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ABSTRACT
In 1948, the High Commission territories (HCTs) of Bechuanaland, Basutoland, and Swaziland (present-day Botswana, Lesotho, and Eswatini, respectively) formed an inter-territorial nursing council responsible for accrediting nursing schools and nurse registration. This article focuses on the Ainsworth Dickson Nurse Training School in Swaziland that was under the council’s charge. The article argues that the medical personnel and epidemiological conditions in Swaziland before 1948 informed and shaped the development of the education of nurses afterwards, during the last two decades of colonial rule. Accredited nurse education led to a gradual emergence of fully trained nurses with the same kind of training as that required for the nurse certificate issued by the neighbouring South African Nursing Council. The article examines the origins of Swaziland’s public health problems and traces the evolution of accredited nursing in relation to these problems. It illuminates the shifts that occurred in the development of nurse education programmes and analyses these shifts in relation to the historical context of the time. It demonstrates how epidemiological, historical, political, and economic context of the time led to a collapse of the racial barriers in nursing so that African nurses could dispense biomedical services even to European patients.
Acknowledgements
I owe a debt of gratitude to the two anonymous reviewers for their valuable feedback. This paper flows from my PhD research completed at the University of Johannesburg in 2015. I am grateful to Professor Natasha Erlank of the University of Johannesburg for her constructive criticism and helpful suggestions.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Notes
1 W. M. Hailey, Native Administration in the British African Territories, Part V: The High Commission Territories, Basutoland, the Bechuanaland Protectorate and Swaziland (London: Her Majesty’s Stationary, 1953). Also see D. E. Torrence, ‘Britain, South Africa and the High Commission Territories: An Old Controversy Revisited’, Historical Journal, 41 (1998), 751–772.
2 Historical Papers Research Archive, University of the Witwatersrand, Church of the Nazarene Records, ZA HPRA A1441, Series D, World Mission Work and Missionaries Information.
3 Swaziland National Archives (hereafter SNA), RCS 869/34, Relations of Hospital to Medical Services, A letter from Dr Hynd to the Principal Medical Officer, 1934.
4 D. Davis, Nursing in Swaziland (Florida: Nazarene Printing House, 1975), 18.
5 SNA, RCS 319/27, Opening Ceremony for the Raleigh Fitkin Memorial Hospital, Bremersdorp, July 1927.
6 SNA, RCS 36/39, Annual Report on Bremersdorp Hospital, 1939.
7 SNA, RCS 418/38, Grant for Construction of Native Nurses’ Hostel at Bremersdorp, Extract from a speech delivered by Dr Hynd during the official opening of the nurses’ home in 1940.
8 The characterisation of nurse education in HCTs in this period as ‘sub-standard’ was made at a conference on nurse training held in Bloemfontein in 1932. See SNA, RCS 940/32, Report by Principal Medical Officer of Bechuanaland at the conference in Bloemfontein regarding the training of native nurses, 1932.
9 Interview with Eva Lukhele (née Mabuza), 14 September 2013, Croydon, Swaziland.
10 Interview with Dr Samuel Hynd, son of David Hynd, 25 July 2014, Manzini, Swaziland.
11 E. M. Kiereini, ‘WHO’s Role in the Development of Nursing in the African Region’, International Nursing Review, 35, 3 (1988), 65–66. These included Zambia, Malawi, Gabon, Mauritania, Niger, and many others.
12 Dlamini, ‘The Introduction of Western Medicine’, 559.
13 I. Schuster, ‘Perspective in Development: The Problem of Nurses and Nursing in Zambia’, African Women in the Development Process, 17, 3 (1981), 77–97.
14 For more information on this, see S. Marks, Divided Sisterhood: Race, Class and Gender in the South African Nursing Profession (Johannesburg: Witwatersrand University Press, 1994); C. Masakure, African Nurses and Everyday Work in Twentieth-Century Zimbabwe (Manchester: Manchester University Press, 2020).
15 Interview with Amy-Joyce Manthatha, 28 January 2014, Piggs Peak, Hhohho region, Swaziland. Manthatha is a former student of the ADNT School and a nurse who later became the first black matron at RFM Hospital.
