Nurses^*

Nina Mihailovna Kovaleva

Extract from report of Pirogov, professor of Medico-surgical academy from Sevastopol: "You couldn't help wondering at their zeal, at their verily stoical selflessness. The slightest wishes of the suffering patients, even their caprices, were met in the most through way... Two of thirty five nurses of the first group have died, and fourteen nurses are ill". These lines are written about the very first people who started the Red Cross movement about one hundred and fifty years ago. They are about nurses of the Crimean war of 1853-1856.

At that time our army was in a rather difficult situation. Medical officers were the first to have difficulties because of the great distance from the center: a critical lack of medicines and experienced assistants told upon them. The grand duchess Elena Pavlovna decided to change the existing situation. She addressed Russian women and urged them, the representatives of all classes, to help their Motherland. Thanks to her energies, Krestnovozdvizhenskaya community of nurses was established at that time; they were to take care of wounded and sick soldiers. Before taking up their duties, those who responded to the summons had to take a certain course of training. Noblewomen and women from lower middle class, young and grown wise with experience took a course of medical aid in clinics and hospitals. After successful exams they were adjured. Then - good luck!

The journey was long, wearing and dangerous for delicate townswomen. By train from St. Petersburg to Moscow. From Moscow to Tula and farther on - Orel, Kursk - in horsed tarantasses (carriages) which happened to overturn astir. On the journey nurses often were seriously injured. Then horses were replaced by bullocks. And leaving Perekop nurses rode camels. And by such means the journey was continued till Simferopol. Alexsandra Prunskaya remembers an arrival on a next station: "On entering the saklya (hut in the mountains) some nurses, in dirty boots, soiled all over during the journey, settled on the floor and I, being already ill with fever, couldn't lie down on a wet earth and thus settled on a bench".

Right after the first group of nurses from Krestnovozdvizhenskaya community the second one set off for Crimea and, having reached Simferopol, found the previous one almost all in typhus fever. But nurses were waited for in places where the fight was in full swing. That is why the order of Nikolai Ivanovich Pirogov - those who were able must set off to Sevastopol immediately - was carried out at once.

And there - bombs and shells which didn't sort out where to fall: on soldier entrenchment or on field hospital. However, the fair sex didn't wavered. Young ladies and ladies did not hide in dangerous situations but often took the initiative themselves, saving the wounded. Mansurov, the state councilor, in one of his reports told about a heroic deed of a nurse Bakunina. During a bombardment people in the hospital succumbed to panic, but the nurse refused to leave the wards until at least one wounded stayed there. The report ended with a phrase: "Fortunately, she kept her word and remained alive". Nurse Linskaya prayed for permission to stay with wounded in case they couldn't be removed: Nikolayevskaya battery, where their bastion settled, was just about to be blown up by its defenders.

During that military campaign Krestnovozdvizhenskaya community sent one hundred and sixty one nurses to the military operations area, eleven of them died of wounds and diseases or perished.

Peoples made a long and steady way to realize themselves civilized. Such feeling as mercy to the enemy was very difficult to achieve. From the end of the XVI century there were cases when conditions of keeping sick and wounded people during the war were determined by special agreements where the belligerents could insert suitable articles. But these were acts valid for one occasion, concluded between concrete states. Only the Great French revolution implemented a principle according to which captive sick and wounded soldiers, as well as French soldiers, should have been taken care at the Republican hospitals.

In the second half of the XIX century the wars did not become more merciful; on the contrary, subtle technique of killing and maiming people was spreading quickly. The Crimean war and its first nurses showed the world how acute was women participation for the wounded. Women especially tender arms caused less suffering, woman sensitive heart guest the slightest wishes of the soldiers who suddenly became completely helpless. These advantages of nurses (both in trenches and in hospitals, and later on in trains) in comparison with sturdy hospital attendants were stressed by many witnesses in official reports and personal memoirs. Famous Pirogov wrote about the first nurses of the Crimean war: "...I am proud to have directed their blessed activity".

However, public opinion proved to be unprepared to such a turn of events which denoted new aspects in a woman question. "The idea to send women to the area of military operations was accepted with distrust in Russian society of that time", - a historian noted half a century later, and then concluded: "But ... the voices of sceptics and doubting were to stop".

