Mary O’Connell’s level–headed character was honed growing up on a farm in the rugged climate of Central Otago, New Zealand, during the early years of the 20th century. Associates remember her as a sometimes formidable personality and an often heard comment was “she didn’t suffer fools gladly”. Those well acquainted recognised her intellectual qualities while close family members recall a supportive friend and one who regularly reminded the younger ones to finish their schooling in order to find good employment.
She spent her middle years working in South East Asia, employed by the World Health Organisation (W.H.O) as part of a tuberculosis (TB) research project. This organisation was established in 1948, with the headquarters in Geneva, Switzerland, to monitor health throughout the world. In a few lines in June 1952 the Otago Daily Times (ODT) mentioned that Miss M T O’Connell had left on her way to India. In later years her career with W.H.O. was celebrated more widely via published articles and recorded interviews of her work. While employed by the W.H.O between the years 1952–54 in India and Afghanistan then 1962–1968 in Indonesia and Philippines, she was the Public Health Nurse in TB control teams made up of international medical specialists. In an article in 1964 the magnitude of the problem was noted as “an estimated fifteen million people suffer from infectious tuberculosis today and more than 3 million die annually”…and approximately “2–3 million new cases occur each year”. World Health 1964.
Mary died in 1987, so information for her story had to be gleaned from people who remember her, but the best material came from her diaries, letters, papers and passports. Mary was a prolific and informative letter writer. These treasures – the brittle, blue and red edged airmail letters, the cryptic diaries, the detailed project reports typewritten on foolscap sized paper and yellow with age and the well travelled passports – are all rich in the history and endeavours of health workers of the W.H.O. They also reveal a New Zealand nurse who fitted easily into new cultures, who knew what was needed and who made the most of opportunities to improve the lives of her charges.
My thanks go to those family members who supplied the background information for this story.
Mary was born on 28th February 1908 in Middlemarch, Central Otago, the third child of John O’Connell and Elizabeth Fahey O’Connell. Later the family moved to Wyuna Station, near Glenorchy “where access in and out depended on one of the three boats that steamed up and down Lake Wakatipu” (Crompton). Later the family bought land in Frankton which eventually became the location of the Queenstown airport. She was educated in Queenstown and Dunedin.
Mary was drawn to the nursing profession and tested her preference by taking a nurse aid position at Lewisham Hospital in Christchurch (formerly Calvary hospital and later Southern Cross hospital) for six months. She followed this by eighteen months training at Cashmere Sanatorium Christchurch for tuberculosis patients and gained her certificate early in 1927. Tuberculosis was prevalent. They lost many sufferers, mostly young, and among them were returned service personnel. Many buildings on the sanatorium site allowed them to accommodate whole families when the need arose. The only treatment was rest and good food. There was little government support for patients. (Lyons)
Mary began her general training on 19th June 1927 in Nelson hospital. At that time Nelson was the infection hospital for those with typhoid and post–typhoid complications, diphtheria, pneumonia and hydatids and a hospital recommended for its patient care. She finished in 1930 and later went back to Nelson for her first year maternity training. Soon after graduation there was a position with Hokianga Hospital Board checking TB in rural areas.
Family commitments called her back to Dunedin in the mid 1930s. She bought a house in Pacific Street. It served as a base for members of her family when they were in Dunedin. Apart from some time as a medical student flat, the open house understanding continued whether Mary was there, or on nursing duty overseas. She was still living there at the time of her death.
During this time she first worked as Junior Sister at Wakari hospital Dunedin, followed by a position as Sister in Charge at the Chest Clinic of Dunedin hospital in 1938. Much of her work for the clinic involved home visiting and she enjoyed a good rapport with patients and their family members. BCG immunisation was being used, mainly for school children. Many patients were from reduced backgrounds so Mary kept a box at work for donations. Members of her family tell of having to get dressed first in the morning or some of their clothes might go missing.
She extended her knowledge of TB care when a position became available at Pleasant Valley Sanatorium in Palmerston, Otago and remained as Senior Sister for three years. She noted that there was little new treatment except artificial deflation of the thorax in the hope it would speed up repair. In her testimonial, the Matron in charge noted that she had “no hesitation in strongly recommending her”. (E E Hollands) That was followed in 1946 by post graduation study in Wellington for a Diploma of Health.
By this time Mary had considerable experience in essential care of tuberculosis patients. She took a position in Preventative Medicine at Otago University and over this time she was examiner in Practical Nursing for the State finals. When she left employment with the Dunedin Hospital the Superintendent wrote “Her general experience, her personal character and demeanour, which is pleasant but firm, make her a most eligible candidate”. (James Thomson, med. Supt).
With a background in TB nursing, Mary applied to the World Health Organisation for a contract. Her diary notes that on 5th May 1952 she received a cable offering her a position in Patna, as Public Health Officer and part of an international team for TB research in India. It was noted in the ODT.
