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 The American 
 Hospital for Women and 
 Children in Madura 
 
 1 
 
 By Rf.v. E. S. Holton 
 
 WOMAN’S HOARD OF MISSIONS 
 
 14 BEACON STREET 
 BOSTON 
 
 I9I9 
 

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 mi::. 
 
 THE AMERICAN HOSPITAL FOR WOMEN 
 
 AND CHILDREN IN MADURA 
 Dr. Harriet E. Parker 
 
 By Rev. E. S. Holton 
 
 T HE ancient city of Madura is on the tenth degree of north 
 latitude about 150 miles north of Cape Comorin. The 
 word “Madura” means sweetness, from a dew of honey 
 fabled to have once settled there. But to thousands of women 
 during the past twenty years it has meant relief from pain, suffer- 
 ing and numbing fear, since it is there that the little white Doctor 
 Ammarl is ready night or day to bring to bear upon any sort of 
 physical ill the skill of her slender fingers, the experience of an 
 active brain and the courage of a dauntless heart. 
 
 There are hospitals for women in Madras and at Vellore in 
 the North Arcot district, 150 and 300 miles north of Madura. 
 But they are as impossible for the bulk of the people that have 
 need as the hospitals in New York would be for the natives of 
 Virginia. In the districts of Trichinopoly, Madura, Ramnad. 
 Tinnevelley and Travancore, a region about half as large as 
 New England and with a population of fifteen millions or twice 
 that of New England, there is no other mission hospital for 
 women and no other woman doctor. There are government 
 or municipal hospitals for women and children, but these are 
 staffed with male doctors; since the drain of the war many of 
 these are Indians. Owing to the seclusion of women and the 
 prejudices and customs of the land only the very poorest women 
 or those in the immediate vicinity will come to such a hospital. 
 
 Medical work for women was begun in Madura city by the 
 late Mrs. S. B. Capron and through her earnest endeavors a 
 dispensary was built and Miss Pauline M. Root, M.D., was sent 
 out by the Woman’s Board in 1885. She began the erection of 
 a small, two-story hospital but left India in 1891 before its 
 completion. It was dedicated in 1893. Dr. Harriet E. Parker 
 was appointed as her successor and arrived early in 1896. Dr. 
 Parker was born in Putney, Vermont. She studied at Smith 
 College, 1885-1887, and is a graduate of the Woman’s Medical 
 College of Philadelphia. 
 
 3 
 
The city of Madura was built originally as a fort with the 
 great Hindu temple of Meenachi, the Fish-eyed Goddess, at its 
 center. A second center is the great palace of Tirumal Naiyak 
 about one-half mile southeast of the temple. The American 
 Mission compound is due east of the palace, with only one 
 narrow block of one-story houses between. Thus the new 
 hospital for women and children is built on the corner of the 
 compound immediately opposite the main entrance of the fine 
 old palace that Government has repaired, restored and taken 
 over for public offices. 
 
 The new hospital, which is of brick and steel with hollow tiled 
 floors, is in the shape of the letter E, with the front towards the 
 West. It is two stories high and the foundations will permit a 
 third story whenever that may be needed. The government 
 generously made a half-grant on the cost of the building and 
 allowed the Executive Engineer of the Public Works Department 
 to supervise its construction. The Mission put the erection of 
 the buildings into the capable and experienced hands of its 
 treasurer, Mr. James H. Lawson, and whenever he has any dis- 
 agreement with the contractors over the quality of either mate- 
 rials or workmanship the decision of the Executive Engineer is 
 final. The hospital plant has also been greatly benefited by the 
 generous counsel of a fine Christian gentleman, Mr. S. D. Pears 
 of Madras, until recently chief engineer to the government in 
 the department of Public Works. All the plans and construc- 
 tion of modern hospitals in Southern India, civil and mission, 
 were carefully considered while our plans were being drawn and 
 revised. 
 
 The hospital is so built that it can easily be kept clean and 
 disinfected without and within, below and above. The stairs 
 are broad and of easy grade so that stretcher cases may be 
 moved up and down easily. One wing is reserved for maternity 
 cases. There is an isolation ward and one for convalescents. 
 The morgue has a building quite apart by itself as far removed 
 as possible from all others. A septic tank is being installed. 
 In a land where there is such strictness in the observance of 
 caste regulations the diet-kitchen arrangements are not simple. 
 A Brahman woman or child may eat only food prepared by a 
 Brahman cook in quarters not used by lower castes, so a separate 
 kitchen is supplied for them. The Sourashta or Silk-weaver 
 
 4 
 
caste has endowed a ward and a kitchen for the use of its own 
 people. 
 
