had time only for the pavilli^s *f the variou^|f||
countries^. il||^K«,  and Indonesia the bast.  "Australia most"amateuri^h.^
U.l^nExhiblt rifht after th^ entrance als^ very ponrly done*^  ^J^^^f"
photographs with aalot'of rather fine printing*     1^0.  the'only section
that ri^sorted to ahy c^l^r.    We thought that this W*uld be our nWt^iwA
onl^^&!it but Mr.  and Mrs  . ^anuadin wl||came In f^r a dBink wi|p:us
in tha^aVaning instistdd ^n taking us t* it    Chinese meal which was
delicious and then back to.the Exhibition V  see it at night*    It really
was vary attractive^ The" trees had" thousands of tiny light bulbs which
g&va thej^he appearance of being covered with exotic flowers;^ We"'Went
to^see thMijalyoa lixdusjfcrl^t "Sa d Health Exhibits which *ere "fery good*
Sometime^  there, was mention..,of the assistance of  t.hea^i^^^^ '^aa
but not;■ ai frequently as"it deserved X am sure*    Great new industries
are under construction how and are projected fo» the future*    This is
certainlyj quite a different country famm    India.
In theafterhoon we had &   meeting wlth^ the nurses iat^Mt. Lavinia       ^mM
Hotel,JPbeautiful spot on the shore about ten mileS out*    *he nurles all
gave me a hrlef background of what they have beOn doing and plan to do*
the details of this^will be recorded lh th/account .f the visits which
we-will be making,  them individually*    ^ses"nurses seem to get
alon^ very well together and they have a go*d conception -g the nee^
 ^38.
prepare Ceylf^nese nurses to take over from|||hem.    ^he q^estlSn of having
matching huripg has been a diff Iculty|^ppa^|tl^:^ %ere is much..'
ayldencdMf |jf^i originaif^lanning--an InheritanOe fr^m thO rushed MCH
: pro jests J|' T^ere Is'alSob^adence that"a leader of thewnursing (BB^-
was much needed.    How S^;i^uld think'otherwise is"beyottd me.    For example
whenwMiss' Pm'seJitv the lastv-;arrlva^*:came ahe||fcd nifl.know wha^,shewwas
$$ do^^ej.followed Uiss' Wilson around foj|| awhiX||^d then1 carved :^t^" a
job'^df^r .h^rjself whena-she sawthat the r&st of thtt'%apital was being
neglectedM/She apparen^^^a^j^^irated on the two remaining pediatric
wards whe^^pe Swa^)asha,^^^enacular gltt were 'Jjjj&Lng grainedJpFhese
girls ar^' given ^Kferl^ce    1$ pediatrics at Jpe iLady : Ridgeway and "-^1
women4s Medicine '«£& surgery at the Lady Havelock. .Originally.-vthe course
w&Bztn*M* W$$. 18 f|^t^s and theftirere t^pKe an"4ssl.^ant type^'^The |ip
'-c^urseyjwa^\ extend apparently graduate as 3'ySE|ra
grada nui/sjes. o||ey H^^^ne tu^g^^fith .wh^m.-Uiaa'tProasar worke*1|§?he
also h^LvMk undfl^&udy. irtiojarsha Is no-w;|^rIng top-.giTe more pediatric-;
experl^llfc tH work her."in t^tak€^verpthewclinical
Instr^^lHn in pediatrics -to;lftese Swabasha girlS and^also  to, take"
oter" the-pediatric leofpurea^  them ^om the -tutor"wbjgr will then continue
to-givarttheir generalgnursln^^ p-She. Is planning now, ^n the lit quest of
thetifcutor,   t^write Kut^^^^pMiatri^lacturesland the"tutor"will give    :
them.    A bery ^p^^lonable"procedurS^^Mrs. Kleppe eIsb is working
only with tbte   vf&aou&ar grou^py-She Is at;:|||e Castle which is apparent|§^
a fairly new institution' aad||xas a Matr^n.jW^y. much      interested in T
training.    Miss Macnem&nin i^pt; theDeSoyga which-has -a very unstatt^^g
m&tron^; is very ?»ve|jfrowdfi aftd^Ls nfit go<»iQ||t» training.    Very Phalli
rotation^ Her^the nurses who  are" taking mid§ife3^iare trained as w$ll
aS the-'-'Swabasha girl^-She has ■ 30 ^^^l!^^^^?h speaking nurses who
do 12 mon'thSa-mldwif 6ry.^,In. Qeylfm they di^^fl^^ mld^rifery|immediatdly
after nurj*!^ long time*    They
^m^-ttyting to, hatfe it"compulsory ttowf^^bd^v it af tex|£t Thi||Srenacular
girls spend 18;Sionths,b^ Months of: whl^' Is l|i th^^^Lnstitutloni^ihe 6
months at-, the en^is Jf«i^^ which they
get atjfpMB health centi|||*" Mrs/wJanuadin is ^charge of this aspect.
She  seema!||o be in cbpix'ge of :^oiym1^^|^^thinfes S |
March T$B^^ Miss"Smlfh*s ill-ans He has
his* offiwf in a co:melrl^ clinic where"
Miss"^im. concentrate^ls a$N*ffl^|SN^ fee|pg^hat only
one,;.of v™p:three objec^res of ^f|e project isrfflfet to be reallElpy
after b<pi&g in the'field for|j|^
are expofclng to move ||f£o- next weels^ fhe pi^pfrograa has n^t ev«t been
atartei^Mnd seemsl^peliss.    -The training prog^a^,which la 1the prl^fi
nobjectly^^^as been a   ^isappointment: He feel£|that this is becauaa there
is a Btjuaaa. attphed^' V.D.  and that th^|^|3We afraid th&t^LT they
take amp special tra||ihg at all "they^^^^j^^&ftsted jfc an^fctpoat
W§r evpr^k-^hey      al^fe'^ject t^Btaf^jaeelS^gf on p same grounds—'
afrai#^p wj^ be e*nxlderOd as'spe'ciall z(^^^,ining^ierhap^^^b
. Lai||i|fe^'^^g;l|;n not ap^p^acfting..th^^:^h a"ii^KgeEyBralized ?*^^B
basj®' X»ve the feeling that neither he '^^ffitt^' Snlth have seen thB
^^^M^^^^1^^ % are thinking- of 4*   S^^llM<mythin^^^^ a ^P@eializ;
BBTf^S^i Miss.^nlthlhas not been^training an^lnursea except the ones
iJdr^ifi^ Is"a p.h.n^^^ha has »€|^§l|f^m?®d
-';tlam^^ made » have-:Jp ge^aral nursing
stt^jdjkj^ntatf. throu|h#    However|feiera has |l$3n ^He- ^3C0Use"'b@e8'US6 "fcht
spa^§i!9wjtow ybeex)t so'crowds^. Miss Stol'th seemswt^^ate^spent ttoit^f her
timi^§4d^ing jBurvey^-    ^^^^^^^^^^^w^^WlW^^^^^ft ^e P?
axtreiti€^ty >cut|^nab|^re.:^| li^pregnant mothers;   S^y&f^ll^e;  1-2^
in th^Sirmy*M0ut of ^^r att"students only^ie real"positive.
