By Dr. Marsha Pearce, Educator & Curator, University of West Indies

15 August 2018 - 10:12

Surgical Support by Stephan Hornsey
Surgical Support  ©

Stephan Hornsey

#UpsideDownHistory Part Two: National Health Service

Instagram Residency winner Marsha Pearce blogs about curating the second series of images for the British Council “Americas IN Britain” Art Project

With my use of work by Jamaican poet Louise Bennett-Coverley – specifically her poem “Colonisation in Reverse” – as a curatorial framework for the 2018 Americas IN Britain Caribbean Edition project, I could not help having the strength of her perspective and her impact on the arts at the forefront of my mind. I wanted, therefore, to focus on women and their contributions as a way of marking the 70th anniversary of the National Health Service (NHS). The NHS was launched on July 5, 1948, in Britain and is considered a major social reform in the wake of World War II. It was founded on the principle that health care would be free at the point of access. Yet, its nascent stage was plagued by staff shortages. Looking back at the early years of the NHS in the post-war context, Linda Ali explains “men were reluctant to work long hours, in poor conditions…Single women, with their newfound freedom, were being more selective about their career choices, opting for occupations such as secretaries and journalists.” The UK, therefore, sought health workers beyond its shores. In his article for The Guardian, Patrick Butler observes the history of the NHS as being intertwined with a history of migration. He writes: “The Caribbean was a primary source of nurses. As early as 1949, the health and labour ministries launched recruitment campaigns that resulted in thousands of nurses arriving in Britain and being dispersed to hospitals all over the UK.” The tremendous role played by Caribbean women in the NHS is captured in such projects as the BBC documentary Black Nurses: The Women Who Saved the NHS and Ann Kramer’s book Many Rivers to Cross: The History of the Caribbean Contribution to the NHS.  

Labour deficits continue to affect the NHS in the twenty-first century. It is reported that increasing workloads and government pay restraint policies are the cause of nurses and midwives leaving their posts. The recently announced Jamaican Nurse Recruitment “earn, learn, return” partnership is expected to increase the NHS workforce. This solution again highlights the Caribbean as a shaping force in British society. This knowledge, coupled with the latest NHS labour statistics: women make up over three-quarters of all NHS staff but are still in the minority in senior roles, reinforced my interest in curating a series that gave attention to women in the health service.  

In discussions with Louise Stewart and Clare Freestone, curators at the National Portrait Gallery London (NPG) and my collaborators for the Americas IN Britain project, I raised the subject of the NPG’s acquisitions policy. I wanted to feature Caribbean women in the NHS but the NPG Collection yielded little in this regard. The NPG’s acquisition policy states:

The principle for the inclusion of a portrait in the Collection is that a person represented should have made, or be making, a substantial contribution to British history or culture. The subject of a portrait acquired for the Collection must either be important in his or her field, be a person whose achievements, influence and reputation set him or her apart as an individual of public interest, or illuminate British history and culture in a significant way.

This policy has meant a focus on individual rather than collective achievement and an outcome of the policy’s scope has been the exclusion of portraits of everyday people. Additionally, Louise noted, “that for much of history most non-elite people (and indeed, non-white people and women) were not the subject of portraits.” She indicated that there are ongoing conversations at the NPG about how their collecting strategy can reflect the varied nature of achievement in Britain, as well as how the Gallery can represent what she refers to as “missing sitters,” as part of its sustained commitment to cultural diversity. This was an important conversation for me as I reflected on issues of representation, focal points in collection efforts and silences or blind spots in history.

Our search in the NPG archive led us to a photograph of a Caribbean woman working in the NHS: Barbados-born Nola Ishmael. She is the first black director of nursing. In 2004 she won the Wainwright Trust Award for her work on equal opportunities in the NHS. Along with her portrait, we selected images of key British-born women: Beatrice Webb, Sheila Kitzinger, and Claire Rayner. Webb’s Minority Report on the Poor Law informed the founding of the NHS. Kitzinger was a pioneer of natural childbirth. She developed the concept of a birth plan, which is used by the NHS today. Rayner was a patients’ rights campaigner and a nurse in the NHS. Before her passing in 2010, she said to tell the then British Prime Minister that if he mishandled her “beloved NHS” she would return to haunt him.

I then put these images in dialogue with my pick of contemporary portraits by Caribbean artists. I chose work from Andrea Chung’s Midwives and Crowning series, and photographs by Stephan Hornsey. In Chung’s collages, she connects traditional medicine with maternity care. She also depicts the uterus as a crown. She presents it as a symbol of knowledge carried from one generation of women to the next. In contrast, Hornsey’s images document clinic visits and behind-the-scenes hospital activity on the island of St. Vincent.    

