For some time, my mind has been much on refugees. In images: the small boy washed ashore dead on a Turkish beach; the man who walked the Channel Tunnel from Calais nearly to Dover; Germany's welcome and later reaction.
And for a longer time, my mind has been much on refugees of a different generation, who came to Scotland, and who made substantial contributions to different spheres of nursing. Here I would like to share some thoughts on three of these refugees, and invite readers to reflect on what of value refugees might bring and contribute to Scotland now.
Annie Altschul (1919-2001) was one of these remarkable nurses. Annie was the most significant psychiatric nurse of her generation in Britain. Born in Vienna, and expelled (along with all Jewish students and staff) from the University of Vienna after the Anschlauss, she was part of the Jewish exodus from Middle Europe in the 1930s. Arriving in England in 1938, a refugee from Nazi Austria, she worked initially as a domestic, before training as a registered mental nurse. At the age of 80 she expressed her core commitments: 'My passionate concern for those suffering from mental disorder, my affinity with them, and my quest for knowledge about mental illness have never flagged.'
Recognised during the second world war for her role in therapeutic community and group therapy innovations in treatment, Annie was a major influence in the post-war development of UK mental health nursing education and practice. She became principal tutor at Bethlem and Maudsley Hospitals; and completed a psychology degree while working full-time. Her 'Psychiatric Nursing and Psychology for Nurses' were the standard texts for many years. In 1960-61, Annie carried out a pioneering investigation and critical appraisal of education for nursing practice in American mental hospitals ('Rer-ReadingAltschul: a Festschrift'). She returned having 'started on a train of thought' she 'pursued' in landmark research following her move to Edinburgh.
The Scottish phase of Annie's life began with her appointment in 1964 to a WHO-funded lectureship in nursing studies at the University of Edinburgh, where she was professor of nursing studies from 1976-83. Henry Walton acknowledged her bringing 'the concept of the autonomous, self-directed nurse' to her 'huge participation in the local renewal of psychiatry,' including teaching and research at the Royal Edinburgh Hospital and Dingleton Hospital.
Her MSc research (and book 'Patient-Nurse Interaction') seeded a distinctive body of UK psychiatric nursing research. Her wider contributions to public life included membership of the Mental Welfare Commission, and writing openly about her own experience of depression, in her chapter in the book 'Wounded Healers.' Annie's achievements were recognised in her appointment as one of the first cohort of fellows of the Royal College of Nursing, and investiture as a CBE.
She concluded the text she wrote in 1999 to accompany her 80th birthday portrait photograph:
Psychiatric nursing does not lend itself to pictorial representation and so I chose to have this picture taken in my own home where I am surrounded by music and books, and where visitors are always welcome. The painting behind me forms a link with my origins: an Austrian rural dwelling with lilac, horse chestnut and window boxes – a painting which was the sole possession my mother decided to bring with her when she joined me in exile, now over 60 years ago.
Annie is remembered, perhaps uniquely, in both the University of Vienna's 'Memorial Book for the Victims of National Socialism at the University of Vienna,' and 'The Biographical Dictionary of Scottish Women.'
Our next remarkable nurse, Dr Lisbeth Hockey (1918-2004) was born in Graz, Austria. Lisbeth studied medicine at the University of Graz for three years before the Nazi occupation in 1938, intending to become a general practitioner, as she thought that was the path to treating the 'whole person.' When the Nazis entered Austria, her father – a government architect and therefore at risk – sent Lisbeth to London. Later the Nazis identified her parents as Jewish; both her mother and father died in a concentration camp.
In London, Lisbeth was helped by quakers, becoming a governess for children of members of the Wedgwood family. Advised there was no prospect of her continuing medical studies in the UK, she learned sufficient English to begin nurse training. Her training was interrupted: as a non-British subject she could not nurse prisoners of war; she was, however, allowed to train as a fever nurse, due to shortages of trainees in that dangerous field. Lisbeth went on to qualify as a general nurse, health visitor and midwife.
Interviewed later in her life, Lisbeth recalled that her mother had always encouraged her to ask questions. She recalled too her deep frustration, as a trainee nurse, at the resistance she encountered when she asked questions about nursing practice. On one occasion, she asked the ward sister whether something could be done to prevent the severe pressure sores many of the patients suffered. The sister replied 'Go back to your work, if we knew the answer we wouldn't have any sores.'
Lisbeth questioned no further on that occasion. Instead, she began keeping a journal in which she noted the problems she thought needed to be addressed, and her questions about practice. This material later formed the basis for a superb, short book, 'Nursing Research: Mistakes and Misconceptions.'
Chosen in 1962 to coordinate district nurse training in London, Lisbeth extended this questioning approach. Diagnosing a need to determine whether the then-current curriculum for training was still suitable, she proposed and carried out research to answer that question. Recognising the limits of her knowledge of research methods, she did a course in statistics, and later a degree in economics as an evening student.
