A brief history of Nursing in Pakistan

Nursing is among the oldest and most prestigious professions in the world and as a result, has a very rich heritage and history of Nursing in the Sub-Continent and Pakistan.

After Florence Nightingale in 1860 had established the first modern nursing school named Saint Thomas Hospital in London the next step was to spread that knowledge throughout the world and especially in low-income countries so that people may be better equipped to deal with various different diseases.

History of Nurisng Before the Partition

First Nursing School in India – Pakistan

The first School for Midwives was soon established afterward by the Indian Government under British rule. European churches sent Sisters to teach nursing along with missionaries who were sent to spread Christianity. Another nursing school was then made in 1884 in Lahore called the Mayo Hospital with rules, standards, and curriculum being established in 1907, civic hospitals also began following these guidelines. Following this, a majority of Missionary Schools also opened Nursing Schools in almost all the regions of the Sub-Continent. Gandhi even praised the service of the missionaries in the field of nursing in one of his speeches.

Nursing became an important profession in the Sub-Continent as demonstrated by the creation of the Association of Nursing Superintendents in India (ANSI) in 1905 and the creation of the Trained Nurses Association of India (TNAI) in 1908. These organizations served different purposes for 12 years after which they were merged into TNAI. The Nursing Registration Council began its operations in 1910. At first registrations were only available to nurses from a small number of districts which were Uttar Pradesh, Punjab, and Bihar but soon afterward regions like Sindh and Bengal were included. TNAI published its first journal in 1910 which gained international recognition leading to TNAI getting membership into the International Nursing Council (ICN) in 1912. TNAI pushed for further reforms in the world of nursing in the Sub-Continent and established the first Post-Graduate Nursing College of the region in Delhi. TNAI then worked to introduce Bachelor of Science in Nursing to the Sub-Continent which they succeeded in doing in 1946. 

However, the majority of the nurses operating in these establishments were from Europe. The locals turned down these employment opportunities for a couple of reasons; some Hindu girls belonging to low-income families were converted to Christianity much to the disdain of their families which then forbade both Muslim and Hindu girls from working as a nurse as they feared they’d abandon their religions, most Nursing Schools at the time were attached to Missionary Schools which further strengthened the belief that girls would be forced to convert to Christianity if they ever wanted to study nursing. Hindu Brahmans also believed that if a Brahaman girl touched another person she’d become impure further discouraging Hindus from becoming a part of the nursing workforce, Muslims girls were denied admissions on the ground that their religious Parda would prevent them from doing their jobs properly.

The European nurses however were the biggest reason for the non-involvement of the local population as they viewed themselves as higher in status and more capable than the Hindu and Muslim Nurses that would like to become nurses, up until 1934 no local was given the job of a nurse at the Mayo Hospital in Lahore. The locals were only given part-time positions with very little pay and all the Matrons and Nursing Superintendents were European and Christian. Nurses in Europe were often given the positions of Nursing Superintendents without having ever served in the Sub-Continent. These matrons and superintendents imposed their own will onto the profession which made the thought of studying nursing very undesirable for these locals.

Evolution of Nursing in Pakistan

After the Indian Subcontinent was partitioned into Pakistan and India on the 14th of August 1947 a large number of nurses went back to Europe and a hefty amount of Non-Muslim nurses decide to serve in India leaving a large gap between both in numbers of nurses and administrators. The TNAI could also no longer function as it lost a large number of executive members and was hence divided into The Nurses Association Pakistan and the Indian TNAI, this was done by the TNAI Leader of the time Mrs. Salma Tareen who was the Nursing Superintendent of Mayo Hospital in Lahore. The first order of business of TNAP was to treat the people who were wounded in the migration and riots that followed but they were very little in numbers with only 50 members of the TNAP present, due to the situation at hand the prominent female political heads rallied the women of Pakistan to come out of their homes and treat the injured, these new women were given training by TNAP and as an emergency resort all girls who had cleared the 8th standard were eligible to receive training by the hospitals that reported to Inspector General Civil Hospital of Punjab.

