|Administrative History||The Medical Department grew out of the need to finance the Society's medical mission work. The CMS had been sending qualified medical missionaries overseas since the early 1830s and Dr William Elmslie opened the first CMS hopsital at Srinagar, India in 1865. Other than small grants through the Society's General Fund, the missionaries were responsible for raising their own money locally until a Medical Missionary Auxiliary Fund was established in 1886. On 10 November 1891 the CMS General Committee resolved to form an 'Auxiliary Committee on Medical Missions' to promote the Auxiliary Fund and so reduce demands on the Society's General Fund, and to act 'as a body with whom they might confer respecting the Society's medical missions generally'; Dr Herbert Lankester was appointed Honorary Secretary (later full Secretary). |
The Auxiliary took on increasing financial responsibilities. From 1893, it became responsible for day to day medical mission expenses including recurrent building costs (rent, lighting, fuel etc), patients' expenses (food, clothing), the cost of employing local staff and purchase of medical supplies (drugs, equipment etc); by 1895 it committed to meeting all of the running costs of the Society's medical missions without aid from the General Fund. By 1898 the CMS had 49 medical missionaries and 1,252 hospital beds.
In recognition of the expanding role of the Auxiliary and its Secretary, Dr Lankester (who on top of his work was acting as the Society Physician), in March 1898 the Auxiliary Committee was merged with a new 'Medical Committee' appointed by the CMS General Committee and for the first time the 'Medical Department' is listed in the Society's Annual Reports. In addition to the functions performed by its predecessor, the new Committee had responsibility for considering medical and medical mission matters arising from all of the Society's work and for reporting to the CMS Group Committees, the Committee of Correspondence and others as necessary. Dr Lankester's work as 'Physician to the Society' was formalised at the same time. The Committee role was extensive as it held executive responsibility for both Home and Overseas work. Work was delegated to a series of departmental committees and sub-committees. The Secretary to the Medical Committee was responsible for public relations work in Britain, day to day correspondence with the Society's Secretaries and the overall direction of the Medical Department.
The Society's medical mission work had a dual focus with work at Home in the UK and overseas. The main areas of medical work overseas were in India and China, but there were also active medical missions in Nigeria, Kenya, Tanzania, Uganda, Rwanda, Sudan, Egypt, Palestine and Iran and, to a lesser extent, in Canada and Japan. In addition to the financing of staff and provision of drugs, supplies and equipment, the MMA fund supported the building of numerous hospitals and dispensaries; as medical mission work was targeted in areas where it was most likely to have an impact, in many cases the building laid the first foundations of local medical service infrastructure. The Medical Secretary maintained contact with the Society's missions usually through the medical missionary-in-charge and, from the late 1930s, Regional Medical Advisers. The main focus of work at Home was on fundraising, exhibition work and other means of equipping and promoting the work of the medical missions including, from 1892, publication of an official journal. Much of the fundraising and supply work was conducted through a network of local branches and a series of sub-departments each with their own Honorary Secretary; the Society's Medical Training Home at Bermondsey (and its Committee) also came under Home Operations. Fundraising initiatives included the 'supported beds scheme' whereby individual beds in mission hospitals were associated with a particular parish, Sunday school etc; as the emphasis of the Society's medical work shifted from hospitals to preventative and outreach work in the 1930s, this was replaced by a more flexible share scheme.
The Society's medical work also had a dual role in the sense that it was concerned not only with medical aspects of mission work overseas but also with the health of the Society's missionaries. The Medical Committee worked closely with the Medical Board which assessed the fitness for service of candidates and missionaries and considered issues relating to the health of missionaries referred by other CMS committees. For many years, the Medical Secretary was also the Society Physician responsible for medical examination of CMS candidates and missionaries (and also a member of the Medical Board).
The early 1900s saw a number of staff changes. As the Home work increased, Reverend Dr Robert Elliott was appointed as an Assistant Secretary, Medical Department in 1900. The Committee continued to take on additional financial commitments becoming responsible for new hospital building costs (from 1900), the salaries of all the Societies medical missionaries (April 1901) and nursing salaries (1903). Medical Organising Secretaries (known as 'Medical Association Secretaries' until 1905) were appointed for North East England (later Yorkshire) and North West England in recognition of the potential financial benefits of engaging the manufacturing towns of North England and avoiding overlapping with other organisations in the South. In November 1903, when Dr Lankester left to become a Home Secretary, the role of Society Physician was separated from that of Medical Secretary. Reverend Dr Elliott succeeded Dr Lankester as Secretary to the Medical Committee and Dr C. F. Harford was appointed to take responsibility for the medical care of the Society's missionaries.
