Nurses and midwives

Scholarly essay written by Roxanne Missingham, Director of Scholarly Information Services Division, ANU

Folder 4: 55 folios

Contains original field and studio portraits of nurses, midwives and trainees; and complementary hand-finished dyelines with variations.

In the late 1960s, nursing in Papua New Guinea was a profession that had seen significant expansion in hospitals, often from a low base. The hospitals nurses worked in were a combination of those established by missions, sometimes with additional territory and local government funding, and an emerging government system.

The first nurses’ training school opened in Papua New Guinea in the 1920s. The introduction of certificate training modernised the training available to nurses with the three first certificated nurses graduating in 1952, in Maternal, Child Health and Midwifery, a three-year program. (1)

Initiatives in the 1960s included a Post basic certificate course in Midwifery in Rabaul (1961); a three-year, four-month nursing programme (1964) and the Nursing Council examination system (1968). Perhaps most importantly the extended program of three years and four months was intended to graduate the nurse leaders of the future who would have a national role. (2, 3)

Nursing included Aid Post Orderlies and Nurse Aids, both are reflected in Elizabeth Durack’s artworks (3) .

A reflection of the broader landscape for this period of change can be seen in the growth at Kapunda hospital. In 1953 the hospital was very small, typical of the missionary established institutions:

The hospital staff consisted of 1 temporary English ward sister, 2 Samoan sisters, 4 girls who had reached standard 2 level (year 3 primary), and 4 married men. (4)

By the 1970s, the staff had grown and facilities included the first jet boat in Papua New Guinea and a radio ‘medical sked’, providing advice other mission stations.

Development of nursing was a strong commitment from colonial Papua New Guinea. Jolly and MacIntyre note that:

As Denoon demonstrates the missionaries were as much engaged in saving lives as saving souls and they preceded the colonial state in both Papua and New Guinea in the provision of medical care…the expansion of maternal and child health nursing and nutrition after the war (WWII) increased the opportunities for local women, but female personnel were still seen as under the direction of doctors who were both male and white. (5)

Denoon notes the social idea of Papuan women at a slightly later time: “to train as a nurse, marry the manager of one of the mission plantation complexes, and become part of a productive and therapeutic team”. (6)

The views of Dr Joan Refshauge, the first female doctor appointed by the colonial administration (in 1947) suggested the evangelical (Denoons word) desire to westernise medicine:

Preconceived ideas of ancient origin, doubtful customs based on tradition combined with a stringent economic need, were retarding factors in Administration efforts to implement a simple standard of mothercraft within the civilising influence of the Maprik native hospital. (7)

Marie Reay also observed that the benefits to local women of paid positions were of great value. (8)

A notable example of gender based restriction was the economic and managerial climate for nurses in Papua New Guinea at this time. The Royal Australian Nursing Federation (RANF) Archives at the University of Melbourne reveal an inferior set of circumstances for Papua New Guinea nurses compared to Australia. Cornwallis analyses a report prepared by “Pixie” Annatt after her visit to Port Moresby in mid 1963. As the Assistant Secretary of the Queensland Branch of the RANF, she was committed to quality nursing education and service. Annatt’s detailed investigation reported that:

Nurses were frustrated with the lack of with the lack of professional autonomy – in areas like training and promotion they were being overruled by the Department, and the result was a clear decline in standards of care. Coupled with this were the perennial problems of work in the Territory. Conditions were poor, with equipment and personal amenities in very short supply. Nurses worked for low wages in often isolated areas and had little more than basic supplies and the goodwill of the local population (not always forthcoming) on which to survive. Annatt declared that these problems were creating a desperate situation. (9)

While this furore settled down by the time of Durack’s visit, it confirms the limited power and economic security provided by nursing as a career. In retrospect, the nurses showed great resilience and commitment to a nation where improved conditions and activism, through the development of female leaders, produced a democratising factor desired by the church (10) , in addition to the Australian Government’s desire to “strengthen social affairs” by involving women. (11)

As time has moved on, much still depends on local women nurses in Papua New Guinea. WHO reports that: “Even in 2012 the low number of nurses was remarkable. PNG has low numbers of health professionals per head of population: 5.3 nurses/midwives and less than 1 doctor per 10,000 people. Community health workers comprise almost 35% and nursing officers about 30% of the total health workforce, while medical officers and health extension officers (intermediate level workers bridging the gap between doctors and nurses) together comprise less than 8%”. (12)

Elizabeth Durack’s drawings show young and middle aged nurses and nursing aides. The recording of their names and hospitals provides a circle of women’s faces that transformed the health of the nation and indeed its very hearth. Their strength and commitment ensured better lives for children, women and men, which comes through as quiet determination.


(1) Kettle, E. 1979. That They Might Live. Sydney: FP Leonard.

(2) World Health Organisation. 2013. Papua New Guinea: Western Pacific Region Nursing/Midwifery Databank. Philippines: WHO.

(3) Voigt, Margaret. 2001. “The change from general nurse education to a nursing diploma in Papua New Guinea.” Contemporary Nurse, 10(3-4): 142-146.

(4) Kapuna Hospital. 2013. “History.” Kapuna.

(5) Jolly, Margaret and MacIntyre, Martha. 1989. “Introduction.” In Family, gender in the pacific: domestic contradictions and the colonial impact edited by Margaret Jolly and Martha MacIntyre. Cambridge: Cambridge University Press. p. 5.

(6) Denoon, Donald. 1989. “Medical care and gender in Papua New Guinea.” In Family, gender in the pacific: domestic contradictions and the colonial impact edited by Margaret Jolly and Martha MacIntyre. Cambridge: Cambridge University Press. p. 98.

(7) Burchill, Elizabeth. 1967. New Guinea nurse. Adelaide: Rigby.

(8) Rea, Marie. 1966. “Women in transitional society.” In New Guinea on the threshold edited by E.K. Fisk. Canberra: ANU Press.

(9) Cornwallis, Charles. 2015. Crying in the Wilderness or, Nursing in the Twilight of Australian Colonialism. Parkville: University of Melbourne.

(10) Flaherty, Teresa A. 2008. Crossings in Mercy: the story of the Sisters of Mercy Papua New Guinea 1956-2006. St. Mary's, S.A.: The Sisters of Mercy – Papua New Guinea Region.

(11) Australian Department of Foreign Affairs and Trade. 2006. “272: SUBMISSION, RESEIGH TO BARNES Canberra, 19 May 1969.” In Documents on Australian foreign policy: Australia and Papua New Guinea 1966–1969. Canberra: Department of Foreign Affairs and Trade. p. 769.

(12) WHO and the National Department of Health, Papua New Guinea. 2012. Health Service Delivery Profile: Papua New Guinea