The Indian Nursing Service was inaugurated in 1888 when two Superintendent Nurses and eight Sisters were sent to India, and worked alongside a complementary service formed by Lady Nora Roberts a year previously. By 1893 the number had risen to fifty-two, working at main Stations throughout India, with two or three Sisters at each, and sometimes working singly. Although their duties were intended to be of a supervisory nature, the lack of any dedicated corps of medical orderlies in India resulted in long and arduous working hours, assisted only by native servants, and a transient population of untrained regimental orderlies. Both the climate and the prevalence of disease caused the breakdown in health, and lifelong debility for many women who lived and worked in India during this period, but despite this, the Indian Nursing Service was popular, and never lacked applicants. Catharine Grace Loch was among the first group of nurses sent out in 1888, and she worked as Lady Superintendent until ill-health forced her retirement in 1902. Her edited notes and diaries make wonderful reading, both in outlining the military nursing service in India at that time, of which little detail remains elsewhere, and also for its outstanding description of the beauties and trials of life in India at the time. As the service increased in size, Miss Loch became increasingly concerned about both the type of woman being sent out, and also the obvious lack of good nurse training that was evident in many of those appointed by the India Office. Registers held at the British Library show that the India Office had a slightly unusual view on suitability, with social status and references from eminent and aristocratic 'names' being held in high regard, with nurse training coming in a poor second. Early in 1892, as the Indian nursing service grew, Miss Loch outlined her own concerns:
Feb.5 —I have been to Dr. Bradshaw's office to talk over with him a good deal of business and to arrange some matters which the Chief wants to alter. I then had to write a long official letter to Dr. B. which was to be forwarded to the Chief, stating my views on the subjects we had discussed; this was very difficult and took me a long time. I am desirous of trying to arrange some plan for selection of Sisters for appointment to the Nursing Service. I am not quite satisfied with some of the new ones nor was I last year, and I think they should not have been sent out. Dr. B. was much concerned when I told him this, and remarked that if nurses of the right stamp are not chosen the nursing scheme will not prove a success, and that is just what I feel too. Of course the gentlemen at the India Office know nothing about selecting or rejecting candidates; how should they ? I am awfully anxious that Mrs. Bedford Fenwick should be consulted in the matter as she is the best possible person. I do wish it would occur to Lord Cross as an excellent plan that I should come home for three months every year to choose nurses.
Feb.12.—I omitted in my last letter to refer to the question of training. The first official papers I saw stated twelve months' training as a necessary qualification for appointment. But in fact a Sister came out last year who had worked for barely six months and for that time solely as a paying ' pro.' in an obstetric ward. I remonstrated and wrote a letter to Government stating the importance, indeed the necessity, for a good three years' training. Whether in consequence of my letter I do not know, but soon afterwards the 'necessary qualification' was officially notified to be three years, instead of one. Nevertheless all the new Sisters appear not to have been thoroughly trained in general hospitals.
Mar.13 —Had to go to another station about a delinquent Sister, the case being one of complexity, and not without disgrace through serious indiscretion. The worst of it is that the culprit is a lady and a clever woman. As to selections of future nurses it would be a great comfort if something could be done. Though after all one can never be sure of anything, for people do behave out here so differently from what they do at home; they seem to be transformed into quite different persons, so even with the greatest care some of them may be found tiresome. Still I should trust Mrs. Bedford Fenwick's recommendation a great deal. But in any case it would be impossible to tell in a mere interview whether the candidate is suitable or otherwise. Appearances are absolutely deceiving, and manner alone is not a safe guide. Therefore it becomes all the more important that the nurses should come from hospitals where their general character has been well known. Doctors' testimonials are absolutely misleading, and often the most unsatisfactory women possess sheaves of the most flaring praise and admiration. I do not think there ought to be any difficulty in obtaining ladies in sufficient numbers. I am sure there would be none if things could be done quietly and gradually, but of course to find nineteen all at once is rather a large order; and when the appointments are made at such long intervals, naturally many who might have come out have settled down to something else before the next opportunity. I do think it will be a grave mistake not to send out ladies. First of all, it is hard on those who are not, because naturally they are sniffed at and make no friends; next, it is hard on those who are, because people always charitably judge the many by the few, and they will find themselves thrown out of their proper position in life on account of their colleagues. It should be borne in mind that the population of an Indian military station is always a shifting one; you cannot make a few friends and keep them as one would at home, it is an endless round of new acquaintances. Finally, if the Nursing Service were placed on a different footing, and a lower class of nurses avowedly introduced, I do not think it would answer at all. The orderlies would have no respect whatever for women whom they would consider of their own class, and the Sisters would perforce make friends with the apothecaries and sergeants and their wives and a whole new set of difficulties would arise which would put an end to the whole thing.
Loch, Catharine Grace, 1854-1904.
Catharine Grace Loch, Royal Red Cross, Senior lady superintendent Queen Alexandra's Military nursing service for India; Bradshaw, A. Fredrick, ed.; London, New York, H. Frowde.
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