Medical Inauguration by Stephan Hornsey
Medical Inauguration ©

Stephan Hornsey

Afro doctor looking at a child with hydrocephalus - Tender Loving Care
Tender Loving Care ©

Stephan Hornsey

Crowning I by Andrea Chung
Crowning I ©

Andrea Chung

Midwives III from Andrea Chung’s Midwives and Crowning series
Midwives III ©

Andrea Chung

Midwives I by Andrea Chung
Midwives I ©

Andrea Chung

For further insight into their work, I reached out to Chung and Hornsey who responded to a couple of my questions. Their answers are shared here:


Andrea Chung

MP: How would you describe your art practice? Your interests and approaches?

AC: I’m interested in exploring the ways in which colonialism has impacted the land and our bodies. I also want the viewer to understand the ramifications of colonialism and not see it as something that happened in the past and as something that has resolved itself to where we are now. Colonialism has never ended, it has only evolved. I hope that people can take the themes of the work and see how they apply to our current fractured political climate.

MP: What motivated the Crowning and Midwives series – works made three years apart?

AC: I was collaborating with a professor whose research focused on black midwives of the southern United States and we decided to look at the similarities of grandmother midwives or nana midwives in Jamaica. The collaborative project is titled Catchin’ Babies, Colonising Black Bodies. We interviewed midwives and people who either knew or were birthed by midwives in Jamaica. I was interested in how nana midwives were perceived in the Caribbean and how those traditions are still evident in modern-day obstetrics. The art pieces are a few years apart but my interests are always there. I work slowly and always tend to revisit my interests at later dates.

MP: You also had a family member who was a midwife? Was that an important reference for you?

AC: My grandmother in Trinidad and Tobago was a midwife. She was definitely an influence. She was beloved so much so that when she became ill, her patients would often pay for her medicine. 


Stephan Hornsey

MP: How would you describe your photography practice? Your interests and approaches?

SH: If I were, to sum up, my approach to photography in one word, it would be ‘Curious.’ Photography is special to me. It allows us to ask many questions of which I, and those with whom I work, have – documenting those answers in beautiful ways. Experiences, which were once mundane, misinterpreted or perhaps obscure can become something truly exciting to share. Knowing that you can help someone else recognise something new in his or her world is very satisfying. My approach is to find those crucial questions of what one is looking to portray, then looking for who or what can answer those questions. Doing this always yields emotions or events to capture and represent.

MP: What prompted your capturing of daily happenings in the health service in St. Vincent?

SH: I work along with a few organisations requiring me to spend many days taking photos at the Milton Cato Hospital in St.Vincent, most notably my work with the World Pediatric Project (WPP). WPP performs many critical healthcare services all throughout the year for children in need, covering much of the cost associated with such services. My goal is to document their efforts, those who contribute to those efforts, and most importantly the patients and their families. The patients and families have inspiring personalities in light of the challenges they face. Those who provide that critical healthcare form such strong relationships with these patients, often seeing them over the course of many years as they frequent the hospitals. They develop strong ties and thus strong resolutions to these difficult times for all involved. The intensity of care, powerful personas, intimate relationships and specialty of skill provide me with many opportunities to point my camera in this environment.

MP: You mentioned that your practice includes finding crucial questions. What questions are you attempting to answer with your portraits at the Milton Cato Hospital?

SH: That’s a fantastic question. The single most important question was to the patients, which can be summed up as: “What does your future look like?” For many it was easy for them to answer: play, run, ride their bicycles, paint. Many of these patients have conditions which prevent them from doing these things. Their personalities are incredibly powerful to undergo such difficult procedures while maintaining an innocent yet positive outlook on life – especially at such young ages. 

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To read Marsha Pearce’s first blog entry for the 2018 Americas IN Britain – Caribbean Edition project, click here

Dr Marsha Pearce

Dr. Marsha Pearce. Educator & Curator, University of West Indies

Dr. Marsha Pearce

Educator & Curator, University of West Indies

Marsha Pearce is a Cultural Studies scholar, writer, lecturer and curator based in the Caribbean. She is a Visual Arts lecturer at the Dept. of Creative and Festival Arts, The University of the West Indies (UWI) and has also served on the board of the National Museum and Art Gallery of Trinidad and Tobago. Her research and critical writings have been published in several academic journals, books, catalogues and newspapers. She holds a B.A. in Visual Arts and a PhD in Cultural Studies from UWI.


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