WitJ^/p^ard • l^^he staff Ing"of the clinl^|^lt has not be^to^ary « yy
saa^sfactory*^Wantaffifere workers^-'The '^vft"sa^\ th*y wil^^mploy^more
if ihey can be goun^   Miss a^ith suggested aHclal workeits»but from
what I  can di§cover there are x$^trained--.o.nes in' Oeyloni^^^fef-
Mextbwen^hrough^^he Lady Ridgeway and. th^^dy Havelf»tek with Miss
Muttamanipjthe Matrott.    fhe Lady Havelock is ^penf« and is f«Kmedical,
and-surgical cases most of whltih are gyn* iT^ir^ioal beds,  ##^edicaltt
5 paying patient^ 59   BapClft^r patients^tJlo^V^Lady Ridgaw^r is
for pediatrics^    *here"is amid portion and"a! newpiilding o|p%n@d^ust
over, a year agt®-the old ^rti^ is vary g^wded and 4n one to^ ^or
 Jb        PH w       39* ww IIP
there are ,TB tiases mmm^mhloh are floo#pasex.      'hen there li Word 5
which Is supposedly for tha convalescent.      It lakes the overflow after
the nei^admissions whlf| tak^ place on regular dayis..;;;^has 48i|jgHU hu|pi:
will have anywhere from 80" to  95 patients.    Tk^mem  "Floor patiepts*is  1
not nearly as bad as it sounds simee thesfe jpopie are"?&ite used to
xleepingu^ the floft and Without any plll»w^| "1 waa-^re disturbed by
the big cr^w which flew"about taking bits ^f^^^^pll^Kthe plates.
The main part Kf the hospital looked fairly well eqM&PPad and clean*
Betelinen wa^^jfc'always Well laundered however.    Apparently there has
been a great ImpraVemeht over December."^bf*a is a wealth of teaching
material^ Many nephrite and malnUt^^^ioia^: Several classified as ld§|
malignant-mainutrltlon||^Sti Matp%iibls a timid,., inaa<^ewperaoto-»^8[a8^:
staff ^^^^^^^^^^^0^^^^^^^^    SayS &hey iniil^lil^
I gather fi^|fsome:thIng said by Mls& ^awford^l^tar.....that. perhaps ;S|* I ■
nuries areT^^KmpatieJ^, and have§f|pt tried l^build up the^aecUMty of
the |B^atro-n*^ttlss Wils^tt:  has 71 general tsj^ifiiri^.nu^ iu
§|§!diatrics for 4feag^fflm^nths:;and a^rae frtre 3 "ci^^psV :'|^p^nls''tW f irate;
time there jha&*^|^ this group.
This has bfen on -^ael^dtBd ward;basl»*"   K^^p,s giva^jactxl^es oncal|l|
week and Miss iilsoa^^Lows with tu^ria»||lss Wilson alslyglvea some
lectures' tf  the medicaiH^udants.fA^piey are hoping thj|§ Miss^Wllson's
understudy/' caaa^akeatl^|s.lster" tutor1 s e*uirs§^^ st^ilhg-' in
July. ■ Th^re wiil. be a.^ri^|^of three monMs whenjl^
any students from, the g|fheri|pLcourse because, there WHJL ^ne^yXa-a^\^hor,i^ft
Miss-Wilsin wKndered what"she e^jbld best,do djflfing tl^X^*l^^^^»^seest^ftF|
staff" education "and mei^onespthis to||§J0, ^atroiafe: AlS^-spH|:a-.« Miss
Crawford*/ who .thinks th^^es,^8^ontributioi^i|feiat -|||hl$l be made w~uld be
"to: assist the sisters w^^the admlnifetril^it of^^a.-^ppa*   ;. *hey have
never ha/i$' any help in ^is^KMiss Prosserl^^Slpclni^Plth thi^pwabasha
girls,' tov Incidentally aiptbetter. prepar^^p^d t^^Ogllsh speaking
firia*iffiahey''must have  their|||*S«C*  whl||gis jj^ulv^ent tH Ma^Jii^.-%^^
he others only have J.S^C*—equivalra|. to jfprade HSra.AlaK the English
understanding is very limited.    Apparemtlyl^i: tha last tw^ years they
study^^er again in Eftglish all the subjects:^^chi^; takm; previously-J9|
in Cingalese.    The sP^rtag^"of teachers fa very great and the quality of
B^^entering;#gh,; sch^f^B .if great:;^|cicern;k;^^pte E^ilatiHnal
•-a^tho^|ties;^|phave since, learned that;^^filagth^f^Irst-group of
Swabasha^trseai'i-•   Whiggif^hey started it waSp* he an 18 month course.    ||||
On ^commendations f^m"Miss Crawford and ;^^&ftaff" they have rev* a ed the
,cUr)r^culum and ara--;impn8ed to' be"sanctionin^^dae-k;^ftpe: for 3 years. |f£
^Ehey get trtaingj|§ty^d General Hospital ih add^i^ng^^pie Lady Haveloek
and"Lady Ridge wayjpt Hon e"of their"tutors however are gained aftd this
is on0 oftthe biggeafeproblems--to-^et tut|§ra- twined' #xo  can spfeak
the Cingalese lang^ag^^ mj this group
and the &gllah':g^.u||^as. beett quite::|||parate Jihd tfyg English speaking
studehthas alwaysi;^^^^|^||erIor to .the other. :M^p^|. General Hospital; ■
warda*w-at laastfifi ai^^|'-them9  Miss Crawford-has fflpycceeded^ih^having
them work together. K^ral^     ^^l^i^K   ^ffl^tf^^
Dr. Bo Sllva has been,having Miss Wilson atid I^i^^r^sser 9§1|H MR
nutrition" clinic ^noej a week*    ?herg they onl||.weigh^
infants for i%^^|i^^^P^^^^^T^Pi!K are.aCf'ncern^^Sj^t this*
Miss Crawford feels J-efJ" keenly thai there" should be^^^seaflitik of
the W.H»<V nur^eS    pith -p$t 8chef$fK She w^j|«lespec|^iyt^lke to have tt&e
underatudies ||)poIn/ted :^^S^b strength Hf'''fth#^?ainl^g s^if*ol as.
Clinical feupetvlso^symd feels that W^HO e«u»thelp jjn bringihg th|t
about*. ;.%rT^pa'^easob Doris, seems to oppose t^isM|Again ahows f^^p
original planiiingi  ~jjjlk' \       I ^^^ ^B     ^Klp      ^   'W*
Kext want t^the/De »|ysa Hospital*    Matron, Miss"Hai^apakse who was
on the sta^Spf /the G^ral Hospital Training School ind h&M had her
Sister Ti^^^rf^^^^rsm Vell^re.     She appears'' lAkB\e4 v^w^rwus
person an^S little ,prsecure^ Our visIt^waS \anfortun^.te, i^pihat    she
had; to ^end s4me. tika .with a visiting doctor jttst aA, Welarriv^d and a.
seemed Wuite upset afbmt something*    We saw thr^ugh^JS^ie WWtha hospital*.
It hasSfH-er 30!0 bed«^>ut many mwre patients.    Do  abo?j^500 deliveries a
month.ftspitaa seen^s very wfcll equipped.    ?here is a■ iiidwi^exfr *^J°r
but shte is"mtrainecMSld not meet hetg Miss SacneMln caiae ^ith us*
?ha relationship between the two did-n^ seem to be *f 1 the ^ppieat.
