Throughout the eighteenth century, the British Royal Navy embarked on a scheme of hospital construction in the Atlantic World. The largest hospitals were in the British Isles, but those that dealt with the highest mortality were in the Greater Caribbean. Most naval medical history focuses on male medical officers, while most nursing history examines the period after Florence Nightingale in the mid-nineteenth century. Scholarship thus gives the impression that female nurses were not central to regular care at these early naval hospitals. This is not the case. In the British Isles, in fact, hospital administrators recruited nurses from the local port community, with preference given to the wives and widows of seamen. In the Greater Caribbean, however, perceptions of immunity dictated who medical practitioners and hospital administrators employed as nurses.
Perceptions of Immunity and Naval Medicine
The military and naval medical communities of the late eighteenth and early nineteenth centuries generally believed that, when it came to tropical fevers, there were two groups of people: those deemed susceptible and those with immunity. Most British medical officers thought that Black and Creole (Blacks born in the West Indies) people were at least somewhat immune to tropical fevers. In contrast, according to military medical practitioners, European-born soldiers and sailors risked death and a lengthy seasoning process. Some military medical practitioners, such as Regimental Surgeon William Lempriere, even believed that Black people could not come down with yellow fever or malaria. He extended this alleged immunity to typhus and scurvy, two nontropical diseases.
The realities of immunity, however, were far more complex. While it is true that many West African slaves were exposed to the yellow fever virus in childhood and then gained lifelong immunity before their forced transport to the West Indies, such immunity was not universal. Immunity depended on having lived in an endemic yellow fever region. The same yellow fever immunity could occur in the West Indies among the European settler, enslaved, or local populations if individuals survived the first exposure. Many experienced the disease as children without showing symptoms. Neither Europeans nor Africans could acquire immunity to malaria, except for those West Africans and their children who had the genetic sickle-cell trait. Instead, individuals would gain differential resistance from regular exposure to the disease, which lessened, and in some cases masked, the illness entirely. Therefore, while African and Creole slaves might have had immunity to yellow fever and differential resistance to malaria, this was not a certainty. Regardless of the complexities of immunity, the persistence of this culturally constructed and racist view of immunity for Blacks and susceptibility for whites formed both the basis of selecting Black nurses for work in naval and military hospitals and larger British civilian and military understandings of labor in the Greater Caribbean.
Military hospital inspector William Fergusson, who himself had been cared for by a Black nurse when he contracted yellow fever in 1815, recommended that the British Army solely employ Black nurses in the Barbados general hospital. Fergusson went on to write in his autobiography that Black nurses “make the best sick nurses in the world” and that “nothing can exceed” a Black nurse’s “vigilance and tenderness.” He believed that Black nurses enjoyed nursing more than any European woman “and it is to be regretted they should not always succeed in obtaining the place they are so well calculated to fill.” Fergusson did not explicitly mention legal status, so he could have been referring to enslaved or free Black nurses. Either way, he subordinated Black women regardless of legal status to serving white interests. Thus, although perceptions of immunity first led Fergusson to recommend the employment of Black nurses in military hospitals, his depiction of Black nurses aligns with the culturally constructed “mammy” image of the eighteenth and early nineteenth centuries. This Anglo-American colonial image depicted Black women as happily subordinate to whites, emphasizing a willingness to nurse children and the sick.
Where did this Black nursing labor force come from, though? When the British Army raised the West India Regiments in the 1790s, the state purchased enslaved Black men from West Indian enslavers. Unfortunately, it is harder to uncover how Black nurses, whether enslaved or free, were recruited throughout the West Indies to work in naval hospitals. When naval surgeon Elliot Arthy, stationed at Jamaica, commented in 1798 on how an “indigent negro women” had provided care to British seamen “labouring under the most violent attack of Yellow Fever,” he didn’t mention how she came to be in that position as a nurse. Luckily, the Royal Navy was very concerned with its expenditures during and after the costly Napoleonic Wars, and we can track some nurses through surviving pay list records.
Bermuda Naval Hospital and Black Nurses
As the pay list record above shows, the Bermuda Naval Hospital employed four nurses in the first quarter of 1821. All were enslaved, and the wages for their labor went to enslaver John Gibson, who signed for their pay. These women worked directly for the British state caring for sick and injured seamen. The hospital agent, responsible for payment, had to swear an attestation to absolve the Navy of the association with slavery. This attestation indicates that the navy was aware of and sanctioned the employment of enslaved individuals in naval hospitals even following the Abolition Act in 1807, which abolished the trans-Atlantic trade to British colonies, and the subsequent policing activities of the West African squadron against the slave trade.
When paired with slavery registers, we can catch glimpses of these women’s lives and labor. Diana, listed above, started as a nurse at the naval hospital at age eighteen in 1816. She was listed as being born in Bermuda and described as a “House Servant.” Although the Gibson family hired out other enslaved women to the naval hospital, Diana worked most frequently as a nurse between 1816 and 1822, after which she vanished from the records. For the labor of these women as nurses and washerwomen at the hospital, the Gibson family received over £500, of which nearly £140 was on account of Diana’s labor. Over the same period, purchasing an enslaved person cost £64 on average. While enslaved women were generally cheaper to purchase than men, due to planters’ perceptions of the latter’s greater suitability for fieldwork and trades, the return on investment to the Gibson family was double that from fieldwork in Barbados. Hiring out enslaved women to the naval hospital as nurses was a good return on planters’ investments; this process also allowed the Royal Navy to provide care for sick sailors within the framework of how medical practitioners understood immunity to tropical diseases.
The historiography of nursing has ignored women like Diana. But the labor of Black women, whether enslaved or free, was central to the functioning of naval hospitals in the Greater Caribbean and has wide-ranging implications for how we understand the history of nursing.
