Purity and Excretions: West Indian Experiences of Nursing and the Substance(s) of Social Orders

In some of her recent work Janet Carsten (2011: 20) examines “how ideas about substance contribute to understandings of relationality.” In this paper I will look at ideas and practices in relation to “unclean” substances as expressions of particular social orders. I will take my clue from Sjaak van der Geest (2007: 393) who suggests that “the feelings of disgust” associated with bodily excretions can “reveal the ‘substance’ of social relationships such as closeness and distance, inclusion and exclusion, affection and dislike, trust and fear.”

My ethnographic study concerns the Caribbean women who were trained as nurses at British hospitals during the post-WWII period. As part of the establishment of the nursing profession, a strict regime of care was set in place at the hospitals devoted to the proper handling of the intimate relations with patients, and associated unclean substances, that nursing involves. This regime took the form of a hierarchy of caregivers, with the novices in the bottom performing the dirty and hard physical labor and the trained nurses gradually advancing to positions as fully trained “sisters” who were devoted to upholding the order, discipline and purity of the hospital. Several studies have criticized the way in which the Caribbean nurses were treated, stating that they tended to be held back in the dirty part of the work.

Based on interviews with Caribbean nurses I discuss here how they, as young women, were inducted into the nursing profession through work with unclean substances, and the ways in which they were associated with “dirty work.” I will argue that the identification of West Indian nurses with “dirty work” may have constituted not merely a form of discrimination and oppression of black immigrant nurses, but perhaps rather an attempt at designating and fixing these well-educated, self-reliant women from the (former) colonies as “matter out of place” (Douglas 1966), because they, with their training in one of the few professions available for women, were posing a threat to established societal boundaries. From this perspective, the designation of certain tasks as dirty therefore may not always simply refer to chores that are perceived to be filthy and degraded, but also to forms of work that have been constructed as “dirty” because the people practicing in these areas have the potential to challenge the social order.

All interested are welcome!