|Author: Joycelyn Hezekiah||The UKAHN Bulletin|
|Edited by: Sue Hawkins||Volume 9 (1) 2021|
The following article is an extract from Jocelyn Hezekiah’s iconic book, Breaking the Glass Ceiling: the stories of three Caribbean nurses, originally published by University of West Indies Press, 2001, and now by Trafford Publishing. The book explores the struggle for indigenous leadership in West Indian nursing, told through the achievements of three leaders in Caribbean nursing, Dame Nita Barrow (1916-1995), Berenice Dolly (1917-2002) and Mary Seivwright (1923-2014).
This article focuses on the early career of Dame Nita and her inspiring rise from middle class schoolgirl, probationer nurse, to become the first black matron of the University College Hospital of the West Indies. It is derived from the Preface, Introduction and Chapter One of Hezekiah’s book, and is reproduced here with the full permission of Jocelyn Hezekiah and the book’s current publisher, Trafford Publishing. In order to deliver an article-length piece it was necessary to edit the original somewhat; this task was undertaken, with Jocelyn’s full support, by Sue Hawkins, editor of the UKAHN Bulletin.
Dame Nita Barrow and the development of black nursing leadership in the West Indies
The history of nursing and those who shaped the profession and health care has been an interest of mine for as long as I can remember. For many years, I taught courses in the history of nursing to nursing students in Canada. Consequently, within recent years, with the formation of history of nursing associations, I became a member of the Ontario, Canadian and American history of nursing associations. I recall vividly at one of the very early conferences in Canada being the only person of colour, and the last presenter, speaking about the contributions of black nurses from a small developing nation. All the other papers presented concerned the contributions of nurses, nursing religious (nuns), and leaders from the European world. It may have been coincidental that the first speaker was from Great Britain, the other presenters were from the white Canadian world and I, as the last presenter, spoke about the West Indies. I commented ‘tongue in cheek’ that it seemed that the colonial relationship was still in evidence at this conference even in 1986.
The opportunity to pursue the subject came in 1996 in the form of a six-month sabbatical at McMaster University. I documented the achievements and lived experiences of three Caribbean nursing leaders in the development of nursing and health care in the Caribbean and the wider world in the period 1940-1990. I chose that period as it covered the late colonial era, about two decades prior to independence of many of the islands, and two to three decades into the postcolonial period. The late colonial and early postcolonial decades were a watershed in Caribbean history as the struggle for indigenous leadership in all areas of West Indian society was being fought.
But equally important was the fact that many of the nurses who provided leadership at that time had died or were ageing and it was critical for me to capture their stories and see their experiences from their vantage point. I do not lay claim that this is a definitive historical or feminist work, I seek merely to begin the journey and it behoves others to continue the task. Specifically, I documented the contributions of three nurses and examined from a feminist and colonialist perspective the political, social and economic context prior to and during their personal and professional development. [In the course of this research] I identified and located other nursing leaders of Caribbean heritage in the West Indies; which could provide a preliminary database for future researchers.
The three eminent and ageing nursing leaders in three Caribbean islands I chose were: Dame Nita Barrow from Barbados, Berenice Dolly from Trinidad, and Dr Mary Seivwright from Jamaica. Their choice was obvious as they are known throughout the Caribbean and internationally.
I envisioned this project as having many useful outcomes. It could benefit women in general and visible minority women in particular because a small part of women’s history will be written for present and future generations. Knowledge will be provided that could help to give Caribbean nurses a feeling of belonging and identification and encourage group pride. Further, it would yield valuable and important contributions to a severely underdeveloped area in the history of international nursing and health care. Finally, it would allow Caribbean nurses to examine their past in order to understand their present professional development and, with that knowledge, plan future endeavours.
Within recent times, the role of nurses in the health care system and the influence of their unique perspective on health care reform have increasingly received attention. Nursing literature is replete with documentation of the achievements and accomplishments of nursing leaders from the developed world – British, American, Canadian, European and, lately, Australian – and their impact on nursing in their own countries and internationally. This issue of leadership assumes greater significance when it involves the developing countries as nursing leadership was traditionally always provided by the dominant group from the metropolitan countries. There is a dearth of documented research about the contributions of nursing leaders to the health care system in the developing world. In terms of a multicultural and international perspective, one might well ask where, if any, are the nursing leaders of African, Asian and Caribbean heritage in the developing countries? What are their achievements? Did they become leaders during the time of European dominance? Or is it only in the postcolonial period? If there are leaders in the developing countries, why have their contributions to nursing and health care not been acknowledged and documented?
A review of the literature identified only a few books and journal articles written about nurses of colour, and it is not coincidental that the authors were of the same cultural and racial background. D.C. Hine, a black American female historian, writing about the history of black health professionals in the health care system in the USA examined the intersection between class, race and gender. She observed that black nurses were denied opportunities for administrative and leadership positions within their chosen profession because ‘such positions were considered the preserve of either black male physicians or white female administrators’. Just as the history of nursing assumed only white nursing history, so did books on black history exclude nursing, which is still a predominantly female profession, until M.E. Carnegie, a black American nurse historian, addressed the issue of blacks in nursing in the United States. Her 1995 publication briefly highlighted some of the efforts of African and Caribbean nurses. In 1999, A.T. Davis examined the contributions of early black American nursing leaders. Within the past few years, nursing leadership was also examined internationally by Splane and Splane through a focused examination of chief nursing officer positions in ministries of health. Of central concern was the lack of in-depth documentation about the contributions of Caribbean nurses and nursing leaders, although a few historical articles and doctoral dissertations have been written by Caribbean nurses and physicians documenting health services, health policies, and nursing education. In particular, Mary Seivwright and Syringa Marshall-Burnett from the Caribbean both focused on the contributions of Mary Seacole, one of the earliest black Jamaican nurses, who set up her own hospital for British soldiers during the Crimean War and whose work was largely ignored until recent times. Clearly the invisibility of the contributions of nurses and nursing leadership in the Caribbean to the development of the profession and healthcare nationally and internationally needed to be addressed. Nursing history had marginalized them too long. I believed that the voices of these women needed to be heard and their achievements and experiences written and shared with future generations.
