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Florida Atlantic Comparative Studies JournalVolume 12 2010-2011CLARA BARTON’S 1898 BATTLES IN CUBA: A REEXAMINATION OF HERNURSING CONTRIBUTIONSBy Christine ArdalanThis study reexamines Clara Barton’s mission in Cuba to bring aid to those sufferingfrom hunger, disease and war wounds while battling with bureaucracy and genderconstraints. Clara Barton was a quintessential frontline nurse. In the last quarter of the19th Century, she defined her work through the American Red Cross, an organization thatshe saw as a reform movement. From 1882 when she founded the American Red Cross, itbecame “her” esteemed neutral vehicle providing a means for her direct participation infrontline nursing care during hurricanes, floods or epidemics. In 1898, when she leftWashington for Cuba she was 77-years-old at the zenith of her career. Barton’s work inCuba exemplified her unbroken link with nursing, a common creed, a collective identity,that transcended transnational boundaries. The link, however, did not include thecommon training. After the Spanish American War, the face of nursing and especiallyarmy nursing changed. The soldiers’ deaths from disease ushered in major healthreforms including the 1901 establishment of the Army Nurse Corp. The 77-year-oldBarton was not a part of this new thrust and her nursing contributions dimmed in nursinghistory as did her presence within the Red Cross organization. Criticism of her work, herpatriotism and even her person undercut her place in nursing history. The reevaluation ofBarton’s work, seeks to complement Cuban historiography at the end of the 19th centuryand to reevaluate her nursing roots.On February 15, 1898, Clara Barton (1821-1912) worked at her deskoverlooking Havana Harbor.1The 77-year old president and founder of theAmerican Red Cross (ARC) pondered over her relief effort to bring aid to displacedCubans—the reconcentrados. From her window, she witnessed the commotion. TheUnited States Battleship Maine had exploded and sunk in Havana Harbor with 250men dead. After the blast, she made her way to the bruised, cut and burnedsurvivors at the Spanish Military Hospital, San Ambrosia. “I am with the wounded,”she cabled to the Red Cross headquarters from Havana.2 The experienced nurseknew her immediate duty was to take the names of the wounded. “Isn’t this MissBarton?” asked one of the wounded men. “I knew you were here and I thought youwould come to us.”3The Maine incident highlights Clara Barton as the quintessential frontlinenurse giving credence to an earlier newspaper report that indeed she was an expert1

Florida Atlantic Comparative Studies JournalVolume 12 2010-2011in binding up “many torn bodies and nearly crushed hearts.”4 Barton was specificwith the details of the injuries that identified her as an experienced nurse.Their wounds are all over them—heads and faces terribly cut, internal wounds, arms, legs,feet and hands burned to the live flesh. The hair and beards singed, showing that the burnswere from fire not steam. Besides further evidence shows that the burns are where the partswere uncovered. If burned by steam the clothing would have held the steam and burned allthe deeper. 5Barton noted the officers and the men were reticent to discuss the cause of the blast,but they thought it was not a result of internal combustion. The boilers werelocated at each end of the ship, places where all escaped. The blast had come fromthe center. In the resulting speculation afterwards, and throughout the followingdecades, it appears that investigators did not consider her observations. 6In the last quarter of the 19th Century, Barton defined her work through theAmerican Red Cross. From 1882, the organization became “her” esteemed neutralvehicle for her direct participation in frontline nursing care. Whether providingrelief during forest fires, hurricanes, floods or epidemics, Barton affirmed hernursing philosophy that guided her work. In 1898, she summed up her goals withthis quote, “Ease suffering, soothe sorrow, lessen pain, this is [one’s] only thoughtnight and day.”7 Her principles speak to the core of modern nursing today.This essay reexamines Clara Barton’s attempts to bring frontline nursing careto those in Cuba suffering from hunger, disease and war wounds while battling withbureaucracy and gender constraints. Moreover, her humanitarian service presentsan opportunity to reevaluate her nursing roots.8 Barton emerges not only as astaunch supporter of women’s rights, patients’ rights and victims’ rights, but also asa fierce defender of her own right to nurse in spite of her age.Although Cuban historiography has largely overlooked Barton’s work,9numerous biographers have documented her relief work and participation in the1898 war.10 This essay draws from the work of these biographers, contemporarynewspapers, Barton’s papers located in the Library of Congress as well as Barton’sfirst person narrative and record of her work that she compiled in her 1899 bookentitled The Red Cross In Peace and War. By addressing her record in Cuba throughher eyes and voice there can be little doubt that Barton deserves a prominent place2

