Although not quite as unique as the editor claims (p. 4), Caregiving on the Periphery illustrates the ethnic diversity of Canada and the value of using this particular, vast country as a microcosm in order to study the history of health care in a variety of sometimes clashing cultures. The history of nursing in Canada is a burgeoning field, and a previous edited volume has also examined the role of place: Jayne Elliott, Meryn Stuart and Cynthia Toman, Place and Practice in Canadian Nursing History (Vancouver: University of British Columbia Press, 2008). Furthering existing literature on the country, the book seeks to bring the diversity of race and ethnicity into prominence in the history of nursing within Canada. For example, in her chapter on Russian Mennonite communities, Marlene Epp explores the ethnic tensions between white immigrant groups. In her analysis of Margaret Butcher’s life writing, Mary Ellen Kelm examines the difference between ‘Englishness’ and ‘whiteness’ in Canada, in addition to wider complexities of race and gender.
Opening with a gripping story of a nurse’s isolation and autonomy, a major theme of the book is isolation. In her chapter on Red Cross nursing, Jayne Elliott highlights how nurses’ autonomous roles in small communities meant that young nurses were under surveillance and judged regarding their social lives and sexuality. Similarly, as Lesley McBain demonstrates in her chapter, nurses in Northern Saskatchewan were concerned for their reputations and professional identity, and therefore suffered social isolation. Judith Young shows that in early-nineteenth-century urban Toronto, this small town in the Empire provided nurses from England, Ireland or Scotland with a sense of being on the British periphery. However, isolation is not highly evident within every chapter; for example, midwives formed part of close-knit Mennonite communities, which placed importance on midwifery practice exclusively performed by their own ethno-religious group, as examined by Marlene Epp, although skis were required in order for one Mennonite nurse to reach patients in more remote areas. Myra Rutherdale usefully reminds the reader that isolation should not just be based on geography, but on power relations in communities and countries.
As with most literature on nursing and midwifery in rural areas, Caregiving on the Periphery highlights the autonomy and diversity of their roles. For example, Epp likens nineteenth- and early-twentieth-century trained Mennonite midwives to those practising in Europe until the seventeenth century, with these midwives performing bone-setting, teeth-pulling, diagnosis and prescribing, emergency surgery, spiritual folk-healing and working as undertakers. Heidi Coombs-Thorne considers the blurred boundaries of nursing and medical practice in her chapter on nursing in the Grenfell Mission Stations.
These major themes of isolation, autonomy, diversity and ethnic communities are examined within four parts, focusing on midwifery, life writing, nursing regulation and professionalisation, and nursing in outposts and amongst Aboriginal communities. Encounters with these indigenous communities and analyses of colonisation are not confined to this latter part but permeate other chapters of the book. For example, Rutherdale addresses an account of nursing work in an Aboriginal community in the 1940s and 1950s in her chapter on Amy Wilson’s life and travel writing. Rutherdale analyses the intrusive nature of Wilson’s colonising and civilising work, judging her to be relatively enlightened in her approach to indigenous health care practices. Laurie Meijer Drees assesses the inhibited role of Aboriginal nurses between 1939 and 1975 in the professionalisation section of the book. The book also includes a chapter on religious nursing – a Canadian Anglican nursing Sisterhood and its involvement in war nursing during the Northwestern Rebellion (1885), examined by Elizabeth Domm.
Some of the eleven chapters forming these parts include rigorous primary research. In particular, Young’s analysis of census data on nursing in Toronto highlights their high literacy rates from the 1860s, their age, ethnic groups and an examination of their social class, undertaken by looking at the occupations of the nurses’ families; she determines that the nurses were largely working class. Drees relies on numerous archival sources to elucidate the training of Aboriginal health workers. Elliott and Judith Bender Zelmanovits undertake extensive archival research and interviews.
The genre of the history of health care in places, and in particular of health in the rural North, is expanding with two volumes published by Pickering and Chatto in 2011, which both include substantial contributions on Canada – J.T.H. Connor and Stephan Curtis (eds), Medicine in the Remote and Rural North, 1800–2000 (London, 2011) and Erika Dyck and Christopher Fletcher (eds), Locating Health: Historical and Anthropological Investigations of Place and Health (London, 2011). Published prior to these volumes, Caregiving on the Periphery is a very worthwhile contribution to this literature. The book addresses the ethnic and cultural breadth of nursing and midwifery in Canada from the early nineteenth century to the late twentieth century, whilst remaining a coherent volume with many of the authors referencing the relevance of each other’s chapters.