I chose ‘feminist oral history’ as my methodology because we [West Indians] are primarily an oral society. I wanted to hear from Nita, Ben and Mary their perceptions and recollections of people and events. Documenting the recollections of ageing people could be criticized since it could be argued that their accounts might not coincide with the facts. But I content that their interpretation of facts has validity and records, where available, were used to substantiate actual events. These primary data were supplemented by archival research – official and non-official – in Barbados, Trinidad and Jamaica – as well as in official documents from the Pan-American Health Organization/World Health Organization (PAHO/WHO) in Washington, DC, and libraries in Canada.
I used a feminist and colonialist theoretical perspective for the exploration of political, social and economic structures of society prior to and during the lifetimes of these nurses in order to provide a context for their achievements and contributions. I think that this approach was most appropriate for an examination of the lives of these women who lived in both the colonial and postcolonial eras and indeed could be considered feminists, though none of them would characterize themselves as such. Nita Barrow in Barbados, Berenice ‘Ben’ Dolly in Trinidad and Mary Seivwright in Jamaica were born between 1916 and 1923, during the late colonial era. Each would have a considerable impact on the status of women and the development of the nursing profession separately and later, at times, together. Unknown to each other they would enter the same profession, work relentlessly for the advancement of women and eventually, by fortunate coincidence, meet at particular points in time to work together for the betterment of nurses nationally and regionally. They all made international contributions. Dame Nita Barrow was the most outstanding of the three women in international stature. Mrs Ben Dolly, who served on the International Council of Nurses (ICN) for many years, was a versatile and influential leader, and Dr Mary Jane Seivwright, was an internationally known, brilliant nurse.
They share as many similarities as differences. They were bright, black women who embraced each challenge that came their way as an opportunity for growth. This growth was not for personal gain or self-aggrandizement but for the good of womankind and the nursing profession. The common distinguishing feature of these three women was their selfless devotion to service. They worked relentlessly to improve the image of nursing, the nursing profession and the status of women. Each one did so in her unique way, and each had a deep, abiding religious faith. In the experience of the black woman, class and sex, like race, have ever been independent or autonomous processes; and these three rose to prominence in a society in which race, gender and class distinctions existed. I chose the title Breaking the Glass Ceiling, to denote that invisible barrier that is both structural and attitudinal, and in male-dominated occupations prevents women from reaching the top. Although they did not break barriers in a male-dominated profession, where the term is more properly applied, they broke the limits that were defined for black women at that time. They defied tradition within a traditional woman’s occupation. They transcended barriers of race, gender and class within a patriarchal society and did so with sustained vitality and more political awareness than most women at that time. They blazed the way for black women, and nurses in particular, to reach for the top. They were the first black women in nursing in the Caribbean to receive national and international acclaim, and were acknowledged role models for black nurses and women in the region.
Laying the Groundwork, the service and activism of Nita Barrow
Nita Barrow, ground-breaking nurse and late governor general of Barbados, was born on 15 November 1916 at Nestfield, St Lucy, Barbados. The social structure of the Barbadian society into which she was born was shaped by the plantation system and slavery. More than any other West Indian island after slavery ended, Barbadian society mirrored its metropolis, Victorian England, in its class system which was modified by slavery and colour. In ‘little England’, as other West Indian territories named the island, at the top were the white plantation owners and professionals in law, church and state; next was the middle class, a group of mixed race, the coloureds, and blacks, stratified by income; and at the bottom was the majority of the black people.
Nita was the second child, and first girl, of Ruth and Reginald Barrow, in a family of five children – three girls and two boys: Graham, the eldest; Nita; Ena, who followed in Nita’s footsteps and became a nurse; Errol; and Sybil, who became a pharmacist. An awareness of being first and foremost a West Indian permeated all of Nita’s life. Her father was an Anglican minister whose ministry took him to many of the islands, and it happened that the children were born in three different islands – Barbados, St Vincent and the American Virgin Islands. Nita’s mother’s family came from Tobago and her father’s family came from St Vincent. Consequently, as Nita said, ‘we say we are a West Indian family. We never grew up with the thing of being strictly Barbadian.’
When Nita’s father was posted to St Croix, in the American Virgin Islands (where there was a growing population of West Indians who were Anglicans) he became increasingly involved in local politics and the condition of plantation workers. He worked with the local people to form cooperatives and buy estates for themselves, and as a result he was deported ‘because he was a [British] non-islander getting involved in local [American] politics’. With the help of friends, Reginald went to the United States, but the family decided it would be better for Ruth and the children to return to Barbados where they would get better schooling and have the support of Nita’s mother’s extended family, the O’Neals.
The O’Neals were comfortably well-off. Nita’s mother, Ruth, had herself attended a first-grade secondary school as a fee-paying student. This was unusual; the three fee-paying high schools for boys were the exclusive domain of the sons of the well-to-do whites who were educated in the island. The coloured and the blacks or lower class, however, deemed education important for both sexes: apart from its usefulness in their daily occupations, it was also seen as a means of increasing the respect they could earn from the white population.
Even though the black community encouraged the education of girls, racism and sexism permeated all aspects of the dominant society. Just as sons of white families received secondary education before the daughters, patriarchy gave black boys the privilege of receiving secondary education before girls. While distinguished secondary schools for white boys had been established in the early 18th century, there was no equivalent girls’ school until 1881, when Queen’s College was established. In the early 1900s, Nita’s father was one of the few black boys who attended Codrington College, where he studied theology. Higher education was even more restricted, limited to the few black male students who won the Barbados scholarship and entered university at Oxford or Cambridge.
It comes as no surprise, then, that Nita had a solid educational foundation. Her first five years of schooling, until she was ten years old, was at the dame school in St Croix, and on the family’s return to Barbados, Nita attended Miss Taitt’s School, a black girls’ school. She was fortunate to have been born to a middle-class family. Later it would afford her the ‘privilege’ of being able to attend St Michael’s Girls’ Secondary School, a fee-paying secondary school for black and coloured girls, the first secondary school for black and coloured girls in Bridgetown. Nita and her sister Ena became nucleus of the first group of students and Nita proudly claimed that she and her sisters were founding members of St Michael’s. The school maintained high standards and the teachers were of very good calibre. Nita remained there for seven years, successfully completing both her junior and. senior exams, set and marked by Cambridge University, following the colonial pattern. She received a Grade I senior Cambridge school certificate in July 1934.
