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1867: Is There a Nurse at the Kid’s School? Thank Lillian Wald

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New York's Henry Street Settlement. Wald started it as the Nurse's Settlement.Credit: Wikimedia Commons

March 10, 1867, is the birthdate of Lillian Wald, the founder of the community-nursing movement and a powerful force for reform in the early decades of the 20th century. Her vision and activism would have a major impact not only on public health in the United States and globally, but also on the very nature of society’s relationship with its weaker members.

Lillian Wald was born in Cincinnati, Ohio, the third of four children of Max D. Wald and the former Minnie Schwarz. Max, a successful dealer in optical products, was German-born, while Minnie’s family had its roots in Poland.

In 1878, after a brief sojourn in Dayton, Ohio, the family moved to Rochester, New York. There, Lillian attended Miss Cruttenden’s English-French Boarding and Day School for Young Ladies. Although the family belonged to the local B’rith Kodesh Reform synagogue, they were non-observant religiously. Lillian never hid her origins or her sympathies for Jews, but she remained universalist in her sentiments through her life.

At age 22, Lillian began to study at New York Hospital School of Nursing. After graduating in 1891, she began pursuing a medical education at the city’s Women’s Medical College. But a visit to an impoverished student’s home would change her destiny.

‘Unloved and unlovely’

Her moment of epiphany came in the winter of 1893, when she began teaching home nursing at a school for immigrants. One of her students needed her assistance and brought Wald to her rundown and filthy tenement home.

As Wald recorded in one of her memoirs, “All the maladjustments of our social and economic relations seemed epitomized in this brief journey and what was found at the end of it.” The degraded conditions in which her pupil’s family was living seemed to Wald to be an indictment not of the impoverished immigrants, but rather of the larger society, “of which they were so unloved and unlovely a part.”

Lillian Wald decided to leave medical school, and together with a colleague, Mary Brewster, moved into a spartan room on the Lower East Side, where she organized the Nurses’ Settlement. A year later, its name was changed to the Henry Street Settlement, which quickly developed into an organization of visiting nurses who provided holistic services to clients at district centers and at their homes.

Wald wasn’t the first to invent the settlement house, but her upbringing had been sheltered enough that she had not been aware of the work that pioneers like Jane Addams were doing – in Addams’ case, at Hull House in Chicago.

Philanthropists on board

Under her vision, Henry Street expanded quickly: By 1906, it had 27 nurses working for it, and seven years later, it supported a staff of 92. Its services expanded, too, coming to include a whole variety of educational programs for immigrant children.

Support for Henry Street came mainly from German-Jewish philanthropists such as Jacob Schiff and Betty Loeb, but its programs were open to comers of all denominations.

It was Wald who would convince the city of New York to begin placing nurses in schools. She worked with Metropolitan Life Insurance to create a nursing-insurance program, and she helped found the Columbia University School of Nursing. She worked on legislation to prohibit child labor, and was active in assisting unions to push for improved safety at workplaces. Wald also co-founded the National Association for the Advancement of Colored People (in 1909), and was involved in a number of different anti-war organizations. She also was an early supporter of the idea of providing mentally handicapped people with education.

Wald never married, and seems to have avoided intimate relationships, investing all her energies in her work. Her legacies include the Visiting Nurse Service of New York, which remains the largest nonprofit community-based care organization in the U.S., and the Henry Street Settlement, which continues to serve the immigrant population, today largely Asian and Hispanic, of New York’s Lower East Side. And through the many other professional organizations she helped lead, many of Wald’s innovations have spread around the world.

Lillian Wald died of a cerebral hemorrhage, on September 1, 1940, at the age of 73.

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