An op-ed titled “Six Nuns Came to India to Start a Hospital. They Ended Up Changing a Country” by Jyotu Thottam appeared in the New York Times on April 2nd and seeked to describe the long-term positive impact a small group of people can affect if they set out to do it the right way. The story takes place in an uncertain time in India, when it was about to be freed from British colonial rule in the spring of 1947 but was unable to fulfill its people’s basic needs. The country was expected to build new institutions, ideas and citizens who were willing to help in the country’s rebuilding.

India was not in the greatest shape to take on such a challenge. The country was devastated by World War II and the partition that followed and split the country into two. India was also struggling with a refugee crisis in the end of 1948 with two of its biggest cities, Mumbai and Delhi, each absorbing more than half a million refugees. The country had endured violence, dislocation and inadequate access to food. More than 20 million Indians found themselves living under direct rationing, entitled only to 10 grains of rice a day. During this challenging time, a few Catholic nuns from Kentucky decided to come to Mokama, a small town in northern India on the southern banks of the Ganges River, with one goal in mind: starting a hospital (Source: NY Times).

“The story of Nazareth Hospital began, for me, as a family story,” writed Thottam, “My mother studied nursing there in the early 1960s, and those skills helped her, with my father, to the United States. But this hospital and the women who started it is also a story of a nation in the process of becoming itself. The people who shaped India in those years included outsiders and misfits, the orphaned and the underestimated, foreigners and Indians from many different religions and castes — those whom history rarely remembers.” One of those trailblazers that helped in creating the story of India was Sir Joseph Bhore, an Indian bureaucrat who had served the Crown, during a time when Gandhi's independence movement gathered force, and retired with a knighthood in 1935 to the island of Guernsey. When Germany invaded Guernsey and other islands around it, Bhore had to place to go except back to India. Upon his return, in October 1943, the colonial government of India asked him to lead a survey of the health conditions in British India. This has never been done in the country before, and it was the most significant thing Bhore would do in his lifetime (Source: NY Times).

During this assignment, Bhore recruited more than two dozen British and Indian doctors and public health officials to serve on the committee he created to complete the survey. He then dispatched the recruits to all corners of India. The result of this effort later became known as the Bhore Committee Report, which offered a scary picture of what it was like being an Indian during that time of independence. The worst numbers came from children. Specifically, in 1941, of every 1,000 babies born, 158 will die in under a year. Children under the age of 10 accounted for almost half of deaths in India. Bhore showcased the toll that hundreds of years of colonial rule that resulted in the neglect of health had taken on the livelihood of hundreds of millions of Indians. However, he also believed that Indians themselves could mitigate and reverse the effects of centuries of neglect and cruelty. The goal he set was to simply increase the number of health professionals, specifically doctors, in the country. While there was one doctor for every 1,000 citizens in England, the number was one for every 6,300 in India. The target was to increase India’s number to one for every 2,000 by 1971, and he envisioned that this would be achieved with the help of a network of small village health centers. A pair of doctors, with the help of a staff of 36, would serve a few villages with a population of about 20,000. “ This was one of the very few moments when someone in the government of India saw with absolute clarity what was required to change India for the better, how to do it and what it would cost,” wrote Thottam (Source: NY Times).

The article goes on to talk about the experience of Lawrencetta Veeneman who accepted her order’s mission to Mokama and led the six nuns who founded the Nazareth Hospital. The six nuns were made up of three teachers and three nurses, with three in their 20s and the other three being a generation older. When Veeneman arrived, she saw an empty warehouse with a number of empty rooms. There were no hospital beds in any of the rooms, no medicines, no electricity, no running water and no staff. The sisters’ goal was to revamp this building into the tenth Sisters of Charity hospital, and they only had six months to achieve that. A month after the sisters landed in Mokama, on January 5, 1948, a young woman, Celine Minj, came looking for them. She had been living in the Carmelites in Patna, a close big city, and was looking to help. She was offered a bed on the roof (Source: NY Times).

