Dr. Sonia Poochikian-Sarkissian presented the following talk during the unveiling ceremony (Kinetzon) of the book Sisters of Mercy and Survival: Armenian Nurses, 1900-1930 by Dr. Isabel Kaprielian-Churchill, at the Saint Mary Armenian Apostolic Church in Toronto, Canada, on April 11, 2014.
Dr. Isabel Kaprielian-Churchill is the author of the book Sisters of Mercy and Survival: Armenian Nurses. The book consists of close to 560 pages, including 12 chapters and multiple photographs, organized in 13 separate sections. The purpose of the book is to focus on Armenian nurses in the Ottoman Empire, Armenia, the Middle East, and Greece, before, during, and after the Armenian Genocide during the period 1900-1930, reflecting on how these nurses laid the foundation of modern nursing, public health, and midwifery in these regions.
The book was published in 2012 by the Armenian Catholicosate of Cilicia Printing House in Antelias, Beirut, Lebanon, and was funded by the Richard and Tina Carolan Literary Fund. The Printing House, which was established in 1931, continues to be an integral part of the Catholicosate, contributing to the promotion of culture and education. Recently, on March 16, His Holiness Aram I inaugurated the 35th Book Fair in Beirut. In his message, he stated that “the Armenian Book sustains our national existence” and continues to nurture our lives through “spiritual and intellectual enrichment and growth.”
Sisters of Mercy and Survival is another in a long list of publications that beautifully testifies to the important role the Armenian Catholicosate of the House of Cilicia played in the past, especially during and after the Armenian Genocide, when besides its mission of faith, it was also instrumental in the fields of religion, education, and social services. In modern times, when the scope of the Cathlicosate’s multifaceted role and services have broadened, particularly in the fields of Christian and Armenian education, in inter-religious relations, and the youth, it continues to encourage and support the documentation, publication, and preservation of Armenian history.
Kaprielian-Churchill successfully increased the significance of the content of this book through a thorough literature review, extensive research, and a detailed account of the sources used. She was able to support the well-structured text of the book through the use of multiple photographs, which include a glimpse of Armenian life before the genocide, followed by the hospitals, clinics, organizations, and orphanages that developed during and after the genocide. The author explains her intention in publishing these photographs at the beginning of the book: “…the main text and the photographs are each to stand alone. They are of equal importance, related but separate…which in themselves can form a photographic album, telling their own narrative.” The photographs were of special interest to me, both as a book reviewer and as the daughter of an orphan who survived the Armenian Genocide, which I will address later in this review.
Kaprielian-Churchill explains in the Broad Perspective section of the book that her inspiration for researching the topic was a picture of a group of Armenian nurses, taken in 1921 at the Annie Riggs Memorial Hospital in Mezireh, near Kharpert, Turkey. While working at the Hoover Institute Archives at Stanford University, she unexpectedly came across the name of a physician, Dr. Ruth Azniv Parmelee, whose archives contained this picture.
The author states early on in her book that these young women remained in her mind and “would not budge until they could be heard. I have endeavored to give them a voice and to acknowledge their contributions to the survival of a nation.” Indeed, through this review and analysis of Sisters of Mercy and Survival, I would like to ensure the author that, yes, she was able to give a voice to these Armenian nurses. They were instrumental in the history and survival of the Armenian nation, Armenian orphans, and the nursing profession. Although the contribution of Armenian male physicians and pharmacists was not the main topic of the author, she made important references to them; as members of the healthcare team, they also played an important role in the history and medical care in the Ottoman Empire.
Although it is sometimes considered essential in a book review to summarize the various chapters, events, or specific sections, I have chosen a different approach. Here, I will present an overall analysis of this book, evaluating it for its purpose and meaning, content and thoroughness, and for the quality and significance of its subject matter, focusing on the following three themes that it explores:
1) historical perspective, and its importance in Armenian history and the nursing profession;
2) the role of North American and Western-educated health professionals and other organizations in the training of Armenian nurses; and
3) the role of Armenian nurses in the nursing profession and the care of the orphans.
