History of Nursing- Indopak

P. K ChandioP. K ChandioMScN, BScN, DNAM, DTA, M.AMScN, BScN, DNAM, DTA, M.A

Principal Principal

Jinnah College of Nursing KarachiJinnah College of Nursing Karachi

(History of Nursing in India & Pakistan)(History of Nursing in India & Pakistan)

April 7, 2023April 7, 2023 PK ChandioPK Chandio 22

Pre-partition Nursing Pre-partition Nursing

• 1860: Nightingale established first formal and modern nursing school in St. Thomas Hospital London.

• First School of midwives opened by Indian Govt in India.

• Anglo-Indian sisters came in India and promoted the Nursing.


Pre-partition NursingPre-partition Nursing

• 1884: First School of Nursing open in Mayo Hospital Lahore

• Mostly nurses were Coming from England to work in Indo-Pak.

• Mostly Nurses from low-cost-Hindu converted into Christianity were serving.

• Muslims and Hindu girls were not joining the nursing due to their culture.



• Even Nurses from UK and other part of Europe to get training in Indo-Pak.

• Brahmans promoted the belief that if girl touches the other person she becomes a dirty.

• Negative attitude of Anglo nurses towards Muslims and Hindus also prevented the joining nursing profession by them.



• Up to 1934 no any Indian Nurses can admission in Nursing even opening of school in 1884.

• If some Muslims girls wants to join the profession but Anglo nurses refused to give admission b/c of Purda and belief that Muslims could not be good nurses.

• Mostly Schools attached to Mission Hospitals



• Missionary Schools promoting the Religion and were giving admissions to lower Socio-economic Hindu Christians.

• All Matrons/ Nursing Superintendents were Anglo Nurses.

• All schools were running under policy of those Matrons.

• In 1871: an other school were open in Northern India.

• In 1907: Great Number of nurses hired on posts of Nursing Supt. from Europe in India.


Pre-partition NursingPre-partition NursingFrom 1931-1941From 1931-1941

Nurses 7,000 1:43,000

LHVs 750 1:400,000

Midwives 5,000 1:60,000



• Rules, standards, curriculum were outlined for nursing training first time in India-Pak for Mission Hospitals by efforts of Anglo Nurses.

• Civil Hospitals also adopted the standards.

• Most Mission hospitals opened Nursing Schools in all provinces of India and Pakistan.



• Holy Family Hospital and Seven Day Hospitals were also efforts of Missionary.

• According to Werkentin that Mr. Gandhi praised the Missionary services towards tremendous growth in Nursing in India in one Speech.


Role of Military HospitalsRole of Military Hospitals

• 1664: Military Hospitals appointed Nursing attendants with few months training for dressing the wounded soldiers.

• 1888: first time Indian Govt hired British Nurses in Military to lay the foundation of Military Hospitals in India.

• These Nurses started 02 Months training of Male as Attendants.


Role of Military HospitalsRole of Military Hospitals

• 1914: Nurses Recruited by the Queen Alexandra’s Military Nursing Services for India.

• 1927:Received permanent status of Indian Military Nursing (IMNS) in India.

• After 2nd World War I.M.N.S emerged into full independent Nursing services of India


Nursing Organizations Nursing Organizations • 1905: Association of Nursing Superintendents of

India (ANSI), First Association formed. • 1908: Trained Nurses Association of India

(TNAI). Second Association.• Same officers of first Association hold the

executive posts. • These both organization worked separately up to

12 years. Then combined together named TNAI. • 1903: Establishment of Nursing Registration

Council moved and approved in 1909, and began its operation in 1910.


Nursing OrganizationsNursing Organizations

• Firstly Nurses of very few hospitals got registration i.e. Utar Pardesh, Punjab, and Bihar joined.

• But very soon Sindh, NWFP, and Bengal were included.

• 1910: First Nursing Journal was published by TNAI.

• After Publication of Professional Journal TNAI got International Status.



• 1912: TNAI received membership in ICN (International Nursing Council)

• All Nurses who got three years nursing training, recognized by council were entitled as a member of association.

• 1941: Indian Govt opened first Postgraduate College of Nursing in Delhi by the efforts of TNAI.


Nursing OrganizationsNursing Organizations• 1943: The School for Hospital Administration

started.• Proposal of starting the B.ScN program in

universities initiated by TNAI. • 1946 this proposal was passed. • TNAI struggled for opening the central Nursing

Council for India and Pakistan. • 1947: The Act was passed for establishment of

Central Council of Nursing.• 1949: The Central Council of Nursing (CNC) for

Pakistan was established.