In Russian enemy's camp, in England, similar events took place, but they were of especially private nature. In English field hospitals, where death-rate amounted to 60%, the situation was simply disastrous. At that time Florence Nightingale came to the rescue of English soldiers together with her thirty seven associates, who arrived in Crimea from the faraway London. The name of this woman, who by her own efforts had established a troop of nurses, became a symbol of nurses' movement. Starting from 1912 a medal, conferred to especially excelled nurses all over the world, was named in her honor.

In modern publications on the history of charity the subject concerning nurses is met very rarely. However the Red Cross movement and its main officials are most directly connected with this social phenomenon. They act according to the same principals. Charity cannot be limited by the concept of helping "ours". Charity implies help to anyone, and this assistance may be limited only by means of actuality. Mercy does not differ our soldier from a hostile one if they are both helpless. It means that in cruel war conditions the highest demonstration of mercy should imply "Inter arma caritas" (mercy between the armies - Latin). And this is the motto of the Red Cross - organization, which establishment was forced by the Crimean war and inspired by spontaneously appearing troops of nurses.

In 1864 sixteen states of Europe and America signed Geneva Convention: from now on everyone who was marked by an arm-band with a red cross had to "save and defend people whose blood washed the field of honor, - without differentiating friends and enemies". Thus, an international union emerged, and "Red cross against a white background" became its emblem. In consequence, national organizations of the Red Cross started to be established everywhere. The initiative of their organization and form of supervision met the traditions of the concrete country. But their direct subordination to military ministers was a common feature of the new establishments.

For Russia such social institutions were not a novelty. By that time a special committee for rendering assistance to wounded had already acted for half a century; it was established by Alexander I. The initiators of creating a new organization in Russia in the context of the Geneva Convention were close to imperial court ladies: maid of honour Sablina and baroness Frederix. Just established Society of care of wounded and sick soldiers (the initial name of Russian Society of the Red Cross was abbreviated into RSRC) was taken under the supreme protection of empress.

In spite of the fact that nurses received a small reward for their work (it can hardly be compared with danger they exposed themselves to), nevertheless, a clear priority of charitable aspects in the work of the Society of care was mentioned in its program documents; to be more precise, the society officials were prescribed "first of all not to hire their members but to look for people who would follow their vocation, and seek them among those who were ready for selflessness not because of minute inclination but because of deep sense of moral duty, and able to endure various destitution".

The future of the Red Cross was determined long ahead: the presence of nurses on the battle fields was becoming a common case. Moreover, in peace time work was also found for them. They kept their eyes on natural disasters - fires, famine, epidemics, floods, droughts, earthquakes.

There was a lot of work, many skilful women hands were required. Different organizations began to train the nurses, and first of all so called nurse communities. These were secular society but charitable organizations. One of the internal rules in such a community said: "You cease to be a nurse if even during illness you ask for something refined".

Russia played a key role in creating secular institution of social communities, while in Western Europe religious communities were the majority. The main difference between regulations of social and religious communities, at least in Russia, was in the priority of spiritual status instead of professional skills; besides, "special training of nurses" was not a single aim of the communities under the jurisdiction of Holy Synod and the first goal in a list of their regulations. Social communities emerged with only one goal - to train nurses and to prepare them for work in the conditions of war. That is why social communities in Russia "are not those closed hostels, which were established in the West, and where girls give up secular life and devote their lives to mercy. In Russia entering the Red Cross community does not impose any vow, does not close an opportunity to lead temporal life. Strict discipline, austere performance of duties, careful attitude to a patient - these are the single requirements made to the nurses", - a historian of the Red Cross movement summed up in 1914.

If we try to draw an analogy with the present, a nurse of a social community should be most likely placed between a sick-nurse and hospital nurse as far as level of special knowledge and skills is concerned. The next step in the hierarchy of medical personnel is taken up by so-called medical assistants who were also trained by RSRC. The first specialized school for doctor's assistants and medical attendants was established in 1879 by Saint-Petersburg Ladies' Sick Quarters Committee. It was this establishment that started women medical courses. At this specialized school the course lasted four years and students were taught quite serious branch of science: physics, organic and inorganic chemistry, anatomy, histology, embryology, toxicology, general pathology, Latin language, etc.