In questioning practice, and herself as practitioner, Lisbeth became a pioneer of nursing research, and of education to enable nurses to play roles in a research-informed workforce; and was a significant influence on nursing research development in Sweden and Germany. In 1971 she was appointed the first director of the nursing research unit at the University of Edinburgh (the first such unit in the UK and Europe). Thus two refugees from Nazi Austria became colleagues. For over a decade (till Lisbeth's retirement in 1983) they were key figures in the university's substantial influence on nursing, locally, nationally and internationally.
Lisbeth offered generous hospitality to guests and visitors, especially to students far from home and alone in Edinburgh during holidays. I think both she and Annie understood, from experience, the impact of being displaced, and of projects interrupted. Lisbeth had to forgo becoming a general practitioner, but was awarded honorary doctorates in law (University of Alberta) and in medicine (University of Uppsala). In 1982 she became the first (and for 20 years was the only) nurse to be made an honorary fellow of the Royal College of General Practitioners.
Our third remarkable nurse, Rosa Sacharin, was born in Berlin in 1925. She arrived in the UK in 1938 on the first Kindertransport train and boat. A 13-year-old refugee, she travelled to Edinburgh where she lived and worked as a domestic with two families. At 16 she moved to join her older sister in a hostel for Jewish refugees in Glasgow, the city where she still lives.
There, with assistance from a minister's wife, she learned sufficient English to progress through secondary school. Advised to train as a nurse, she found her vocation, training first as a sick children's nurse, and later a general nurse (adults) and midwife. Very focused, and making the most of opportunities available to her, Rosa became a senior nurse teacher and an examiner (nursing), and completed an Open University degree.
Like Annie and Lisbeth, Rosa questioned, challenged and changed then-current practice and authority. For example, instead of nursing child patients in their cots or beds, Rosa sometimes played with them on the ward floor; her example led to change in ward practice. Later in her career, perceiving a lack of suitable books on paediatric nursing, she co-wrote (with M H S Hunter) 'Paediatric Nursing Procedures' and wrote 'Principles of Paediatric Nursing'; the latter was translated into two languages.
In 'The Unwanted Jew: The search for acceptance,' self-published in 2014, Rosa Sacharin tells the story of her life. She contextualises that story by first sketching the history of Berlin and of the Jews in Berlin, and her own family's history. The book has elements of both personal and historical narrative: the title conveys the relationship between those elements.
In the preface, she notes that she wrote the book especially for her two daughters and her grandson. The book conveys the impact of her childhood experiences of distress, separation, and loss, on her later life. She was cared for in Jewish children's homes and a Jewish orphanage from the age of three to 13, following her parents' separation. She recounts the rise of Nazi power and its impact on her family, and on those institutions. Her father was imprisoned on political grounds and later died in a concentration camp. Her brother also died in the holocaust; Rosa spent years trying to establish where. Her mother survived the war in Berlin, joining Rosa and her sister in Glasgow in 1947. She lived near Rosa's family till near the end of her life, severely affected by the traumas she had endured.
Rosa has played important roles in Jewish refugee communities and societies in Glasgow, Scotland and the UK, and in the creation and maintenance of those Jewish communities' archives. She recounts one singularly significant act of memory. Rosa travelled to Germany in 1966 to see the Catholic woman who had been an important carer for her as a child in Jewish care homes in Berlin, who entrusted to Rosa photographs and memorabilia from those homes. In 2000, Rosa donated these artefacts to the then-new Jewish Museum Berlin, where they became part of the exhibits.
In one of her textbooks, Rosa invited readers to consider the experience of a child coming to hospital, and the experience of the paediatric nurse responsible for meeting the child's needs:
It is important to remember that the child has suddenly been uprooted and placed into an environment which is both strange and frightening to him…If the child shows obvious signs of illness, it is comparatively easy for the nurse to be compassionate…Greater difficulty is experienced with the child, coming to the hospital, who is active, resentful and frightened or timid and frightened.
At one stage in her work, Rosa experienced significant difficulties in understanding and responding to the mother-child dyad. She sought help with this from Dr Winifred Rushforth, pioneer of Edinburgh's family- and community-focused Davidson Clinic and Wellspring. The significance of that relationship was deepened when Rosa asked Rushforth to help her mother. Rushforth's intervention helped Rosa's mother find work in a Jewish restaurant and a valued connection with the Glasgow Jewish community.
Rosa brought much of value when she came to Scotland in 1938. She has given – and still gives – much through community, public and professional service. 'The Unwanted Jew' is a unique document and resource for thinking and feeling more deeply about those seeking acceptance: what they may bring and what we may bring to them.
Rosa, Annie and Lisbeth let us see how much potential refugees have to contribute, but their stories also show some of the challenges they faced. They invite us to respond to refugees now in the light of what these women – their lives and work – have taught us, and can still teach us.
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