Category Archives: war

Florence Nightingale: a pioneer of hand washing and hygiene for health



Helping the wounded.
Shutterstock/Everett Historical

Richard Bates, University of Nottingham

Florence Nightingale, who was born 200 years ago, is rightly famed for revolutionising nursing. Her approach to caring for wounded soldiers and training nurses in the 19th century saved and improved countless lives. And her ideas on how to stay healthy still resonate today – as politicians give official guidance on how best to battle coronavirus.

For example, although Nightingale did not fully subscribe to the idea that many diseases are caused by specific micro-organisms known as germs until she was in her sixties, in the 1880s, she was well aware of the importance of hand washing. In her book Notes on Nursing (1860), she wrote that:

Every nurse ought to be careful to wash her hands very frequently during the day. If her face, too, so much the better.

During the Crimean War (1853-1856) Nightingale had implemented hand washing and other hygiene practices in British army hospitals. This was relatively new advice, first publicised by Hungarian doctor Ignaz Semmelweis in the 1840s, who had observed the dramatic difference it made to death rates on maternity wards.

Nightingale’s attention to international medical research and developments was just one factor behind her ability to make effective interventions in public health. Like many public health experts of her age, Nightingale considered the home to be a crucial site for disease-preventing interventions. This was the place where most people contracted and suffered from infectious diseases. (The same is true today: in Wuhan’s coronavirus outbreak, around 75-80% of transmissions were reportedly in family clusters).

Nightingale’s book, Notes on Nursing (1860), was more of a public health instruction book than a nursing manual. It advised ordinary people how to maintain healthy homes – particularly women, in accordance with the worldview of the times. There was straightforward advice on everything from how to avoid excessive smoke from fireplaces (don’t let the fire get too low, and don’t overwhelm it with coal) to the safest material with which to cover walls (oil paints, not wallpaper).

Nightingale strongly counselled that people open windows to maximise light and ventilation and displace “stagnant, musty and corrupt” air. And she advocated improving drainage to combat water-borne diseases like cholera and typhoid.

In her view, all domestic interiors must be kept clean. Dirty carpets and unclean furniture, she wrote with characteristic bluntness, “pollute the air just as much as if there were a dung heap in the basement”.

Notes on Nursing also called upon the “mistress” of every building to clean “every hole and corner” of her home regularly, for the sake of her family’s health. But Nightingale also recommended a more holistic approach to health. She encouraged soldiers to read, write and socialise during their convalescence so they would not sink into boredom and alcoholism.

Good data

During her youth, Nightingale’s father had introduced her to a leading practitioner of statistics, then a brand new academic field, and paid for her to have a mathematics tutor. During and after the Crimean War, Nightingale seized on statistics as a way of proving the effectiveness of different interventions.

She went on to produce her famous diagrams, which demonstrated the high proportion of soldiers’ deaths caused by disease as opposed to battle wounds, and became the first woman admitted to the London Statistical Society in 1858.

Thereafter she designed questionnaires to obtain data on such questions as the sanitary condition of army stations in India, or the mortality rates of aboriginal populations in Australia. Her guiding principle was that a health problem could only be effectively tackled once its dimensions were reliably established.

In 1857, around a year after returning from the Crimean War, Nightingale suffered a severe collapse, now believed to have been caused by a flu-like infection called brucellosis. For much of her subsequent life, she was racked with chronic pain, often unable to walk or leave her bed.

Working from home

Having been declared an invalid, she imposed a rule of seclusion on herself because of pain and tiredness rather than from fears of contagion – a form of self-isolation that extended to her closest family (though she still had servants and other visitors).

During her first years of working entirely from home, Nightingale’s productivity was extraordinary. As well as writing Notes on Nursing, she produced an influential 900-page report on the medical failings during the Crimean War, and a book on hospital design.

This was in addition to setting up the Nightingale Training School for nurses at St Thomas’ hospital in London in 1860, and a midwifery training programme at King’s College Hospital in 1861, plus advising on the design of a number of new hospitals.
Later in the 1860s, Nightingale proposed a reform of workhouse infirmaries to make them high quality taxpayer-funded hospitals; and also worked on sanitary and social reforms in India. All of this she accomplished without leaving her house (though government ministers sometimes came to her home for meetings).

Having said this, it is worth remembering that Nightingale’s was a privileged form of self-isolation. Her father’s fortune, derived from Derbyshire mining interests, meant she had no money worries.

She lived in a nice house in London with various assistants and servants to help, shop and cook for her, and had no children to look after. Her entire waking time could be devoted to reading and writing. So while this is an appropriate time to recall and celebrate the huge contribution Nightingale made to modern nursing and public health care, we shouldn’t feel too bad if we don’t quite live up to her high standards of isolated productivity.The Conversation

Richard Bates, Postdoctoral Research Fellow, Department of History, University of Nottingham

This article is republished from The Conversation under a Creative Commons license. Read the original article.