“In June 1952 New Zealand nurse, Mary O’Connell was assigned to a WHO tuberculosis project in Patna, the capital of the State of Bihar”. (Rattray) This contract was based around research into the incidence of tuberculosis and included training local nurses in modern tuberculosis care. She was forty four.
New Zealand was an early member of the W.H.O. Previously medical teams had been allowed into some countries usually as part of missionary groups. The wives, with varying nursing skills, provided basic care of the sick. Some of these teams were from New Zealand but eventually political unrest drove a number of them to leave. When countries chose to join W.H.O, teams of trained medical personnel were permitted to enter.
Patna, in Northern India, is situated on the south banks of the Ganges River not far from the Nepalese border and across the river from Kathmandu. People have lived there for hundreds of years and under many empires. At first, for Mary, the Indian heat was hard to tolerate after life in southern New Zealand. During her first year she had malaria, was ill for four weeks and had to spend most of that time resting. There were local people to take care of the household needs. Later in the year she was able to spend time in cooler Kashmir. Her time in India came only a few years after the end of English rule and the separation of Pakistan from India. She had few language difficulties “because until 1948 both medical and nursing education had been in English…but then things changed” and eleven different languages were used. (Rattray).
In Mary’s time Patna had a population of around 40 millions. The first task in a new contract was to find and update staff in TB care and make sure all equipment and supplies were available. Patna had a 44 bed unit but Mary managed to order, or sourced locally, anything else that the team required. All this took time and gave her “the opportunity to observe local conditions…hospital administration and purchasing methods”. (Patna report).
Life outside work was wide–ranging. One letter written in Patna on 4th April 1953 is crammed with Mary’s easy to read and lively script… every tiny space has some informative note. She tells of travels in India, both for work and leisure, of going by train to Delhi for a meeting, then visiting Agra and the Taj Mahal in the moonlight, on her birthday. She met party of New Zealanders who had been tiger hunting. In the same letter she says “I will leave for my annual holiday in Kashmir in May”. She also mentions her future work in Kabul and had holidayed there before she began her Afghanistan contract. Mary had a cousin she often visited in Calcutta, who was serving as a member of a convent and she valued this connection with family and New Zealand.
From her diaries, the social life in Patna reads as if she lived under the British Raj with The Club being the centre of everything for parties (which Mary often evaded), tennis and swimming, and visitors, both tourist and work related. The team often had visiting colleagues to stay which helped to keep up with current news of the world. She knew that Princess Elizabeth had been crowned Queen of England and Ed Hillary had climbed Mount Everest. The climbers visited Patna. Mary’s account of their visit was succinct and to the point. Her diary entry reads:
Wednesday 24th June, 1953 “went to airport and met Mr Hillary and Colonel and Lady Hunt, then to club. Took photos“.
Thursday 25th June “Saw Coronation film. Went to the Club and met expedition personnel. George Lowe came home for dinner and stayed here that night”.
Friday 28th June. “George and I took photos of expedition members”.
There is no more about the Everest visitors except a comment four months later, getting some editions of the Auckland Weekly News with photos of the expedition members. At that time Ed Hillary was a mountaineer and bee–keeper, not yet so well recognized as he is today. When her contract was finished, Mary was offered a post in Kabul similar to the work she was doing in Patna. She left early in January 1954 and reported to headquarters in Kabul a few days later.
The capital of Afghanistan is Kabul. It is thousands of years old and has survived under the control of various rulers over the centuries. Its setting is still a calculated position for business as it was in times gone by. Kabul is 6,000 feet above sea level where Mary found the cool weather a relief after India’s heat. When Afghanistan joined the United Nations (UN) many changes took place. “Now that Afghanistan is a member of the UN American teachers, engineers and technicians are allowed to enter the country to develop national projects”. Health services had also been introduced and “Mary O’Connell, as a member of a W.H.O. team, pioneered the way for New Zealand nurses”. (Rattray).
On the day Mary was due to fly to Kabul the flights were grounded because of snow. She and her doctor colleague had to travel from New Delhi by train “through India and West Pakistan to Peshawar” via the Old Silk Road. Overnight train passengers were given a “bed pack” of sheets and toiletries. When Mary complained her sheets were not clean, she was told that a VIP travelling on the train the night before had used the same pack and he didn’t complain. Mary did not record her reply.
The train trip “took two nights and one day and left us with another two hundred miles to go. We set off by road in a station wagon. By evening of the first day we had crossed the Khyber Pass…and entered Afghanistan. On we went through miles of wasteland and rocks…past high walled mud forts from which armed tribesmen kept guard…and by the afternoon we entered a fertile valley rich in orange groves. By seven o’clock “we were installed in a comfortable hotel…built by German engineers…Next morning…our journey took us over the 8900 feet Sataband Pass…that two days earlier had been covered by 5 feet of snow,” cleared and piled on the roadside”. (Rattray) And so Mary arrived in Kabul on 4th January 1954.
