History of-nursing-indopak

History of Nursing in India &
Pakistan
Fundamental of Nursing BScN
September 3, 2021
Clinical Instructor: Sir Jerry Zahid
GFNC 1

OBJECTIVE
After the end of this presentation the students will be able to:
• Identify the scope of pre-partition Nursing
• Explain the role of military hospitals & organizations in spreading
nursing profession
• Elaborate the history of nursing in Pakistan by knowing the
contribution of female & male nurses
September 3, 2021 Clinical Instructor: Sir Jerry Zahid GFNC 2

Pre-partition Nursing
• 1860: Nightingale established first formal and modern nursing school
in St. Thomas Hospital London.
• First School of midwives opened by Indian Govt. in India.
• Anglo-Indian sisters came in India and promoted the Nursing.

• 1884: First School of Nursing open in Mayo Hospital Lahore
• Mostly nurses were Coming from England to work in Indo-Pak.
• Mostly Nurses from low-cost-Hindu converted into Christianity were
serving.
• Muslims and Hindu girls were not joining the nursing due to their
culture.

• Even Nurses from UK and other part of Europe to get training in Indo-
Pak.
• Brahmans promoted the belief that if girl touches the other person
she becomes a dirty.
• Negative attitude of Anglo nurses towards Muslims and Hindus also
prevented the joining nursing profession by them.

• Up to 1934 no any Indian Nurses can admission in Nursing even
opening of school in 1884.
• If some Muslims girls wants to join the profession but Anglo nurses
refused to give admission b/c of Purda and belief that Muslims could
not be good nurses.
• Mostly Schools attached to Mission Hospitals

• Missionary Schools promoting the Religion and were giving admissions
to lower Socio-economic Hindu Christians.
• All Matrons/ Nursing Superintendents were Anglo Nurses.
• All schools were running under policy of those Matrons.
• In 1871: an other school were open in Northern India.
• In 1907: Great Number of nurses hired on posts of Nursing Supt. from
Europe in India.

Pre-partition Nursing From 1931-1941
Nurses 7,000 1:43,000
LHVs 750 1:400,000
Midwives 5,000 1:60,000

• Rules, standards, curriculum were outlined for nursing training first time
in India-Pak for Mission Hospitals by efforts of Anglo Nurses.
• Civil Hospitals also adopted the standards.
• Most Mission hospitals opened Nursing Schools in all provinces of India
and Pakistan.

• Holy Family Hospital and Seven Day Hospitals were also efforts of
Missionary.
• According to Werkentin that Mr. Gandhi praised the Missionary services
towards tremendous growth in Nursing in India in one Speech.

Role of Military Hospitals
• 1664: Military Hospitals appointed Nursing attendants with few
months training for dressing the wounded soldiers.
• 1888: first time Indian Govt hired British Nurses in Military to lay the
foundation of Military Hospitals in India.
• These Nurses started 02 Months training of Male as Attendants.

Role of Military Hospitals
• 1914: Nurses Recruited by the Queen Alexandra’s Military Nursing
Services for India.
• 1927:Received permanent status of Indian Military Nursing (IMNS) in
India.
• After 2nd World War I.M.N.S emerged into full independent Nursing
services of India

Nursing Organizations
• 1905: Association of Nursing Superintendents of India (ANSI), First Association
formed.
• 1908: Trained Nurses Association of India (TNAI). Second Association.
• Same officers of first Association hold the executive posts.
• These both organization worked separately up to 12 years. Then combined
together named TNAI.
• 1903: Establishment of Nursing Registration Council moved and approved in
1909, and began its operation in 1910.

• Firstly Nurses of very few hospitals got registration i.e. Utar Pardesh,
Punjab, and Bihar joined.
• But very soon Sindh, NWFP, and Bengal were included.
• 1910: First Nursing Journal was published by TNAI (Trained Nurses
Association of India).
• After Publication of Professional Journal TNAI got International Status.

• 1912: TNAI received membership in ICN (International Nursing Council)
• All Nurses who got three years nursing training, recognized by council
were entitled as a member of association.
• 1941: Indian Govt. opened first Postgraduate College of Nursing in Delhi
by the efforts of TNAI.

• 1943: The School for Hospital Administration started.
• Proposal of starting the B.ScN program in universities initiated by TNAI.
• 1946 this proposal was passed.
• TNAI struggled for opening the central Nursing Council for India and
Pakistan.

