It was the Indian Mutiny of 1857 that originally drew the attention of Florence Nightingale to health conditions in India. Her initial concern was with the British troops stationed there, but her attention quickly turned toward the natives, and they became the main focus of her forty year involvement in the health of the region. As in the hospitals of Scutari, Nightingale understood that the lack of sanitation and healthy living conditions were the main culprits in the spread of infectious diseases and high mortality in India. She became active in the discussions of a Royal Commission set up to address the health conditions in the colony. And in 1874 she wrote a pamphlet, Life or Death in India, with an Appendix on Life or Death by Irrigation, which reported the progress of recent sanitary measures, and called for the central government to continue its aid to the local governmental leaders in bringing public health to their areas. As Nightingale later explains in a letter of October 10, 1888, "Without this, without the engaging the people themselves on our side - without convincing them of what is their own interest, we may pass what Sanitary Acts we please, but they remain a dead letter: We may have the most exact knowledge of what is wanted, but we cannot carry it out."
Nightingale maintained correspondence with various British and native leaders in India over the course of several decades, with whom she exchanged advice and updates on public health matters. The Reynolds-Finley Library holds a collection of letters spanning the years 1867-1889, written to Dr. Thomas Gillham Hewlett, who served as sanitary commissioner and Health Officer of Bombay. Nightingale provided advice to Hewlett regarding issues such as cholera prevention, water supply and the disposal of sewage, engineering needs, reaching out to the native women to spread sanitary education, and other sanitary and public health issues, as well as related government legislation, and British political and bureaucratic concerns that affected his work in Bombay. She provided commentary on reports and pamphlets he wrote on related subjects, and she was a beneficial ally of Hewlett, promoting the man and his work back home in England. In one letter of reference she describes him as "... a Sanitarily engineering city in himself: up at 2 or 3 a.m. himself leading & organizing his army of scavengers." The Reynolds-Finley Library letters also reflect Nightingale's active role in the formation of the Bombay Village Sanitation Bill. She consulted with Hewlett and various other leaders, native and imperial, in the development of this legislation.
Florence Nightingale's Global Health Legacy
Florence Nightingale reached out to leaders across the globe to advance health care knowledge and conditions. This global ethic was passed down to the nursing profession as part of her legacy. Today, the UAB School of Nursing participates in a variety of Global Health Partnerships and activities, and is a designated Pan American Health Organization (PAHO)/World Health Organization (WHO) Collaborating Center for International Nursing. The images to the right document some of this international work.
Letters to Hewlett Concerning Sanitation in India
Nightingale writes to T. G. Hewlett, CIE Health Officer of Bombay, 1867-1889, thanking him for sending a copy of his "Report on the Prevention of Cholera", and she comments upon it. Her remarks concern methods for the disposal of house sewage.
Florence Nightingale responds to a letter from T. G. Hewlett, Health Officer of Bombay. She explains the debate that has been resolved for England, but that was still undecided concerning India regarding the duties of health officers and inspectors and whether there should be one executive officer over both sanitary positions.
Nightingale corresponds with an unknown recipient about publications related to sanitation in India.
Nightingale explains to Hewlett how the sanitary works of municipal officers in Bombay came to be omitted from a recent report. She assures him that the mistake will be corrected in next year's report.
In this letter to T. G. Hewlett, Nightingale speaks of strategies they should consider in attempting to educate the women of India about sanitation, and to organize them into a women's Sanitary Mission.
Nightingale thanks Hewlett for two documents he sent to her, one concerning sanitation in Ahmedabad, and the other, the Annual Sanitary Blue Book Proof. She reports to him the steps she has taken regarding both.
Nightingale expresses astonishment over a resolution attacking Hewlett's Annual Report. She advises him to consult Sir James Peile about it. She also gives her own praise to the report.
Nightingale writes to T. G. Hewlett about sanitary and health conditions in India. She mentions the possibility of a famine in Western India and a new report on sanitary conditions in Madras.
Nightingale writes to Hewlett updating him on the status of the Army Sanitary Commission re-organization and asking to borrow a pamphlet on the port in Bombay.
Nightingale informs Hewlett that she is trying to obtain the report he wants to see about the Bombay port.
Nightingale asks permission from Hewlett to use a letter from Colonel Ducat to convince the native president of Ahmedabad, Mr. Runchorelal Chotalall, of the cost efficiency of employing an experienced sanitary engineer from England.