16 See C. Searle, The History of the Development of Nursing in South Africa, 1652–1960 (Cape Town: Struik, 1965); Davis, Nursing in Swaziland; S. Selelo-Kupe, An Uneasy Walk to Quality: A History of the Evolution of Black Nursing Education in the Republic of Botswana, 1920–1980 (Battle Creek: W.K. Kellogg Foundation, 1993); E. Potgieter, Professional Nursing Education, 1860–1991 (Pretoria: Academica, 1992). S. Duma, ‘The State of Nursing Regulation’, Trends in Nursing, 1, 1 (2012), 1–20.
17 See Davis, Nursing in Swaziland; Selelo-Kupe, An Uneasy Walk to Quality.
18 Marks, Divided Sisterhood.
19 Lomagugu Magagula, a student at the ADNT School from 1952 to 1956, revealed that out of the twelve first year students in the HCTNC Nursing Programme she attended, two were from outside Swaziland. These were Irene Chocogo, a Mozambican national, and Jumaima Simelane, a South African. Interview with Lomagugu Magagula, 11 September 2013, Mliba, Lubombo region, Swaziland.
20 Selelo-Kupe, An Uneasy Walk to Quality, 123.
21 Interview with Beauty Makhubela, one of the nurse tutors at the ADNT School, 15 September 2014, RFM Hospital, Manzini, Swaziland.
22 Selelo-Kupe, An Uneasy Walk to Quality, 123.
23 Ibid., 123.
24 S. Feierman and J. M. Janzen, ‘Part I: Introduction’, in S. Feierman and J. M. Janzen, eds, Social Basis of Health and Healing in Africa (Berkeley: University of California Press, 1992), 5.
25 S. Dlamini, ‘Colonialism and Race in Nursing Education at Ainsworth Dickson Nursing Training School, Swaziland, 1927–1980’, UK Association for the History of Nursing Bulletin, 9, 1 (2021), 1.
26 SNA, RSC 306/05, Extract from a letter written by the Resident Commissioner to the Secretary of Swaziland Affairs in Johannesburg, 1905.
27 J. Crush, ‘The Colonial Division of Space: The Significance of the Swaziland Land Partition’, International Journal of African Historical Studies, 13, 1 (1980), 71–86.
28 H. S. Simelane, ‘Capitalism and the Development of the Swazi Working Class, 1947–1962’, in N. G. Simelane, eds, Transformation: The Case of Swaziland (Darker: CODESRIA, 1995), 39–72.
29 Dlamini, ‘Colonialism and Race in Nursing Education’, 4.
30 A. Kuper, The Social Science Encyclopedia (London: Routledge and Kegan Paul, 1985), 247.
31 H. Beemer, ‘Notes on the Diet of the Swazi in the Protectorate’, Bantu Studies, 13 (1937), 199.
32 A. M. Kanduza, ‘Children and Poverty in Swaziland: A Search for a Total Strategy’, in A. M. Kanduza and S. Dupont-Mkhonza, eds, Poverty in Swaziland: Historical and Contemporary Forms (Matsapha: Blue Moon Printing, 2003), 37.
33 Dlamini, ‘Colonialism and Race in Nursing Education’, 4.
34 H. Sweet, ‘A Mission to Nurse: The Mission Hospital’s Role in the Development of Nursing in South Africa, c. 1948–1975’, in P. D. Antonio, J. A. Fairman, and J. C. Whelan, eds, Routledge Handbook of the Global History of Nursing (New York: Routledge, 2013), 201. Also see S. Marks and N. Anderson, ‘Industrialization, Rural Health, and the 1944 National Health Services Commission in South Africa’, in S. Feierman and J.M. Janzen, eds, Social Basis of Health and Healing in Africa (Berkeley: University of California Press, 1992), 132.
35 R. Packard, ‘Industrialization, Rural Poverty, and Tuberculosis in South Africa, 1950–1950’, in S. Feierman and J. M. Janzen, eds, Social Basis of Health and Healing in Africa (Berkeley: University of California Press, 1992), 121.
36 Ibid.
37 See SNA, RCS 22/32, Swaziland Annual Medical Report, 1931; M. Miles, ‘Missing Women: A Study of Female Migration to the Witwatersrand, 1920–1970’ (MA thesis, Queen’s University, Belfast, 1991).