 The Nurses’ Home is in a long wing at right angles to the 
 Doctor’s bungalow, fifty or sixty yards to the rear of the hos- 
 pital. The training of nurses is an important part of the work 
 of the hospital and candidates are sent by Missions in other 
 districts. In a country of such dense ignorance and gross super- 
 stition very little dependence can be placed upon the intelligence 
 or judgment of either the patients or their attendant relatives. 
 Instructions are but imperfectly understood and are not thought 
 worth the trouble of remembering or obeying. The magic 
 Western medicine is the thing. If a little does good, more will 
 do it quicker and better and allow the patient the sooner to get 
 back to a festival, funeral, wedding, or to the domestic tasks 
 in house or field. A medicine may be prescribed for external 
 use only, but the pain is inside and the magic can get to work 
 sooner and more effectively, it is thought, if put within — often 
 with surprising and disappointing results. Moreover the Dra- 
 vidian ideas of sanitation or even of simple cleanliness are almost 
 always rudimentary and hostile to any improvement in the 
 patient. So while a relative or two has to be allowed to stay by 
 the patient to help care for her and to reassure her timid mind 
 in strange surroundings, a trained nurse has to be in constant 
 attendance to see that the doctor’s orders as to rest, medicine 
 and food are obeyed. A common danger is that a zealous 
 friend will smuggle in bazaar-food, long-cooked and exposed to 
 flies, dust and indiscriminate handling — often of the utmost 
 danger to the patient, especially in the time of epidemic cholera. 
 
 India is yet a century from the general acceptance of the germ- 
 theory of disease. It is much simpler to believe that Kali- 
 Amman, the smallpox goddess, is angry and demands victims 
 rather than that germs from the patients cause others to be ill! 
 Garlands across the street and sacrifices to her idol are to their 
 minds much more useful than the dreaded vaccination. What 
 cannot be seen does not exist, seems to be their simple creed. 
 Such patients and their village sympathizers obey hospital rules 
 generally only under the fear of being sent away. Many are 
 the anxieties of the doctor lest bandages be removed too soon 
 because uncomfortable, or patients insist upon leaving pre- 
 maturely because homesick or tired of restraint. Too often any 
 
 5 
 
reason save the right one is given when a case thus turns out 
 unfavorably. But experience is a dear teacher and a good part 
 of the nurses’ work is to warn obdurate patients of the dire 
 results of disobeying what the Doctor Ammarl has said. 
 
 India is a land of such brilliant sunshine and of so very little 
 protection to the eyes from glare, dust and infection from the 
 minute swarming eye-flies, eager for the moisture of neglected 
 eyes, noses, and mouths, that eye-troubles are very common, 
 ranging from ophthalmia or “country sore-eyes” to glaucoma, 
 granulated lids and cataract. 
 
 After harvest time the women and girls walking bare-footed 
 over the woody stubble cut their feet badly and the wounds 
 bound up with soiled rags often become infected sores. Scanty 
 and improper food often aggravate what would be otherwise 
 simple cases. Malignant ulcers often result from unclean lives. 
 Reliance upon quack doctors, with their worse than useless 
 remedies and incantations, often result in a patient coming 
 either too late or needlessly ill to the place where alone skill and 
 the right remedies are available. 
 
 But in this respect conditions are steadily improving. With 
 thirty or forty thousand treatments a year or possibly twelve 
 thousand separate patients, ideas and treatments learned, or at 
 least partially understood, while in the hospital, are carried back 
 to their homes by patients who have been helped. These new 
 ideas are given currency at the village well, at the community 
 threshing-floor, or during the long walks to the weekly markets 
 where grain and fuel are taken to exchange for the week’s supply 
 of curry stuffs and oil. The Bible-women assigned to the hos- 
 pital tell the Gospel message to the patients waiting at the 
 dispensary for their treatment and mingle freely with the con- 
 valescents. So the knowledge of the “new way” is brought to 
 thousands of lives through the ministry of suffering. 
 