Nita’s uncle, Duncan O’Neal, had placed second in the Barbados Island scholarship in 1899 and was one of those whose family ensured that he had a university education. He went to Edinburgh where he studied medicine and won the gold medal in surgery. During his studies, he witnesses the struggles of socialism, the growth of trade unions and the progress of the Independent Labour Party [and] on his return to Trinidad and then Barbados he became involved in community activism and workers’ movements to improve the lives of the poor and underprivileged. O’Neal had his office next door to the family home. Nita ‘would wander in and out of there’ [and] her uncle’s social and political activism would have an impact on her [and her decision to become a nurse].
A more obvious reason for Nita’s entry into nursing appears to have come from three of Nita’s friends [who] had decided to go into nursing. They had an active social life and Nita’s main concern was that ‘our social life was not curtailed’ by going into nursing! Her friends assured her that they would still be able to get home to parties and encouraged her to apply. She was interviewed by the matron of the Barbados General Hospital and agreed to enter the programme. The fact that there had been registration for nurses in Barbados since 1932, long before the other Caribbean islands, seems to have been a favourable contributing factor. Nita had not told anyone in the family that she had decided to go into nursing. At the time, her mother was with her father in the United States, so Nita wrote to Ruth, whose advice to her was ‘Whatever you start, you have to finish.’ Before she was married, Ruth had thought of going into nursing … but her parents would not permit her to do so.
Duncan O’Neal was on the hospital board when Nita decided to enter nursing. He knew what a difficult occupation it was, as well as the politics involved with the administration of the programme, of which Nita was totally unaware. He did not believe that Nita would stay and so he did not take her entry into the training programme seriously. The family had divided opinions on whether she was going to stay or not, but she was determined to stay, no matter how tough it was. And persist she did.
It was not so unusual that Nita would go into nursing, as there were few opportunities or professions open to black women then. They could get married and raise a family or go into teaching or nursing. In fact, if they married during training they were not allowed to continue. Bank jobs were occupied primarily by whites, and coloureds were being only gradually accepted; the civil service offered some technical jobs.
Less than a decade before Nita embarked on a nursing career, housing, health and sanitary conditions in Barbados were in decline with high mortality and morbidity rates, especially among the impoverished black people, caused mainly by epidemics of typhoid fever, yellow fever, malaria and diarrhoea. Infant mortality soared, ranging from 217 to 222 per 1,000 live births as a result of diseases such as neonatal tetanus, enteritis, congenital syphilis and prematurity. Many of these deaths were attributed to the lack of trained midwives. Births outside Bridgetown were still attended by village women who acted as midwives. Their skills had been passed on from one generation to another since the days of slavery. They lacked knowledge of aseptic techniques and women were delivered in unhygienic conditions. Hospital conditions were just as deplorable. The black nurses worked long hours, were poorly paid, lived in atrocious dormitories, had substandard meals and functioned under outdated rules. ln 1926 the Public Health Commission was appointed to examine the condition of public health in the island. The commission made sweeping recommendations for the reorganization of public health services, among them the need for training public health nurses and midwives as a means of bringing about effective improvement in public health. As usual, the recommendations were slow to be implemented.
The period between the two world wars, 1918-39, saw the rise of a number of black individuals with a social conscience and the agitation of the black masses in most of the West Indies which culminated in the riots of 1937-38. It was inevitable, then, that there would be a political awakening of the nurses: their agitation for better working conditions, higher salaries and a better standard of living was a reflection of what was happening in society at large. Many nurses purposely broke existing rules as a sign of protest, knowing that they would be suspended; others resigned after breaking oppressive regulations. Many senior nurses resigned to take up positions in the prison, the leprosarium and alms houses. Yet others emigrated to the United States. Some took up private practice, caring for the sick in their own homes or as private nurses for wealthy hospitalized patients. In the face of this grave situation, the colonial authorities were forced to consider the recommendations in the 1926 Report.
The militant action of the nurses was, in fact, the catalyst for action to remedy the situation. By 1931 a sister tutor had been recruited from England to be responsible for the training of nurses and, in 1932, the Nurses and Midwives Registration Act came into being, requiring hospitals to employ trained registered nurses. The Nursing Council was formed with responsibility for prescribing the training for nurses and midwives’ discipline and registration.
The registered sister tutor (nurse educator) who had been recruited for the Barbados General Hospital was a Miss Mary Page. She arrived in Barbados in February 1932, the first trained tutor of nurses in the island, and the first to introduce formal training for the probationer nurses at the general hospital. Lectures were scheduled, classes were organized and teaching aids such as skeletons, models and anatomical charts were sent from England. Within a week of Miss Page’s arrival, lectures had been organized in anatomy and physiology, hygiene, and the theory and practice of nursing. The Nursing Council used the syllabus of the General Nursing Council for England and Wales as a prototype, and a committee was formed to conduct registration examinations. There were two examinations: the preliminary examination, which was conducted after students had been in training for eighteen months; and the final examination, conducted at the completion of the programme, in effect, at the end of the third year. The examinations consisted of both theory and practical components. In the first year of operation, the papers were set by a physician, and the practical examination was conducted by two English nursing sisters (senior nurses). The novelty of the first formal programme generated much interest within the hospital, with many doctors offering to assist the sister tutor with setting and correcting examination papers and conducting the oral and practical examinations.
The administrative structure of nursing at the Barbados General Hospital (now known as the Queen Elizabeth Hospital) consisted of five key positions at the senior supervisory levels: the matron; the assistant marron; the night sister; the theatre sister; and the sister tutor, all of whom came from England. The next level consisted of Barbadian senior nurses, who were in charge of the wards. Finally, there were the staff nurses and student nurses. The hierarchical structure replicated the prevailing social and class structure of the society, with the colonial whites at the top, followed by the Barbadian whites, and then the blacks as the nurses and students at the bottom of the hierarchy.