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Why Australia is still grappling with the legacy of the first world war



Soldiers in Anzac Cove. The war had driven Australians apart in the demands it made upon the people.
State Library of Victoria , CC BY

Bart Ziino, Deakin University

Historians have long been engaged in a fractious, sometimes spiteful, debate about the legacies of the first world war. This is especially so because the politics of the war continue to resonate in our own discussions of national identity and purpose.

We debate the extent to which the Anzac tradition reflects our understanding of what makes a good Australian, and how important our cultural affinities are with Britain. Did the war curtail a progressive spirit, and entrench political conservatism, or did it encourage a new confidence in ourselves?

These evaluations were already present the moment the war ended in November 1918. Australians had endured a terrible trauma. Sixty thousand of them were dead from a population of not quite 5 million. Another 150,000 returned sick or wounded, physically and mentally.




Read more:
World politics explainer: The Great War (WWI)


Those at home were quick to draw attention to their own sufferings, too. They had known the war not only in its military dimensions, but as an ordeal of waiting and worrying, of constantly fearing the worst. The Victorian parliamentarian John Percy Jones simply declared the war

has kept me in a condition of mental agony. I am hardly able to realise even yet that the fearful times through which we have been passing are now over.

What, then, should we make of that sacrifice? Some called the nation to unity around the experience of the war, and in doing so elevated the Anzacs to the peak of Australian virtue.

In the federal parliament, Senator Edward Millen declared:

this war, amongst other things, has made Australia a nation in a sense that it was not before. It has given us a new conception of national life.

A divided nation

But it was also clear the war had driven apart Australians in the demands it made on the people. Calls to unity faltered, as intense debates over recruiting for the army crystallised in two failed attempts to endorse compulsory military service by plebiscite.

Armistice celebrations in 1918. Conscription campaigns polarised Australian politics and society.
National Library of Australia

The conscription campaigns divided Australians bitterly. Those who voted against the principle found their loyalty to nation and empire questioned. Those in favour faced accusations they betrayed Australia’s future by sending its young men to die.

Australians voted against conscription in October 1916 and again in December 1917, but the effect was still to polarise Australian politics and society. The Labor Party split over the issue. Prime Minister Billy Hughes walked out and formed government with his erstwhile opponents.

The party’s now unequivocal anti-conscription sentiments found it tarred with the brush of disloyalty and ensured a conservative ascendancy in federal politics until 1929.

Even in private life, those political divisions were deep and abiding. One woman wrote to her soldier husband at the front that she had broken off friendships over the issue:

they don’t come here now since conscription I told them what I thought of them.

Returned soldiers as ‘most deserving’

It is small wonder that those on the political left – many historians included – should feel uncomfortable about the effects of the first world war on Australian society and culture.

Dugout at Gallipoli. 60,000 Australians were killed in the First World War.
State Library of Victoria, CC BY

The tendency of the war had been to draw Australia more closely into the British Empire’s embrace. The German threat provoked deep expressions of cultural unity with Britain from Australians, and further encouraged them to see their future security in terms of even closer defence and economic ties with the empire.

The Anzac tradition itself embodied those difficult politics, as it promoted the Empire-loyal “digger” as the embodiment of the Australian national character.




Read more:
100 years since the WW1 Armistice, Remembrance Day remains a powerful reminder of the cost of war


In Anzac’s rhetoric, Australian soldiers had proved themselves the exemplars of a series of desirable qualities such as courage, initiative, and loyalty to mates. But they had not so much achieved independence for Australia as raised Australia to equality within a British brotherhood.

For those on the political left, the veneration of the digger displaced all other potential contributions to the making of Australian nationhood, including the contributions of women, pacifists and political radicals.

Australian soldiers became the embodiment of national character, and they assumed the position of the most deserving in citizenship hierarchies.
State Library of Queensland

It reorganised hierarchies of citizenship, so returned soldiers assumed the position of the most deserving, whether in terms of government largesse or in cultural terms as the embodiment of national character.

But conservative historians have naturally been much more comfortable with that interpretation of the war’s effects than their counterparts.

It speaks to a sense that Australians held close to their British descent and traditions, while also recognising the economic and security value of continued close ties. And it gave Australians a figure whose characteristics were not only to be admired, but emulated in civic life and subsequent conflicts.




Read more:
How the Great War shaped the foundations of Australia’s future


A century on from the national trauma of 1914-18, the politics of that event remain present. The kind of Australia we prefer to see depends on whether we regret or embrace the effects of the first world war on Australian politics and culture.

As we gather again on the anniversary of the end of the “war to end all wars”, we might observe that the conclusion of the war only started the long and continuing effort to come to terms with its meaning.The Conversation

Bart Ziino, Senior Lecturer, School of Humanities and Social Sciences, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.


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