At that point, the warehouse still did not resemble a hospital. There was only a small hall in a building near the railway station, and a cabinet with several boxes of medicine. Even though, this was the life Minj wanted, having witnessed her own father’s death due to high fever. She also saw the differences between her life and the lives of other children. She saw other kids go to school, and a hunger for education led her to work in construction until she could afford tuition, books and pencils. As the war ended in 1945, Minj was 12 and had finished seventh grade. However, her ambitions soon led to her facing challenges because she was a young girl that did not want to be married and was not smart enough to make her way out of the village yet. She eventually ran away from home and found herself in Mokama. Immediately, Minj became an important member of the team, helping the sisters understand the symptoms by translating. When they started receiving calls to go out to the village and help deliver babies, she went with them. By late January, patients began lining up for treatment at the facility, but the sisters had no doctor on their staff. Veeneman tried getting a doctor by writing letters to missions, hospitals and medical schools all over the country. The official opening date was set for July 19. In a letter to her family, she wrote, “Please, redouble your prayers that we will get a doctor by that time” (Source: NY Times).

On July 24, 1948, just a few days after the official opening of the hospital, a young doctor finally joined the mission. The doctor, Eric Lazaro, was not the team’s first choice, and they expressed hesitancy in his skills. However, they finally decided that “he was as good a substitute as they were likely to find.” Lazaro also had his fair share of struggles when he was younger, starting with his mother’s death due to possibly tuberculosis and his father’ alcoholism. Because his father was unable to care for him, he was sent to live with his relatives and was able to scrape enough money to go into medical school after finishing high school. Upon finishing his studies at medical school, Lazaro found himself as one of millions of others who were clueless as to where to go after the end of the war but before independence. Even though Mokamo was a town in the middle of nowhere, he was a doctor with no experience and one that was ready to leave the past behind (Source: NY Times).

Once the hospital was officially open to the public, patients were coming in every day with illnesses ranging from cholera and malaria and unspecified fevers to infected wounds and women in labor. The supply of medicine and equipment that the sisters brought with them from Kentucky as cargo, such as antibiotics and penicillin, were often enough to treat the common illnesses and injuries, but in many cases, they could do nothing but watch the “woman in the throes of a psychotic episode or the baby in the final stages of dehydration.” Lazaro surprised the sisters by proving himself to be an able and skillful doctor. Not only did he help treat the constant stream of infections but also helped with eye surgeries at a temporary clinic set up by some visiting doctors. His most impressive moments include doing an autopsy on an orphan boy that showed an enlarged spleen that reveals the toll of malaria and kala azar, a disease spread by sandflies, and operating on a woman with ectopic pregnancy by lantern and flashlight (Source: NY Times).

However, the troubles did not stop with the opening of the hospital. The record shows that it was so humid at the time of the opening that it took days for clothes to dry, and they struggled with dozens of flies that descended on their plates and teacups. They also still lacked running water, but that all proved unimportant with the number of patients that came in everyday. Sister Crescentia Wise later set up a till to produce purified water. In August of that year, the sisters began recording their census of patients. On August 7, 19 in the hospital and 61 in the dispensary. By the end of that month, both were overflowing with patients. During the first few months, the sisters struggled to find enough nurses, since the committee established by Bhore had found that there were only 7,000 nurses in all of India, which means there was one nurse for every 43,000 people. Even when Veeneman was able to find nurses, they would be clearly underqualified. In fact, it was known that the schools teaching nurses were nothing but a scheme to have women perform unpaid work. Therefore, the sisters found themselves having to perform a number of different tasks, such as cleaning trays and working to register patients. Although they tried their best to ensure the best care for their patients, the sisters found it hard to maintain the standard that they set for the hospital, so they set out to start a makeshift nursing school. They set aside a room in the hospital and added some tables and chairs, and the sisters and Dr. Lazaro started teaching anatomy, first aid, diet, nursing arts and patient care (Source: NY Times).

What the sisters achieved in the creation of the Nazareth Hospital within two years of arriving in India is nothing less than impressive. By December 1949, the sisters made a list of everyone that had helped them in the hospital- cooks, gardners, nurses and doctors- and it only added up to 30. It might not be what Bhore had envisioned when he imagined 36 staff members for every two doctors, but it came very close to Bhore’s vision of ensuring quality healthcare in post-colonial India. “India has taken many turns inward and outward in the 75 years since independence, and although it remains a proudly pluralistic democracy, that tradition seems increasingly fragile,” wrote Thottam, “ The hospital has managed to endure through all of this. Its presence, as an institution founded and run by women, stands as a challenge to those in power, a lasting reminder of those early years and that crystalline moment of hope” (Source: NY Times).

Sources:

Thottam, J. (2022, April 2). Six nuns came to India to start a hospital. they ended up changing a country. The New York Times. Retrieved June 19, 2022, from https://www.nytimes.com/2022/04/02/opinion/india-nuns-nurses-hospital.html