• 1947: The Act was passed for establishment of Central Council of
Nursing.
• 1949: The Central Council of Nursing (CNC) for Pakistan was
established.
• CNC comprised on 33 members. 09 Nurses, 03 Midwives and LHV and
others were eminent doctors and educators. It began to function in
same year.

Nursing Organizations after Birth of Pakistan
Year ACT Reason for Change
1949 Central Nursing Council Act
1949
To establish a uniform standards of
training and certificate throughout country.
1952 Pakistan Nursing Council
1952
Profession was evolving and changes were
needed in different such reduction in
nursing categories admission criteria for
nurses to name a few .
1973 Pakistan Nursing
Council 1973
Establishment of examination
boards, addition of course in
curriculum, inclusion of private
schools as a member and re-
enforcing the licensing regulation

• TNAI worked up to 1947 in sub-continent.
• After independence of Pakistan TNAI Leader Mrs Salma Tareen Nursing
Superintendent of Mayo Hospital Lahore met Chairperson of TNAI
Miss Vice France to form independent association with name of TNAP.
• And TNAI Divided and Pakistani part called TNAP and Indian TNAI.
• Total members of TNAP were 55.

• First time rules of TNAP were adopted in 1950.
• First President of TNAP was a Mrs Ismat Khanum Shah LHV, and
Principal of Public Health School.

History of Nursing in Pakistan
• After independence British Nurses and non-Muslims Nurses left the India
and Pakistan.
• Huge gap created in nursing services.
• Very small Pakistani nurses were served the wounded refugees in riots.
• On call of imminent political female leaders of West Pakistan Ms Fatima
Jinnah, Rana Begum Liaquat Ali Khan called the women to come out from
homes and to serve the Refuges in camps.
• They all lay women served under supervision of trained nurses.

• Inspector General Civil Hospitals Punjab started the 02 weeks training
to prepare Nursing Assistants after 8TH Class pass.
• 1948: First Nursing School was established in Ganga Ram small private
Hospital Lahore.

• Mrs G.M Darrah was first Nursing Tutor up to 1961.
• Mrs Mumtaz Painda Khan first Nursing Superintendent of this school
up to 1979.
• First Medial Superintendent of this school was Mr. Shujaat Ali.
• In 1952: first group of 07 girls passed the nursing course from this
school.

• In 1948: Second School of Nursing was opened in JPMC Karachi.
• This development followed by Bahawalpur, Hyderabad and Multan, Lady
Reading Hospital Peshawar, Civil Hospital Karachi, Mayo Hospital Lahore.
• In 1951: LHV Training extended to 02 years, one year midwifery and second
in nursing emphasized on community nursing.

1950: CNC passed the rules that:
• Two grades of nurses- General Nurse and assistant Nurse
• 17 years age for girl in nursing admission
• Unmarried, widowed, divorced and childless will be preferred in training
admission.

• 08 class education, only can read or write the English.
• For Nursing assistant: only can read and write Urdu.
• Male can not take training of Assistant Nurse but take 03 years general
nursing after passing Matriculation.

• 03 years with 03 months as preliminary training School (PTS)
• Later these points become a part of ACT 1952 Legislature.
• Nursing Assistant can not practice without supervision of Trained Staff
Nurse.

Course comprised on:
• Anatomy, Physiology, Medial Surgical Nursing, Fundamental of Nursng,
Hygiene and Sanitation.
• Exam of first year and third year only.
• Midwifery certificate included in one Nursng Diploma Certificate which
was separated later in 1960.

• no fixed date for admission, round the year admission was opened for
girls due to shortage of nurses.
• Students Nurses were considered helpers and assistants of staff
nurses.

• Mrs Wazir got postgraduate training in teaching and administration
from India and become first postgraduate nurse teacher in JPMC
Karachi. Other Staff Nurses, Matrons were used to teach the students.
• She used to teach 03 times a days to different classes.
• Before Ms Wazir, No separate classes for first, second or third year
students, all have use attend class together.

• Doctor teach medical subjects and nurses teaches nursing subjects:
proposed by Ms Begum Wazir.
• After 1952 Nursing Admission were given in April and November months
(Twice a year)
• 1955: PNC abolish the two grades of Nurses, converted into one ‘A’.
• Matric fixed for female instead of 08 class and 08 class for midwives
instead read, write Urdu.