Standards of patient care followed a similar pattern. There were two very different standards of care: one for the white upper class who had private rooms, and the other for the majority of the poor black and coloured people who occupied the bulk of the general wards of the hospital. The quality of care on the private wards was comparable to that in the private wards in England where medical and nursing care was individualized, and patients had all the amenities they would have had at home, including fine linen, silver, china and cocktails with dinner, unless contraindicated by the attending physician. The atmosphere was conducive to recovery and the patients were treated as individuals, with respect and courtesy. The general wards, by contrast, were severely overcrowded. Patients were viewed as bed numbers or objects, often nameless, and many of the basic amenities were lacking:
Admission to these wards was a traumatic experience for most people; there was an immediate loss of identity, and everywhere the atmosphere contributed to depersonalization of the people; patients were generally addressed as bed numbers, except on rare occasions when the surname was used … the prevailing conditions on these wards … caused the Hospital to be viewed by a large section of the population as a place of last resort… 
Nursing practice, then as now, was greatly influenced by the prevailing health problems. In the early 1930s, typhoid fever, tuberculosis and pneumonia were among the major diseases. Patients remained ill for long periods and many of the techniques were laborious. Shortage of supplies meant that nurses often had to improvise, and the fact that nursing staff was inadequate meant that the delivery of nursing care was not an easy task. Some of the procedures were time consuming, such as the oil meal poultice used for patients with pneumonia. Nurses had to mix, make and spread the poultice which was kept on the patient’s chest by an item of clothing called the ‘pneumonia jacket’. Eventually the jacket was replaced by the kaolin poultice, a premixed medicated poultice available in tins and merely requiring to be heated and spread. An epidemic of typhoid fever required that critically ill patients who had continuous high fever and delirium be treated by the students and nurses with frequent sponge baths and ice caps to the head to bring the fever down. Continuous feeding was needed and careful observation was required of the patient’s condition, especially at the critical third week when complication of intestinal bleeding could occur. Early recognition of this could be the deciding factor between life and death. The care of patients after surgery was equally challenging, especially postoperatively. Anaesthetics at that time were chloroform and ether which caused much vomiting and restlessness. The postoperative care of patients was most demanding as they remained in bed for three weeks after abdominal surgery and, in the absence of appropriate beds, it required two or three nurses to help to position the patients comfortably. Students were petrified at the use of leeches to the eyes of patients with elevated eye tension. They had to learn to master the technique of getting the leech to bite and to maintain sucking until the prescribed time had elapsed as well as removal of the leech and its subsequent care.
These were the conditions in place when Nita and the six other young women with her were admitted for training at the Barbados General Hospital in 1935. They were the first to enter as a group. Formerly, applicants had been taken in haphazardly, whenever the need arose for a pair of helping hands. The basic qualification was only a primary education and training had been, in effect, an apprenticeship.
By the time Nita’s group arrived, there were regular lectures to be attended, which took them away from the wards for about two hours a week, and examinations to be passed before a nurse could be registered. Their sister tutor was Miss Nance Purvis who had replaced Mary Page. She first brought applicants in as a group and developed more structured classes. She was also instrumental, with the collaboration of the matron and the resident surgeon, in arranging refresher courses for the charge nurses and the senior nurses in the hospital. In addition, in 1938 Dr Cato, a black obstetrician from St Vincent, volunteered to give lectures in midwifery with a final examination set by him as there was no formal midwifery training in the island at the time. These lectures were most useful to the nurses as they increased their skills and knowledge in an area that was sorely needed, given the high infant and maternal morbidity that still persisted in the colony, despite the recommendations emanating from the Public Health Commission in 1926, reinforced by the report of the Moyne Commission of 1938, in the aftermath of the 1937-38 agitation. Seven of the recommendations dealt with public health and among them was the training of nurses. The implementation of many of the recommendations was delayed until after the war, although some improvements were seen before then.
Nita remembered that probationers were sent to the wards from their first day. They usually went to the children’s ward, where feeding the children and washing their cups were part of their duties. She added,
If you were fortunate to have a good charge nurse, you learned a lot, …[I] had one of the good ones … Nurse Chandler, [who] showed you everything as she talked, so you did not get this fear of being left [alone] and not knowing what to do. But … some of the older ones, they were angry at what they called “these little nurses who come to take away me cap”. You know, in those days, we were the big four and were senior and had a better basic education. Naturally, they figured we were going for interviews. Now I realize [that] for them you were a threat.
Secondary education, as has been pointed out earlier, had not been available for black girls and when it was introduced, few could afford to pay the fees. In the hospital. Local black nurses were only just moving into charge nurse positions and those who had waited for such a long time to get there would certainly resent any perceived threat to their status.
The training course for nurses was supposed to be three years in duration, but applicants signed on as probationers for five years. The implied intent was to repay some of the cost of the training given. They were paid a stipend of sixteen shillings and sixpence a month. By Nita’s third year, this had risen to one pound a month, but the hospital withheld two shillings of that in the event that students broke a utensil. Ilene Murray Ainsley, a good friend of Nita’s, recounted that there was a great deal of breakage of plates in the hostel.Nita herself had been [wrongly] blamed for breaking a plate, and her money was withheld. ‘She went to the hostel and picked up a plate and broke it and said, “Now I’ve paid for it!” When you broke a bedpan, it was even worse. They were porcelain and the cost was more like twenty shillings. That was plenty of money.’ Nita’s sense of justice and fair play and courage always asserted itself in words and actions.
All the nurses and student nurses lived in residence. The juniors had a dormitory called ‘Cherry Village’, which they all laughed about. Then there were the middle quarters for the senior students, the married women’s quarters for the most senior ones, the charge nurses, and the night dormitory where the student nurses lived when they were on night duty.
Because most of the meals were so inadequate, Nita’s family often sent snacks or a full meal which would be shared with her colleagues. Nita described how her brother, Errol (who later was to become prime minister of Barbados) often came on his bicycle, bringing meals and snacks for her. Naturally, she and her friends shared the goodies. Ilene remarked that all the students used to gather at Nita’s home when they were off duty.
Nita and her group found nursing hard work but because they all supported one another she never found it tedious. They all felt, however, that had they known beforehand how laborious nursing would be, they would never have entered the training programme. Nevertheless, the fact that their families did not think they would stay was a challenge and they wanted to prove that they could stay the course. There were tears of grief at night over the arduous tasks given to them on the wards and they all wanted to pack their bags and go home; the conditions of service were onerous, so that many other young women left without completing their training. Before the erection of a new nurses’ home in 1937, which provided housekeeping services for the nurses, they had to undertake these chores themselves. Although the girls would come off duty tired, they would shower, dress and go to whatever party was on. Some young West Indian medical practitioners had returned from their studies abroad and were assigned as juniors to the Barbados General Hospital [and] Nita and her friends were the ‘clique’ that socialized together. On duty, they pretended they did not know each other, since the rigid prevailing British system separated their professional from their personal life.
Of the seven students who entered nursing with Nita only two graduated, the other five, in spite of their determination, left three months before the end of the last term. It had proved too much for them. Only Nita and Grace Thorne graduated. It is to Nita’s credit that she persisted … [but] she intended to stay only long enough to get through as she wanted to pursue further studies.