For conducting lessons with nurses communities had their own hospitals, ambulance stations and chemist's shops. In peacetime all these establishments rendered skilled assistance to population and in wartime - according to paragraph 131 of the RSRC manual, together with "available and willing reserve staff" they are placed at the disposal of the General Administrative Department of the Red Cross. Then, taking into account the current situation, the community got down to accelerated training of new nurses. Taking into consideration such a serious predestination of future graduates, the rules of acceptance to social communities were rather strict. Those who wanted to enter them, aged from 18 to 40, had to present necessary documents: birth-certificate, residence permit, educational certificate; and those who were under age had to secure parents' consent.

Svyato-Troitskaya community, established on the initiative of the grand duchess Alexandra Nikolaevna in Saint-Petersburg, was the earliest community of nurses in Russia, as far as time of establishment was concerned. Fifteen years later the grand duchess Alexandra Petrovna founded Pokrovskaya community there. In the after reform time Moscow Ladies' community intensified social nature of this movement having "accepted some nurses in the four Moscow convents, who were allowed constant watching in laborer's and prison hospitals in order to be used to their duties". Soon Saint-Petersburg Ladies' community supported the Muscovites by opening Saint George community in 1870. Almost at the same time emerged a community with a peace name "Soothe my grieves", which nevertheless didn't change its "military" destination. The community was not created in a moment; it was a long single-minded process, depending on a natural course of events and perseverance of its founder, princess Shahovskaya, the widow of college councilor. She started as a nurse herself taking care of the patients and helping during surgical operations at Moscow Police hospital. Ten years later she decided to found a community named "Soothe my grieves". For this purpose she bought a land lot in Lefortovo, reconstructed and equipped the factory buildings situated there to become a hospital. According to approved regulations, the community was reckoned among the Society of Care of Wounded and Sick Soldiers (later referred to as RSRC). In 1877, during the Balkan war, princess Shahovskaya donated the buildings of the community hospital to the city hospital^**, and soon left for the Danube to the front army. Countess Tolstaya (the widow of Alexei Tolstoy) and baroness Vrevskaya also set off there, in a so called Yassko-Kishenevsky district. Both almost immediately were taken ill with a spotted fever, and "baroness U.P. Vrevskaya paid with her life for her real Christian deed", - was mentioned in the report of the Red Cross. As a quarter of a century earlier , Russian soldiers were similarly cared by both titled ladies and those women, whose infamous names were not traced in documents of the past.

To recreate a real picture of women participation in the Motherland fate it is extremely important and natural to address the testimony of direct participants of the events, bringing us an attitude to the events and, therefore, spiritual values typical for that time. Today historical publications are full of enthusiastic maxims, often little motivated or unmotivated at all, imposed by the author's sympathy. A certain displacement of stresses takes place, and sometimes complete nonsense is presented. Intelligent public keenly reacts to such displacement and doesn't always trust the author's interpretation. That is why let's have the floor to Abaza, a famous figure of the movement, representing the Red Cross of Russia in the Balkans in 1877 - 1878: "In addition to community nurses, in the troops there were several representatives of the rank and fashion, who joined them for the wartime. In spite of want of habit to a persistent and hard manual labor, they didn't use their preferred position, and, on the contrary, they tried to take upon themselves the hardest and the most unpleasant work... There were no duties of care after sick and wounded soldiers which nurses would refuse to fulfil. Never feeling tied, these self-sacrificing workers work without rest for the whole days subduing everything - both unattractive side of work, and natural disgust, almost fainting from harmful and unbearable smell they often had to endure during bandaging and looking after the captive Turks, who were brought in terrible condition."

During the Russian-Japanese war, as soon as military actions began at the Far East, both skilled nurses and graduates, who had just passed the exams, set off there. Medical troops of Alexandrinskaya, Iverskaya, Evguenievskaya communities were the first to be formed. Princess Obolenskaya, a nurse of Evguenievskaya community, died of pneumonia in Mukden. Mariinskaya community found some nurses missing, because they stayed with wounded till the end of evacuation from the Port-Arthur. In Mukden personnel of the Red Cross hospitals stayed with wounded even after the town was occupied by the Japanese.

