The VNA of Boston story continues...

The next installment from Rebecca:

In this posting, I continue to share the historical insights I’ve been gleaning from reading Annie M. Brainard’s 1922 book, The Evolution of Public Health Nursing.

Social Reform in Elizabethan England and the Reformation of the Church

Beginning in the mid-1500s, monasteries, which had been providing care and support for the poor and sick in England for centuries, were dissolved under the English Protestant Reformation. The first Poor Laws, a system of taxation to alleviate the suffering of the “deserving” poor, were put into place by Elizabeth I in 1601. Thus in England, the care of the poor was no longer an individual problem dependent on charity, but had become a national duty. The poor laws were eventually abolished in 1948 when the British National Health service was established.

In the early 1600s, European countries began to emerge from the chaos of the Middle Ages and with that came a renewed recognition of the inequality between the wealthy and the poor. In France, the religious orders were still the primary distributors of charity for the poor, but after the Reformation there was more freedom for the charity to be independent of the strict structure of the monastery system.

In 1633 Vincent de Paul, a German priest, formed a group named the Daughters of Charity, Servants of the Sick Poor. They were a community of women who took simple, private annual vows, were not cloistered, and dedicated their lives to visiting the sick poor. Brainard sees in this group the start of a more organized and systematic approach to the care of the sick poor. de Paul found that while many wealthy women were eager to be of service, they did not really have the skills to care for the sick. He found that all too often they would send their servants in their place, and as such were essentially buying the benefits of charity work. He introduced the idea that charity didn’t have to be the work of just the wealthy, but even those of humble means could partake. He originated the idea of drawing women from the peasant or laboring classes who were desirous of serving their community and who were better suited than their wealthy counterparts to the labor of charity. He oversaw the work of the group, introduced standardization of processes and held regular meetings to stay informed of the caregiver’s progress. de Paul was the first to say progress could not be made without understanding the root causes of poverty and that just giving money to the affected person or community was actually a barrier to self sufficiency.