First Nursing School in Pakistan

The first Nursing School in Pakistan was made in 1948 in Lahore called the Ganga Ram Private Hospital. Mrs. G.M Darrah was the first nursing tutor at the establishment and served till 1964, Mrs. Mumtaz Painda was the first Nursing Superintendent of the hospital up to 1979, and the first Medical Superintendent of the hospital was Mr. Shujaat Ali. The first batch from the instituted graduated in 1952 consisting of 7 girls

The second major institute for Nursing was established in 1948 called JPMC in Karachi and cities like Bahawalpur, Hyderabad, and Multan soon had their own nursing institutions

The TNAP introduced a standardized set of rules for all nurses leading to the formation of the Central Nursing Council (CNC) in 1950.

The CNC passed rules stating that there would be two grades of nurses namely General Nurse and an Assistant Nurse, the applicant must be 17 years of age, widowed, divorced, unmarried would be preferred, the applicants for a general nurse must be able to speak and write in English, and males could not apply for the position of assistant nurses.

The CNC also made changes to the duration and contents of the curriculum making it a 3-year course with 3 months of training and basing the course on Anatomy, Physiology, Surgery, Fundamentals of nursing, and Hygiene and Sanitation. Exams would be conducted in the first and third year of studies only and there was no fixed date for admissions.

This continued until Mrs.Begum Wazir who received her postgraduate training in teaching and training nurses from India came to JPMC and became the first certified teacher in Pakistan, before this other matrons and nurses tutored the applicants. She taught round the clock three times a day to all the batches of all three years.

CNC Transformed into Pakistan Nursing Council in 1952

The CNC would then be transformed into the Pakistan Nursing Council by the Pakistani Parliament in 1952. The PNC would be responsible to set up provincial examination boards, to issue a teaching license to the nursing institutes and to standardize the curriculum.

The PNC set itself in action by first restricting the admissions to only twice a year in April and in November, they abolished the classification of nurses and unified all of them into one.

In 1955, the College of Nursing was proposed under the USA’s Health and Sanitation Scheme. The college was affiliated with Karachi University and was given a temporary campus at Civil Hospital Karachi. Miss Catherine Hardeman, who was a nurse educator in the USA was given the position of Principal in the new college. Miss Virginia Arnold, who the chief nurse of Washington and Mrs. Begum Wazir joined the college as tutors. In 1957 the first batch of this college graduated consisting of seven girls. The college was then given a permanent campus in JPMC Karachi. In 1963 the PNC approved the curriculum designed by the college and in 1966 Mrs. Begum Wazir became the first national principal of the college.

Number of Nursing Institutes in Pakistan

Important Figures for Pakistan in the History of Nursing

Begum Rana Liaqut Ali

Begum Rana Liaqut Ali was the wife of the first prime minister of Pakistan Liaqut Ali Khan and was a midwife herself. She was the ambassador to many European countries and was the president of the Women’s Association of Pakistan. She was also the Patron-in-Chief of the TNAP from 1950 to 1980.

Mrs.Imtiaz Kamal

Mrs.Imtiaz Kamal belonged to the family of a barrister and was the Principal of The College of Nursing at JPMC. She wrote a book on family planning and her work was published as part of scientific research journals. After she retired she went on to serve at WHO.

Begum Wazir Ali

Begum Wazir Ali got her diploma in nursing from India in 1936 and completed her B.scN from the USA becoming the first Pakistani woman to do so. She completed her postgraduate studies from India which was a first for a Pakistani woman. She also revolutionized the teaching methodology in College of Nursing JPMC while there as a tutor and later became the first Pakistani Principal of College of Nursing at JPMC.

Mrs.Nisab Akhtar

She worked as the General Secretary for the PNF and was trained in Wales in 1949. She took charge of various different nursing institutes across Pakistan

Mrs.Kaneez Moula

Mrs. Kaneez Moula was a leader in the nursing space from 1965 to 1985. She served as the nursing advisor of Pakistan and became the longest-serving nursing advisor in Pakistan. She completed her M.A in History from Calcutta University in 1947 and got her training in Midwifery and Nursing from England. She was awarded the Pride of Performance for her services by the Pakistani Government