• CNC comprised on 33 members. 09 Nurses, 03 Midwives and LHV and others were eminent doctors and educators. It began to function in same year.


Nursing Organizations after Birth of PakistanNursing Organizations after Birth of Pakistan Year ACT Reason for Change

1949 Central Nursing Council Act 1949

To establish a uniform standards of training and certificate throughout country.

1952 Pakistan Nursing Council 1952

Profession was evolving and changes were needed in different such reduction in nursing categories admission criteria for nurses to name a few .

1973 Pakistan Nursing Council 1973

Establishment of examination boards, addition of course in curriculum, inclusion of private schools as a member and re-enforcing the licensing regulation



• TNAI worked up to 1947 in sub-continent. • After independence of Pakistan TNAI Leader

Mrs Salma Tareen Nursing Superintendent of Mayo Hospital Lahore met Chairperson of TNAI Miss Vice France to form independent association with name of TNAP.

• And TNAI Divided and Pakistani part called TNAP and Indian TNAI.

• Total members of TNAP were 55.• First time rules of TNAP were adopted in 1950.



• First President of TNAP was a Mrs Ismat Khanum Shah LHV, and Principal of Public Health School.


History of Nursing in Pakistan History of Nursing in Pakistan

• After independence British Nurses and non-Muslims Nurses left the India and Pakistan.

• Huge gap created in nursing services. • Very small Pakistani nurses were served the

wounded refugees in riots. • On call of imminent political female leaders of

West Pakistan Ms Fatima Jinnah, Rana Begum Liaquat Ali Khan called the women to come out from homes and to serve the Refuges in camps.

• They all lay women served under supervision of trained nurses.


History of Nursing in PakistanHistory of Nursing in Pakistan

• Inspector General Civil Hospitals Punjab started the 02 weeks training to prepare Nursing Assistants after 8TH Class pass.

• 1948: First Nursng School was established in Ganga Ram small private Hospital Lahore.



• Mrs G.M Darrah was first Nursing Tutor up to 1961.

• Mrs Mumtaz Painda Khan first Nursng Superintendent of this school up to 1979.

• First Medial Superintendent of this school was Mr. Shujaat Ali.

• In 1952: first group of 07 girls passed the nursing course from this school.


History of Nursing in PakistanHistory of Nursing in Pakistan• In 1948: Second School of Nursng was

opened in JPMC Karachi.

• This development followed by Bahawalpur, Hyderabad and Multan, Lady Reading Hospital Peshawar, Civil Hospital Karachi, Mayo Hospital Lahore.



• In 1951: LHV Training extended to 02 years, one year midwifery and second in nursing emphasized on community nursing.



1950: CNC passed the rules that:– Two grades of nurses- General Nurse and

assistant Nurse– 17 years age for girl in nursing admission– Unmarried, widowed, divorced and childless

will be preferred in training admission.



– 08 class education, only can read or write the English.

– For Nursing assistant: only can read and write Urdu.

– Male can not take training of Assistant Nurse but take 03 years general nursing after passing Matriculation.



1950: CNC passed the rules that:

• 03 years with 03 months as preliminary training School (PTS)

• Later these points become a part of ACT 1952 Legislature.

• Nursing Assistant can not practice without supervision of Trained Staff Nurse.




• Course comprised on: – Anatomy, Physiology, Medial Surgical

Nursing, Fundamental of Nursng, Hygiene and Sanitation.

– Exam of first year and third year only. – Midwifery certificate included in one Nursng

Diploma Certificate which was separated later in 1960.




• no fixed date for admission, round the year admission was opened for girls due to shortage of nurses.

• Students Nurses were considered helpers and assistants of staff nurses.



• Mrs Wazir got postgraduate training in teaching and administration from India and become first postgraduate nurse teacher in JPMC Karachi. Other Staff Nurses, Matrons were used to teach the students.

• She used to teach 03 times a days to different classes.

• Before Ms Wazir, No separate classes for first, second or third year students, all have use attend class together.


History of Nursing in PakistanHistory of Nursing in Pakistan• Doctor teach medical subjects and nurses

teaches nursing subjects: proposed by Ms Begum Wazir.

• After 1952 Nursing Admission were given in April and November months (Twice a year)

• 1955: PNC abolish the two grades of Nurses, converted into one ‘A’.

• Matric fixed for female instead of 08 class and 08 class for midwives instead read, write Urdu.



Establishing College Level Nursing: • In 1955 college of nursing proposed under

health and sanitaiton programme • This was approved by the help of Govt of

USA. • College was established and affiliated with

Karachi university • This college temporarily placed at Civil

Hospital Karachi.