Florida Atlantic Comparative Studies JournalVolume 12 2010-2011in nursing history and Cuban history, as well as in humanitarian and philanthropichistory.Barton’s Background: War, Peace and EqualityKey points about her background illuminate Barton’s character and mission.During the Civil War, she was literally and figuratively a battlefield nurse. Inwielding considerable power to overcome prejudices against women at the frontlines of battle, her initiative and autonomy stood out.11 As scholar Ellen LangenheimHenle points out, Barton was “fearless under fire.”12 Henle argues that women’sexclusion from war sustained their subordinated status. War was the legendarymale realm. Without the franchise, women could not participate in governmentaldecisions to initiate or avoid war. Barton fought gender constraints to forge the wayfor women to participate in the forefront of battle.13The Civil War and the aftermath of her care for the war dead followed by theendless rounds of public lectures took a toll on Barton’s health as she moved aroundthe country. In breaking ground as a public speaker, she met many suffragists whosought her support. Her feminist rhetoric was just as forceful, or even greater, thanthat of the suffragists. When asked what women should do in time of war, suffragistElizabeth Cady Stanton replied that just like many of her male counterparts, shewould urge others to go to war.14 Barton was truly a battlefield nurse. She declaredthat if people consider “the positions I occupy were rough and unseemly for awoman—I can only reply that they were rough and unseemly for men.”15 Although afirm supporter of the movement, she refused any formal leadership roles. Instead,she placed herself in the forefront of yet another battle to bring humanitarian, orfrontline nursing services, to women, men and children in need. She devoted her lifeto the cause when her physicians finally advised her to recuperate in Europe.During her recuperation from ill health in Switzerland, she energized thefounding of the American Red Cross. It was through her powers of persuasion, thatthe United States government finally endorsed the Geneva Accords and signed theinternational treaty. This was no small feat. Twice it had refused, even whenrequested by Dr. Henry W. Bellows, the head of war relief during the Civil War.163

Florida Atlantic Comparative Studies JournalVolume 12 2010-2011Barton secured her place as the ARC president insisting that disaster relief was in itsarticles of incorporation. In 1882, the ARC set to work bringing relief nationally andinternationally—with Barton at the center of the effort.To provide nurses to assist in service under the Red Cross flag, she hoped the1894 founding of the Red Cross training school for nurses in New York wouldbecome a model.17 This was the only Red Cross training school for nurses in thecountry. Barton hoped it would become a model that would prepare Red Crossnurses for service under the Red Cross flag. However, according to Lavinia Dock, oneof the most prolific nurse historians of the Progressive era, the Red Cross school wasdoomed to fail. Dock was a contemporary nurse who trained at Bellevue School ofNursing, the first reformed nursing school to open in 1873. The Red Cross Hospital,founded by Bettina Hofker and sanctioned by Barton, was a facility that ran underthe auspices of the Red Cross. (Hofker later married Red Cross surgeon-in-chief Dr.A. Monnae Lesser.) While the fledgling nursing profession strengthened itself withdynamic leadership to unite nurses under professional controls, Barton preferredher nurses to volunteer for service and practice regular military tactics.18 Incontrast, Dock asserted merits of the “new” profession’s building blocks. “Thefounders of Bellevue had affirmed the principle of economic and professionalindependence,” she noted. “This was tenaciously held on to by the youngprofession.”19 Historian Barbara Melosh explains the growth of professional nursingand the early nurse leaders’ struggle aimed to make nursing into a respectableprofession. However, the influential nurse leaders faced an uphill battle to negotiatebetween the hospitals’ need for service and the schools’ insistence of education.These issues remained an unresolved difficulty.20 Consequently, Dock and hercounterparts did not endorse Barton’s vision for nursing education. Dock concludedthat the Red Cross Hospital met the forthcoming emergency of the 1898 SpanishAmerican War with “pathetic inadequacy.”21In her diary, Barton brings to light the difficulty of running the Red CrossHospital that added credence to Dock’s criticism , as a younger nurse Hofker-Lesserhad problems maintaining authority among the older “ambitious” nurses who would“resort to scandal as a means of [obtaining] power for themselves.” After a visit to4