First, enslaved labor of Black nurses in naval hospitals adds another dimension to the familiar tale of Black labor benefiting European colonial rule by situating that narrative within cultural and environmental understandings of medicine. While these nurses provided the care sick sailors so desperately needed, their work operated within the framework of eighteenth- and early nineteenth-century understandings of race and immunity. Nursing required a combination of domestic skills such as cleaning and ventilation with patient care, activities that medical practitioners viewed as distinctly and naturally the purview of women throughout the Atlantic world, and in this case, also the purview of the enslaved. For naval medical practitioners, from both a gender and a racialized immunological perspective, Black women in the Greater Caribbean were the ideal nurses.
Second, and in keeping with the theme of this series, studying the experiences of the Black nurses in British naval hospitals forces us as historians not only to consider the work of nurses before Nightingale but to push beyond Nightingale’s racist view of nursing as a white, middle-class occupation. For too long, with the exception of work by Darlene Clark Hine, Karen Flynn, and others, historians have left the stories of Black nurses out of the broader narrative of nursing history. The teleological and professionalization narrative perpetuated by a nursing historiography that frames Nightingale as the mother of the nursing profession not only obscures all the nurses who came before her, but relegates nurses of color to a position as the “other” rather than the norm. Centering the experiences of Black nurses, both enslaved and free, in the Greater Caribbean reveals a deep history of racial diversity within nursing, a diversity that is too often obscured by the long shadow cast by Nightingale.
- See Rana Hogarth, Medicalizing Blackness: Making Racial Difference in the Atlantic World, 1780–1840 (University of North Carolina Press, 2017); Suman Seth, Difference and Disease: Medicine, Race, and the Eighteenth-Century British Empire (Cambridge University Press, 2018); Londa Schiebinger, Secret Cures of Slaves: People, Plants, and Medicine in the Eighteenth-Century Atlantic World (Stanford University Press, 2017). ↑
- Seasoning, or acclimatization, was the period of tropical sickness that all new arrivals to the torrid zone underwent before adapting to the climate. As the eighteenth century progressed, there were increased references to African slaves both enduring the seasoning process and suffering from tropical fevers. Hogarth, Medicalizing Blackness, 34, 53. ↑
- William Lempriere, Practical Observations on the Diseases of the Army in Jamaica, as they occurred between the years 1792 and 1797, vol. 2, (T. N. Longman and O. Rees, 1799), 25. ↑
- John R. McNeill, Mosquito Empires: Ecology and War in the Greater Caribbean, 1620–1914 (Oxford University Press, 2010), 44–45; Robert Desowitz, Who Gave Pinta to the Santa Maria? (W. W. Norton, 1997), 99. ↑
- McNeill, Mosquito Empires, 45. ↑
- McNeill, 53. ↑
- McNeill, 2, 53, 252. ↑
- This understanding of immunity to disease coupled with perceived ability to work in hot weather were one of the reasons for the transition from seventeenth-century indentured servants to enslaved labor in the British West Indies. See Simon P. Newman, A New World of Labor: The Development of Plantation Slavery in the British Atlantic (University of Pennsylvania Press, 2013), 85–89. Moreover, the belief among British military commanders that African slaves were the only people capable of performing intense manual labor in the West Indian climate led to the assignment of Blacks to “fatigue duties” or hard labor, such as hospital construction and the transport of regimental stores for the army. Roger N. Buckley, The British Army in the West Indies: Society and the Military in the Revolutionary Age (University of Florida Press, 1998), 98. In short, this culturally constructed view of immunity for Blacks was a key part of both the plantation economy and social hierarchy that benefitted elite planters. ↑
- “Basseterre Guadelopue, William Fergusson to John Weir, 13 October 1815.” Wellcome Library RAMC 210/2. ↑
- William Fergusson, Notes and Reflections on a Professional Life, (Longman, et. al., 1846), 63–4. ↑
- Rupe Simms, “Controlling Images and Gender Construction of Enslaved African Women,” Gender and History 15, no. 6 (2001): 882. ↑
- The purpose of these regiments was to have a supposedly immune fighting force to defend the islands during the French Revolutionary and Napoleonic Wars. Roger N. Buckley, “The British Army’s African Recruitment Policy, 1790–1807,” Contributions in Black Studies 5 (2008): 5–6. ↑
- Elliot Arthy, The Seamen’s Medical Advocate (Richardson and Egerton, 1798), 41. ↑
- “Bermuda Pay Lists,” TNA, ADM 102/89. ↑
- J. R. Ward, “The Profitability of Sugar Planting in the British West Indies, 1650–1834,” Economic History Review no. 31, no. 2 (1978): 203. ↑
- Preference for male slaves: Trevor Burnard, Mastery, Tyranny, and Desire: Thomas Thistlewood and His Slaves in the Anglo-Jamaican World (University of North Carolina Press, 2004), 57; Sheridan, Doctors and Slaves. For limitations of the occupations open to enslaved women, see Bush, Slave Women in Caribbean Society, 34. Lucille Mathurin Mair, “Women Field Workers in Jamaica during Slavery,” in Slavery, Freedom and Gender: The Dynamics of Caribbean Society, eds. Brian Moore, B. W. Higman, Carl Campbell, and Patrick Bryan (University of the West Indies Press, 2003), 186. ↑
- Darlene Clark Hine, Black Women in White: Racial Conflict and Cooperation in the Nursing Profession, 1890–1950 (Indiana University Press, 1989); Karen Flynn, Moving Beyond Borders: A History of Black Canadian and Caribbean Women in the Diaspora (University of Toronto Press, 2011). ↑