Establishing College Level Nursing:
• In 1955 college of nursing proposed under health and sanitaiton
programme
• This was approved by the help of Govt of USA.
• College was established and affiliated with Karachi university
• This college temporarily placed at Civil Hospital Karachi.

• Miss Catherine Hardeman Nurse Educator of USA, joined this college as a
Principal.
• Miss Virginia Arnold, chief Nurse of Washington, and Begum Wazir joined
college as a tutor after passing B.ScN from USA.
• One year course formulated with administration and teaching together.
• In 1957 group of seven girls graduated from this college.

• 1959: college was given permanent place in JPMC Karachi.
• After Hardman left her position, Ms DeMara Took the charge of Principal.
• 1959: PNC visits the college
• 1963: PNC approved and suggested additions of coursed in curriculum of college.
• In 1966: Ms Begum Wazir become first national Principal of this college. She was
4th in number of principal.

• Mrs Imtiaz Kamal returned to Pakistan after passing Master Degree in
Nursing and became second national 5th in overall principal of this
college.
• 1966: 134 Nurses got graduation this college and involved in teaching
all over Pakistan.

Nursing Institutes 1947 1990
School of Nursing 03 69
Public Health
Schools
00 07
College of Nursing 00 04

Men in Nursing in Pakistan:
• Lady Reading Hospital Peshawar, Civil Hospital Karachi and Good
Shepard Hospital Quetta accepting male students in nursing.
• 1950 TNAP sent recommendation to CNC that Male Nurse also treated
equally on pay and facilities to females.

• 1989: there were 66 Male Nurse out of 6389 nurses in country, 85%
were in Balochistan and NWFP Provinces. Among 66 one was teacher
and 4 were managers.

• When first college of Nursing was opened, male nurses were refused
to give add mission. Said by: Mr. Mushtaq
• 1966: College accepted the admission to male.
• Up 1970 Male Nurses were restricted to higher positions of nursing.
E.g. Controller, superintendents and principals etc.

• After long arguments to PNC and Govt Male Nurse succeeded to get
agreed the Govt for appointments of male on managerial positions.
• 1973: first Male Nurse Mr. Mushtaq became a controller of
examination in Sindh.

Pakistan Nursing Council:
• In parliament ACT was passed in 1973 to form the PNC with 35
members.
• The president is D.G Health Govt. of Pakistan, vice President is Nursing
Advisor, Members includes controllers, chief nursing superintendents,
principals, LHVs, Midwives and staff nurses.
• Before PNC, there was CNC.

Through PNC:
• Provincial examination boards established
• Formation and uniformity of Nursing curriculum
• Every institute have get recognition of PNC
• To check standards of institute and issue license.

Nursing Colleges:
• College of Nursing JPMC Karachi opened in 1955.
• College of Nursing Peshawar opened in 1988 by Federal Govt from
women development fund & ODA, UK.

• College of Nursing Lahore opened in 1987by Punjab Govt & ODA
(Overseas Development Authority) was affiliated with Hillington Health
Authority London.
• College of Nursing Jamshoro opened in 1998 by FHP & DWHP.
• College of Nursing PIMS Opened in 1991 by JICA.

Miltary Nursing Services of Pakistan:
• Miltary Nursing Services of India up to 1947.
• started Nursing Auxiliary training to male in Mayo Hospital Lahore and Holy
family Hospital Rawalpindi for soldier in Miltary of Pakistan in 1948.
• PAFNS ACT 1952 was passed and gave rank of commissioned officer to a Nurse.
• In 1959 formally given status of Lieutenant to a Nursing Sister in practical.

Miltary Nursing Services of Pakistan:
• In 1956 Miltary Hospitals started Nursing Training itself.
• Firstly 06 Months PTS training was started CMH Lahore, after that 06
Months they transferred to CMH Rawalpindi for three years General
Nursing.
• In 1950 Operative Nursing and Intensive Nursing was started, this course
was for 06 Months.

Military Nursing Services of Pakistan:
• Due to shortage AFNS hired the Colonel Maudsley from London who
took charge of Chief Principal Matron in 1962.
• She served a lot in Nursing.
• She was appointed as a first Director of AFNS Pakistan in 1965.

• In same year 1965 Colonel Maudsley retired and charge of Director has
been given to colonel M.F Qureshi first Muslim on this seat.
• It was first time in history that Muslim Nurse has been given higher
position.
• In war of 1965 with India, Nurses has been awarded with meritorious
awards and medals on their services.

