Enemies of Isolation: Rural Healthcare on the Frontiers of Empire, 1880-1920

Abstract

From 1880 to 1920, a number of strikingly similar new healthcare associations were established across the British Empire targeting the perceived isolation of impoverished rural people from the advances of modern medicine. The inadequacy of the healthcare available to many poor rural residents was nothing new; the amount of attention it commanded was. This dissertation argues for the existence of a “Rural Nursing Network” of similarly-structured healthcare associations in England, Wales, Scotland, Ireland, Canada, Australia, and South Africa (and, to a certain extent, India and New Zealand). These associations were connected to each other in intriguing and counterintuitive ways, linking disparate frontiers in the common cause of improving rural healthcare provision. In exploring these connections, it becomes apparent that discussions about the medical isolation of rural people in different parts of the Empire did not take place in isolation from each other. Local demand and innovation, a constant flow of practitioners and administrators back and forth from urban and rural locales, and a cross fertilization of ideas carried by the wives colonial administrators made for a network in motion−one that challenges us to reevaluate the marginal place of rural people in most histories of late nineteenth to mid-twentieth century change and reform.

The interlocking associations of the Rural Nursing Network shared the same basic district nursing healthcare model, employing mobile nurses who provided in-home care. In addition, these associations had in common the involvement of elite and aristocratic women who served as vectors of healthcare ideas. This dissertation uses pathways forged by elite women on their personal healthcare crusades as the building blocks of the wider network of closely-related associations. Rather than providing an in-depth analysis of each association, it explores the relationship between them, demonstrating the interconnection and innovation that occurred in areas of the Empire that have too often been described in terms of “isolation” and “backwardness.”