Florida Atlantic Comparative Studies JournalVolume 12 2010-2011the hospital Barton wrote, “Poor Bettina is downhearted and wants to give up. Goout of the hospital and let someone else take the helm.” Barton greatly encouragedthe younger nurse to continue and offered solutions. She suggested a chaperone tohelp her “hold these unscrupulous wretches in place.”22 Yet in spite of difficulties,during the absence of war and disasters, Hofker-Lesser organized the Red Crossnurses to care for the city’s poor.23 In 1898, the hospital and training school closedto permit the staff to meet the challenges in Cuba.24Relief Efforts for the Reconcentrados.In the midst of bringing Red Cross aide to those suffering through disasters athome and abroad, news of the Cuban reconcentrados plight distressed Barton andonce again, her autonomy stood out. She argued that the Red Cross was a “directservant of the government,” therefore, without President William McKinley’spermission, Barton would not endorse any Red Cross involvement.25 Those whowere impatient for Red Cross action included Cuban patriots. In a gripping letter,they attacked Barton and the Red Cross for inhumanity towards the reconcentrados.As the summer of 1897 wore on, no longer able to quietly bear the reports, Bartonrequested that “the Red Cross [take] steps on its own in direct touch [and with thecooperation of] the people of the country.”26 Illustrating her ease of communicationwith the President, she called on him at the White House and joined the meeting inprogress with his Secretary of State.27 Finally, they agreed to form the “President’sCommittee for Cuban Relief,” headquartered in New York, to solicit and to distributefunds. Urged by the President to take charge of the relief effort in Havana, theelderly Clara Barton journeyed to Cuba where she could be at the center of action.28Barton Spearheaded the Humane IssueUpon arrival three days later, the hunger and starvation that had permeatedthe small villages overrun with people suffering from years of want struck Barton tothe quick.29 Barton’s graphic penmanship illustrated her dismay at her visit to theconcentration camp at Los Fosos and other facilities where the inmates were inslightly better condition.30 She set to work visiting sites where the Red Cross couldarrange distribution centers.31 The Red Cross hospital’s chief nurse Bettina Hofker5

Florida Atlantic Comparative Studies JournalVolume 12 2010-2011Lesser, Dr. Monae A. Lesser and four nurses from the now closed Red Cross Hospitalfollowed Barton to Cuba to support her work.Relief After the Maine DisasterAmid the speculation of the cause of the Maine’s blast, Barton continued withher relief effort.32 She traveled on to the small towns and villages where she founddeplorable conditions. Calling for a battle against the “enemies,” of “dirt and filth,”Barton rallied for volunteers to thoroughly clean and whitewash a hospital, forexample. Once enlarged, a freshly supplied hospital could accommodate morepatients.33 Local physicians anguished by lack of resources, spurred to action withRed Cross support.34Barton kept the public alerted to the progress of the Red Cross relief effort.Highlighting its humanity and neutrality, she reported about her cooperation withthe Spanish authorities. Spain was one of the original founders of the InternationalRed Cross and Barton fostered a rapport with General Ramón Blanco y Erenas. Shereported that, “General Blanco was glad of this relief and sorry for the condition ofthe people.”35 She explained that her cooperation with the Spaniards was throughthe international recognition that the Red Cross operated as a neutral humanitarianbody. Barton disregarded any gender inequality. Rather she met the Spaniards onequal terms. “I meet you gentlemen not as an American and you as Spaniards but asthe head of the Red Cross of one country greeting the Red Cross men of another,”she affirmed. “I do not come to speak for America as an American, but from the RedCross for humanity.”36 Throughout her stay, she noted that General Blanco and hisstaff’s unfailing “kindly spirit” prevailed. She wrote, “I was begged not to leave theisland through fear of them.” They promised to extend “every protection in theirpower” to the Red Cross. When the coming war forced Barton to abandon her reliefwork, she accepted Blanco’s farewell and blessing and in her words, she left those“poor, dying wretches to their fate.” 37 One newspaper reported, “The whole systemof succoring the starving Cubans is for the time being brought to a completestandstill.”38 Barton moved the Red Cross headquarters to Tampa.At thedeclaration of war on April 25th, she had placed the Red Cross headquarters at a6