Sftmetiimes se^mad^ %%&•[ differences of opinion, ^fnr^a^y ^^«
 "lip   IS w     111 w        *0# f»«
was not. an opportunity to-; sit down and talk wltfpttfe %tr^S H||
Miss Macneman has 30 genttral . trained nurses"who are doingbfifeei^^ months
^^midwifery#fy^|^as-,^Cbeen neseasary for tha ntirse tj||take midwifery
on graduation"and many ]»tfhese.have beetl out for some time.    What $hey
are wrklng||b not is. ||i; include three months..obs^  in tl^KgeneraX course ea
and the^ have; them takeM months in midwifery"almost immediately.^  Ihe ^t
chief treason being that ^paquently the nurse '.^^ra^^tl^pgets pasted to
"an^;p|itpost'^spital an$| finds ^^seXf in charge oj^heb|p^ternlty war4vlpnd
other wards a$. w&llt^Thipr&a alsoytJ^ venacular group f#"midwivea whotj|a^e
the 18 monthi^^^Also  takes the general treining hura^^Tor two monthd
obs*    $as argewlfceii;. two fremature"units*"   .Ha4|^w^ understudies.
Miss Ma^Eiemanln a2^Mrs*b:Kleppe working on  t|t^midwifery *y^iculum*"
^pfthe afterpoon vlpitedn$astljp Street Maternlty/|||ere Mi^-k;'Kleppa-.works*
Matron Is M^ss De Sil^s^^^prainOd'' sl&ter tut*3$|;:-who waii^n the general*-''"
■H^apit-ai1 Training ^ci^X Sj^ff f oif IS yaars^^^^ell%>repared person with
]^^^|Ktfa1M'i Wants^&l^^l^fejpa 6 months observationg;?i^ir on her ^mi, Js '
thinklngN^ clos^*^-This '^^pr#ry nice 152 bedded
hKspitaX*.^^lke a&$|p&a maternity hos||ttal^
fHr anywh^j^Tup iM^^jpont^r ba^p^e d<^ver||^^
of the"Matr^|^^H^atersJ| Mrs* Kleppe who confln^fe her&elf largely-.p^a
the Labour Ibom, fm n^Ldwives, 5 staff nurses^^^^^^5wl|*|ftis a midwife,
and 65 venac^lai^UplfemidwivesiSrh^re aretaXsn^^feof the general |^j
training ijjgtfetee who" areift'lng^he ir obs. Mr3^^EXeppa:^S' re sponsible for
these 7# Sh^Sas two 'tinkerstudies*    Has s.ei..up^a|^
they are al$pvery pi^ud* This IS a spl^pfcdid ^spi-1^^ and they are
endeavoring ^xw^rk j^fc up as a good teaching ^l|^^^piri^feomplains
that Mrs. Kleppe :^s"^fej' a trained ..mldwifwx^ is more interested
fin the administration »^S(he place J|oes have an. aiimt Dutch'.cleanliness
^and'tidyness,  bu^ is. an excellent practical"
teacher|^?he Ma"|j||k:% stud^atai^peir general nursing
procedures as shil|:f^ imagine that tha
venacjilar studenti^in. me De&oysa get very littf^bf*4    of this.*
(Later: Miss. CrawjfefiM^.speaks4'very highl^lg^f Mrs* Eleppe,  and especially
<m her relatIo-nshIpS;..,i4^h people*} ||j|
Met the^PrinclpaX Matioft&Kiss Someraslnghej^ she has jus ^returned from
a year ^f study ai^^awi^l^^ in ^«f|l>  ^aiftly at Westerh Reserve*  ; X
landerstSnp;.that she^B^E^t^a]'f|tery"strong person^^f;- ^^:.portion}.:; was
given t*v hergjfln  thebfesis of seniority. ,\ Sffif
•  \J     ■ mJ    . :.  ffl .      .Vi'hffl   1        '     "   . \ W '. V
Want to  Indonesian', (jPali)  and Sumatran dancing at    the ^oy^'ftllega \
Half|    Very fIne'^^jp»ier after at the Fountain Cafe with 'the nurse^g:
March 4* \ Spe'n/1||^.M*  pg^n Kurses Training School and Gen'eml Hospital.
Miss Crawj^^^SMiss Sutherland.'^ava inefuly.^^ckef^pl* are not
sanding ahy^^^E^Miss Elig^^Jitake P^^^^^^^^^^P^t^^M tofe
Govft Tc^^^mkii^ea *4|a foreigliJurse;eta!ing over and still iaterflrom
Miss Masse|^»at\ there have been several hintsytha|||^^
terrlfiedP^i^/t tf^S|yght happen" and ready t*  ref|ign,|^^ fatal
ofgcours^^^^)f^Sigh person to be brought": in when these :Ceylonese girls
have be^n prepared" and are ready"to take responsibility..   Sphere is a
Miss-Pltfiold'll^th^f.SA -flow who will be back in July*. Sh^ .^Lll b&jg
Mis& Ellas) .^[s^stant ai|d"iater"might take over Kandy^i^^May hp-ve one
tut*ir Inf^alEpatg at.^^f^re who, return|||h, April* One .l^dianj&rse las
beeft f&§m a ye4r and 4a on^a c^l^ract for tw* mo,ra years!,, sha Xk a go«d
tutor^Slrs. Gomaz, Miss    Massey.'s present"undorstudyj^pr go toNfelXore
•oh;aGo^^^pholarshi^" (There ate two-'such provlded^avelylyear;   sometimes
-•they hav^^^islgn a contract to  tremaain In the    position\ forg whi6b
bttog^pailned for-as mu^as 10 ;yeai^.    Misr^*D^Sliva"'sClfo- returns ^m
from ?ell|re^at fl end/?f April and might theli work along-\*lth Miss
Massa^ Schotl isfbsuppnjs^^ have a strength '^|f;.8 inst:^^&rs."  %ara
is a P.T.SS* of three mon^^during which time the■■ studenta.W notggfi n<n
the warda» Theh'gthey ^ara^llowed' through ;fo-ra^;least the ^irst e*»
three iiontha-:Mf their wa^itexperience gby the instrubtors.^Almissions.
are about 56 students twiifei yaarly*    Miss Crawford hoping tha^ia Kandy
they will not hai^to. admit more than once a"year^^pKris expressed the
hopo^ ^^^^^^HM^^^^^^tt yaaras. have more^control :f>ver-^^8
studenta^^Can^'iae the^logic *f thimM^    | hmk        «   ^       -^tA tviA
There is an MylartSPnard'Tor the Training School^m Members a-t^he
 l^MS I «'   41.
app^priate^vernnient officials andjj$*spital:offidals*  tha Matrons*
and  thrifcfararm the Nurses"Training Scho*x||; Wh^lt mmes S Tralttin g
qtiestioii^Mlss:Crawford does n*t have to gr» $k9H Medical Supt. Of the
hospital but can g4^ire^y to  the jftMUJK    Ihfjhe Kandy pro jest there
needs m be... a ksafeguaa^Xn"relation to feh^ will .have pie say in nursing
education*^ Misse^aWford *nly has to  supply a Certain number of students.