38 R. Packard, ‘Tuberculosis and the Development of Industrial Health Policies on Witwatersrand, 1902–1932’, Journal of Southern African Studies, 13, 2 (1987), 187–209.
39 Packard, ‘Industrialization, Rural Poverty, and Tuberculosis’, 126.
40 P. Kallaway, ‘Education, Health and Social Welfare in the Late Colonial Context: The International Missionary Council and Educational Transition in the Interwar Years within Specific Reference to Colonial Africa’, History of Education, 38, 2 (2009), 217–246.
41 SNA, RCS 938/32, Application for Assistance under Colonial Development Fund for Medical outpost, 1932.
42 D. A. Tobbell, ‘“Coming to Grips with the Nursing Question”: The Politics of Nursing Education Reform in 1960s America’, Nursing History Review, 22 (2014), 40.
43 R. Packard, ‘Maize, Cattle and Mosquitoes: The Political Economy of Malaria Epidemics in Colonial Swaziland’, Journal of African History, 25, 2 (1984), 189–212.
44 P. Matse, ‘A History of Disease and Medicine in Swaziland, 1870–1993’ (PhD thesis, University of Cambridge, Cambridge, 1995), 118–177.
45 Ibid., 118–177.
46 Ibid., 2.
47 Due to access to land and favourable climatic conditions in the second half of the nineteenth century, Swaziland was a surplus producer of maize, a staple food which she traded with neighbouring countries. However, land expropriation changed all this.
48 H. Simelane, ‘Colonial State and the Political Economy of Famine in Swaziland, 1934–1945’, South African Historical Journal, 66, 1 (2014), 105.
49 Public Record Office (hereafter PRO), DO35/1190/Y1207/2, Food Supplies in Basutoland, Bechuanaland Protectorate, and Swaziland.
50 H. S. Simelane, ‘The Colonial State and the Political Economy of Famine’ in Swaziland, 1943–1945’, South African Historical Journal, 66, 1 (2014), 109.
51 PRO, DO35/1182/Y1032/12, Swaziland Medical and Sanitary Report, 1943.
52 Simelane, ‘The Colonial State and the Political Economy of Famine’, 109.
53 PRO, DO35/1182/Y1032/1/3, Swaziland Medical and Sanitary Report, 1944.
54 SNA, Swaziland’s Sanitary and Medial Reports, 1953–1962.
55 See also Dlamini, ‘Colonialism and Race in Nursing’, 7.
56 Davis, Nursing in Swaziland, 23.
57 Searle, The History of the Development of Nursing, 283.
58 SNA, RCS 940/32, Report by Principal Medical Officer Bechuanaland on conference held at Bloemfontein regarding the training of native nurses, 1932.
59 Ibid.
60 The conference recognised that the health needs amongst Africans in rural areas needed immediate intervention at a time when most nursing schools in African reserves did not meet the requirements of a certificate of the South African Medical Council. It was decided that the health needs of the reserves would be better met by African nurses with a qualification of a lower standard than that of the full certificate.
61 SNA, RCS 940/32, Report by Principal Medical Officer of Bechuanaland on the conference held at Bloemfontein regarding the training of native nurses, 1932.
62 Marks, Divided Sisterhood, 96.
63 Selelo-Kupe, An Uneasy Walk to Quality, 122.
64 SNA, File 1829, The High Commission Territories’ Nursing Council, 1944.
65 Ibid.
66 Ibid.
67 Ibid., 93.
68 Davis, Nursing in Swaziland, 62–63.
69 Ibid., 25.
70 Historically, very few African women had the educational qualification to take the full nursing certificates granted in European nursing schools. In Swaziland, for instance, although accredited nursing programmes commenced in 1948, unaccredited programmes persisted until the 1960s because the low education qualifications of most Swazi women made their admission to accredited programmes impossible.
71 Up to independence in 1968, Swaziland had an eight-year curriculum at primary school and a three-year curriculum at secondary school (Forms I to III).