Theme 1: Historical perspective
Sisters of Mercy and Survival is a historical study that focuses on Armenian nurses in the Ottoman Empire, Armenia, the Middle East, and Greece in the late 19th and early 20th centuries. It demonstrates how Armenian nurses contributed to the foundations of modern nursing. In transforming the history and the role of Armenian women at that time in the fields of medicine, nursing, and public health, they were true pioneers and change agents in the profession of modern nursing.
As a historian, Kaprielian-Churchill was successful in examining “the training and work patterns of Armenian girls during the birth of the nursing profession and placing Western style nursing in the framework of Armenian history.”
The author sets the historical framework through the use of documents from more than 15 archives in North America, Europe, Armenia, and the Middle East, as well as various other sources in English, French, Armenian, Turkish, and Russian. These are supported by numerous photographs of nurses, doctors, hospitals, orphanages, and organizations. It is necessary to mention that the occasional repetition of information in the book can be considered as unavoidable due to the multiple archives and the variety of sources included by the author.
Sisters of Mercy and Survival studies the training, practice, and contributions of Armenian nurses, and places these experiences within the framework of the great events that shook the world during the Armenian Genocide. The main text examines the work of Armenian women in laying the foundations of modern nursing in the Ottoman Empire and its neighboring countries. This occurred at almost the same time as hospitals and professional nurse training facilities were being set up in North America, specifically in cities such as Toronto, New York, and Boston. By addressing the work of these nurses in the fields of nursing, public health, and midwifery, in addition to the various challenges in treating the contagious diseases during and following the war and the genocide, the book also reflects the empowerment of women in the medical profession and the leadership role that placed the Armenian nurses at the forefront of the overall medical profession in the region. Interestingly, through her research “in Turkish accounts of nursing in the Ottoman Empire, there was little or no mention of the pioneer work of Armenian women…who were being trained in Aintab, Turkey in 1893.”
Kaprielian-Churchill mentions that “Not only did nursing become an appropriate profession for Armenian girls, but it also empowered them, gave them a certain status in the community, and generated a measure of respect. Nursing gave their lives structure, enabled them to take some control over their future, and taught them self-discipline, all of which served them well during a period when family and community rules, regulations, and supports had crumbled.”
Thus, in addition to its role in reflecting the medical and nursing history at that time, the book also makes an important contribution to the social and cultural history of Armenians.
Theme 2: Role of Western professionals and organizations
Research conducted in Sisters of Mercy and Survival indicates that “during and after the Armenian Genocide, the relationship between orphans and nursing was intensified.” The Armenian health facilities and health personnel were “swept away” during the deportations, a time when care for the sick was critical. Kaprielian-Churchill’s research indicates that the North American and Western-educated healthcare professionals “entered the world of Armenian women, taught them, guided them, and in the end exercised a profound influence on them” through nurse-training programs. She continues that doctors like Ruth Azniv Parmelee, Mabel Elliott, and Caroline Hamilton, and nurses like Mabel Power and Laura Mcfetridge were “more than symbols of change. They were also agents of change.” They enabled Armenian women to have access to modern nursing, pursue education, realize their potential, and increase their awareness of the nursing profession and its benefits to mankind.
The courses included anatomy, physiology, bacteriology, obstetrics and gynecology, and hygiene. The clinical training included bedside nursing, surgery, and midwifery. In responding to the spread of malaria, cholera, typhoid, and trachoma, the program offered special training in tropical diseases, focusing on prevention, as well as in ophthalmology.
From the archives of Ramela Martin called Out of Darkness, we learn that in the early 1920’s, “Students were taught to deliver normal-birth babies, assist the surgeon in the operating room, change dressings, remove sutures, give irrigations, catheterize patients, do gastric irrigation and lavage, and give intravenous injections.”
The condition of the refugees and the orphans also forced the ongoing demand of many organizations, such as the Near East Relief (NER) and the American Women’s Hospitals (AWH). The NER and the AWH established nurse-training schools to meet the educational needs of nurses who would care for the sick and the devastated people following the Armenian Genocide. These nurse-training programs were modeled after the Bellevue Hospital in New York City. The Hoover Institution’s 1925 NER Archives mention that “English was used extensively in the hospital and the training school, and students received instruction in speaking, reading, and writing English.”