They haveg#Ver the eiurse of^iae been able to  select tthe wards to which
they trill gK. and they can cohtroibtheft time there,    laying to get a w
Model WardM:whiah theBi|§|an demonstrate what the Burse can"reallyud||g
WiH;htakei-awqy from-:tl^attehdants  the nursing"duties ;fehey now perf^r^|t
Later laafflirne#»hat Dr|EBarlow ;has. taken half ^;plthie. ward fO^lhoracic
sUrgery.    He ^^^-^apeclalist here from Ihgland who haS been making
some wild recommendations;  such as that 200 nurses should beysen^idbroad
immediately- ingbat^hei^^K^^f^r trainlng^aid, thj|||. every tha?racia|p
surgery patierifeiahould hafe-Matalnless steejj^Mdaide ;iabinai^^^
School'-has oye^^B^-^udents iholuding 17 mala*. ,n |n ^ntr4st^0' Miss
Adranvala, Miss Cra^fOrd t^inkaf^^re Is a real fu||tre forjpale s*Hde»4
ntirses in ;this  ofik^tryj^^^ n«ps^     Jfai
So;^aalled; pnat graduaf^^terses are given^||ifter giraduatiofif'fee nurse
must serve for Ihree yearly She then t<^e|ife^ takes
..the p.g* ;'^preht||^ ^er'^^
pSt;no organized in^^SMon* Mlss^raWfArdj.aays thej\g^ffi^&ganize some
evOnt^al^. "^^^^^^^^^^^^^^^^^$ .»^bb9 Ml^t^pf^p^- tft||| if
two 'i^-|paen#wach^ear to Vellore, this shouffi'be s'utefe^^Ratf^;the
time being.       •   |||b .     lt"pg :      tybyg: l^^^^^J^^^^     itPl§
M^n-pay4hg. war4s of the hospital"are run by! the^^,thol!^jrIsters.t;- They
^pemgt^; be' fin$ people and are mostly American and 'Eutf^]^^m^.Working
lander tsr$: difftcauit positions.    Beds K|papItal-^Xj^^^patientsb:
usually. 2300*yW|ln %j$f, %e Hospital,  whffi|^p^g^^itfq^ li^jje-afohed ward
normally ;JiaSaffl^ye?r ;ifl#^par^:120^atlents*. '^0^^^W^m
In. aft efUf^pIre turned ^^^llfeol for tea*    MisSa^awriWi ^^liss-^utheirland.
invited the W*H.^.nurses," Miss Kragh aftd M^^NIc^'llsw'd^^ in time
also.*   the Matar^p.,   and staff e/vf the  schoo^j|||| Re;^^pe^|ip;o HObtOlywith |
W.HO nurses,   arjd Miss    Taylor. "Had maetingfet^l^^Ussed devklopmWt of
the progtam—ertphasize^^p|> need to  wor|^^^|r and gi^^^»\Ceyl^m. jfcurwip^
the"securlty:-^^r"need^Dlscttssed Genev||:CKnfa^^      and^jfhahgeS at;llUi# -
J5hcouraged"thei^^ '^^0 fj^^m. up disoussI?^r^^P^lly and to' do  e^Ory-thing
possibia to ge."^&fe:^prses t^^lscuss^theiii^^^^ems.  ||B|        ShhE^'    u
-Aft^ dinner M^aa filson and Mjss" Propser wkt't«some!n3uggestlo3ffl aS to"
their program*. "Asked what they would augge^^^hfemse^^s.    Miss Willdon
^^|^Pl!^P^^^^S#^^^^ help the:||^
the ward administration, prnblett^*     Stressed :tjii^^
t*  eventually b/e placf^^ii School^taff*. , WHOf g^p'o^gran^^tS unfortunately
not set "a gO;*d/exani^ theiHN?: discuss their
plans with Misfe  Grawfg||t,   and after she Is g^fj^Kyith Miss illias.
March*-5»^^MS;an|p' with' Mis^omtterasinghe,,an4.'Miss 'Mb ^il^i^^E^^^70
miles^||iaryM*autifm coug^y/b1 Hosfital |^pituat^b#, th^||X&a of a hill
and isTbuil£-/ln^ climb.
Beds-#00f  patients iaverage 1,000 daily nowg Example- «'-*vej^nwdiag--
T*B. male,Jl4bfeds,hi^ patients female I5a^adst^^^dentsj0^
20 bed^ ahd^?:cotsi«:patient^^p^ wiping :Ward.,yX8pbeds, - 65 patients
^r^l-Gomp itk the Medical SupH^    Has only b^ei^pt' 'thi* position for 6    "
weeks,   ifoapi'tal m divided into"two- parts^ the^ MatrW!a and tha Religious
Sister^ifelhe . M^ti^n7-laya Ceylouase, Mia^Stii^ andysho has an'lusalstant
who  i^fci^lo- -Caylottese.    She has'about AOO'h.^^j   Male,|and f^al.fypSi^al
:andMH|6rgiaaiy JLd.H^ ' whichXs'' a'small unit(n^V see«;»^i long way from
thc^mainW j^lical and surgica^ whic^ ^r^ghoused    in
open buildings M' tin 'ti|bi aid extremely j^,r favpllaj^|)i)  th* f.St  in
sa fimiliar typo'p^|^ildlng||^and a   Planter1^'; wa2pM|.eh' ia for paying
patients,*. : There arefS'l R(eilgl^us slatwijp *f the    Mary ^^|^^
Order^^Cen arJpitirs^a and are alltwell. preparefe£rem|-iAi^ and
Sanadiah^ph^oXa^Maw^ M*A^| ^he;, fI#ar;^i^r^«^is Madeleine
Maria and her assistant,  who\ was in^ncentratioii, ^Pl^f^^ Phillipines
throughout the    war iV sikte* Brigltine.    A Canadianb^t^is ^ C^J
of the    Pediatrics »8£d a^d one took ^i^ifery afte^#gfSL5 havf
responsible for the rr idwifery students.      The Relxgiom|^#sters have
 43*
M*fch §Bfrft *>l«*to« at%30 A.M.    "Sice flight to Madrasif Immediately
after lunch    went"to Madras Genaral Hospital to^meet Miss Evarat*     1
Discussed plans for pediatric unit with Professor Achar who later showed
us the. existing facilities for pediatrics*    Dr* Achar is a Very anthusia*-
tie pedIatriciar"who has taken P#G* work in Boston and in Toronto and    ^5S
who wants to  introduce" the treatments etc.. which he saw there*    He wants to
make the General  a good pediatric teaching *centre^M present there
are 30 beds for Ohildren who have infectious diseasaafeincluding diphtheria*
I did hot see this unit,    There are 20 beds for typhojpjdaaea.  Ihaae are
along one side ^f a big ward and on the other side thafre are female eases,
typhoid, 'J^thinfe^he main pediatrle^ard has 22 bedai|as a ;%unta but the
larger oetfs have been replaced by^ts Sttd "witpfhalving s^me on the
flofiiSheyt take 43 patients*    tha top floor ^-fl^ie"hospitai was the
nurses quarters but "mow that they are iln the new hostel this has been
vacated*    Adults who"are in the accommodation    adjoining thi present
pediatric ward are towbe moyed up and the vacated rooms remodeled for
childrenJptfhis has not started jtet"and Dr. Acher thinks it may be ready
in about three months.    «^"Acher going on• $ffxiday in May.    The new
$ayters will give 60 beds for pediatrics. «h^se    will be medical  cases
only.    Dr*    AChar does not have anything .'tOliftwith 'tha;^urgical.. :cases.