72 M. L. Thamsanqa, Education in Swaziland (Research Report, 1985), 10.
73 Davis, Nursing in Swaziland, 26.
74 SNA, File 1829, High Commission Territories’ Nursing Council, 1944.
75 See Marks, Divided Sisterhood; M. Lunde, ‘North Meets South in Medical Missionary Work: Dr Neil Macvicar, African Belief, and Western Reaction’, South African Historical Journal, 61, 2 (2009), 336–356.
76 Interview with Amy-Joyce Manthatha, 28 January 2014, Piggs Peak, Hhohho region, Swaziland.
77 Selelo-Kupe, An Uneasy Walk to Quality, 97–98.
78 Ibid., 97–98.
79 Ibid., 97–98.
80 R. J. Durrant, A. K. Doig, R. L. Buxton and J. P. Fenn, ‘Microbiology Education in Nursing Practice’, Journal of Microbiology and Biology Education, 18, 2 (2017), 1.
81 Ibid., 1.
82 SNA, Swaziland’s Medical and Sanitary Report of the year 1951, 25.
83 SNA, File 3044GV, Nursing Council, HCTs.
84 Davis, Nursing in Swaziland, 63.
85 SNA, File 3044GV, Nursing Council, HCTs.
86 Sweet, ‘A Mission to Nurse’, 198–217.
87 T. G. Mashaba, Rising to the Challenge of Change: A History of Black Nursing in South Africa (Cape Town: Juta, 1995). Also see L. B. Kumwenda, ‘African Medical Personnel of the Universities to Central Africa in Northern Rhodesia’, in D. Hardiman, ed, Healing Bodies, Saving Souls: Medical Missions in Asia and Africa (Amsterdam: Rodopi, 2006), 210; Sweet, ‘A Mission to Nurse’, 198–217; J. Parle and V. Noble, ‘“The Hospital Was Just like a Home”: Self, Service and the McCord Hospital Family’, Medical History, 58, 2 (2014), 188–209.
88 Interview with Lomagugu Magagula, 11 September 2013, Mliba, Lubombo region, Swaziland.
89 Ibid.
90 Davis, Nursing in Swaziland, 45.
91 Interview with Lomagugu Magagula, 11 September 2013, Mliba, Lubombo region, Swaziland.
92 Davis, Nursing in Swaziland, 21.
93 Ibid., 21.
94 S. Hynd, A Pictorial History of Manzini Nazarene Mission, 1925–1975: A Report on the Activities of the Church of the Nazarene in Swaziland (Manzini: Manzini Printing, 1975), 11.
95 Lomagugu Magagula, ADNT School transcript, made available to author.
96 Interview with Lomagugu Magagula, 11 September 2013, Mliba, Lubombo region, Swaziland.
97 See Mashaba, Rising to the Challenge of Change; Sweet, ‘A Mission to Nurse’.
98 Selelo-Kupe, An Uneasy Walk to Quality, 30.
99 SNA, File 3303A, Raleigh Fitkin Memorial Hospital Reports.
100 Searle, The History of the Development of Nursing, 288.
101 J. M. Mellish, A Basic History of Nursing (Durban: Heinemann, 1990), 130.
102 Ibid., 98.
103 D. M. Shabangu, ‘My Experiences in the United Kingdom’, Teachers Journal, 43 (1962), 35–36.
104 Searle, The History of the Development of Nursing, 288.
105 Interview with Lomagugu Magagula, 11 September 2013, Mliba, Lubombo region, Swaziland.
106 Ibid.
107 D. Hynd, ‘Raleigh Fitkin Memorial Hospital at Work in Africa’, The Other Sheep, May 1928, 11.
Additional information
Notes on contributors
Shokahle R. Dlamini
Shokahle R. Dlamini is a lecturer in and head of the Department of History at the University of Eswatini. Her PhD research focused on the Church of the Nazarene and the evolution of nursing education in Swaziland. Her research interest is in medical missions, nursing, and medical history in Swaziland. Her most recent publications include the article ‘Medical Missions and Proselytisation: The Case of the Church of the Nazarene Medical Missions’ Proselytisation Activities in Swaziland, 1925–1968’, published by the African Historical Review (2022); and the article ‘Gender Dynamics in the History of Nursing Education at Ainsworth Dickson Nurse Training School in Swaziland, 1927–2007’, published by the Canadian Journal of African Studies (2023).