In the 20 years from 1950 to 1970 Afghanistan had enjoyed relative political calm. Mary’s time in Kabul came during this period. She noted that “it was comparatively peaceful, though many adjustments needed to be made to allow for the rules of Islam and it was a fantastic place and I loved it”. (Crompton).
Mary was tutored in Farsi language in order to help communication with the locals. The people “were not slaves to the clock” and had few of the modern complaints related to stress. “Time meant nothing to ordinary people…and was a pleasant aspect of life there”. (Afghanistan Could…Evening Star). She “lived in a comfortable mud house surrounded by a high mud wall…and when she hired a taxi, it was a horse and cart”. (Crompton). She settled in to Kabul with its many narrow lanes and mud houses where her patients lived. She soon became familiar with their lives and “with the gaily embroidered waistcoats and skull–caps and artistically tied turbans of the men”. She noted that “she transplants very easily” (Crompton). Other projects had been established in Afghanistan with personnel from different countries. (Rattray).
She tells of garden parties at the British Embassy and having to dress to suit the occasion, “stockings, hats, gloves etc.” (diary). There were parties at other embassies and many visitors passing through. She had a collegial relationship with staff from UNESCO, the British Embassy Hospital, International Labour Organisation (ILO), Food and Agriculture Organisation (FAO). She had an article published in the London Times January in 1956. When her contract finished, Mary returned to New Zealand.
She was welcomed back to Dunedin Hospital, resumed her work in TB care and guessed she knew almost every patient in the lower South Island. She helped set up an industrial clinic on the wharf area of the city and inspected factories for health hazards.
She travelled back to Afghanistan which she barely recognised due to ongoing development in the intervening years.
In 1963 Mary began her third contract with W.H.O. Her time in Indonesia coincided with severe civil upheaval. President Sukarno was in power in the early part of the 1960s when conflict between various political, religious, economic and ethnic groups was widespread and all convinced of their own rights. Local rebellion erupted. The President supported the “wrong” side and there followed, in the mid 60s, a brutal genocide of thousands of people and the downfall of President Sukarno. But under President Suharto, life was no more peaceful for the local people.
Working under these conditions made life frightening for the staff and the programme in general. They saw the bloodied results of civil hostility, bodies floating in the river and nervous people. Some local doctors were pro the revolution and others not. The risk of moving about safely in a number of areas was very uncertain. Project members were warned never to leave their cars or the cars could vanish. All staff and their vehicles were well marked to make sure of instant identification but this did not always guarantee exemption from hostility or attack. For Mary it was a very different situation after life in Afghanistan. Her family in New Zealand was concerned about her safety but the project continued.
Mary began in Jogjakarta (Yogyakarta) which was chosen for the first phase of a tuberculosis control programme in Indonesia. The project (started in 1961 and backed by the Indonesian Government, W.H.O. and U N I C E F) was to structure a pattern that could be repeated in other areas as a Pilot Project. After briefings with the National Tuberculosis Institute in Bangalore and the TB control Project in Bangkok, her work began. Her job as Public Health Nurse was to oversee the progress, recommend changes and send detailed reports to W.H.O. Mary’s reports show the scale of the work.
Preliminary training had been completed before she arrived. The teams were made up of various medical, administrative and field workers. The home visitors were crucial as everything depended on the first approach and the influence of the Headman in villages.
The census was used to ascertain the number of all people aged ten years and older. These were x–rayed and those with symptoms of TB were treated. After a year, those treated were examined again. The process did not always go smoothly in every area. When the second x–ray was due, some individuals were hard to find. For example parts of Jogjakarta had a highly mobile population. If a rural area was not producing well, people might head for cities and try to make a living selling street food, so their original address was of no use. Others moved permanently or “decided” they had been cured by the first treatment so didn’t need a repeat. Some died. Continuous cross checking was needed to find missing individuals.
This meticulous process was repeated in Jakarta, East Java, Surabaja and Malang, with variations to allow for differences in ethnic groups. In her final report, Mary had some insightful suggestions for improving any similar scheme in future. When all was well established she left in July 1965, had a few weeks break and in September of the same year, reported for duty in the Philippines.
In the 1950s and early 1960s the Philippine economy ranked as the second most progressive in Asia, next to that of Japan. After 1965, when Ferdinand Marcos (and Imelda) became president, the nation experienced economic problems and social unrest, especially from the 1970s, when corruption spread and the economy suffered a progressive downturn. It is difficult to get members of the general public to collaborate in a programme when their daily routine is disturbed by conditions such as these.