During the campaign of 1904-1905 effective work of the Red Cross couldn't be based only on enthusiasm. Considerable funds were required in a very short space of time. The situation was worsened by the fact that this war was unpopular in the society. The country's government had to interfere. According to the RSRC's regulations the organization was financed from the three sources. Firstly, these were taxes upon transport service providing "conditions higher than a certain level of comfort" and taxes upon receiving foreign passport. In other words, those, who could afford to travel refusing themselves nothing, had to pay. In the wartime, national campaigns, aimed at collecting funds, were held. And the third source was represented by different donations. The state could influence only the first source of income, and it realized this right. In February 1905 the Personal Highest Decree to the Senate in Power was issued. It was stressed in it that the Red Cross activity had "reached the scale, unachievable before; consequently the Organization's expenses increased considerably". To avoid spending the Treasury's funds, financing of the RSRC was directed to be increased at the expense of extra increase of tax upon foreign passports.

In peacetime Russian nurses worked in other "hotspots". A conflict flared up in the Balkans and in Greece, and in 1913 St. Evgueny community was sent to Belgrade and Krestovozdvizhenskaya community - to Greece. The work of nurses' groups was not always strictly limited by religiously scheduled regulations. Often they had to act to fit the situation. Thus, in the town of Scopie a troop of Russian Red Cross Comunity had to introduce some innovation - to open at a hospital a department for Muslim women where only nurses and doctors had an access. The situation of a century ago, but so similar to news from a Russian hospital in Afghanistan. The same problems and the same solutions.

The World War I broke out a year later, and again women found themselves at the front line, irrespective to class differences. Nurses trained at Old Ekaterinensky hospital of Moscow set off to the front-line forces. A daughter of Marine Minister worked at Nikolaevsky naval hospital and a daughter of the Prime-Minister set off to front as a nurse. News of heroic deeds of nurses soon were reported from the front. It was the third month of the war when Elizaveta Alexandrovna Girinkova was rewarded with the first St. George order "for notable courage shown under the enemy's fire, helping the wounded". Baroness Evgueniya Petrovna Tolle by the end of the second year of the war had been wounded three times, rewarded with St. George Cross of the forth degree and presented for rewarding with crosses of the third and second degrees.

But the fate was not always favourably disposed to those who without hesitating challenged it. Doing her duty during the battle Olga Shishmareva, a nurse of Elizavetinskaya community, was wounded and died. Vera Semenova, nineteen years old, was killed with a splinter of a bomb, thrown from an enemy airplane. Baroness Arps-Gofen (born Romanenko), a nurse, died during barbarian sinking of a hospital ship in the Black Sea. Yes, deeds of such kind were considered barbarity, as international Geneva Convention had been in force for already fifty years: it ran that all medical personnel and all bandaging and other means were to be considered neutral. But the rules of a civilized war waging (if such rules existed) settled down slowly. That is why nurses couldn't count on any kind of indulgence at the front.

Lubove Vasilieva, eighteen years old girl, was killed during the battle at the Austrian front. A daughter of Major-General Panaev died at the front line of the Prussian front. Countess Ekaterina Nikolaevna Ignatieva, a marvelous woman, sister of the Education Minister, died on duty in a hospital train. Newspapers wrote at that time that as a nurse she "participated almost in all wars of the last years and had all battle honours, including orders of the first degree".

All the contemporary newspapers wrote about famous Rimma Ivanova, who was declared a heroine but after her death. In her native city Stavropol people decided to set up a monument and to publish biography of the nurse, who kept her head and instead of lost officers urged the whole regiment to attack the enemy. Not everybody had an opportunity to glare up so brightly before perishing. Nurse Antonova died of a common blood poisoning, got during bandaging of a festering wound; she was not yet thirty years old. Being a mother of two children she worked at a city hospital of Saratov. Zinaida Baranova, a former teacher, twenty-two years old, died of typhus, got from captive Turks, at a hospital of Perm. Longing for going to the front, she "finished nurses courses and was eager to be sent to the military operations area". Women mercy got under a cross-fire. It was decimated both by bullets and missiles and by jail-fever, a scourge of trenches.

Names and facts formed a sorrowful, but glorious story of women heroic selflessness. There is nothing to add and there is no need in it.

As for the role of nurses movement in the context of problem of equality of women rights, theorists of feminism may not agree with it but an image of a nurse is the most characteristic example of a real emancipation which, unfortunately, has not yet lost its actuality.