Florida Atlantic Comparative Studies JournalVolume 12 2010-2011strategic location to offer immediate war service and in spite of war, she hoped thather relief work would continue.Two days before the outbreak of war, the Red Cross relief ship, the State ofTexas, left New York harbor full of supplies for the reconcentrados. Barton wasanxious that the Geneva Convention did not cover naval warfare at this time.Moreover, in war the Red Cross was supposed to have an active role with themilitary. She appealed to military leaders to follow the Geneva accords, but shefound the same prejudices against her and “her” organization as she had in the CivilWar. The generals believed that volunteer committees were unnecessary. Themilitary should take care of its own medical needs.39On April 29th, Barton joined the State of Texas in Key West. She beggedAdmiral Sampson to allow it to pass the blockade surrounding the island. AdmiralSampson declared it his duty to keep the supplies out of the country. Barton insistedit was her duty to get them in! She had no choice but to wait patiently in Tampawhere the troops gathered to depart for Cuba. Although tedious, the wait was notwithout action. Barton and her staff turned their attention to the Spanish crew ofvessels, offering them sustenance under the auspices of the Red Cross. Again, “easesuffering” was her philosophy. She explained that until then “they had only live fishand brown sugar to eat.”40While Red Cross President Clara Barton waited in Tampa, many relieforganizations throughout the country adopted the Red Cross insignia to offerassistance. Scores of trained nurses also rushed to volunteer. To accommodate thesurge, the New York Red Cross committee organized an efficient auxiliary relief tothe army that included recruiting and paying the nurses. Barton had neglected toprovide specific guidance from the headquarters. Instead, she saw the young“branches” as evidence of the Red Cross success and another step in her passion tobring nurses to the battlefront as an integral part of the military. As Pryor concludes,she did not realize that while she waited in Tampa the adoring public wouldassociate the Red Cross, not with her, but with the tremendous work of these“branches.”417

Florida Atlantic Comparative Studies JournalVolume 12 2010-2011Returning to the Battle FrontFinally, when war arrived, functioning under the realm of humanitarianrelief, Barton followed Theodore Roosevelt and the Rough Riders to GuantanamoBay.42 Yet the prospect that she would go to the battlefront seemed dismal. She metwith resistance from army surgeons.43She wrote in her diary: “All seemedinterested in the Red Cross, but none thought that a woman nurse would be in placein a soldier’s hospital; indeed very much out of place.”44 She reflected that it was thesame old story and wondered what gain there had been in the last thirty years. 45 InSiboney, army surgeons at the American hospital rebuffed her offer to help and soshe turned her attention to the adjacent Cuban hospital. Soon the Americans sawthat the nourished, clean and cared for patients provided a stark contrast to theirplight and changed their minds. The surgeons then requested Red Crossassistance.46During the July 1st Battle of El Caney wounded poured into Siboney. Barton,Sister Bettina, Dr. Lesser and the Red Cross team worked round the clock. On thesecond day of the July 3rd San Juan battle, Barton received a message that thewounded desperately needed care at the battlefront. Ensuring the supplies wereloaded in the only two wagons available, she commandeered a hay wagon andproceeded over hills to a valley surrounded by dense jungle and mountains. Shereached a collection of tents, the First Division Hospital of the Fifth Army Corps.Here she complained the conditions were far worse than anything she had seenduring the Civil War.47Wounded men lay everywhere, exposed to the tropical elements madeworse than ever by the rainy season. More than eight hundred men were“recovering” from surgery, some sheltered by palm leaves, many lying naked, inpools of water, exposed to the elements. Those more able greeted her with adelighted roar: “There is a woman! . . My God, boys, It’s Clara Barton. Now we’ll getsomething to eat.”48 Setting up an emergency station, she worked relentlesslyproviding the best care her resources permitted.Throughout the war, Barton was the only female nurse allowed to work atthe front.In fact, some of the later criticism that she faced arose from her8

Florida Atlantic Comparative Studies JournalVolume 12 2010-2011willingness to minister to the Spanish soldiers as well. Barton arranged with GeneralShafter for these soldiers to receive emergency care and to return behind their ownlines under a flag of truce.49 To Barton, most trying of all was her continual struggleto maintain her authority to administer care for all at the battlefront.She fought her cause with a sharp tongue and penned her anger to her diary.Her fight against gender constraints loomed large in her records. “You have been tothe front,” inquired one Major. “I should think you find it very unpleasant there.There is no need of your going there—it is no place for women. I consider womenvery much out of place in a field hospital.”50 R