In ti^Womens -and Childrens Hospital  there- are; 40 pOdiatric bads. '$$$!*
Acher also has -'these*  The'llajorlty *f the mothers com^^and stay at least
during the daytime"with  the children*     *he wards appeared olean and there
was more evidence of specialf|§reatmants and nursing care tfatip"' In many
sueh"hoapitals*    ?he Sister ih charge see&e^^ery bright aMllpnterested*
I do not know if she is the one"who  is to go  away on FaiX§w»hlp but think
not."  There was a. great variety"of cases.    Many nutritional odemaSj^paf.
chirossl&,   etc*    Thete is a BXood Bsnk adjacent t^Wihe pediatric ward and
many BXood.|fransfuslons are given. |gH|
Dr.  Achar sees the duties of the TOO "nurse as the folio wlngxm teach
prOttatur* nursing care techniques^    to  teact^"such procedures aa fBm
Mood Transfusuons,   Continuous Drip,  Subcutaneous Drip^  piXXeotl^m^of
urine from infants,   cystograms,  formula r^om^STAtOH Bhe w*mXd also give
pediatric lectures"and clinical instruction In pediatric to  the students*
Maithar iS given now. Dr* Achar would likO to have a nttrse from"Toroa^S
or from Boston*    Might write to Miss Mastottj|^and also speak"%»ladys
Sharps and Ruth Sleeper"when they are in fOf^n^*    He seems to remember
a"Miss lelsoh in Toronto.    Might inquire.    It wouldtcertainly be a
wKnderful experience for any nurse because they would see eaaes thay
wotild rarely if ever see at home.tel think thlsttoighfal^i a womth-while
project even if "no thing further develops in Madras, i -Perhaps |f|;was too
critical and too'hasty in condemning it as a fspotty prpjectl* § Bh|
uThis hospital"has 887 beds,  didided as follows:  medlcai;252^   surgical 3®Xf
Children Si^ptherr 280.    Thfgdailv average number of^tildren in the
children1 a ward iSh^b at present.   *he daily average ^ffi|*ut-patient
children: new cases 100,  old cases,  150.    Staff" employoMln the Children1 s
•ard:   4 trained,   6 pupils,  day and nightJduty*     2 pupil*; are      1** th^
Out-patient Dept.Monthly aberage nttmber of admissions if* the Isolation
Ward,  X29j  monthly average number Of deaths in f|lLs wa|f|^.    Total
nursing staff:     Superintendent ||||
Assistant Superintendents    "2
Kurslng Tutors      5    (Two for the diploma" «uraet  2 for tha
GeliSral bourse and one«n the
ll|§| . |&o**d Bank, "f^M
Head lurses      14
Kursee;    87 SRaHJ
j|P        Pupil Hurses      172 Wm
The **ady Hope School      of Hursing is l&ejlentral^Preliminiary %a|#ii*g
School for the General a&lp§tanley Hospitals»*here are two losing
tutors for this school      and/50 students*     This has been for six months
but in the future will probably only be three and students wl^ be Mmitflp
four times a year.t nfhereare 60 male Students  in the General ft^e.  |||f
was said that ffr every three female *ne mala student is taken,  ^here zre
many more; applicants thim,;can be aoc*P^^||^
Interviewed the two tutors for the ^ipl*ma **urse In Ngr?Ittgjjs the two"
tutors-f*r the general" course were also present^ the ylplama course would
seemuto be rather a poor show^iere are 8^^^^1 »resent^  5 ta*i*lg
the    ister Tutor's and 3 taking **spl«K Administration.
 Wig    44*
jhe senlojg-tut^l;  Miss Adaline teaches"PsychpKgy,  genaral^gocial,  and
educational ;Prmciplei^f Administration and"Supervision; Principles of
Education; Methods of Toaching^lursing School Administration; Ethics;
Professional Adjustments*  . MIss"Adalina^^ike alSthe tutors,  ate a graduat*
of thla tho splt^^aM she alari^|J0^f,her, teaching certi^^ate'hare*^She
has .p^^muchekldd^J^^feal education.   ;fly^fesxistsnt^^iss Ch&rkrapa*iit ■
who has had her Health ?is§|||^ no better."
She teaches ElstgjK th§ public health point of
vieifcand givesr|||^^ Which
lneigide"the following;. J^ysics^^piemiStry:,  Anatopy an^?hysiologyf        1§||
Bscteri^logyM^ygiene,   ffl|l'i|l^Itionf BioXogyj|^|:""atuden^a w»re admitted jjjg\
"the presant.t^pss :bu^p;fg|p!#d the first preliminary-t^at which- is given at
ghe etid '^f-^^weeks." Jljbls given in the bas||f. sciences taught fey
the d^;ot^rs-^K^ar abou^^S^cturas in eac^:' Mii|ll.Adaline could hpt see
that, thl$^||fe the- right waj^ufp|&* iiii^^ie maximum
number-^^^Sidents ,i^^Sian fef" taken" is 2Q|1|X0 from iadras: State and 10
exteznaSp^pher^; is suppOs|p;to.be :ao.me. practical exp;^^^anca-.ln teaching*
%er^S^ in Mland- C*;fiiTeentres*::^^fe:k t lEll       m
Following^pxese In te^l'Ie way we attended the f*xma|§|^ !
hosteX|j|by Heig^ghness -t^-Maharini- Sahoba of Bhavng^ar..:ni|pl(--'attached
:'naWspapp^^^»1Mi;t,^f,' speeches gi^ren. -      jj« ^^^kII
Kaxritf^g^^ at 7 ^A*M*||Sifter • two-Mtops -and a hippy
fligh^^Alve#|n .^elhi. at 3§45* iSR^r
Ellz&^jP^^ at e£u£ SheJ$* a^Slpie same I8l|
ataga^^w ^^^^^^^firy confusd^^|it it- all',f||^^
remember'wh^fl^s b^fh seen and where|^Phe alid Da^^ataoit^feave worked ':jMt
out a-achemSK^h ha-^^^^- the Bracket^Wati^p plan fo^Rirsing educati||§l§
&l*&abe||^ an^publlc-:%ealth"can ba put
I^E^o  three yearsi^pfhis i|^Lik«^^.!what they wlllf^e trying out i»|ll|
Travand^re.  Feels that -pubi^^fe;haal|^Tnursea will ba^^L^"damand v*rytlfe
W0^n*.tthinks the;Health Vislto^^roup: are^^*:tyrjgalngng enoughi^pport; to'.',
continue for ■long^JJUst centres are apparently noj|jgettliig''enough
eandid&ted,   theyg^fe wanting Something which gives .'.them b||*re* After dinner
Dr.  Warner sat at~our table dory a few minujtji^^^iacussed this with
her and saiftta.-.would like llpsee- tba|Lady Reading here offer'public
* haalth"rathor^than a H.V.  course#^|r.  Warner a3l|§yis agreeing that the j
H*l^course Is n<||||adequate. : "This"is a slight .change in-her view, -"^^ft
thinks'D^pPandit Wjpuld be rfcadJlSt* mak^|ha Ohang^l Jhr*' Warfier also
t^Id ns-liJlpl: Hazfel IfoOrisa^ in time ^^Kse to
India.eWlth-pthe P<^^^"aj|K;that Lillian Bish^^|ls .coming almost"
: immediately. Between Point 4 ^^W#H^* we might get-.p|mething g&ing to
replace the presentllraining alllfche Lady Reading, pit
p a * p-r.-pphp Z^t.,. -. •** i ppppi a^afffl- \A   .
