Byng on Grypma, 'Healing Henan: Canadian Nurses at the North China Mission, 1888-1947'

Sonya Grypma
Adrienne Byng

Sonya Grypma. Healing Henan: Canadian Nurses at the North China Mission, 1888-1947. Vancouver: University of British Columbia Press, 2007. 292 pp. $93.95 (cloth), ISBN 978-0-7748-1399-0.

Reviewed by Adrienne Byng (University of Waterloo) Published on H-Canada (April, 2009) Commissioned by Stephanie Bangarth

Navigating Identity, Understanding Place: Deconstructing the Role of Canadian Nurses at the North China Mission, 1888-1947

Through her examination of the contributions made by Canadian missionary nurses to the development of the healthcare system in the province of Henan, China, medical historian Sonya Grypma makes an important contribution to the history of missions and medicine in both Canada and abroad. A product of the “new historiography” of nursing, which emphasizes the study of “ordinary” lives over heroic biographies, Grypma’s examination adds considerably to the scant research conducted on the work of Canadian nurses in Chinese missions. Predicated on a wide array of public and private sources, Grypma analyzes sixty years of missionary nursing to contextualize Canada’s role in the missionary era, the culture of missionary nursing, and the globalization of modern nursing. Restricted to an examination of the North China Mission (NCM), Grypma analyzes the personal, professional, and religious aims of thirty Canadian nurses commissioned by the Women’s Missionary Society of the United Church of Canada (WMS), in order to understand their contributions to the creation of a cross-cultural nursing practice. Bounded between the years of 1888 and 1947, Grypma analyzes how the interplay of professional nursing with issues of religion, gender, culture, health, and nation shaped the approaches of Canadian nurses to their work and the creation of a malleable nursing practice that was neither fully Canadian nor Chinese.

To demonstrate the evolutionary nature of missionary nursing, Grypma organizes her chapters chronologically, using significant sociopolitical crises as markers to define each period of study. By employing this approach, she effectively demonstrates how the work of Canadian nurses tied to the NCM was shaped by periods of antiforeign uprisings, national revolution, warlord rule, imprisonment under the Japanese, and civil war. Divided into seven chapters, Grypma’s examination outlines how Canadian nurses collectively developed an ideal of nursing practice that evolved out of a web of tensions existing between the NCM, the United Church of Canada, the National Association of Nurses, and the government of China. With considerable attention paid to the friction existing between evangelical and nursing aims, Grympa’s chapters are connected thematically in that they chart how missionary nurses successfully navigated discourses of difference to create a vision of professional nursing that tempered cultural and national displays of superiority, emphasized collaborative unions between physicians and nursing staff, and encouraged the adoption and adaptation of modern hospital care by the Chinese.

To contextualize how the Canadian missionary nursing movement influenced the development of healthcare in Henan, Grypma begins her examination with a detailed discussion of the nature of early missionary nursing. Based on an analysis of memoirs and the unpublished history of the NCM, she describes how the development and success of nursing practice was circumscribed externally by Chinese attitudes toward foreigners and internally by the first generation of nurses who remained committed to a missionary, rather than a medical, agenda. Noted by Grypma in her second chapter, this situation was reversed between 1901 and 1920, following the gradual acceptance of the missionary presence, the establishment of the Nurses’ Association of China (NAC), and the arrival of a second generation of nurses who exhibited an increasing commitment to a vision of modern nursing and medicine. These themes remain consistent throughout her third (1921-27) and fourth chapters (1928-37), which attribute the continued operation of missionary nursing to funding provisioned by the WMS, the establishment of a national and international professional nursing network by NAC and the International Council of Nurses, and the allocation of human resources by the NCM for the purpose of establishing modern hospitals.

In her last three chapters, Grypma’s narrative is modified, becoming one of fragmentation and regression. In her fifth chapter, she examines the brief interlude leading up to the Sino-Japanese War (1939-45) and assesses its impact on the organizational and physical structures established by missionary nurses. Divested of modern medical equipment, access to state-of-the-art hospital buildings, and carefully designed curricula, Grypma argues that by 1940 the clash between Chinese and Japanese soldiers had transformed missionary nursing into a profession “on the fly” (p. 161). Despite their exile, Grypma notes in her sixth chapter that missionary nurses continued to feel a sense of belonging and deep-rootedness, which continued to structure their experiences and the execution of their work throughout the course of the Second World War. While this collective sense of belonging was sufficient for the continued practice of missionary nursing, Grypma demonstrates in her seventh chapter that it was insufficient for maintaining them under the chaotic conditions of war and in a postcolonial nation that was in the process of reinventing itself as an exclusively Chinese Communist Republic.

Exceptionally well written and researched, Grypma's book presents a compelling and comprehensive examination of an important period in the development of Canadian missionary nursing. Despite the narrative’s lack of information on Chinese nurses and students, Grypma’s study is useful in that it stimulates a more nuanced discussion of the role of Canadian nurses’ missions’ history and the history of medicine in Canada and abroad. In contrast to previous scholarship written on the subject, she challenges the belief that missionary nurses held an imperialist agenda, subverted Chinese self-determination, and sought primarily to evangelize. Nor does she subscribe to the interpretation that Canadian missionary nurses aligned themselves more closely to internationalized, professional ideals at the expense of nationalized, church ideals. While there was a clear division between early missionary nurses, who focused on evangelism to the virtual exclusion of nursing service, and post-1920 nurses who reversed this pattern, Grypma demonstrates how NCM nurses found room for both approaches. Similarly, she does not believe that the phenomenon of Canadian missionary nursing can be categorized as a failure. While she acknowledges that Canadian missionaries failed in their attempts to Christianize China, to develop a sustainable system of modern medicine and nursing, and to reestablish mission interests after the Second World War, Grypma asserts that the frustration of these aims are only part of the story. Despite the permanent closure of the NCM in 1947, the continued presence of the Christian church established by Canadian missionaries and the provision of Western medicine and modern nursing services suggests that Canadian missionary nurses were successful, albeit in unanticipated ways. While some readers may find her conclusions contentious, as a result of her source base, Grypma’s seminal examination of the role played by Canadian nurses in northern Chinese missions will enliven the debate concerning the nature, motivations, and impact of missionary nursing.

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Citation: Adrienne Byng. Review of Grypma, Sonya, Healing Henan: Canadian Nurses at the North China Mission, 1888-1947. H-Canada, H-Net Reviews. April, 2009. URL:

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