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Introduction to Volume 9 T he material of the present volume documents Nightingale’s efforts to improve the sanitary conditions of soldiers and civilians in India, and identifies the issues she was confronted with in her work. It is presented thematically. It begins with the planning for and the formation of the Royal Commission on the Sanitary State of the Army in India; next comes the work of the commission, its report and actions toward implementation of its recommendations; there are then sections on irrigation and the prevention of famine, sanitation and the prevention of epidemics, and nursing. In each case there are actual published papers, correspondence and notes toward their preparation, dissemination and follow-up action. There is some overlap, of course, as new issues emerge and old ones require further work. Efforts were made to avoid duplication as much as possible, but some remains. Sometimes the same issue had to be explained many times (to different people), with some nuance in the explanation. Sometimes also Nightingale simply did not succeed in getting the requisite action and had to return to the problem time and again. First, the correspondence shows Nightingale anxiously working toward getting the right members on the royal commission. A large number of candidates was proposed and evaluated, then chosen or rejected. In each case a lively exchange of information took place and judgments on persons were expressed, always with a view to securing the most competent candidate. In general Nightingale succeeded in having her preferences accepted. Once the commission was appointed and its work launched, a frustrating situation emerged: there was reluctance on the part of the India Office to open its books: ‘‘The office throws all kinds of obstacles in the way’’ (see p 97 below). It was difficult to get to the relevant data concerning the sanitary conditions of the army, which were buried in reports that the India Office wanted to keep confidential to avoid the risk of showing how deplorable the situation was. That is / 41 why, on many occasions, the information had to be obtained by a personal contact willing to leak it. Nightingale makes her frustration abundantly clear in her letters. But in the end the commission got the necessary data from the India Office and, additionally, plenty of data from India thanks to the questionnaires sent there and the corresponding returns. The result was a thorough survey of the health condition of the army and, indirectly, of that of the Indian population at large. Detailed recommendations for remedy were made, including precise points for administrative changes. In the implementation stage of the commission’s recommendations , Nightingale could count on an impressive network of wellplaced and qualified collaborators: public figures at home and in India, sanitary experts, whom she was eager to encourage and consult, and friends whose influence she was able to put to use. Of all those collaborators many were congenial and willing to act; others had to be prompted. But all had to be kept on their toes, so Nightingale felt, and reminded of their duties. Typical of her attitude was her relationship with John Lawrence, whom she admired so much, with whom she was basically in agreement, but with whom also she recognized important differences, as the correspondence shows. Her differences with Lord Cranborne (later Lord Salisbury)1 in his various functions are also revealing; she was angered by his reluctance to undertake irrigation works due to financial constraints, yet she remained civil in her criticism though firm in her proposals. An important shift is evident in this volume as Nightingale’s interest in the health of the army gradually widened to include the civilian population and even the establishment of a public health system in India. Her early position appears first in the remark that the army cannot enjoy good health if the surrounding area is unhealthy. Attention to the sanitary state of the ‘‘native lines’’ or ‘‘native lanes’’ then led step by step to a concern with the entire civilian population. In time the health of Indian nationals became the end, not a mere means to an end. Added to her insistence on sanitation in general were concerns to prevent famines by promoting irrigation and increasing food production, and her efforts to battle epidemics by spreading information on hygiene and basic health precautions. In fact the main obstacles to public health were seen in famines and epi1 See Jharna Gourlay, Florence Nightingale 130-32...

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