• In war 1971 With India, AFNS Worked a lot and seven Nurse Officers held
by India as a Prisoner
• These prisoners has been given physical and mental torture by Indian
Army.
• Major Salma Mumtaz (Nurse Officer) has been awarded with “Florence
Nightingale” and promoted as a Colonel position on braveness and pivotal
services.

• In 1978, due pivotal services of nurses in wars, the rank of Brigadier has been given to
Director of AFNS.
• Brigadier is second highest position after General in Army.
• Colonel Safdri Beg was given the post of Brigadier first time in AFNS in 1978.
• In 1982 Brigadier M.B Chugtai become a Director of AFNS and PNC awarded permission for
B.ScN training in AFNS.
• In 1982 AFNS launched a Journal for Nursing Issues.
• In 1986 Brigadier Nusrat took charge of AFNS.

Pakistani Nursing Leaders:
Begum Rana Liaquat Ali Khan:
• She was a Midwife basically
• She was a wife of former Prime Minster of Pakistan.
• She was first Lady Governor of Pakistan.
• She also assumed the job of Ambassador of many European countries.
• She was president of all women's’ association of Pakistan
• She was patron-in-chief of TNAP from 1950-1980

Mrs Imtiaz Kamal:
• She is daughter of a Barrister
• She belongs to very well-to-do family
• She entered in nursing at St.Giles Hospital London.
• She remained a Principal of College of Nursing JPMC.
• She wrote a book on family planning and she also get published her Scientific
Research Articles. After retirement she joined WHO on very big position.

Begum Wazir Ali
• She Got Diploma in Nursng from Delhi in 1936.
• She got B.ScN from U.S.A as a first Pakistani Nurse.
• She got post graduation from India as a first Pakistani Nurse.
• She remained a first Pakistani postgraduate Nursing TUTOR in College of Nursing
JPMC.
• She remained a First Pakistani Principal of college of Nursing JPMC.

• Pakistani Nursing Leaders:
Mrs Nisab Akhtar
• She worked as General secretary of PNF.
• She got training from Wales England in 1949.
• She took charge as Administrator of many nursing institutes in Pakistan.

• Pakistani Nursing Leaders:
Mrs Kaneez Moula:
• She is Nursing Leader from 1965-1985.
• She served as a Nursing Advisor of Pakistan, and she has a title of longest served as
a Advisor of Nursing.
• She completed M.A in History from Calcutta University in 1947.
• She got Nursing and Midwifery Training from England
• She got Pride of Performance of Govt. of Pakistan on Nursing Services.

Mrs Khadija Mushtaq:
• She served as a first National Principal of College of
Nursing Lahore.
• Her father was a lawyer, Politician, Active member of
Muslim League.
• She was responsible for care of wounded Refugees
after during partition.
• She got Nursing Training from England in 1949.
• She got “Pride of Performance” Award by Govt of
Pakistan on outstanding services in Nursing.

Mr. Mushtaq:
• He got Training of Nursing in 1948 from School of
Nursing Civil Hospital Karachi.
• He served as a first and Male Controller of Sindh
Nurses Examination Board Karachi in 1970 for seven
years.
• He got Prograduate in Nursing from College of
Nursing.

• He was honored with academic excellence Award in Diploma in of
Nursing.
• He served as a President of PNF.
• He served as a Editor of Journal of Nursing and Health Review
• He currently serving as a Principal of School of Nursing Zia-ue-ddin
University Hospital Karachi.

Miss Illmya Mughal:
• She got Nursing Training from Liaquat university
Hospital Hyderabad.
• She got Post graduation from College of Nursing JPMC
Karachi.

• She served as Nursing Instructor, Nursing Superintendent, Controller
Nursing Board Sindh. Principal College of Nursing Jamshoro, and
Director of Nursing Sindh.
• She has been awarded with Pride of Performance by President of
Pakistan on her good services in nursing.

Ms Khairulnissa Ajani
• Pakistan's first-ever
doctorate in nursing has
been awarded by the Aga
Khan University's School of
Nursing and Midwifery,
SONAM, to Ms
Khairulnissa Ajani. As part
of her PhD, Ms Ajani
conducted original
research into hypertension
or high blood pressure – a
condition that affects one
in three adults in Pakistan.

Anila Ali Bardai
• she stands as Pakistan’s first nurse to have received the award for
excellence in neonatal nursing, presented to her on Friday at the 8th
International Conference of Nurses, held at the Waterfront Hotel in
Belfast, Ireland.

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