1 Miss"Roberta here*    Has"siz^up the Delhi situati||i quite'welliWa 10^|.
f|$r confusion and a lot of people dabbling-in.a-the, $ame thlngs||f
March 8.     Interview with Dotis'^p-.'start as. tO-see.'>J^^K;Mani at 12.
Gave Doris an Opportunity^^"speak t^ggjjthe Mnntents^f QigR^|t letter but
she woul& not*    This I^.ne,-;.^T the unsatisfactOM thingS^jfehat she Will '
notbaek up"her oim'.:^^iiflsti^n"aefJ:give an -^pf^^unlty for| dis cuss ion.
Asfed:Mw long she w^u^pfl^feJ^Btaj&with W#^^3 and"lf shf wanted to
stay longetMhan One year, woiii^^pi^onsider^^ii^lsome W^^|Sobgurslag
Educati0o.*g^|Baid^^<w^uld.1^t want to stay -iW:i?d^'^hJ^R.two ^Sfere yeaTs in
afty Case and thati s^p*roiii|l probably, like" to &n-&nme Mudylng^t JBot
for :fujb.th^r w^Kk i^mS^^ ^^m^^^f^81^''-^d she
definitely" wan ted;T^3fe turn  there^ Later in -interview withj ^^^Marii
and with;Mris preftent^;repeated; this statemant^^^l^^^Bagreed &hat
at presOnt the Oontract w^uld be renewed fOr one yea:^tel  jDafMlJani made
a li^tja;^^KhIs 0nv6iB*f s JM||t6r.  "So mention was made 'a^U't Grinds and I
though^^ffl:would be ^fe wepgn^t t^ bring it- up. fig
With f^ps I diseusskd planning for 1954* "She expaessed $*me lilttla
dlssallsf^cti^n th^K; h#.^^fe: been .able-i^; help her wlth'i-^ls#^fi?rei^ J
iouslWeshe had told ae that the planning was domeift^and and" July and
that fhey had dee4d#ed qlifestioned whether I wouldi^toaa thei| to  help
with that or nowj| She agreed that I needed to  see things first and that
l^rf^yas not time for m<^e||^However I have been abl^^pan with her
 :    ; 45.
frtr the Xudhianal'jrojw^and do some tentative plans for the  forking
Conference*  Making a mlmo nf our discussion for planning*      |^I   |^|gg
Had a nice interview With Dt. Mani.    Discussed Burma and ha;does not
fthink Ingram should, go^ack there.    Perhaps he"is right and as hursing
educators are diffi ^ult to  fin^. perhaps we"should let; her W^^
Bombay. "He said.'toe'^ulfr-' dictate i^Jetterplp^Mrs^^ Aun^p^an notify ing" h|^|
that we were g*4*&3»: put"i^^^eplaceSient f*r' Ingrai^^pat we did not-.
thingk"it fair fo  tjie team there not to have a Senior person a&d that iggjigi
were not giving |the,yb*^.bservice without this pKat filled* J|fhls,,  as
Dr. Man* said^  fould be afpuntry Nursing Advis^^Xri disguise. He agreed
to P 3.      Incid-|ntaliy.'.;|^r.:- MaHI said;,' in relatlo^^o planning,   that he
had hoped that iach Oountry: could have a flursingadvig^r and; that' aftlijl
she;J§a& been there fo^^^^ut a year, sha wou|^make rllfhrnmehdations fo'r; :<^H
the program plpqni^g X$l||ursing*    I• sp^ke about the need"for-such"a persoj|lS
In Afghanistan tjp.d Q®$0$$*~'" (B*rissays -that^I!fe#^uXi^ook"thls f^at(u^^g
*ut last. year.»b.iH ^^lon: to -Ceyl^'X spoke apmt the poaslbiailtyi^K
of a request costing fi.r;if.H*0*gto put someone Ij^MIss Crawfordrs place.    "
When the reason \f^«ffl*¥m~ withdrawing waS gl;V€^^e- agraed that we" should ri|^|
an^Jjasked Doris Ito m^phis on record so; that there would be a note of
It when"request^ aro"pricessed'^r To return-.to Burma,  Dr. Mani was sign-i^^
the 6 ttoiithiev^uytloh^^-^uald, Davis,.- and"Williams^fu. a'.%aid- has had
her probationarjl, Jerl^^ftixtanded for'athree months-and.|& latter has gone
:-t0 her;e*plainp;|rfg the reason*. Graham an#^^iria have had their contracts
Confirmed alth*mg!h Dri Man! said h%ffelt this recommendation Was inoonsister
ent jfj^^ was suggeste«E|£hat ifiaham, Ds^fUfr
and %aid shptomf&t have their -contracp.extehded"bey$jid the "two '.yeari|||
Dr. Man! apl^tfle hesitaa^^boUt    puling Davies out'Of Mandaiay«| Says if
-they hava;4|^vltudents ^^^^^^^M^^K^^^^^^^^^^^^ffi^^^^S Mani
that the^||^Wa^»limit'^ thi^aumber J0T pro j acts wj^^pi'ft carry - in
nursing aiicl^^p^K: th4ug% we"had pla&ned about all we eOuld manage in
this .RegionJ^^Wit iiartherArojeots would, be the naturalydavaiopmen'fe^^
from ;thesa*SiJfe agreed to; thia|j||^ ma^j^ir/;'«|p:.a"BagIoiiai
Working CVsi^fflence or Semina^   Explained wha«";We wanted ina at follow
up from .f^.Meheva oonfjerencj^'   He. smiled., and -th||h asked If it Mgh||:be
p&sslble ftlge^tt otlfyOfy^^ she could. Work it up .
f*r 1952» We said thaiKwoul^ibe Ijaj^BlbXe.^d that w:e had thoughife^f it
for X90|^ agre^;|^;the p£in&l$le
and--to gftahOM.^.a^ris. will"^oed"^[^t *f haijp witSfe this; as  I do H^p:|0ink
she h^s £he 'foggiest, idea ahout^BH^O go ..about It.^Dr. Man! had:-'the
Idea immediately ^^^.tt't;^^rking ;|p up|||srrugh correspondence ..and"finding
*Ut wha^"';^|^groj^p3RoBgp' wai^ttop d.-ll^SsSgitSuggest We write unofficially
to Dr...",^rna lhit^immediatej^ani^Ing;:^t ij;she5»^d be availab|^g
next year and when*)
Went ti Presentation   |il"the Florence Nightingale Medal to Miss Dorothy
Davis,    Principal Matron of the Ari&y Murslng ^ervlce.    Presentation
made by the President, terrific l«tijgmt coio||; .pompt,  and ceremony*
 project, in. Ca!etti|§
we should try'.i|f!