 Some peculiar ideas are current among the people. Often chil- 
 dren are to be seen with three horizontal scars across the abdomen; 
 these show that during an attack of colic the sufferer was branded 
 with a hot iron. She recovered; post hoc ergo propter hoc. 
 Among the Romanists this branding is usually done in the form 
 of the cross or sometimes by four dots on forehead, chin, and 
 both cheeks. An ancient dame comes along with a great recital 
 of ills and ailments, from wandering pains and sleeplessness to 
 
 6 
 
coolness of the blood and cc a sort of a kind of feeling” winding 
 up with a rat-bite. 
 
 “When were you bitten?” promptly queries the doctor. 
 
 “Seven years ago last mango time,” the dame replies. And it 
 appears that as many ills spring from the bite of a rat as from 
 the breaking of a looking glass in more enlightened lands. 
 
 One day, out in a distant village, a farmer brought his mare 
 with both eyes blinded by cataract and his old sister with two 
 joints missing from her middle finger ever since she was born 
 and asked that both be made whole! An old man comes and 
 drops dejectedly at the door step and when asked his ailment 
 he says, “Butthi illai!” (I have no sense). While the doctor 
 has the greatest sympathy with his need the pharmacopeia lists 
 no remedy for his cure. 
 
 The doctor in India meets many abnormal growths and un- 
 usual perversions of Nature’s orderly ways; but their recital 
 would be more appropriate in a medical journal. One inter- 
 esting disease, known the world over as “the Madura foot” is 
 peculiar to the district. It is a form of elephantiasis where, first 
 in the foot then the ankle, but never higher than the knee, the 
 foot swells until it is the size of a twelve-quart pail and the toes 
 are swallowed up until they appear to be but warts. There is 
 no remedy for it but amputation; ordinarily the sufferer endures 
 the burden for a long time before willing to submit to treatment. 
 
 The Visitors’ Book, maintained at the hospital for officials 
 and others to record their impressions of its work, has many 
 interesting records. Some of the most flattering were written 
 by the governors of the Madras Presidency — Lord Wenlock, Sir 
 Arthur Havelock, Lord Ampthill, Baron Carmichael and Lord 
 Pentland, often by their Ladyships as well. The Surgeons 
 General and district medical and sanitary officers, while pointing 
 out occasional lack of equipment, have uniformly praised the 
 good work they have found done. 
 
 Both the Madura Municipality and the District Board have 
 generously supplemented the Government’s grants-in-aid by 
 annual donations from their budgets. The Lessees of the 
 Sigaganga Zemindari have for years made an annual grant to 
 the Hospital from their Mahimai Fund which is a regular portion 
 of their yearly income devoted to charity and religion. But all 
 these grants total only about one-sixth of the hospital’s yearly 
 
 7 
 
expenses. This means that, in addition to the doctor’s consti- 
 tutional unwillingness to miss a single opportunity to save life 
 or alleviate pain, there is added this stress of supplementing the 
 hospital’s income by outside practice. 
 
 Until Dr. Parker was able to replace her horse and carriage 
 some four years ago with a Ford car, she was extremely for- 
 tunate if an emergency call took her most of the way by railway. 
 Only very rarely was the husband or father of the patient able 
 to send his own car or hire a reliable one. The doctor has had 
 many experiences with ill-found cars, balky or under-fed jutka 
 ponies, and long journeys over rough country roads in bullock 
 carts with a cruising speed of two miles an hour. A tiffin-basket 
 and thermos flask, or' a humble earthenware water jar, were 
 necessary parts of her equipment along with instrument bag, 
 medicine chest, toilet case, and, if the conveyance permitted, a 
 nurse. The car has more than doubled her effective radius 
 beside allowing her many more nights of sleep at home. A new 
 one should be supplied soon to replace the much-used old one. 
 
 Many people living in remote parts of the District never have 
 seen a railway train, a motor car, or a horse-drawn vehicle. 
 Such folk learn to suffer uncomplainingly and never realize that 
 by a few miles or hours of journey they could gain relief for them- 
 selves, their wives or children. Dr. Parker enjoys nothing 
 better than to go on a medical tour to visit such regions. Us- 
 ually she joins with some district missionary who can furnish the 
 necessary tents and transportation Notice is sent on before 
 to the weekly market or to some central village that on a given 
 date the white Doctor Ammarl is coming and will freely treat all 
 pain and illness. Hundreds will come, men, women and chil- 
 dren, and gather under the trees near her tent; the missionary 
 and his helpers will preach to them while awaiting their turn 
 with the doctor. Scores of minor troubles are relieved imme- 
 diately; the severer cases are sometimes persuaded to make the 
 long journey to the hospital where they may have the further 
 care that is necessary. 
 
