Notes on Asian Pacific Heritage

What We Have Learned Along the Way

For those joining us for the first time — welcome. To those who’ve joined us since day one, thank you for your commitment to diversifying nursing and our history.

Asian Pacific Islander was designated by the U.S. Census Bureau in 1980. The month of May recognizes over fifty countries. As such, a brief overview of relevant history is helpful to more fully understand our forthcoming shared nursing stories. This serves as a companion aid to leave our curious audience with the resources and background we have gathered so far.

Photo Source from The Library of Congress

Sharing the stories of nurses from such a vast and culturally distinct geography as the Asian Pacific required an education of its own — as trained nurses, not historians, we are plainly indebted to the noted researchers and authors, who have left clues and trail maps as we piece these lesser known stories together. We learned that the origin and expansion of “professional nursing” to these regions of the world is understood through multiple eras of wars, colonization, and immigration policies that spanned centuries.

Photo source from Britannica

Dates You Should Know

Here are notable periods and dates to consider in the background or foreground of our subsequent nurses’ stories. We intend this “bite-sized” information as purely illustrative context for historical framing — and provide links for those seeking more comprehensive histories. These are the dates and eras we’ve learned so far and will provide updates as our reading and research continue.

[Note: The following includes mention of internment camps — please proceed cautiously if that is triggering]

Relevance of Victorian Era (1837–1901)

• The 1850 — 60s was a time of well over 100 wars fought, often simultaneously, across the globe.
• This included both the American Civil War (1861–1865) and the Crimean War (1853–1856), the latter of which is credited for developing the foundations of nursing as a profession.
• The Nightingale nursing school opened in Britain in 1860 and in the United States in 1873.
• Four nursing organizations founded during this time were international in scope and influence: 1) the Red Cross founded in 1881 2) the Colonial Nursing Association founded in 1894, credited with recruiting over 8,000 nurses for international training through the 1960s 3) the International Council of Nurses, founded in 1899 which still exists today and 4) the Nurses Missionary League which was established from 1903 through 1967.

Select Philippines History

• Spain’s colonial rule of the Philippines lasted from 1521 to 1898. Nursing at this time was perceived more as a task than a job.
• During the Philippine Revolution, from 1896 to 1898, many women adapted their homes into quarters so as to nurse soldiers and revolutionaries (Melchora Aquino, considered the “grand woman of the Revolution” is profiled here).
• Despite gaining independence, the 1989 Spanish-American War resulted in Spain ceding its colonized territory to the United States with the Treaty of Paris. This subsequently started the Philippine-American War, which occurred from 1899 to 1902, leaving 200,000 Philippine casualties from famine, war, or disease.
• The Pensionado Act of 1903 created an early path for select Philippino students to study in the U.S., as they were now U.S. nationals. This included nurses who studied at places like Columbia Teacher’s College and upon return, ultimately became heads of local nursing schools (under American nurse supervision).
• In 1906 the formalized nursing education based on U.S. curriculum was established to train Pilipino nurses with initial training from Lavinia Dock — the first nursing board exam was given in 1920.
• The Philippines gained independence in 1946. During the subsequent decades, in combination with local politico-economics and immigration changes in the U.S., Philippino nurses now comprise between 4–8% of the U.S. nursing workforce.

Select Japanese and Korean History

• The first formal nurse training program was established in Japan in 1886 through Protestant medical missionaries and American nurse Linda Richards.
• Japan and Britain engaged as allies from 1902 through the end of World War 1 in 1923.
• Korea was a colony of Japan from 1910 until the end of World War II in 1945. In essence, the alliance with Britain meant when Japan colonized Korea, British influence expanded there as well.
• The first two Korean nurses graduated from mission hospital training in 1907 and while not initially characterized as a female, became legislated as such in 1914. Chastity expectations meant married women or mothers had only limited roles in the profession.
• Mission nursing schools at the time required conversion to Christianity as well as the use of the Japanese language and Korean students were capped at 30% — as such, Japanese nurses and midwives outnumbered Koreans during the colonial period.
• By the early 1920s Korean nurses began striking for low pay, poor treatment, lack of leadership representation and career mobility and began to formally organize. However, they were unable to join the International Council of Nurses on their own as a colony of Japan, so Korean nurses joined Japanese nurses to form the Nurse’s Association of the Japanese Empire which became a member in 1933.
• Most Japanese immigrants arrived to the U.S. during the period from 1890 to 1924, when the National Origins Act of 1924 ended further Japanese immigration. Unlike European immigrants, Japanese immigrants (like the Chinese before them) were denied the right to become naturalized American citizens; therefore, most had permanent alien status until after World War II.
• During World War II, in tandem to the establishment of Japanese internment camps from 1942–1945, Japanese American women were for the first time accepted to serve in the Army and Army Nurse Corps. These nurses were American-born, English-speaking children (known as Nisei) of the first wave of Japanese immigrants (known as Issei).
• In exchange for free education and leaving the camps, 350 Japanese American women joined the nurse corps in exchange for service in the nurse corps.