We muat watch
that one nurses
March-a*;    Sunday.     Worked in A.M.    Doris  invited several t^the Club
,f^r.lunch*i'^nclude^&r#^Pandlt;, Miss Adrailvala, the Mew^ealanl^^s
Miss Hgafy and"Miss||avitu Dr. Pandit setjon Health Visitors. W$ may
have to glye s*me help to  the ^ady Reading1 and gradually"Change over.
Af ter;^paoh! Miss Adraftvala and |§4««~"ft*ris.. came to myf room for discussion
-Told Mlas Adranvala about my concern.i^rer Sl^^^^%^^pK&^ri
relati«^t'o- publlphealth. nursing in theAlX Xndi^ Ihfptute* j        |aS   w
MsS^Mranvala Is-^pX^^^ggetting publitf^aalw^^atflj^mjbasic." M|l|-so
strong *n thePAG*^ i^r^P*H*_^it when w$ pointed^|ut. :th^fc|wa^thought
these would be  essential  to give th^se out n*w ^^fi^ind thjfct they could
gradually-replace  tha H.V.   she agreed.     In oftr l^l^aipg
^If Ml&s eoakiay-has.^fetk:ffl^i^epted as  the pediatric ^|ftse
gat^ someone f«w$:-.-with a pfl^. nurslntg background", ,alsr||p
for this m:alX our-^^&cts;^':Miss Adranvala ";(^feiinks
should be; In the I&|||lt^^ beforjfe taking In any p.h. .
students ^^tt^^ftg^^pl^^^ pr^g^am^^Agr^^^ffi
Discussed- possibilities of refresher courses gained for:;X95.2 budgef|||f
Will try. to  work ing^blic health, nursing this BM^pi,in; ConeO»^n'.^p
with the P*G*  coursaM i^iss Broe has bfeen working with' the  C^xiage on
a cor§ curriculum ^m^Qt^e Admlnlstratioli, . Teaching,;-agjid P*H. feroup^j|||
Miss ^avls will"have s|^^§^achlng t|^^^and•^SfeffteXA. w*rk for th«f§!?*&.rs
The refresher;y&r^.e migh^be worked in with^Hbl'Si^MrS. Boase Is   i|||
willing tfcglve  tlMi raf^shei^^urse 1ft pedia^lc^ bef§re"she gofes Jspf
liavo in bctober*MShe fii&hes wor^^^®orr^W,•'and will dob this on ;||||
volufttee^^aais. j^fctstead'^f a midwifery refi^pher MlsS Adran vala.||p
things ilti^l^d bax better to have' Earefreshe25J|our^^or.;§ister Tui^0^%\
ThMthSMli^' wl|^^|ed toa*lVe.^The i*B. refr^^^^s to"start va
^^^^^^^^^^^^^^^^ titles Hudson; Miss-^p|||s veryg§§ixious  to have
hhr J eoftrac<^ renew^^le^ year ^^..woi^grith the affiliates^   If they.
can $e/l|l>talned; j m&    was  agreed"-that Miss Hudso3|nshould be approached
'to.is^ai'If she ^ou||i be willing V Jfcome back" af tar home leave.f||lf so^;^^
the^h^essary. negotla'^^ns'^r a request i^uld^be mad0^fe^f"Mtss Hudson:
was ^^gpWilling t^yJj^turn il||was fel||gth^||[fwe should not encourage any
request ,^s:;so much$6pends '^f^^e knowledge she has-^ready gainedijj
Mi^flAdrjanVala sayi^Bta;Indian Nxirslngkfcunc^bis asking the Medical
ReSe/arclr/ §f^|^ ntirsing
pro ordures ^S|^^ -my"asking whait" could be'
§^Bhe atyout the WardySisters- having t^ sp.ei^;so: much time on Inventories.
ttlq/s ;ijHg-vth'itfks a ;o'j^pral .supply Tw^uld help.       ^^^
I -     • Zd.
Marchlfe     ^fficii^BftaferBaCes with-Dj|||?uli, Dri  ChelJ*pah, Wsgjh
VeenhM an«^E:Metp^   Broiaght Up s~me ^f M   points |«ri« and||„.. _
haveljeen diseasing/iftespecf^few'the various c-untrles.        |l   .   „ !„+-..
Indonesia has ^ithdraw^ its request f~r NurSing;i^Tisor|^e    ister    uw,
and the addit^al tw/p.h.n's ■ the M.G.H»Tea^^; Jeenhas says it
will be 2,3,44 y^ra before Ifldonesia is ready «^r«^ K2££
E.C.A.  is' siding 'agister.,t^r and Miss Murray^s fusing Advisor.
Dr. Mettmp nteels/s>,mewha«embarrasesd with a!I|Ithe\problems left by
Dr.   %llia£ig~LateLlP.is a-£ri§les of refresher f^rs^s ifi P^J^J8'
He i»!trying' to BE&P»ai "f a diffiftult situation so we ^ouia
give his. fivery supi^^'ssible.- He recognizes that the P*«P«sal put
up is not/'j^y aay M§ff>mM H-pe we can have^r p^iatric -nurses in
place first.        ;^J,    y&£ 1 ..« \     '.V
i»unch '<?itfe Miss.imd'So^ipt the.. Gymkhana Club.
 is
Meeting ih afternoon re briefing With Mr.  Broulanjl Mr*  Sundarham,  and
Doris.    ?o11^wing points brought out!
1#ll^ug|gst  that all arrangements re finances be made  In RL©*  rather than
■■■   in Geneva. |||g       ^ ~ |M-     '-1811     l^psi^      W^S^
2.    Idea of having information on e'ountrl^pfrom Post Repnr^ favora bly
recievedfS^ R#0jfplanning"a letter 'ta^p sent to:^each;j|lidiVldual
giving more specific information re salary,  allowahf&s,  ^untry
.lnformatioi^;etc»-A personalized1 !ef4er. ,f|luggeatdd this be     l|f|l
cleared"fro® Geneva"and that it might be. aen^p^^ie. individual from
there to^||roid. any over-lapping or. the- giving o^^fenflletting
information. :§|uggested it might be pant m Oemmm^t the same time
as ;WHO . 81.     -     '    m& ,      .' g / " Wm
^*-WS&*< plan to have'a, Brief ittg Sect  f5^1thlh- t^|^Rntl^ B.S* will
ha^e a check liallpp all"peopie seM and for /^^mtwms- dis cussed.,
(fhls latter mlghtbe a" good idea ^r-H^Q.^^^^^^I^pJfM
B.*^. jtfill s|nd minutes of _nmmittee medting^ :tSG^neva*^g    w
* 4*Sugg^s|pJBend letter^;or ratfierbCopies,l||fe reerm^fcm/ ent so R.C^gkept
'''i^jM4 date.-  tty::-  ' Spy        atllbblfbl jSl
5.     **eid information:f|%arly re dependents.      »arj^^
6*    kf^t^get  in lettersbf||fflcandldates who plan |.Sat|H(efamilies  that
family come lat^r*. ||||| ^^^P^^b  Ipl     IIP
^^^^new regulation that linen,   crockery,- cut^^;n|t provided by
|K^tt^fflS^tter  to b^ thi* equipment on thjOyspot^ | except might take"
so mo linen* Equipment allowance is given and also f 30 day installation
per di erf;    " 3§g     sl28l| SIP
8. Pleas* d^n^t set^tvpeople to arrive in Mew Delhi te Sat*  Trying
to'close Office OjlbSat.,   at least during thd summ|eK|''K^tice of tha^^l
arrival  to be"se!it -as- Oarly as rpOSsIbl^|gm       ^«PflH^
9. ffould like"two  copies of minutes of Geneva Briefihg^^ommittde
Meetings so have one for file ahd one fftl1.circulatio^^fe ';
10*!#Suggest thatlin briefing book do n*»lncltide R.O^jhart hor list of
names until  theywget more stabalise^a; Probably should^aot gi^e more
names<■ than that of R.3^P.R*B*»f^*&F*,  Personnel,  and   ipecisle .