 One of the most terrible diseases of India is leprosy, the only 
 one that Dr. Parker confesses she fears; so it was characteristic 
 of her to volunteer to open an asylum for those afflicted with this 
 malady when there seemed no other way to secure one. Under 
 the easy rule of England the attendance is purely voluntary; 
 
great numbers prefer to haunt the cities and large towns, or 
 beat their way from shrine to shrine, festival to festival, to 
 gather the generous alms which it is a part of the Hindu religion 
 to bestow indiscriminately. The Edinburgh Leper Aid Society, 
 the Government and the Sivagange Zemindari gave grants-in-aid 
 to erect the necessary buildings and sink the wells at Daiyapuram 
 (Village of Mercy) on a wide, wind-swept, treeless plateau a 
 mile out of Manamadura. There for ten years a growing work 
 of mercy and healing has been carried on. 
 
 Strange as it may seem the American army surgeons in the 
 Philippines discovered, used and reported a cure for leprosy — 
 chanmoogra-oil — which injected intraveinously has the power 
 to arrest the ravages of the disease. Dr. Parker is very reserved 
 in her claims as to results obtained, but when the disease has not 
 advanced too far before treatment is begun, most cases show 
 marked improvement; many have been sent back to their homes 
 without any signs of the disease and without recrudescence. 
 Many a sufferer has found the Great Physician and entered into 
 a new life through the ministry to the body, mind, and soul at 
 Daiyapuram and, like the lepers of old, have gone back to their 
 homes to witness to His power and grace. 
 
 This institution requires a visit at least once each week by the 
 doctor-, involving a thirty-mile railway journey for herself and a 
 nurse, with two miles by bullock cart, and the return journey 
 late the same night. The physical labor of giving one hundred 
 or more sterilized intraveinous injections at one clinic is in itself 
 a great task. But with the exception of the American missionary 
 nurse the doctor has never entrusted them to anyone else. The 
 utmost precautions as to dress and contact have to be observed 
 to prevent contagion that would endanger herself and others; 
 this makes an added strain. 
 
 There remains the Birds’ Nest, the doctor’s one diversion. It 
 is really a private orphanage which has grown out of the con- 
 junction of the unloved and abandoned babies and the doctor’s 
 tender heart. All are legally adopted by the doctor. Only she 
 herself can tell how many have learned to call her “Mother- 
 Doctor” in the past twenty years that she has had a residence 
 outside the hospital building itself. Several have succumbed 
 to starvation or to the diseases which they had suffered before 
 they came under her care. Some had all too poor a start in 
 
 9 
 
their ill-assorted parentage and could not weather the usual ills 
 of childhood, even though the utmost care was lavished upon 
 them. Without actual count a casual friend would say that 
 they number now about twenty, not including one of the eldest. 
 Miss Grace Kennett, who, in 1918, returned from her medical 
 studies in Madras a licensed practitioner. She is proving to be 
 an immense help to the doctor in the care of the hospital. Nor 
 does it include Compounder Margaret, plump, smiling and 
 efficient, a great help in shepherding the little flock of Birds’ 
 Nesters who might otherwise overwhelm the doctor while off 
 duty and relaxing in the midst of her happy, bare-footed, smiling 
 family. 
 
 The Nest itself is a series of rooms at the rear of the doctor’s 
 bungalow where a matron cares for the children as they eat, 
 play and sleep on the floor in true Indian style. All attend the 
 day school from earliest school-going age, and such as can benefit 
 by it are sent to the higher schools to fit them for useful lives. 
 Two of the younger boys are albinoes with pinkish white skins 
 and weak eyes that will never have normal vision. It is natural 
 from the prejudice of the people against girls that in the Birds’ 
 Nest the girls outnumber the boys about three to one. 
 
 When the record of India’s redemption is completed it may 
 prove that the little Doctor Ammarl with her Hospital,, Leper 
 Asylum, Birds’ Nest and medical itineracies out in the neglected 
 corners of the District, will have counted for more than some of 
 the better known and more amply financed agencies. It is difficult 
 to imagine a work where an investment of help will yield larger 
 returns. 
 
 Note: Rev. Mr. Holton is a missionary of the American Board in the Madura 
 Mission who has first-hand knowledge of the Hospital at Madura and of Dr. 
 Parker's self-denying work. 
 
 The Editor. 
 
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