Another instrumental role of the NER was the evacuation of close to 22,000 Armenian orphans from Turkey between 1920 and 1923. Dikranouhi Bonapartian, a 1913 graduate of Euphrates College, who worked in the orphanages, shared her thoughts of North-American medical relief workers in 1922, as they gathered thousands of starving children from roads. “The Americans placed the children on stretchers and sent them to orphanages. Day by day those children improved. I remember hundreds who would have died, had they not received immediate care.”
Armenian humanitarian organizations such as the Armenian Red Cross (later called the Armenian Relief Society) and the Armenian General Benevolent Union also raised funds in North America for medicine and clothing to meet the various needs of the orphans and the widows, the sick and the wounded, and the survivors of the genocide. A 1921 report mentions that the Armenian Red Cross worked with the NER to run a Tuberculosis Hospital for Children in Constantinople. This sanatorium was funded largely by donations from Canada, which “was probably the first for children with tuberculosis in Turkey.”
In the development of early modern professional nursing in the region, Sisters of Mercy and Survival thus examines the role played by North American-educated health professionals and organizations in the training of Armenian nurses during a critical period of their history. This important influence led many Armenian women survivors and orphans to pursue careers in nursing.
Kaprielian-Churchill’s research enables us to witness the Armenian nurses’ knowledge, training, and experience in the early part of the 20th century. These young nurses came into contact with the medical and technological advances that were available at the time in Europe and the United States. The textbooks provided to them, the lectures they attended, and the practical training provided by the North American Western-educated healthcare professionals “drew them into the sphere of the modern Western World.”
Theme 3: Role of Armenian nurses
Dr. Kaprielian-Churchill indicates that the Armenian Genocide fundamentally changed the traditional image of nursing. Nursing was initially considered “unsuitable” for the so-called “respectable girls.” However, through their commitment, compassion, and expertise, especially during and after World War I, the Armenian nurses became a major force in transforming this attitude to one that recognized nursing as a viable and important profession for females. During the war, they made great contributions in military hospitals and in caring for the injured soldiers. This was continued in clinics and hospitals that treated the survivors of the Armenian Genocide, and subsequently in various orphanages.
“The girls who entered nurse-training programs were hand-picked because they were smart, conscientious, hard-working, competent, and morally upright,” and who themselves were usually orphans. In a letter to Kate G. Lamson of the Women’s Board in 1920, Dr. Ruth Azniv Parmelee, one of the driving forces in educating the Armenian nurses, wrote that the Armenian nurses “will be pioneers in the nursing profession in their country.” She was well aware of the fact that Armenian women had contributed to the medical field even before World War I. These nurses extended their contribution by bringing modern nursing to Greece. In their turn, the Altounian Hospital in Aleppo and the American University Hospital in Beirut, the Armenian Red Cross, and the Armenian General Benevolent Union also contributed to the teaching and the training of nurses in Syria and Lebanon.
The author explores how these Armenian heroes struggled in hospitals and orphanages with courage, warmth, and selfless dedication. They aided in the survival of a nation through unexplainable devotion. They saved the lives of tens of thousands of orphans and refugees of the Armenian Genocide who were surrounded by death, hunger, epidemics, and deportations, and were on the brink of extinction. At the same time, these brave women contributed to the pioneering work of nursing and in laying the foundations of modern nursing in the Ottoman Empire and neighboring countries.
Personally, it was an honor and great pleasure to accept Very Rev. Father Meghrig Parikian’s (currently, His Eminence Bishop Meghrig Parikian, Prelate of Canada) request to present this book, Sisters of Mercy and Survival: Armenian Nurses. During my review and analysis, I came to realize my deep connection with the content of this book. It created a special interest in me both as a nursing professional and as the daughter of an orphan who survived the Armenian Genocide.
