When asked to invite a public health figure to dinner I was very excited. I had a few criteria that I wanted to incorporate into my dinner guest selection. First, I wanted to invite a woman. Although many of the “helping professions” such as nursing, public health, and social work, are both currently and historically dominated by women, it is not until recently that women were shown similar levels of respect as men. I am very curious to learn about the experience of a smart, driven female during a time when women were very repressed. My second criterion was to find a woman who has made an impact in the field of human rights as well as public health. This requirement sounds a little but difficult at first blush because the concept of “human rights” was not fully formed until after world war two. However, human rights existed long before then in the idea of natural law. The inequalities and injustice women faced based on their gender has and continues to be a violation of their human rights.
Now that I had my basic criteria I began to brainstorm. Should I invite Jane Adams one of the great leaders in social work? What about Margaret Sanger, the champion of reproductive rights? Or should I invite Marie Curie, one of the first well re-knowned female scientists? What about Eleanor Roosevelt, the voice behind the Universal Declaration of Human Rights? It was then that I remembered the third criteria I had to consider. The public health figure had to be someone from the 19th century or before. This was much harder. Important female public health figures before the 20th century were not nearly as well known or easy to find. I finally settled on inviting Florence Nightingale. Now, I know that she did not die until 1910, but she did most of her important work occurred before the 1900’s. Additionally, I wanted to invite someone to dinner who I could relate to, and although Cleopatra, Queen Elizabeth and Abigail Adams were very interesting they were a little too historically distant for me to really relate to. As it turns out Florence became an invalid after her experiences helping wounded soldiers during the Crimean war. She rarely left her home, but fortunately she invited me to come to her place for dinner.
Florence Nightingale was born on May 12, 1820, what is now International Nurses Day.[i] Although Florence had an interest in nursing her parents did not think the occupation was appropriate for a woman of her class and background. They would not fund her education.[ii] Finally, after much effort Florence convinced her parents that nursing was her calling. During dinner I asked Florence if she had ever considered becoming a doctor rather than a nurse. My assumption was that the medical profession for women was strictly limited to nursing during that time. Florence confirmed my response; she said that she had wanted to become a doctor but that the medical profession was closed to her.[iii] In response she had become a strong advocate for women, and campaigned for woman’s suffrage, and for opening the medical profession to all women.[iv] I found it interesting that although today women are technically allowed (at least in the United States) to become whatever profession they want, in most of the world their role remains as the mother and caretaker of the family. The injustice that Florence fought so hard against still remains. I told her about how in Afghanistan the Taliban forbid women from seeking care from a female doctor. Then the Taliban forbid women from becoming doctors. Florence was shocked and saddened by the revelation that society as a whole has not come very far.
In 1860, Florence wrote a book titled Nursing: What it is and What it is Not; the book was basically a textbook on how to be a good nurse.[v] What is most interesting to me was that the book was not targeted to nurses but rather as a guide to all women, because as Florence put it, “Every women, has at one time or another in her life, charge of the personal health of somebody…in other words, every woman is a nurse.”[vi] I was impressed with Florence because she was empowering women everywhere to take control over their own education and the health of their own family. She taught women to keep their house clean and sanitary, to separate the sick from the well, and to ensure that food was clean and safe. I was really impressed that Florence decided to empower the average women. However, after speaking to her I realized how frustrated she was because although there were simple things that every woman could do to help ensure the health and well-being of her family, it was hard to communicate those things to them. She told me that many women did not know how to read. Even if they did know how to read, they did not have enough money to purchase her book. Again, I was shocked by how similar the situation in 1860 was to the situation of today. In our world one of the primary indicators of good health is educational status of an individual. If an individual cannot read, then he or she may not know simple ways to protect themselves from disease and risk factors.
In 1863 Florence wrote another book titled Notes on Hospitals.[vii] Florence recognized that more people were dying in hospitals then they were outside of the hospitals. She found this fact fascinating. Florence was one of the first people to understand and recognize the concept of iatrogenic illness. She understood that simple precautionary measures could keep the sick from becoming sicker and may even allow them to get healthier. She spoke to me about how frustrating it was to see so many people die because simple mistakes. She also spoke about how a lack of resources in some countries she worked, such as India, were a real detriment to the quality of health care. I spoke to her about how the same is true today. We both found it frustrating that so much of medicine is concentrated on helping the individual fight whatever ailment he or she might have, but that the underlying root causes of the ailment were never addressed.
Florence and I also discussed biostatistics. I had no idea that she was one of the great statisticians and had used her love of math and statistics to find correlations between health and physical conditions. She even created pie charts to present this knowledge.[viii] We chatted about our shared love of math and science.
Overall dinner was really interesting and informative. What I learned is that since the 1800’s we have not really come so far. Even 100 years after her death women face inequality and the health system in developing countries has yet to learn the valuable lessons she presented in her books. I did not feel completely without hope though. Through her contributions Florence paved the way for the concept and acceptance of public health as a field. She also opened the door for me to be able to attend law school and participate in the political system. On November 4, I will honor her hard work and vote!
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