Adviser* RS
IHaJter with Br.  &nd Mrs Williams and  their daughter.
Pllauw at the    Volga.- 'mm
Beliclous chicken
Made:,: selections
M
March"II.  Reviewed personnel histories with $oris.
and notes for further follow-up fro& Genev^*$g|^ |1    \
Lunejh at the Rajkumarils.JfTMiss Bro^r Miss ^aglor,  Mlsif ^dranVala,
and the  three New **ealanderf s.~     Colombo Plan very much-In favor.
Conference wljth    Miss Craig,fprls*. Mis #;^ avis Vat"; 4. P*M*    ^Jss Cralg^
let it be known that she had heard from various purses ±ha£ v*;£*0*
n»t satisfle4wlth *haS%-    the way she w&s using Ki^s ^^Jl^f011; oti
t*  talk abn^-ih* HlfeKPI certificate course ®nd Stated M^ss /Davis
to be In/charge -f the Public Health-studmt|i;wh^b||^<i *>e taking   |p
so&e wo^k with the who^group^g'fhere will be W$^?f ajthlngs to be.
^iron^f>ut as'thdy go.^mong«-Mis^. Batis understandsJ|his*    Had her. to
tfea after,    fthe seemed^elleved tflknow that we appreciated that there
wouldhe di|flculties.^^&:discusslon"wi1hffl Misspraig said-1' did mn%
tthihi we should worry" abo^'the lattc.#f .a matft^g nurse this year^^The
budget line is there and4 perhaps someone can^b^^ilected from the first
#lass m have a year*a experience and then go g&road^r study,    fe
agreed that it w^uld prl^ably take -five years  t^geally get this oigflts
own fe>st.      |PIB     W/B^^^'^    S ^0^4l8[- '
^^jHP^^er*s';*>* RabgOon, to-morrow and I to Bombay.
 March 12J|gMids ^ctor unable tobbe in Bombay as ahe had"lj§attand
\ Council meeting in BaLhi^^go left a planned pr*gra» for me.    At
}.30w«ent»"t*xe Matronfs ^£f|ce of th* J*J*G**up of Hospit&ls.
atron, Mrs.eiinej  and Anglo-.Indian who has had a P.G.  in Hospit&l
administration at the Royal ^Ilege and impressed me as being about the
jaost efficient Matron I have met on this trip.    Interview with Dr.
S^thna tha Medical Superintendent who  also  seemed very nice.    They are
looking forward to having the W.H.O*a*pg|£and were pleased with the
suggestion that the leader might" Come earlier th to the resti    Want"
senior people because they are lookingb^yward to the development of
a B*Sc.  program.    -Agreed that this was for the future.  "Saw somdof
the representative wards and  those which w:^p|be used for  t each ing. Wlhey
are prepared to use    sel^etef| wards which ar^petter staffed and better
equipped.^ See attached for. statistics re beds afes^ staff.
Met the ^ister tutors in"the l&Tge and fairly wal\|||quipped class-room.
Ulster Peres is the senior.     Took    the Sister Tutol^ coU±s6"atthe
Royal §ol*ege 1947,-48. Her assistant is Miss Chandkaiywh* took %e
same eourse"1944-45*  A Miss Punn^ose'Tis at present acting as Understudy
arid planst^ take  the sister Tuto.^p»:urse In"Delhi this'Xaii*  There ix    1
now one i#;TDelhi taking the-co^turse..;;|Mt'.ls;.hoped that    sh1£%iii b& bstck on
the teaching" staff "but the difficulty Is that      there||§re oh^ two
sanctioned posts for.:the school.      g||| 39s |9B|
Re.salaries: S^ister    Tutor—.1,e§&§^;U 200x10"ily&SO per mo.
Ward sisters 125x5  to 150x10 tog200.
^taff nurses 80x5  to 100
Students    first  4 mo.  10 plus allowances—26.
* fl§.f irat NPPH    * « 36'
* 2n|||:ffl3rdI    and Hd*    ,g|| 46.
4ll get ma.^tenence^and uniform allowane#§t| &L%
There are' two Health.ViJItorSe.on the staff^:0na works in the pediatrli|^.
0*P.I3^^^^parently does some follow-up in %&e"homes.   : aha oth&r  Is In  this
ante-natlA cllnicS.    It is said that she fiollows-up ali"thfe mothers
discharged froft hospital^^Dbvicuily It is impossible to d^this as"
there are 10 to  12 births dally and most are discharged at the   end '.j||||
g^^^P- days. mlm fBm I 8111   *lll /
there are many Anglo-Burmese and some Europeans on tltfe staff .^practically
all wear western dreSi^fe;. The  Sisters  eahf European    food and  It Is
expected"that\the W.H^Q/linurses will tfiess with them.  "There    Is a two
roomed cottage next to the"tiurses^||i^stfel    where    tx^o  can  st^y and    the
other two'w^Ul^paVe^ t^pr^oms In the hostel.  Al||nurses are: supplied
with lined a* Mm w^nldj;i|ot be necessary to take linen*
Bi mm  &B- mm
At 12:30 met /Pikshiiipthe.Surgeon General.    He"also very friendly*    Said
he hftd been  talking with Dr*  Ra|a about"the project.       It Is Signed n ow
itt Bombay.     Sha/matter whlc^bas been holding it: up is the provision
for^pe catrr^Ing o^^tthe project after W.H*0* withdraws,     which
means/ getting sanction for"mor© post^|feny!^nteaching staff*;, fhls th||||
ar£ trying b|0 make provision: for^^^hey were g also hesitating over the
provision y^ dep^idanta of W.H.0*  staff*i^p|asured him th&t we Would
not saalgfet nurses whoywoit^have d^lpmdents who-would be brought trr
the co-pitry.g f^fe
Took bufc f~r airport g^2;3o'p.M.  from the-;.Taj"H-taX^^lane left 'ij|||
5*    Only 14 passengers      Sid  2 babies  so had lots of room.
|o  Cairo* 2700 mlles/g^phours les£ 20yminutes.    ^ary different
atm-sphere at Cairo  than  in Jan.fo police K  escort us*    From Cairo
to  Geamva 1900 miles- flying time 8    hours*    Av."altitude 20^000 ft.
Flew around Alps    which were beautiful.    PIeked"Out Matterhorn amd
Mt.  I^saj,  pa d then Mt.  Blanc    which w$    flaw aro|ind.
Time differetice Geneva to Delhi—4?r hours.
 

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