History of Nursing in PakistanHistory of Nursing in PakistanEstablishing College Level Nursing:• Miss Catherine Hardeman Nurse Educator of

USA, joined this college as a Principal. • Miss Virginia Arnold, chief Nurse of Washington,

and Begum Wazir joined college as a tutor after passing B.ScN from USA.

• One year course formulated with administration and teachng together.

• In 1957 group of seven girls graduated from this college.



Establishing College Level Nursing:• 1959: college was given permanent place in

JPMC Karachi. • After Hardman left her position, Ms DeMara

Took the charge of Principal. • 1959: PNC visits the college• 1963: PNC approved and suggested additions of

coursed in curriculum of college. • In 1966: Ms Begum Wazir become first national

Principal of this college. She was 4th in number of principal.



Establishing College Level Nursing:

• Mrs Imtiaz Kamal returned to Pakistan after passing Master Degree in Nursing and became second national 5th in overall principal of this college.

• 1966: 134 Nurses got graduation this college and involved in teaching all over Pakistan.



Nursing Institutes

1947 1990

School of Nursing

03 69

Public Health Schools

00 07

College of Nursing

00 04



Men in Nursing in Pakistan:

• Lady Reading Hospital Peshawar, Civil Hospital Karachi and Good Shepard Hospital Quetta accepting male students in nursing.

• 1950 TNAP sent recommendation to CNC that Male Nurse also treated equally on pay and facilities to females.


History of Nursing in PakistanHistory of Nursing in PakistanMen in Nursing in Pakistan:

• 1989: there were 66 Male Nurse out of 6389 nurses in country, 85% were in Balochistan and NWFP Provinces. Among 66 one was teacher and 4 were managers.


• When first college of Nursing was opened, male nurses were refused to give add mission. Said by: Mr. Mushtaq

• 1966: College accepted the admission to male.

• Up 1970 Male Nurses were restricted to higher positions of nursing. E.g. Controller, superintendents and principals etc.


History of Nursing in PakistanHistory of Nursing in PakistanMen in Nursing in Pakistan:• After long arguments to PNC and Govt

Male Nurse succeeded to get agreed the Govt for appointments of male on managerial positions.

• 1973: first Male Nurse Mr. Mushtaq became a controller of examination in Sindh.


History of Nursing in PakistanHistory of Nursing in PakistanPakistan Nursing Council:

• In parliament ACT was passed in 1973 to form the PNC with 35 members.

• The president is D.G Health Govt of Pakistan, vice President is Nursing Advisor, Members includes controllers, chief nursing superintendents, principals, LHVs, Midwives and staff nurses.

• Before PNC, there was CNC.


History of Nursing in PakistanHistory of Nursing in PakistanThrough PNC:

– Provincial examination boards established– Formation and uniformity of Nursing

curriculum – Every institute have get recognition of PNC– To check standards of institute and issue

license.



Nursing Colleges: • College of Nursing JPMC Karachi opened

in 1955.

• College of Nursing Peshawar opened in 1988 by Federal Govt from women development fund & ODA, UK.



• College of Nursing Lahore opened in 1987by Punjab Govt & ODA (Overseas Development Authority) was affiliated with Hillington Health Authority London.

• College of Nursing Jamshoro opened in 1998 by FHP & DWHP.

• College of Nursing PIMS Opened in 1991 by JICA.


History of Nursing in PakistanHistory of Nursing in PakistanMiltary Nursing Services of Pakistan:• Miltary Nursing Services of India up to 1947.• started Nursing Auxiliary training to male in

Mayo Hospital Lahore and Holy family Hospital Rawalpindi for soldier in Miltary of Pakistan in 1948.

• PAFNS ACT 1952 was passed and gave rank of commissioned officer to a Nurse.

• In 1959 formally given status of Lieutenant to a Nursing Sister in practical.


History of Nursing in PakistanHistory of Nursing in PakistanMiltary Nursing Services of Pakistan:• In 1956 Miltary Hospitals started Nursing

Training itself. • Firstly 06 Months PTS training was started

CMH Lahore, after that 06 Months they transferred to CMH Rawalpindi for three years General Nursing.

• In 1950 Operative Nursing and Intensive Nursing was started, this course was for 06 Months.


History of Nursing in PakistanHistory of Nursing in PakistanMiltary Nursing Services of

Pakistan:• Due to shortage AFNS hired the Colonel

Maudsley from London who took charge of Chief Principal Matron in 1962.

• She served a lot in Nursing.

• She was appointed as a first Director of AFNS Pakistan in 1965.