Mary joined a team in 1965 on the Cebu Pilot Project. The population was made up of several distinct ethnic groups with a Spanish influence still evident and the project design had to be acceptable to all these groups. Mary’s job was to oversee and direct the care of TB control project. She began with briefings at the Regional Office of W.H.O. in Manila and with local staff. Each unit included various levels of training and expertise. In her earlier contracts with WHO, Mary had enjoyed a professional status. In the Philippines she felt this respect was limited and therefore her authority not always appreciated or her practice applied.
The census was again used to contact patients and again, not everyone returned for the follow up x–ray. The excuses ran along the same lines. Good personal contact and trained personnel were the key. In her report she notes that “the public health nurse and the midwife are active in the prevention, treatment and, to a certain extent, in case finding”. Mary pressed for such staff and her advice was taken. The change began soon after with an intensive training course and the first new trainees soon in place.
The refrigerators for storing vaccines were run on kerosene. As long as the fuel was available, these functioned normally but there were difficulties with supply. In the more remote areas she was sometimes frustrated, on her return, to see the buildings abandoned and valued drugs had joined the remedies of the local spiritual healer. In some cases whenever staff took legitimate leave there were no relief employees to replace them. This delayed the process and increased the work load on remaining staff. Transport was also a problem. Jeeps were the local method and they were to be driven only by a doctor. If a community worker needed transport, the visit was required to coincide with a doctor’s travel to the same area. Some home visiting staff could travel so far with the doctor then resorted to walking. Motor bikes were purchased but fuel supplies were intermittent and maintenance limited.
She established TB clinics in outlying areas of Rural Health Units, noted conditions and equipment for storing the TB vaccine and returned periodically to check their progression. These units were made up of medical officers, public health nurse, midwives and sanitary officers. Some private doctors practised in urban districts and there were uncertified midwives in more rural areas. It was an assorted workforce. The Philippine contract ended in 1966.
Mary’s time with WHO saw many changes in tuberculosis care, from hospitalisation with fresh air and good food, to specialised nursing treatment and BCG vaccines which gave almost immediate control and allowed patients to remain in their communities. Her experience was recognised when her contract was finished and W.H.O. asked her to write a paper on the care and treatment of Tuberculosis. She was allocated an apartment in Geneva to complete this work. Among her papers is a letter from W.H.O. nursing chief noting her paper would be not be published under her own name but with a number listing only.
There is a difference in the content and tone of the details of life in the four countries. The notes from India and Afghanistan show that life was very enjoyable and relaxed and working conditions safe. In Indonesia it was very different. The setting was dangerous and her reports contain only details of the work and little of her leisure time. In the Philippines she was frustrated with lack, and the slow delivery, of essentials. And again, the reports are detailed accounts of employment conditions but few of life outside work.
Mary over sixty when she finished in Geneva so retired and spent her time in unpaid work. She tutored Red Cross trainees and school age students for St John’s ambulance in her spare time. She established an Insurance scheme for disabled children into which parents contributed. She was offered an honour for her work but refused saying “her life as a nurse gave her the privilege to serve the people”.
Her passports show, other than her work, she travelled widely in Europe, America and Africa. Every other year she visited friends and work colleagues overseas and these people also holidayed in New Zealand. Her last flight was a trip to Brisbane a couple of years before she died. During a 1987 interview Mary said she planned to write an account of her life, on which she looked back with some satisfaction. She was about to start when she died suddenly, a few weeks after that interview (ODT). Her diaries were found spread across her desk, ready to help tell her own version of the widespread work of a mid 20th century New Zealand nurse.
8th June 1951
I have much pleasure in stating that Miss Mary O’Connell is well known to me both during the period she was employed by the Otago Hospital Board and also during the time she has been with the Health Department in Dunedin.
She was appointed Junior Sister at Wakari hospital in Dec 1936 which position she held till Dec. 1937. AT the Chest Clinic in Dunedin Hospital she was Sister in charge from May 1938 till Dec. 1939. In Feb 1939 till Oct. 1942 she was senior sister at Pleasant Valley Sanatorium where she gained further nursing and administrative experience in sanatorium routine. She has been an examiner in Practical Nursing in the State Final examinations during the time she was employed by the Department.
Her general experience, her personal character and demeanour which is pleasant but firm, make her a most eligible candidate for the position for which she is now applying.
James Thomas med. Supt.
Pleasant Valley Sanatorium
8th January 1942
I have much pleasure in certifying to the excellence of Miss O’Connell who has been Senior Sister of the above for three years. I have found Miss O’Connell efficient, trustworthy reliable and an energetic worker. She has always been interested in her work and gets on well with the staff and patients.
I have no hesitation in strongly recommending her to a responsible position. I am sorry to lose her services.
E E Hollands