Those who graduated in 1938 were entitled to receive their certificates in 1940. It will be recalled that the graduates had to work as payment-in-kind students for two years after their apprenticeship was over. However, the matron had the practice of withholding the certificates of the graduates after they had completed their ‘apprenticeship’. This was a major handicap as it meant they were unable to seek employment elsewhere. This policy was yet another example of racism and classism where the white English matrons had the power over local black nurses to withhold their certificates as they wished. With the war in progress, it was impossible to recruit senior personnel from England; and at the same time, nurses could no longer go to England for postgraduate experience. This fact was apparent to the colonial leaders. Withholding their certificates was a means of retaining cheap labour for maximum work.
Nita’s leadership abilities were quickly recognized at Barbados General Hospital. Her assertiveness and political ‘savvy’ could be seen even as a student. She was not only appointed a student member of the executive of the Registered Nurses’ Association, which had come into being in 1937, but was also placed in charge of the theatre. It was a very demanding position as she worked five or six nights with one additional daytime tour of duty as scrub nurse.
Nita recalled that, ‘Finally, three or four of us, they used to call us the troublemakers, we decided it was time that we had our certificates.’ Since the matron had not given any of the nurses their certificates after five years in the hospital, they decided that they were going to have their own graduation. So twelve of them, from different years, who had not got their certificates planned the first graduation ever held at the Barbados General Hospital. They invited their lecturers and friends and had a party. The authorities were astounded at their assertiveness and gave them their certificates. Nita’s sense of fairness, even at this early stage of her career, was reminiscent of her uncle Duncan O’Neal and her father’s political social activism. After this ceremony, decisions were made by the graduates as to their future plans. Most stayed on staff but Nita was not interested in doing so. She left the Barbados General Hospital and did ‘a bit of private practice’, but she had a thirst for knowledge and wanted more advanced training.
While Nita was in charge of the operating room theatre, she met Nora Cotton, a graduate of the School of Nursing at the University of Toronto, the first Canadian to serve as a sister and supervisor at the hospital. This change in the leadership from the British to Canadian was a direct result of World War II. The war created a shortage of British-trained sisters, who had previously been sent out by the colonial office in London for senior posts at the Barbados General Hospital, and consequently Canada, as a member of the commonwealth, was the next logical choice as a source for supervisory staff. The difference in the approach of the Canadian nurses to the Barbadian nurses, compared to the British, was evident. Canadians treated Barbadian nurses as equals. Perhaps it was because Canada was also one of the colonies, although arguably racism existed within the social, economic and political life of Canada. In the course of conversation, Nita shared with Nora her dream to go abroad for further studies. It was impossible to go to Great Britain because of the war. In any case, financial assistance from the colonial office in London would not be available. Nora told her of the post-basic nursing programme at the University of Toronto and about the Rockefeller Foundation scholarships, based in New York, which sponsored ‘good’ nurses from Latin America and other parts of the world.
Nita acted promptly on Nora’s suggestion and wrote to her mother in New York. Her uncle ‘Ebie’, Ebenezer O’Neal (her mother’s brother), who also lived in New York, made enquiries for her and took her letter of application to the Rockefeller Foundation.
Meanwhile, Nita had heard of an excellent formal course in midwifery in Trinidad and made up her mind to go to take the course. So, in 1940 Nita went to Trinidad for midwifery training and on her return to Barbados, after the successful completion of the Programme, she received a reply from the Rockefeller Foundation requesting her to go back to Trinidad to be interviewed for a scholarship; she was offered a one-year scholarship to the University of Toronto.
Her journey to Toronto in 1943 was complex. She had to fly via Haiti and Miami for her connection to New York, to be briefed by the Rockefeller Foundation. When she arrived in Miami, she missed her connection to New York and was forced to remain a further two days there. Miami in the 1940s was a hotbed of racism. The two hotels that catered to blacks were not suitable for her. Fortunately, her friends in Trinidad had given her the address of a family in Miami who agreed to put her up. In Miami Nita encountered racism unlike anything she had experienced in Barbados. She told the tale of getting on a bus after leaving a restaurant that served blacks, handing over her fare, and sitting in the front of the bus just as she normally would have done at home. The driver did not move the bus and said, ‘Go to the back of the bus.’ He repeated it a number of times but Nita did not realize that he meant her. At last he approached her and told her that he could not move the bus until she went to the back. She was not to be intimidated and boldly responded that the back of the bus was full. The driver then handed her back her fare and she refused it, saying sharply, ‘You can keep it’, and proudly got off the bus, although she was hurting inside.
There were ten students in the Toronto programme including students from Latin America, Australia, and India, but Nita was the only one from the Caribbean. There were, however, West Indian students in other disciplines at the university who greeted her warmly. Several young West Indian men were students at that time, including David Boyd from St Kitts who was studying dentistry. His recollection of those days and of Nita were that ‘she was a live wire when it came to having fun … after the day was done. She might have been doing nursing but it seemed to me that she had a lot to do with the culinary aspect because the two (Nita and Eugenia Charles) agreed to put on a West Indian feast and I personally loved it because the Canadian fare was not quite my, shall I say, cup of tea.’
Nita had expected to return to the Caribbean on completion of her year of study. However, she was invited to be the valedictorian at the graduation dinner. She chose to speak on the training of nurses in Barbados and the state of public health in the island. During the function, she was approached by Miss Tennant, an advisor with the Rockefeller Foundation. Miss Tennant had been very impressed with Nita’s presentation and was aware of the fact that the Public Health School in Jamaica had positions available but could not find qualified West Indians to take them. She thought that Nita would be a most suitable candidate and asked her if she would stay on at the university of Toronto for a second year and focus on nursing education with teaching preparation as a main thrust. A further scholarship from the Rockefeller Foundation made it possible.
A year later, in May 1945, Nita was sent to Jamaica for one month of field experience and to observe public health training there. This was Nita’s first visit to Jamaica and she found the conditions on the outskirts of Kingston and in the rural areas more depressing than any she had encountered in Barbados or Trinidad. However, it provided a valuable learning experience. At the end of her month in Jamaica, Nita ‘took [herself] to Trinidad to have a real ball on VJ day.’ While she was there a cable arrived from the Rockefeller Foundation, offering her the position of assistant instructress with the School of Public Health in Jamaica. Nita was not sure if that was really the job that she wanted but it was the job so you took it’, and agreed to stay for two years.