I would like to express my admiration, respect, and sincere gratitude to all of the courageous health professionals and trained nurses who, in addition to laying the foundations of modern nursing, were also able to care for the sick and the orphans of the genocide, including my own father… Although I consider all Armenian and foreign healthcare professionals mentioned in this book as heroes and pioneers in the medical field, I would like to highlight my admiration for two people in particular, Dr. Ruth Azniv Parmelee and the nurse Sister Sarra Saprichian.
Parmelee graduated as a medical doctor in the United States. She began her gynecological and obstetrical nursing training of young Armenian women in Kharpert, Turkey, and continued it in Kokkinia, Greece, following her exile in 1922. “She even set-up a number of out-patient clinics and provided sanctuary and public health care to thousands of Greek and Armenian refugees.”
Sister Sara Saprichian, who was planning to continue her nursing studies in Bellevue Hospital in New York, always remained by Parmelee’s side, and even followed her to Greece. She was the head nurse of a unit, in charge of the delivery room, and also taught students in the first nurse-training school in Salonica and Kokkinia.
These two remarkable women never waivered in their dedication to serving those in need during the genocide (sometimes under very difficult conditions), and made great contributions in nursing education. It is also worth mentioning that many of these nursing graduates from Turkey and Greece continued their education in North America and the Middle East.
As to the multiple photographs of orphanages published in this book, I have to admit that I could not help but look at every single one of these orphans’ eyes and faces, wondering if my father was in any of these pictures, wondering which one of these orphans resembled him as a child.
My father, Kegham Poochikian, a survivor of the genocide, had written his own memoirs about the various orphanages he experienced. These valuable memoirs were only found following his death, and were published by us, his four children, in 2007. Entitled The Caravan of Hope: The Journey of an Orphan of the Armenian Genocide, it was translated into English and, in 2011, by permission, into Spanish.
Kaprielian-Churchill, in her description of the evacuation of thousands of orphans out of Kharpert to Lebanon and Syria, states that “many children were packed into carts or into baskets hanging on either side of mules and sent on their journey…” We can find a similar description in my father’s memoirs, when he states, “We are placed in small crates that are all arranged on the carriages and pulled by the mules…”
Furthermore, my father made reference to a nurse, named Nurse Maritza, who helped save him from the amputation of his infected leg by a Turkish doctor. The encouragement, compassion, and love of the Armenian nurses towards the orphans were evident in the following conversation with Nurse Maritza that he documented: “Kegham, I WILL NOT allow that Turk to amputate your leg. I already told him you could walk with difficulty. You have to help me prove him wrong. You can do it, one step at a time. I will be right here. Do not be afraid.” My father had compared this Turkish doctor to “the angel of death” and Nurse Maritza to his “guardian angel.” He continued, “…she also comes from Kharpert and is one of the older orphans, who was subjected to the same fate, and has been trained to take care of patients in the American Hospital.”
Kaprielian-Churchill ends her book: “In spite of all personal anguish and their own insecurities, these young women, with kindness and dedication, played a decisive role in healing and consoling thousands of Armenian survivors.” Like my father, I personally have no doubt that all of the healthcare professionals, including the Armenian nurses mentioned in this book, were perceived as “Guardian Angels” by every single one of these orphans—orphans who had witnessed death, had been separated from their parents, deprived of their childhood, moved from one orphanage to another, ultimately on their way to survival…
The author, through extensive research of various archives, multiple photographs and sources used, succeeded in exploring the multi-dimensional contributions made by this exceptional generation of women. She accomplished this with objectivity, clarity, and with good writing style. Focusing on the role of Armenian nurses and the North American and Western-trained healthcare professionals, she brought to life their contributions and their role in the history of the Armenian nation and the nursing profession. This book, in addition to focusing on a medical profession, represents a valuable historical document, and is recommended as a resource for both healthcare providers and historians.
Finally, Kaprielian-Churchill brought to light the fact that these “Sisters of Mercy,” as she calls them, or the “Guardian Angels,” as my father called them, made a lasting impression on the Armenian orphans during their dark days. These orphans kept alive their torches of compassion and the spirit of survival. These orphans made a deep commitment to contribute to their communities and/or professions, always striving for excellence, and indeed succeeded in becoming role models to their own children, us all, the communities they served, and to the society in general.