In January 1905, as part of a drive to unify the different aspects of the Society's work in the UK, the Home and Overseas work of the MMA was divided into two distinct branches. Overseas work remained under the Medical Committee and its Secretary within the CMS Foreign Department. The Home work of the MMA was delegated to a secretary with the title of 'Organising Secretary Medical Mission Fund' (assisted by the Organising Secretaries for the North East and North West) and came under the umbrella of the Society's Home Department. Although 'MMA' continued to be used to refer to any work supported by the MMA fund, it more generally became synonymous with the Home work. The MMA continued to operate quite distinctly from the rest of CMS work with its own staff, annual meeting and publications although liaison with the CMS Home Committee was further promoted by the setting up of a Medical Mission Home Committee in 1921. This committee operated until July 1941, receiving reports of the MMA training home and sub-departments and advising other CMS committees on medical mission matters at Home.
In 1942, a Nursing Superintendent was appointed, the CMS being the first medical mission organisation to do so. She maintained an overview of the Society's nursing needs and gave professional help and advice; she was available to missionary nurses on furlough in England and to nurse recruits in training.
The Society's medical mission work continued to grow. By 1941 there were around 240 medical missionaries and wives and 1300 trained non-Western doctors and nurses working in 52 hospitals, 108 outstations, and 'hundreds of maternity and welfare clinics'; staff saw 94,000 in-patients and dealt with approximately 2,500,000 out-patients attendances ('Memorandum on the Future of the M. M. A' by H[arold] G[ilbee] A[nderson] September 1942).
As the MMA approached its Golden Jubilee it entered upon a period of review that was to lead to a realignment of medical policy and operations and the integration of the MMA Fund with the Society's General Fund. Two of the key catalysts were the 1934 CMS Commission and the Secretaries' Tour of India 1934-1935; they brought the medical work of the Society, its relationship to the general work of the CMS and the health of its missionaries, under scrutiny. At the same time there was recognition of the need to adapt to the changing political context in which the medical missions were operating particularly in light of CMS resources and the growth of national medical services where previously there had been no alternative to CMS provision. There was recognition of the need to maximise effective use of resources, promote needs-led service development and work cooperatively across regional mission groups.
In order to more closely link the Society's medical work with its general policy, in 1939 the Secretary to the Medical Committee was made a Full Secretary of the Society attending meetings of the Executive as the on-going demands of the concurrent role of Society Physician permitted.
One of the recommendations arising from the Secretaries' Tour was the establishment of a Medical Commission to review policy 'from every angle' 1935-1939. The Commission's recommendations included a shift in emphasis towards mobile, outreach services to extend the work of the necessary but costly hospital bases, the need for cooperative working with national services and other societies providing medical care overseas and health promotion and welfare work.
In March 1940, Dr Anderson reported on 'A Survey of Health of C.M.S missionaries in the Field (1925-1939)'. As a result of the report and its recommendations, commissions were set up on the health of women and the health of missionaries. The Commission on the Health of Missionaries 1945 was appointed by the CMS Executive Committee 'to examine and report on the Society's methods and facilities for ensuring the health of its missionaries' (source: printed report).
On 16 February 1943, the General Committee approved the Medical Committee's recommendation to more closely integrate the work of the MMA Fund with the CMS General Fund. To reflect its changed status, whilst the same initials were retained, the term 'Auxiliary' was dropped, and the MMA came to stand for the Medical Missions Appropriations Fund.
Moves towards closer working relationships across groups of missions and between the medical and general work of the Society also led to the appointment of Medical Group Advisers (later known as Regional Medical Advisers) and medical representatives to sit on the Local Governing Bodies of CMS Missions. The idea of having medical liaison officers to maintain links between the Parent Committee and the medical work of the Society was mooted in 1938 and an unofficial Medical Adviser Group system was set up on the outbreak of World War II in 1939 but in 1943 the scheme was revised, and five Regional Medical Advisers formally appointed.
In 1950 the Home Division of CMS, which administered all work within the British Isles, took over the responsibility for medical property, while the General Wants Department was gradually incorporated into the Home Division.
Sources: Rosemary A. Keen 'Catalogue of the Records of the Medical Department 1891-1949', London: Church Missionary Society 1989; Gordon Hewitt 'The Problems of Success: a History of the Church Missionary Society, 1910-1942, London: published for the Church Missionary Society by SCM Press, 1971-1977); 'Memorandum on the Future of the M.M.A' by H[arold] G[ilbee] A[nderson] September 1942; Minutes of the Committee of Correspondence November 1891; CMS Outlook, Medical Number, October 1949, p 9; 'Preaching and Healing' 1901-1906.