• In same year 1965 Colonel Maudsley retired and charge of Director has been given to colonel M.F Qureshi first Muslim on this seat.

• It was first time in history that Muslim Nurse has been given higher position.

• In war of 1965 with India, Nurses has been awarded with meritorious awards and medals on their services.



Miltary Nursing Services of Pakistan:• In war 1971 With India, AFNS Worked a lot and

seven Nurse Officers held by India as a Prisoner • These prisoners has been given physical and

mental torture by Indian Army. • Major Salma Mumtaz (Nurse Officer) has been

awarded with “Florence Nightingale” and promoted as a Colonel position on braveness and pivotal services.



Miltary Nursing Services of Pakistan:• In 1978, due pivotal services of nurses in wars, the rank

of Brigadier has been given to Director of AFNS. • Brigadier is second highest position after General in

Army. • Colonel Safdri Beg was given the post of Brigadier first

time in AFNS in 1978. • In 1982 Brigadier M.B Chugtai become a Director of

AFNS and PNC awarded permission for B.ScN training in AFNS.

• In 1982 AFNS launched a Journal for Nursing Issues. • In 1986 Brigadier Nusrat took charge of AFNS.


History of Nursing in Pakistan History of Nursing in Pakistan Pakistani Nursing Leaders:Begum Rana Liaquat Ali Khan:• She was a Midwife basically • She was a wife of former Prime Minster of

Pakistan.• She was first Lady Governor of Pakistan.• She also assumed the job of Ambassador of

many European countries. • She was president of all women's’ association of

Pakistan • She was patron-in-chief of TNAP from 1950-

1980



Pakistani Nursing Leaders:Mrs Imtiaz Kamal:• She is daughter of a Barrister • She belongs to very well-to-do family • She entered in nursing at St.Giles Hospital London. • She remained a Principal of College of Nursing

JPMC. • She wrote a book on family planning and she also

get published her Scientific Research Articles. After retirement she joined WHO on very big position.



Pakistani Nursing Leaders:Begum Wazir Ali • She Got Diploma in Nursng from Delhi in 1936.• She got B.ScN from U.S.A as a first Pakistani Nurse. • She got post graduation from India as a first

Pakistani Nurse.• She remained a first Pakistani postgraduate Nursing

TUTOR in College of Nursing JPMC. • She remained a First Pakistani Principal of college

of Nursing JPMC.



• Pakistani Nursing Leaders:

Mrs Nisab Akhtar

• She worked as General secretary of PNF.

• She got training from Wales England in 1949.

• She took charge as Administrator of many nursing institutes in Pakistan.



• Pakistani Nursing Leaders:Mrs Kaneez Moula:• She is Nursing Leader from 1965-1985.• She served as a Nursing Advisor of Pakistan, and

she has a title of longest served as a Advisor of Nursing.

• She completed M.A in History from Calcutta University in 1947.

• She got Nursing and Midwifery Training from England

• She got Pride of Performance of Govt of Pakistan on Nursing Services.


History of Nursing in PakistanHistory of Nursing in PakistanPakistani Nursing Leaders:Mrs Khadija Mushtaq: • She served as a first National Principal of

College of Nursing Lahore. • Her father was a lawyer, Politician, Active

member of Muslim League. • She was responsible for care of wounded

Refugees after during partition. • She got Nursing Training from England in 1949. • She got “Pride of Performance” Award by Govt

of Pakistan on outstanding services in Nursing.


History of Nursing in PakistanHistory of Nursing in PakistanPakistani Nursing Leaders:

Mr. Mushtaq: • He got Training of Nursing in 1948 from

School of Nursing Civil Hospital Karachi. • He served as a first and Male Controller of

Sindh Nurses Examination Board Karachi in 1970 for seven years.

• He got Prograduate in Nursing from College of Nursing.



• He was honored with academic excellence Award in Diploma in of Nursing.

• He served as a President of PNF.

• He served as a Editor of Journal of Nursing and Health Review

• He currently serving as a Principal of School of Nursing Zia-ue-ddin University Hospital Karachi.


History of Nursing in PakistanHistory of Nursing in PakistanPakistani Nursing Leaders:

Miss Illmya Mughal:

• She got Nursing Training from Liaquat university Hospital Hyderabad.

• She got Post graduation from College of Nursing JPMC Karachi.



• She served as Nursing Instructor, Nursing Superintendent, Controller Nursing Board Sindh. Principal College of Nursing Jamshoro, and Director of Nursing Sindh.

• She has been awarded with Pride of Performance by President of Pakistan on her good services in nursing.

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