Nita’s Jamaican sojourn
On her arrival in Jamaica, Nita met more than she had bargained for. Her arrival coincided with the unexpected early departure of the Canadian nurse who had been in charge of the programme, whose British officer husband had been ordered back to England. Nita said, ‘I arrived green to a desk as clean as the top of that table,’ pointing to one in her room. So, here was Nita, a young, relatively inexperienced nurse, faced with heading a public health programme that she had never taught, with her sole support and advisor gone! However, she rose to the occasion. With the able assistance of two of her male colleagues at the School of Public Health, Nita got the programme under way.
Her Barbadian accent was a shock to the Jamaican nurses. More than that, there were many words that each island used or pronounced differently and that also created quite a stir when she was teaching. Irene Murray Ainsley was one of the students in that public health programme. Ilene said fondly, ‘I did my public health there. She taught me. I remember we had a child who was very sick. She was Barbadian and everyone was scared for this child but not Nita. Nita brought her from the hospital, put her in the tub, let her have a bath, and everybody was scared. But not Nita. She was that sort of person.’
There were seven senior nurses who had been practising public health in Jamaica although they did not have any training. These nurses were the first to be trained, followed by nurses from other islands where public health programmes were to be developed. One of the first students in the programme told Nita a story years later. It always made Nita laugh: ‘The morning that you walked in the class, we said, “But wait! Where this little gal come from? What teacher? You think she know(s) anything?”’ This has to be understood within the context of the islands’ insularity. In 1945 Jamaican nurses had little or no encounter with nurses from other islands. Colonialism had created artificial barriers by decreeing that the avenues of communication should be between the various islands and London rather than among the territories themselves. It was once said that ‘a Jamaican sees more of his brethren of the other islands in six months spent in London and on shipboard between Barbados and Southampton, than in six years in his own island.’ That was largely true up to the 1960s and helped to explain the notorious psychological alienation of Jamaicans from eastern Caribbean islands. This was clearly a matter of communication, not geography, where the British policy of keeping the colonies apart from each other for three hundred years failed to build up a sense West Indian nationhood.
Nita’s experience in the public health programme laid the foundation for her long outstanding international career in the field of public health. She remained with the School of Public Health for five years, planning the courses and teaching some of them. She organized both the theory and the practice components of the one-year public health post-diploma nursing programme in the West Indies School of Public Health. Together with colleagues in the school, she organized the practice field: ‘We had to set up a programme so we could be sure … we had control … It was quite a big programme when I look at it now.’ Health centres were set up, the students were assigned a given number of hours together and then Nita would go around and supervise them individually as well.
During her stay at the School of Public Health, Nita observed that nurses from Jamaica and the other Caribbean islands coming for post-basic training in public health had many learning deficiencies. Knowing that there was no uniform training in the islands and that few, if any, had registration for nurses, Nita began to focus on the need for better standards in nursing education in the Caribbean. The University College of the West Indies (UCWI, later the University of the West Indies) had come into being and was starting a medical school, ‘so you needed a certain standard of care’. This need fitted in quite well with Nita’s ideas for nursing education.
The School of Public Health was undergoing change; the University College Hospital of the West Indies (UCHWI) opened its doors in 1952; and at about the same time seven Jamaican nurses, who had gone abroad for training during the war years, had returned to the island. Two were appointed as assistant instructresses in the School of Public Health with Nita; others were made sisters at the UCHWI. Only two English matrons remained in the island and they identified strongly with the Jamaican nurses.
Once she had seen the need for better nursing education in the Caribbean, Nita realized that united action would be necessary to bring it about. Gathering a group of nurses of kindred spirit, she worked with them to form a nurses’ association. It was the nucleus of what would later become the Nurses’ Association of Jamaica (NAJ). For three years they met in her living room every month. Their whole filing system was held in a suitcase kept under Nita’s bed. In West Indian culture where West Indians, by and large, do not seem to hold on to things of the past, where records are destroyed, misplaced or lost, it is most heart-warming to know that the nurses of Jamaica have held on to that suitcase. It tells a story of struggle and achievement, unity and diversity; the struggle to get the NAJ off the ground; the sense of achievement in introducing registration for nurses; unity between islanders, Barbadian and Jamaican; and diversity in its formation with representation from black and white, English and West Indian. That now old brown weather-beaten, leather suitcase is a symbol of pride and joy to Jamaican nurses. It is today housed as a treasure in the headquarters of the NAJ, in the Mary Seacole Annex in Kingston. Attached to the suitcase is an inquiring label: ‘Can you see where we are coming from? Let’s not forget the past!’ A haunting reminder to nurses of the early beginnings and struggles of their nursing association
On Friday 19 July 1946, the Jamaica General Trained Nurses’ Association (JGTNA, now the NAJ), was launched with much pride, great exuberance and a spirit of commitment by all nurses. There was the desire to gain recognition abroad, particularly from Great Britain, which was held to be the gold standard. Such recognition would be seen as an acceptance of local standards. There was a great desire among the rank and file nurses for Jamaican leaders to emerge who would promote their individual interests and encourage their belief that, given the opportunity, Jamaicans could attain great heights. Their major goals were to obtain registration for local nurses and to advance the status of nursing in Jamaica. To that end, the newly formed nurses’ association requested, through the director of medical services, that representatives of the JGTNA meet formally with the two colonial office representatives, Blanche Shenton and Emily MacManus, who had been sent to examine standards of nursing in the colonies. At the meeting, which was attended by a delegation of Jamaican nurses headed by Nita Barrow as the president of the JGTNA, several items were on the agenda. These included educational standards for nurses, standards for training, the need for sister tutors and a preliminary training school, the establishment of an examining board with nursing representation, registration for nurses and midwifery training.
Securing registration was no easy task. Apparently, there was no pressing desire on the part of government to change the status quo, as it was to their economic advantage to continue staffing the hospitals primarily with student nurses as cheap labour. Paternalism and gender, class and racial barriers persisted. Since most physicians were men, little attention was paid to any ideas generated by nurses, almost all of whom were women. Local nurses continued to be exploited financially. Although nurses were employed by the government in the hospitals, they were not considered to be civil servants so they were denied the benefits offered to civil service employees. There was a vast difference in salaries paid to the British matrons who were sent by the colonial office compared to those of the local matrons, who were underpaid and had little or no status. The nurses were aware of these discriminatory practices and were determined to address these injustices so they supported the bill for registration wholeheartedly.