Select Chinese History

• Western medicine in China was influenced in the sixteenth century by the Jesuits and in the nineteenth century by Protestant missionaries. The first Western influenced hospital was established in 1835.
• After China lost the Opium War in 1842, more Western missionaries arrived. The first American nurse, Elizabeth McKechnie, arrived in 1884 to teach Nightingale nursing in Shanghai.
• The first school for Chinese nurses was opened by another American, Ella Johnson in 1888 (with two nurses in the first class) and later transitioned to nurse Nina Gage in 1908. The Nurses’ Association of China, co-established by Cora Simpson, began in 1909 and was led by missionaries for its first 20 years.
• The nursing boards exam was established by 1915 and the first five-year baccalaureate program was created in 1920 with the support of the Rockefeller Foundation and nurses from John Hopkins. By 1926 they were accepting foreign students and by 1930 there were 41 Chinese nurses on faculty.
• U.S. policy and attitudes toward Chinese immigrants impacted the migration of Asian groups, including nurses. The ultimate repeal in 1943 of the immigration ban after 60 years of the Chinese Exclusion Act paved the way for measures in 1946 to admit Filipino and Asian-Indian immigrants, but kept in place quota limits — Chinese were initially allotted around 105 visas per year. While Asian exclusion formally ended with the 1952 Immigration Act, it was not until the Immigration Act of 1965 that Congress completely did away with the quota system of national origin.
• World War II, the Communist takeover in 1949, and the Cultural Revolution (1966–1967) were disruptive periods for nursing education in China, leaving an almost 30-year period without access to baccalaureate nursing programs until the first class graduated once again in 1988. Post-graduate programs began in 1992.

Select Indian History (mostly cited from Dr. Sujani Reddy’s work unless noted)

• India was colonized by Britain from 1612 to 1947.
• American Protestant missionaries were active in India since the early 1800s. In 1819 Rev. Dr. Scudder became the first known medical missionary in India. A western medical mission hospital was opened by his son in 1866.
• Dr. Ida Scudder (the Reverend’s granddaughter) was trained at Cornell University, the first to admit women to medical school at that time, and opened the Vellore Christian Hospital and Medical College in 1899. By 1902 she created a women and children’s center and by 1909 opened the first Nightingale diploma nursing school staffed by mostly American nurse faculty.
• Government hospitals at this time rarely employed Indian nurses. While mission hospitals provided trained Indian nurses employment, they could not achieve authority. In 1912 the Trained Nurse of India organization became the first non-Western member of the International Council of Nursing (with one Indian nurse member) and subsequently broke the race barrier of member organizations.
• American corporate philanthropy by the Rockefeller Foundation (as seen in China, noted above, and the Philippines as well) built upon missionary ground work in the region with a focus on public health and nursing education, especially in the decades between World War I and II.
• During the Cold War, from 1947 to 1991, nurses formed part of the mass transfer of labor from India to the United States.
• In India, nursing was perceived as an ill-regarded and ill-paid occupation for the lower middle class; whereas in the United States it was perceived as a recognized profession, thus enabling upward mobility.

Build Your Library

The core texts which prepared us to profile nurses this month are listed here. We profusely thank these authors, as their contributions demonstrate the undeniable benefit of interdisciplinary collaboration in advancing what we know about the history of our field.

• Empire of Care by Catherine Ceniza Choy on Philippine nurses
• Imperatives of Care by Sonja M. Kim on Korean midwives and nurses
• Nursing & Empire by Sujani Reddy on Indian nurses

As we attempt to unearth names and histories of the nurses we should know, we often find ourselves in corners of the internet to locate obscure sources — as such, we also thank the determined nurses and scholars who created online archives of their peers in the earlier internet days!

Should you know of books, articles, resources, relevant historical context — or even corrections — that should be added here, always feel free to contact us and we will update this shared list: email nursesyoushouldknow@gmail.com.