Throughout the 1950s and 1960s the work of the Medical Secretary was divided into five sections defined in 1962 as 'maintenance of wide public relations in Great Britain, general medical responsibility for the health of missionaries, superintendence of medical work overseas, day-to-day co-operation with other Secretaries, overall direction of Medical Department.' He was assisted by the Nursing Adviser/Superintendent who had special responsibility for all nurse enquirers and deputised for the Medical Secretary in the administrative side of medical work. She had also the prime responsibility of liaison with the Home Division on all medical aspects of work within the British Isles.
In 1973 the Society altered its committee structure. The Medical Committee changed to become the 'Medical Advisory Committee' reporting to the Selection and Training Committee. It was no longer concerned with administration, focussing on advising on the professional training and ability of candidates and acting as a resource to whom candidates could be sent for guidance and assessment. Responsibility for the Medical Secretary's duties was dispersed amongst other sections of Headquarters administration: the Overseas Division took over the Secretary's consultative duties and contact with ecumenical groups, and shared with the Candidates Department the Secretary's responsibilities for the care of candidates and missionaries. Recruiting was undertaken jointly by the Home Division and Candidates Department.
In 1975-1976 there was a further extensive reorganisation, this time of the Overseas Departments at Headquarters. From mid-1976 the post of Medical Secretary was ended and a new 'Honorary Medical Adviser' role introduced. Medical representatives were included on several committees, including the new 'Life Advisory Committee', the 'Mission Operations Committee' (formerly the Africa and Asia Committees) and the Selection and Training Committee. The Medical Advisory Committee held its last meeting on 8 June 1976. The Medical Department, headed by the Society's Honorary Physician, continued at Headquarters until 1986 when the building began its transformation into the centre for Partnership for World Mission.
Staff and officers:
Secretary to the Medical Committee (also under the title 'Medical Superintendent'): 1891-October 1903 Herbert Lankester (as Honorary Secretary 1891-1894); November 1903-April 1911 Robert Elliott (previously Assistant Secretary 1900-1903); October 1911-February 1919 Charles Forbes Harford (Herbert Lankester served as Acting Secretary 1915-1919); May 1920-July 1938 John Howard Cook; January 1939-1959 Harold Gilbee Anderson; 1959-1962 Florence Collier; 1962-1972 Arthur Durnford Iliff; 1973-1976 William Roy Billington.
Nursing Superintendent: 1942-1959 Helen Cowan; 1960-1968 Meredith Sinclair; 1969-1976 Dorothy Dykes.
CMS Physician: 1894-1903 Herbert Lankester; 1904-1911 Charles Forbes Harford; 1911-1922 Leopold G. Hill. From 1922-1976 the Secretary to Medical Committee was also the Society's Physician.
(Departmental) Secretary to the Medical Mission Auxiliary: April 1905-February 1906 Reverend Edward James Goldsmith; 1906-November 1909 Reverend Ernest William Cox; October 1909-June 1920 Reverend Henry Gladstone Harding; June 1920-May 1925 Reverend Edwin Arthur Miller; June 1925-October 1939 Reverend Stuart George Cox; December 1939- Reverend G. J. Rogers; May 1941-1943 Reverend Oswald Norman Garrard (appointed Assistant Home Secretary (Medical Missions) 1943).
Assistant Home Secretary (Medical Missions): March 1943-October 1945 Reverend Oswald Norman Garrard; December 1945-March 1949 Miss L. F. Churchill; February 1949- Miss Jean Lawrence (appointed as an assistant secretary within the Home Division supporting the Society's medical work until December 1949 when she was appointed Assistant Home Secretary).
Areas of work overseas 1891-1949 (the dates below give the date at which medical work was established unless otherwise noted):
Most of the work in India was in the Punjab and North West Frontier area with hospitals founded at Amritsar 1882-1921, Anantnag 1900, Bannu 1893, Multan 1899, Peshawar 1896, Quetta 1885 and Shikarpur 1909 There were also medical missions in Bengal (at Purulia 1888, Ranaghat 1906 and Hiranpur 1928) and in Western India (Lusadia 1905).
In China, medical work centred on the Fukien mission area where hospitals were opened at Foochow 1900, Kienow (Kienning) 1889, Ningteh 1905, Putien (Hinghwa) 1895 and Siapu (Funing) 1878. There were also hospitals in South China (at Pakhoi 1886), in Chekiang Province (Hangchow 1871), in Western China (at Mienchu 1908) and in Kwangsi-Hunan Province (at Kweilin 1910).