Nita’s leadership style in words and action throughout all these endeavours was participatory and group oriented. She put it aptly: ‘You don’t want to end up and say, I have done so and so. To me, you have to do it with a group and through a group.’ There was active lobbying to get the nurses’ registration bill passed. In August 1951 the bill went to the House of Representatives where many of the members opposed it, so the nurses organized a representative group to be present during the debate. When the bill was presented to the floor of the House, there was much stonewalling. Prime Minister Alexander Bustamante looked around the House and saw all the nurses in their flowing falls, sitting in the visitors’ gallery and looking adamant. He sent a note to Donald Sangster, who was leading the debate, saying, ‘Man, stop playing the fool – don’t you see the women there in the gallery – they mean business!’ The bill was passed that day, 15 August 1951. Such political activism on the part of the nurses led Nita to comment that ‘they would be called feminists now’. Indeed, like black women who have historically been agents of change in their own world, the nurses played a significant role in shaping their immediate environment. Their struggle reminds us of all women’s struggle against oppression and subordination, and black women in particular.
Nevertheless, it had taken five years from 1946 for the registration bill to become law. The government feared a loss of control over nurses, which was apparent as the bill would provide for the Nursing Council to have authority for the education of nurses and give nurses more autonomy. The law eventually came into effect on 15 December 1951. It was greeted far and wide with congratulations from both lay and professional supporters. The Nursing Council for Jamaica held its first meeting on 14 January 1952, creating a new era in the history of nursing in Jamaica.
Just as Florence Nightingale used important political contacts to achieve her goals, so did Nita. She formed strong connections with women in powerful positions, such as Lady Foot, who was president of the YWCA, and other women in the Red Cross and the Women’s Federation. As she so well observed, ‘Life is political. Anything you want you have to work on it.’ The support of influential people, both men and women, was crucial for success.
Nita became the first president of this newly proclaimed JGTNA in 1946. She had a tenure of three years as president of the association, a major feat considering that she was not Jamaican. But by then, arguably, she could be considered an honorary Jamaican. The registration of nurses raised the profile of the profession, and so encouraged nurses from other islands to come to Jamaica for public health training. Nita, always modest, was adamant that these were not her achievements but the achievement of all Jamaican nurses: ‘I am always amused. You do not do it all alone … You have people who you propose the ideas to [like] doctors. I said, “You have a strong medical association, why don’t we have a nurses’ association?” They said, “Why don’t you do something about it?” So you do something about it. I collected twelve like spirits … We had a lot of rejections … Even nurses don’t see what we want … and then you get an association.’
Nita noted that these accomplishments were not only Jamaican but also West Indian. Jamaica became the hub for nursing, medical and public health activities, with nurses, doctors and health inspectors from the Caribbean islands going there for studies or to teach at the School of Public Health or UWI. Many others contributed their knowledge and skills to the hospitals and the university. That era of the late forties and fifties was one of optimism and high hopes for the West Indies.
Those decades saw a number of important developments in the growth of the West Indies, politically and intellectually. It was the first time in its history that unity was seen between the islands. In a series of conferences between 1944 and 1958 the concept of political federation was brought to fruition. Unfortunately, the Federation lasted for only four years, from 1958 to 1962. When it collapsed, the West Indian territories embarked upon the task of building free nations out of British colonies. Political independence in later years created the states in which Caribbean nationhood could develop, and economic necessities forced some common action.
Envisioning a new dawn
In 1950 Nita was offered a Commonwealth Development and Welfare Fellowship at Edinburgh University to do a sister tutor’s course, arranged through the Royal College of Nursing, Edinburgh. It will be recalled that Nita had long been concerned with the deficiencies in the students’ preparation when they entered the post-basic courses in public health. Remembering the words of a tutor who always said to her, ‘All right Nita, don’t complain – go do something about it’ she did. She took the tutor’s course, and on her return in 1951, Nita joined a team of teachers at the School of Nursing at the Kingston Public Hospital who were working to prepare students to be efficient nursing staff for the proposed UCHWI. The reorganized Kingston Public Hospital school was just beginning with a team consisting of two English tutors hired to assist Gertrude Swaby, a white Jamaican nurse who had completed post-basic nursing education at Columbia University. Their task was to organize the basic nursing education programme, which was still very inefficient, and rationalize the experiences in preparation for the three-year programme recommended by the General Nursing Council. Nita and the other tutors knew that it was imperative to improve the quality of nursing education as there was the strong possibility of a new teaching hospital – UCHWI. Nita worked for three years, until 1954, in the basic programme, getting it reorganized with Gertrude Swaby and the other team members. Nita credited Gertrude Swaby with working diligently in nursing education to improve standards in nursing.
When the new and long-awaited UCHWI (a teaching hospital for medical students) opened in 1951, it was still a British nurse, Miss Foster Smith, who was appointed matron. But, when she resigned in 1954, Nita was appointed to the post, to be the first West Indian matron of the hospital. This was a cause for much celebration not only in Jamaica but throughout the West Indies, as it was the first time in the history of the region that a local black woman was heading one of its major health institutions. At long last, West Indians were coming into their own and a transfer of power was gradually taking place.
Nita (and the other two nurses, Ben Dolly and Mary Seivwright, discussed in Glass Ceiling) left their stamp of zeal, enthusiasm, courage, persistence and dedication to high standards to future generations. Each one was unique. Dame Nita was unassuming and unpretentious, and always made others feel special; Ben was forthright, a storehouse of knowledge and information, and highly principled; Mary was impressive, formidable and brilliant. Sticklers for detail, with a remarkable capacity to recall minutiae, they were the undisputed leaders and role models for nurses and women of the region. What served as the fundamental core of their passion and caring? It is undeniably their deep spirituality. Their profound and abiding faith in God enabled them to persist where others might have given up. They expressed their deep faith in service to others through the modality of caring. All three were seeking much the same goal – to be of service to all, but to women and nurses in particular. Their concern for the status of women nationally and, in Dame Nita’s case, internationally, saw them addressing the needs of the less privileged through their active participation in educational, social and health activities for women. I think they would agree that these qualities were gifts from God. Gifts that they shared with humanity.
