From old wives & witches to nurses & doctors

In a rare 1975 television Interview, the French feminist icon and author of The Second Sex (1949), Simone de Beauvoir, in trying to give a concrete example of how in every era, women have been banned from productive work so that men could control everything, said:

During the Middle Ages and the Renaissance, female physicians had a lot of power. They knew all about remedies and herbs… which were sometimes of great value. Then medicine was taken away from them by men. All of the witch hunts were basically a way for men to keep women away from medicine and the power it conferred. In the 18th and 19th centuries, statutes were drafted by men that prevented women… from practicing medicine unless they had attended certain schools, which did not admit them anyway!

Admittedly, such ridiculous circumstances were not easy to overcome. But we all know about a woman who did defy 19th century medical conventions and went on to become the real hero of the Crimean War (1853-56) – the English nurse Florence Nightingale, re-christened ‘Lady with the lamp’ by grateful soldiers whom she healed and attended to even at night. Nightingale, as is well known, professionalized nursing for women and introduced hospital reforms in Victorian England – both of which had a great impact worldwide. A generation later, mainland Europe witnessed the emergence of two other women pioneers in medicine, who went further in their careers to become practicing doctors, while also embracing wider women’s causes in their long and eventful lives – the German Franziska Tiburtius (1843-1927) & the Dutch Aletta Jacobs (1854-1929). They were not only contemporaries in time, but also led unconventional lives that mirrored each other in many respects.

aletta jacobs1

Both grew up in small towns and came from large families – Franziska was the 9th child and Aletta the 8th of 11 children; both had a bad schooling experience – one at the hands of a harsh German governess and the other at a Dutch ladies’ school; both faced problems entering medical school; for both, England played an important role – Franziska studied there for a while and Aletta visited the city in 1879; both focussed their energies as medical practitioners on treating the urban poor, especially women; and both became involved (perhaps inevitably) with the women’s movement. In their individual trajectory, Zurich and Berlin (for study and practice) were to Franziska what Groningen and Amsterdam were to Aletta.


Franziska: “uncertifiable”, but not unsung

While both the women achieved what they did because of their singular determination, unlike Aletta, who was inspired at a very young age by her physician father, Franziska had to traverse a rather long and circuitous path before she found her calling. She worked for six years as a governess before turning to teaching – the only two professions available for ‘respectable’ women in her time. She was studying in Britain when she was suddenly called back home to care for her brother, who had contacted typhoid in the Franco-Prussian War (1871); and it was while nursing him back to health that she decided to become a doctor. She enrolled at the University of Zurich and graduated in 1876 at the age of 33!

tiburtius1For her practice, she chose to stay in Berlin with her doctor brother, but had to face unremitting gender discrimination as a practicing physician. Supported by her brother and sister-in-law (who was herself a dentist), Franziska opened a Charity Clinic for workers’ families with her friend Emilie Lehmus, whom she had met at the University of Zurich and with whom she would form a long medical collaboration. Their clinic – The Berlin Clinic of Women Doctors – initially faced both public hostility and the reservation of male physicians, but they persisted in their efforts and it eventually continued for 15 years, creating an unprecedented history and inspiring a new generation of German women to follow their example.

It is hugely ironic that though a pioneering figure, Franziska remained an “uncertifiable” doctor till the end of her life. She had a medical degree from Zurich, but in order to practice in Berlin in Imperial Germany, she needed a certification from the German government. But as it happened, women were not allowed to take the German state medical certification examinations, with the result that they had to practice without an “official” acknowledgement of their degree. This rule was finally changed in 1899, but Franziska refused to take the exam when it did. She was 56 then and had practiced for more than two decades; she found no reason to prove her credibility anew!


Aletta: International Leader in Health, Suffrage, and Peace

Aletta Jacobs was the first woman to earn a medical degree and the first female physician in The Netherlands (her application at the University of Groningen being accepted only after Prime Minister Thorbecke intervened on her behalf). However, her achievements went much beyond medicine. The title of her autobiography – Memories: My Life as an International Leader in Health, Suffrage, and Peace – very aptly sums that up. Though the fight for women’s suffrage and peace activism would take up all her energy in the second half of her life, as a young doctor in Amsterdam, it was to questions of women’s health that she devoted most of her attention – her most singular contribution being in the matter of birth control and health care reforms for prostitutes and shopgirls.

Aletta first started her practice on the Herengracht, an affluent area close to the the city centre in Amsterdam. But her worldview changed when she met Bernardus Heldt, leader of the General Trade Union of Holland. Through him, she came to know working-class life more closely, and the sheer lack of health and hygiene in it. She then shifted her practice to the Jordaan, which was then a working-class slum; and with Heldt’s assistance, opened a free clinic there for two mornings a week. Like Franziska and Emilie’s clinic in Berlin, this clinic in Amsterdam also catered to a special need of the population – poor women – and was a great success. It was also here that Aletta first advocated the need for contraception in the 1870s, convinced that freedom from unwanted pregnancies would result not only in better health for women but also better living conditions for her family as a whole. To put her theory into practice, she even distributed pessaries (a kind of diaphragm) to her patients, thus turning her office in the Jordaan into “the world’s first birth control clinic” (preceding Margaret Sanger’s Clinic in New York City by almost four decades)! For this, she had to encounter “the wrath of the entire medical esablishment”, but she rode out the storm and henceforth became a figure to reckon with in public affairs.

atriaAletta indeed became a very influential figure in the Suffragette movement – collaborating with other suffragettes from the UK and US, attending conferences, travelling the world, translating feminist texts in Dutch, and leading the movement in the Netherlands. She was in fact involved with the Dutch chapter of the movement right from its beginnings in 1894, and lived to see Dutch women gain the vote in 1919. Her peace activism culminated in an audience with American President Woodrow Wilson, whom she persuaded (unsuccessfully) to desist from joining the Great War. It can be undoubtedly said that she dedicated her whole life to improving the lot of women – in multiple spheres. But perhaps her most lasting legacy is the fact that Dutch women have a substantial presence in the medical profession in Holland today! Her other legacy has been her writings, which has been archived and is now housed at ‘Atria: Institute on Gender Inequality and Women’s History’ in Amsterdam.

Both Franziska Tiburtius and Aletta Jacobs lived through a time of transformative change in the lives of women in Europe and America. Being the first female doctors of their respective countries, they were both preoccupied with the physical health and well-being of women, sadly neglected in their patriarchal societies; but they were also quick to understand that these issues were organically related to the larger social problems of class and gender inequality. They tirelessly fought to eradicate that inequality, enabling future generations to reap the benefit of their efforts.