T. G. Hewlett thinks that it should be necessary to get approval from the central Government of India to borrow money for local engineering work. In this letter, Nightingale sends her response and the response from the India Office explaining why things should remain de-centralized.
In this brief note to Hewlett, Nightingale explains that she will write more soon about advice she has received that will be of interest to him.
Florence Nightingale writes to an unknown recipient about sanitary matters in India and the favourable review of a relevant pamphlet.
In this brief note, Nightingale thanks Hewlett for a reply she recently received.
Nightingale informs Hewlett that she has forwarded the proof of his pamphlet, "Village Sanitation in India, " to Sir Douglas Galton for his valuable suggestions. She also explains that problems with her eyes make it difficult to read.
Nightingale copies a note from Sir Douglas Galton in which he remarks on how T. G. Hewlett should respond to attacks upon him in a memo.
Letters Promoting the Work of Thomas Gillham Hewlett
Nightingale had great respect for her frequent correspondent and his tireless work improving public health in India. She in turn was a beneficial ally for him in England. In her letter to him on February 11, 1881, she mentions having recommended him for the Star of India. She also wrote a letter of reference for him on October 10, 1888 citing his devotion to the cause of sanitation in India and the many successes of his work. On several occurrences, Nightingale informs Hewlett of positions becoming available and how he might work to obtain those jobs.
Nightingale writes to Mr. Whitfield, praising and making recommendations concerning a sanitary report written by his nephew, Thomas Gillham Hewlett, Health Officer of Bombay. She also comments on Sydney Infirmary, recognizing similar health abuses in all countries.
In this letter, Nightingale urges Hewlett to write to Sir Bartle Frere as soon as possible about the question of the administrative position of the Medical Officer of Health of India. She recognizes that Hewlett's background would make his views particularly valuable.
Nightingale writes to Hewlett about the steps she has taken to get him the Star of India. She also asks for more information about his work at Hurrachee.
Nightingale quotes an unknown source in this letter to Hewlett. The source responded favorably to a question about who Hewlett should consult regarding a newly opened position with the Army Sanitary Committee that he is seeking.
This is a letter of reference for Thomas Gillham Hewlett, Health Officer of Bombay and former Sanitary Commissioner. The position he seeks is not noted. Nightingale's review is very complementary regarding Hewlett's abilities and knowledge. She speaks particularly of his experiences and successes in dealing with cholera and the Famine of 1876-8 in Bombay.
Florence Nightingale writes to Hewlett about the possible re-organization of the Army Sanitary Committee and the steps he is taking to obtain the position of retiring committee member, Dr. John Sutherland.
Nightingale writes to Hewlett about the possibility of a reduction in staff for Bombay Sanitary Commissioners.
Nightingale arranges an introduction between Hewlett and Lord Roseberg, Chairman of the London County Council.
Letters Concerning the Bombay Village Sanitation Bill
The Bombay Village Sanitation Bill, the final version of which became law in 1890, provided for sanitation in villages and local districts, and Nightingale was actively involved in commenting on drafts and discussing the bill with British and Indian government officials. She corresponded extensively with Dr. Hewlett regarding the pros and cons of this legislation. Also, in letters to him from 1888-1889 she made reference to additional correspondence with native leaders in India, such as the president of Bombay, Runchorelal Chotalall, and officials at the capital of British India in Simla.
Florence Nightingale letter to Thomas Gillham Hewlett, October 17, 1888
Nightingale writes to Hewlett about a recently proposed act concerning Bombay village sanitation and the establishment of an executive agency and local and district boards to link the villages together.
Nightingale writes to Hewlett about a village conservancy bill that is in the drafting process. She questions him about the problems he sees with one of the drafts.
Nightingale writes to Hewlett about the Bombay Village Sanitation Draft Bill, and about her correspondence with the native Ahmedabad President, Mr. Runchorelal Chotalall. She also asks Hewlett about positions in Bombay for researching and evaluating the status of sanitation.
Nightingale explains to an unknown recipient that she is forwarding a letter she wrote to the native Indian associations concerning the Bombay Village Sanitation Bill. She also mentions problems with her eyes.
Nightingale writes to T. G. Hewlett about the proof for a document he is working on. She also mentions giving advice to native Indian associations about a government bill, which is probably the Bombay Village Sanitation Bill.