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The Historical Role of Women in the Creation and Growth of The Children’s Hospital of Buffalo–Part 1

The Women’s Health Professionals Endowment Fund–Philanthropy Combined with Advocacy

Old CHOBIn 1995, 7 women clinicians–physicians, nurses, PhDs and others–formed the Women Health Professionals Endowment Fund.  We grew to more than 100 women at the Children’s Hospital of Buffalo over the next 7 years.  We believed that through philanthropy for the Children’s Hospital, we would be able to wield more influence in the destiny of a once great institution where the PKU assay was developed and surfactant use pioneered (just to name two great achievements). Other descriptors of the 1980’s include being one of the top ten Children’s Hospital, the fourth largest in the U.S. and the only mainland U.S. hospital where women and children together received care in a free standing facility.

The 1990’s created challenges that we women wanted to address.  Pooling resources, the Endowment fund was used to solve problems more often recognized by women–more social workers, breast feeding rooms for employees, better access for families from the garage to the hospital, and empowerment of women leaders in day to day decision making at the hospital.  A yearly symposium for women health professionals with a key-note speaker (one year we had Dr. Katherine DeAngelis, editor of JAMA, another with renowned feminist Betty Friedan in a small group discussion), workshops and a business luncheon.  We had by-laws and dues that went to fund the endowment, and hopefully build our influence.  A sliding scale of yearly dues with the surgeons paying most, and the nurses paying somewhat less.

We published a monograph with the same title as this post.  Excerpted from the first keynote lecture given by historian and activist, Ms. Libby Sholes, at the First Annual Educational Program of the Women Health Professionals Endowment Fund on June 10, 1994, the history of women at Children’s Hospital is celebrated.  From it’s introduction:  “This historical review underscores the central role women have always played in the life of The Children’s Hospital of Buffalo.  We hope that by reflecting on our past, we will have renewed vigor to shape the future of Children’s Hospital.”

Alas, that future has not been as we had hoped.  But the historical perspective and the story told below is worth sharing.  We should tell the stories of  how women work to make great things happen.

Part 1.  An Overview of Women’s Roles in America:  A Prelude to the Children’s Hospital Movement

In Colonial America, women participated in a wide range of occupations ranging from craft and artisanal production to what we now consider the professions (medicine and law) and business.  The diversity among communities, the decentralized character of work which was not corporate but household or village-based, and the short lifespan among the inhabitants made every willing pair of hands and eager mind a welcome addition.  In a society with a severe labor shortage, women were welcome.

Women therefore controlled property as well as skills, and since property ownership conferred citizenship, we have learned that women could and often did vote in their town meetings.  Women made contracts whether they were married or single, and they ran businesses.  They practiced most of the traditional arts, sometimes for family members and sometime s for pay.  There was at least one full-time woman attorney in the 17th century colonies.  Medicine, the traditional health art, was very frequently the province of women.

In the post-Revolutionary War decades, the woman’s status rapidly changed.  The demands for industrial and commercial growth created a huge demand for quick sources of private capital–just at the time when increasingly large numbers of women were heads of households due to the untimely deaths of husbands and male relatives from war injuries.  Alexander Hamilton, among others, waxed indignant at the specter of “dependent” women, that is, women without men. Very quickly, the colonial laws were eroded to make it possible for men to take property away from women–in the women’s own best interest, of course. Thus, female property could be amalgamated with other property to fund a nice supply of investment capital.  In 1836, Massachusetts just cut to the chase and voted a statute making women the outright property of their husbands, and that settled that. 

In New York, during those same decades, the codification of property laws delineating the extremely narrow circumstances under which married women could operate autonomously was collected into a book of statues entitled the “law of Baron and Femme”. The title indicates the relative worth of each gender–he the aristocrat, she “merely a woman.”  

As the property laws were changing and narrowing women’s opportunities for business activity, the professions were likewise becoming more restrictive.  Early schools of law and medicine replaced apprenticeships and one-to-one forms of study.

Professionalism or specialization is not necessarily a bad thing. Establishing codes of knowledge and conduct with reproducible standards for training goes a long way to eliminating those practitioners whose activities would otherwise be harmful.  One only has to think of Charles Dickens’ Sairy Gamp–the filthy stupid nurse who epitomized the medical field of the early 19th century and who was created as a cautionary image warning against ever getting sick in Victorian London to appreciate the benefits of professional training.

BUT–specialization and professionalization, while designed admirably to keep out the ill-trained, the careless and the venal, also creates a hierarchy which limits access.  Such pyramids of authority have also, for whatever reasons, served to keep out entire classes of people–minorities and women in particular.

It was not until the Civil War that the United States produced its first woman doctor, Dr. Elizabeth Blackwell.  Simultaneously, and perhaps because of the emergency situation in which once again willing hands were welcome, the nation finally embraced its first professional nurses, trained and directed under wartime conditions by Clara Barton.  However, in the aftermath of the war, the diffusion of such training and professional opportunity remained uneven at best.

The care of sick children was left almost exclusively to women. As wet nurses for infants, attendants in foundling homes, and matrons of poorhouses, women who had lost all knowledge of traditional care and who had no professional training whatsoever and who received negligible monetary resources presided over the suffering and death of countless legions of hapless children.  The wet nurse was as often as likely to permit the infant to go unfed as not, and those in charge of institutions of children were equally neglectful.  Children without mothers to nurse them had no future.  In New York City, the rate of death for infants under one year old raised in foundling homes approached 100 percent.  During this era, nearly 62% of all of this country’s children died before the age of 5 years due to ignorance, lack of care, poor nutrition and inept medical knowledge.

It is thus somewhat understandable that Dr. Louis Starr, an early Philadelphia pediatrician, should pronounce heartily against women as the sole medical caregivers for children when he stated in 1890 that, “it is no longer competent to trust the dietary management of infants to the garrulous old aunties and ignorant nurses that formerly assumed coctrol of this important field.  Science and skill are now in vogue where ignorance and carelessness formerly stalked abroad.”

By the mid-1800’s new reform movements were seeking to address and rectify these horrors.  The new-found focus on pediatrics as a specific medical discipline was, from its inception, almost entirely the province of male practitioners.  But even with the growing medical knowledge of child physiology and development , these young patients were nevertheless treated within the confines of adult wards.

The recognition that children’ were not just “small adults” and that they needed special protection arose from a new group of women, the substantially middle-class women of the late Victorian society.  During the 1890’s, which historians have now dubbed the “progressive era,”  these individuals, endowed with some financial means, sought to translate the relative privilege of their own comfortable lives into a means of preserving the lives of all children. 

(Editor’s Note”  And here we are in the 1990’s, seeking to do the same!)

Expanding the Victorian woman’s sphere of hearth and home, they translated their bounden duty to children from a purely private concern into a social movement.  No form of child protection work garnered more interest than that of the children’s hospital movement.  It fell to these women to focus the new medical knowledge within a new environment created specifically for children that would not just treat their diseases but also tend to their personalities and their minds in a climate free from intimidation and, rather, be hospitable to their childish needs.”

Next Post:  The History of the Children’s Hospital of Buffalo:  A Reflection of Women’s Roles in America

 

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