Nursing has been deemed a woman’s occupation, and, like the history of black women, has suffered in the neglect of its recorded history. Nursing in the Caribbean has many hidden heroines. I chose to open the window on only three such women. Their striking similarities were their passion for nursing and their care for the well-being of women, their unswerving pursuit of excellence, the articulate expression of their beliefs and the translation of those beliefs into practice for nursing, healthcare and the welfare of women. Whatever mission they undertook, they did it tenaciously and with a fervour and vigour paralleled by few. Individually and collectively they propelled Caribbean nursing to the forefront politically. This is the legacy of these three women.
Nita Barrow’s career and ambition did not stop with her achievement as the first black matron of the UCHWI. Glass Ceiling carries on the story of her relentless rise, both internationally and at home in her beloved West Indies. The table below summarises these achievements which are discussed in Chapter 2.
The Career of Nita Barrow, 1954-1995
1954: Matron of UCHWI – the first black matron of the hospital
1956: Principal Nursing Officer in Jamaica – the first black woman to hold the post
1963: Awarded degree from Columbia University in Nurse Education
1963: Project director of a survey of West Indies schools of nursing under the auspices of PAHO/WHO
1964: Caribbean Nursing Advisor to PAHO/WHO
1970: Appointed Director Young Christian Women’s Association (YMCA)
1976: Director Christian Medical Commission; President, World YMCA.
1980: Dame of the Order of St Andrew and St George
1982: President, International Council of Adult Education
1986: Barbadian Ambassador to the United Nations
1990: Governor General Barbados
 D.C. Hine, Black Women in White: Racial conflict and cooperation in the Nursing Profession, 1890-1950 (Bloomington: Indiana University Press, 1989), xviii. Hine’s book explored black American health care professionals with a focus on black nurses.
 M.E. Carnegie, The Path We Tread: Blacks in nursing worldwide 1854-1994 (3rd Ed) (New York: National League for Nursing Press,1995); A.T. Davis, Early Black American Leaders in Nursing: Architects for Integration and Equity (Sudbury, Mass: Jones and Bartlett, 1999); S.K. Khanna, History of Nursing in India from 1947-1989 (Missouri: Cape Girardeau, 1991); K. Kodamer, Nursing in Japan (Tokyo: Nippon Kango Kyokai, Showersznner, 1977); R. Splane and V. Splane, Chief Nursing Officer Positions in National Ministries of Health: Focal Point for Nursing Leadership (San Francisco: The Regents, School of Nursing, University of California, San Francisco, 1994); A.B. Thoms, Pathfinders: A History of the Progress of Colored Graduate Nurses (New York: Garland, 1985).
 S. Marshall-Burnett, ‘A Brief Reflection on the Life of Mary Seacole, 1805-1881’, Jamaican Nurse 21/2 (1981), 14-15; M.J. Seivwright, ‘The Florence Nightingale of Jamaica’, Jamaican Nurse 21/2 (1981), 16; L.M. Comissiong, ‘Health Services in the British Caribbean: 1935-1969’, Caribbean Medical Journal 30 (1970), 40-42; E. De Verteuil, ‘The Urgent Need for a Medical and Health Policy for Trinidad’, Caribbean Medical Journal 5/3 (1943), 107-19; J. Grayson, ‘The Nurse, Association of Trinidad and Tobago’, Unpublished doctoral thesis, Teachers College, Columbia University, 1989; J. Hezekiah, ‘Post-colonial Nursing Education in Trinidad and Tobago’, Advances in Nursing Science 12/2 (1990), 28-36; ‘The Development of Healthcare Policies in Trinidad and Tobago: Autonomy or Domination?’, International Journal of Health Services 19/1 (1989), 79-93; ‘Nursing Leadership and the Colonial Heritage’, Image: Journal of Nursing Scholarship 20/3 (1988), 155-58; P. Hay Ho Sang, ‘The Development of Nursing Education in Jamaica, West Indies: 1900-1975’, Unpublished doctoral thesis, Teachers College, Columbia University, 1984; S.M. Laurence, ‘The Evolution of the Trinidad Midwife’, Caribbean Medical Journal 3/4 (1941), 204-8.
 G. Lewis, The Growth of the Modern West Indies (New York: New York Monthly Review Press, 1968), 229.
 Quotes from Nita Barrow are derived from interviews conducted by the author between January and June 1996.
 Generally, the children of the upper-class whites were educated in England.
 F. W. Blackman, Dame Nita: Caribbean Woman, World Citizen (Kingston, Jamaica: Ian Randle Publishers, 1995), 8.
 St Michael’s opened in 1928 and Miss Tait transferred her pupils to the new school.
 H. Beckles, A History of Barbados: From Amerindian Settlement to Nation-State (Cambridge: Cambridge University Press, 1990), 151-60; E.K. Walters, Nursing: A History from the Late Eighteenth-Late Twentietb Century Barbados (Bridgetown, Barbados: E. K. Walters, 1995), 8-12; Report of the Committee on the Training of Nurses for the Colonies, Cmd. 6672 (1945); West India Royal Commission Report, Cmd. 6607 (June 1945).
 Walters, Nursing: A History, 43.
 Ibid., 13-14.
 Ilene Murray Ainsley followed Nita in training two years later and went on to become the first local black sister tutor in the island.
 Ilene Murray Ainsley, personal interview, January 1996. All material quoted from Ainsley is from this interview.
 It was indeed ironic that almost forty or more years later, in 1986, Nita would be invited to Miami, to attend an American Jewish Committee meeting and to receive an award in recognition of her contribution to peace and her special skills as convenor of the United Nations Decade of Women Conference in Nairobi the previous year.
 David Boyd, personal interview, December 1995. All material quoted from Boyd is from this interview. Eugenia Charles was a fellow Caribbean student studying law. She would go on to become Prime Minister of Dominica.
 Frank Cundall, “Jamaica” in British America (London: Kegan Paul, Trench, Trubner and Co., I900), cited by Lewis, The Growth of the Modern West Indies, 18
 Nita was not able to be there, she was in the UK completing her sister tutor course.
 The fall is a traditional flowing headdress once worn by nurses, also called a veil.
 Nita and others received fellowships supported by the imperial treasury’s Colonial Development and Welfare Fund, designed to prepare Caribbean nurses as ward sisters or sister tutors.
 Gertrude Swaby was born in Albert Town, Trelawny, in 1912, the fourth daughter of an Anglican minister, and died in 1989. Her untiring efforts to make nursing a respected profession through sound education have been described by Syringa Marshall-Burnett as the hallmark of this woman’s career. See Jamaican Nurse 28 (1990) where the entire issue of the journal is devoted to tributes to Swaby for her contributions to her profession in her country.