Women in green: the contributions of Hadassah nursing to immigrant and refugee health in pre-state and the early years of the state of Israel.

The contemporary image of health-care in Israel is one of laser technology, nuclear medicine, and high-tech research. Yet the early years were reflected in the green uniform of the public health nurse who established a foundation of hygiene, sanitation, preventive medicine, and, no less important, hope in the future for the pioneers and refugees who sought new lives in a Jewish state. Immigration was a guiding principle in the prestate era and has been an immutable right for Jews since the founding of Israel. Throughout its history, many waves of immigration have brought culturally, religiously, and economically different groups of Jews to the region. Moreover, though this point has been neglected in the literature, these groups came with varying health statuses and levels of knowledge of public health. The difficulties of meeting these diverse needs were compounded by the demands of the rapidly emerging health-care delivery system in the newly independent state. This article explores the contributions of nurses to the care, absorption, and acclimation of the waves of immigrants in the years before and immediately after the founding of the State of Israel in May 1948. The history of Zionism and the development of the Israeli health-care system have been adequately researched by scholars in many disciplines in both Hebrew and English.1 The contributions of the voluntary association Hadassah, The Women's Zionist Organization, and its charismatic founder, Henrietta Szold, have also been documented.2 The paucity of research on the role of nurses and nursing, however, particularly in the history of Jewish immigration, can be attributed to several factors. First, the history of medicine is strongly associated with just that-medical science. The contributions of individual physicians and medical institutions and the development of technology and treatments for specific diseases continue to dominate the field. Moreover, interest in the science and philosophy of medicine, including the paradigm of the scientific method, germ theory, and rational decision making, seems to be focused on acute care and disease rather than on public health, preventive health, and non-physician-related health-care.3 Interest in the unique features of the Israeli Kupat Holim (workers' sick funds, essentially a single-payer system) has overshadowed interest in the ongoing contributions of community-based practitioners such as nurses.4 Yet Israel's historically strong showing among industrialized countries on health-care indicators is the result not only of its formidable institutions and unique payment system, but also of the daily contributions of the nurses who treat the population. Nurses made significant contributions in public health and in the daily health-care needs of Jewish immigrants, particularly those living in immigrant camps, known as ma'aborot, and development towns (government-sponsored population centers placed in remote areas) throughout the country.5 This study draws on archival materials from Hadassah: The Women's Zionist Organization of America in New York City. A fundraising organization in the United States, Hadassah, was committed to raising money for the development of health-care services in Mandatory Palestine.6 Primarily concerned with maternal-child health, Hadassah nursing was the first attempt to bring professional health-care education to Jews in that area. In addition to the American archives of Hadassah, this research also examines the holdings of the Central Zionist Archives in Jerusalem, which contain the historical records of the Hadassah School of Nursing from its inteption in 1918 to 1977. Finally, ten interviews were conducted with Hadassah-trained nurses who practiced during the late Mandatory and early state period to supplement the archival data. The interviews not only validated archival findings but also provided important contexts from which to better understand the activities of nurses involved in immigrant health. …