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Obstetrics as part of Missionary Work in Latin America

by Alice Fagan

The Centre for Research Collections has recently begun cataloguing a series of periodicals from The Regions Beyond Missionary Union (RBMU). These texts summarise the Union’s work in Africa, India, Polynesia, China and Central and South America in the late nineteenth and twentieth centuries. In particular, our current work has focused on the missionary practices applied in Latin America. The following blog post will discuss articles on missionary obstetricians featured in the 1906 periodical (ref. CSWC 51/23/3/9).

The RBMU periodicals feature a range of articles, covering the training of missionaries in England, recommended texts, prevalent issues in missionary areas and accounts from missionaries in the field. These articles are intended to be read by RBMU supporters, encouraging them to donate or enroll in training, as well as to become missionaries. The periodicals give significant historical and geographical information on the countries in which missionaries were stationed, particularly the “Neglected Continent” Latin America. Many of the articles on Latin America discuss the difficulties faced by missionaries, for example clashes with Roman Catholics or the impact of political instability. The articles in the 1906 edition on missionary obstetricians focus on the poor conditions in which the patients live and how this inhibits the role of the nurses.

The principal article on obstetrics is titled Cuzco Women’s Wrongs and was written by obstetric nurse Mrs McNairn.[1] The title is somewhat misleading, as the article highlights the needs of the women McNairn is treating, it appears their “Wrongs” are the poor conditions in which they live. She describes how her mission training at Doric Lodge, the RBMU training school, was supplemented by a full obstetrical course (fig. 1 shows Mrs McNairn with two other Regions Beyond nurses). This shows that the Union were keen to provide medical support as part of their missionary work. In Mrs McNairn’s case her husband was also a missionary and so they both travelled out to Cuzco together. He worked as a minister whilst she tended to the health of his (potential) congregation.

Figure 1: Portrait photographs of three nurses, including Mrs McNairn, p241  (CSWC 51/23/3/9)

Mrs McNairn describes how the obstetric nurses in Peru were sought out by the “well-to-do” in Peruvian society who believed English medical care to be more reliable. However, the article focuses more on the poorer women McNairn has treated herself. She was very concerned that many of these mothers are young teenagers that were unable to properly care for their children. She describes three cases where women have died or been close to death due to poor conditions or a lack of nearby hospitals. McNairn recalls the case of a woman she visited in a “Indian Tambo” (Inn) who was in labour and required surgery (fig. 2). She describes the Tambo as dirty and uncomfortable with “hens and guinea pigs running about the floor”.[2] The unsanitary room and the lack of clean water led to McNairn recommending she be taken to hospital. However, the hospital was two miles away and, due to a lack of ambulances, she had to be carried there by her family on a blanket. McNairn believed that this arduous journey unnecessarily led to the woman’s passing. It seems that the lack of established medical facilities in Peru at this time made it very difficult for nurses to apply the training they had received in England.

Figure 2: An Image of a Cuzco House similar to those that McNairn was working in. p239 (CSWC 51/23/3/9)

According to McNairn’s account it seemed missionary obstetricians in Cuzco were in high demand in this period and treated very high numbers of women. Though she was frustrated that the poor conditions led to preventable deaths, the care provided by missionary nurses would have exceeded any medical treatment typically available to poorer women. McNairn describes the gratitude of her patients and how she “always gets a warm welcome back into their homes”.

The importance of obstetric care to the missionary cause is stressed by Mrs McNairn. She believed that her home visits were “almost the only way to reach [native] women’s hearts”. The childbed has offered a woman-only space in many cultures throughout history, and this has been observed by McNairn as an important tool for missionaries. She describes the native women in Peru as confined to their houses, and so through offering treatment she was able to form personal connections to individuals who may not otherwise access ministry. Though McNairn is sympathetic, to a certain extent she blames the poor conditions in which the expectant mothers live as “misery of their own making”.[3] She strongly believed that conversion to Christianity was the best way to help the native people make “their home-life all it should be”.[4] Her medical work certainly seems to have helped the community, but this article makes it clear that Mrs McNairn was not impressed by the Peruvian way of life.

This article was intended to encourage patrons to fund improved medical facilities and greater numbers of practitioners in Peru. This shows that in some situations missionary organisations put the support of native communities and saving lives first and conversion second. Nursing, including obstetrics, was clearly considered an important skill for many missionary women. As McNairn’s account shows, it offered an opportunity for missionaries to connect with women face to face and build a personal relationship. However, as a researcher we must acknowledge that the central aim was always conversion and aspects of McNairn’s account speak to a colonial mindset within the Union.

(Source: Regions Beyond, 1906, CSWC 51/23/3/9, Cuzco Women’s Wrongs, pp. 237 – 241)

[1] Mrs McNairn, “Cuzco Women’s Wrongs”, in H. Grattan Guinness, Regions Beyond, (S. W. Partridge & Co: London, 1906), pp. 237 – 241

[2] McNairn, “Cuzco Women’s Wrongs”, p. 239

[3] Ibid, p. 237

[4] Ibid

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