In Africa, the CMS had hospitals in Nigeria (at Iyi Enu 1898 and Zaria 1930), Kenya (at Kaloleni 1929, Maseno 1921 and Mombasa 1887-1892), Tanzania (at Kilimatinde 1929), in Uganda (Mengo 1896 and N'gora 1925), in Ruanda (at Bunyonyi 1931, Gahini 1928, Kigeme 1932 and Kigezi 1920) and in the Sudan (Ler 1932, Lui 1921 and Omdurman 1900).
In the Middle East there were hospitals in Egypt (at Menouf 1915 and Old Cairo 1889); in Iran (at Isfahan 1880, Julfa 1887-1892, Kerman 1901, Shiraz 1923-1947 and Yezd 1898-1942) and in Palestine (Gaza 1892, Nablus 1891 and Salt 1883). Within the Turkish Arabia Mission there were hospitals at Baghdad 1886-1917 and Mosul 1902-1920.
In Canada the Society's medical work was at Metlakahtla 1889-1902 and Onion Lake 1898-1911. In Japan there were dispensaries at Hakodate 1897-1909 and Ikebukuro 1925-1941.
Sub-Departments and Sections of the MMA:
Hospital Supply Department (known as the Medical Wants Department until 22 December 1925). Originally set up to supply medical missions with bandages and old linen and each hospital with complete sets of bedding and clothing, it later began to supply medical equipment of all kinds; in 1921 it became a sub-section of the General Wants Department.
1897-1899 Miss Grace Fox; 1899-October 1912 Miss E. M. Fox; 1912-1916 Miss Mona N. McCormick; 1916-1925 Miss Dorothy S. Pratt; 1928-? 1940 Miss P. M. Bennett.
Sale of Work Department: supplied boxes of needlework free to CMS medical mission stalls at Sales of Work; in 1921 it combined with the Medical Wants Department and became a sub-section of the CMS General Wants Department.
1897-1900 Miss Fox; 1900-1903 Mrs R. Elliott; October 1903-December 1905 Mrs Mary E. Skipton; 1906-1908 Miss C. S. Hannington; September 1908-March 1911 Miss D. M. Orton; April 1911- Miss Mary Hey.
Patterns Department: looked after and sent out paper patterns provided for supporters making clothes, quilts etc for hospital patients.
-1915 Miss Birk; 1915- Miss Dorothy S. Pratt.
Foreign Stamps Department: collected stamps and sold them for MMA funds.
May 1897-February 1900 Miss A. G. Amsler; 1900-1907 Miss Mary Nicholson; 1907-1911 Mrs Nicholson; 1911-1914 Mr J. Pring Farmer; 1914-1919 Mr Leonard P. Sells; 1919-1923 Mr C. Perrott; 1923-1933 Miss Matte; 1933-1937 Mr E. Hardy; 1937-1939 Captain McCaffery; 1940- Reverend J. S. Tudor Jones.
Linen Rag Society in connection with the CMS Medical Mission Fund: started in January 1892 to furnish CMS hospitals with linen, cotton wool, lint, sheets, blankets, flannel and bandages supplied by members and sent out by the Missionary Leaves Association.
Boys Brigade Branch of the MMA: founded in 1892 to raise funds and support the work of the Society's medical missions; by 1942 it was raising over £1,000 per annum. The 'Bugle Call' was published to promote the work of the Boys Brigade.
Order of the Red Cross (for Prayer and Work) in connection with the MMA: medical mission prayer union established January 1899 to link those interested in the work of medical missions. Members were expected to pray regularly for medical mission work, to try to help through gifts of money, clothing, dressings or providing articles for Sales of Work and to interest friends in the work.
The Medical Wants Department from the first was allocated a room in the Basement of CMS headquarters at 6 Salisbury Square. In 1906 the Sale of Work Department was moved from Mrs Elliott's home to share the Medical Wants room; in 1919 they were moved to the West end of the Basement. In 1921 the Medical Wants and Sale of Work combined with the other small Sections becoming Sections in a Department known from then on as 'General Wants'. The General Wants Department continued in the same Basement room until 1966 when it was closed as part of the reorganisation at the time of CMS Headquarters' move to 157 Waterloo Road.
Medical training homes for women:
The Medical Training Home Committee was appointed by the Committee of Correspondence 17 October 1899. A hostel for medical and educational students at 67, Guilford Street opened in 1900. In 1901 the Medical Committee set up a special training home for women called the 'Bermondsey Medical Mission' in Riley Street. It took in its first patients 9 January 1901 and the students started a week later. The aim was to 'maintain the same spiritual atmosphere which [one] would expect to find in one of the Society's medical missions, schools or other institutions abroad' whilst providing basic medical training for women candidates through 3 month courses of lectures and practical work. The MMA managed the home and was responsible for raising funds (Source: Committee of Correspondence 17 October 1899). Both training bases were closed 1907/1908 as part of the Society's economic cutbacks.