Karitane

Karitane

Karitane started as the Australian Mothercraft Society in 1923. It and many similar philanthropic organisations were part of a world-wide wave of concern about high infant mortality around the turn of the twentieth century. In Australia the appalling number of deaths of so many men in World War I was an added spur to the interest in baby care.

Foundation

Dr Frederic Truby King – later Sir Truby King – was a New Zealand psychiatrist with an international reputation for starting New Zealand's Plunket Society in 1907. This was a nationwide community-based organisation whose 'Plunket nurses' assisted mothers with infant care and feeding. Truby King's methods were considered scientific at the time and were also popular with mothers and nurses in Australia.

The Australian Mothercraft Society was set up when the Tresillian Mothercraft Home – founded in 1921 by the Royal Society for the Welfare of Mothers and Babies – ceased using Dr Truby King's baby feeding methods. Matron Elizabeth McMillan was dismissed from Tresillian because she had continued to use Dr King's Plunket mixtures: formula feeding mixtures based on the science of the time and designed for mothers to use at home. McMillan was a World War I nursing veteran who had trained as a Plunket nurse in London while waiting to be repatriated in 1919.

When Matron McMillan left Tresillian, a group of Sydney parents who believed in Plunket's mother-centred approach to baby care wanted to start a branch of the Plunket Society. McMillan had close links with the New Zealand society, and the new Australian Mothercraft Society adopted Plunket's 'Aims and Objects'. McMillan became founding Director.

McMillan began with a clinic in Elizabeth Street, and she was in charge of the Karitane Mothercraft Home at 72 Howard Street, Coogee, when it opened in 1924. It operated the same way as the Plunket Society's Karitane Home in Dunedin, New Zealand. It provided residential accommodation for mothers and babies and trained two categories of nurse. Plunket nurses were registered nurses who were trained to give advice to mothers in baby health clinics. The training for Karitane nurses focused on how to care for babies and young children in their family homes. The trainees lived at Karitane and worked without pay.

The Australian Mothercraft Society applied for a state subsidy under the scheme that subsidised philanthropic organisations such as the Benevolent Society and Royal Society for the Welfare of Mothers and Babies. It also requested recognition of the Home as a nurse-training centre. The New South Wales Department of Public Health declined both requests. Consequently, registered nurses who did the mothercraft course at Karitane could not work in the department's baby health clinics. Karitane nurses worked independently and a bureau for nurse placement was set up. It ran until 1982, always with more requests than it could meet. Mothers came to the Home on their doctors' recommendations, and a roster of honorary medical practitioners with a paediatric interest provided medical oversight and lectured the student nurses. Dr WC Petherbridge was one of those doctors. He provided medical supervision at Karitane for 40 years and also worked for the Royal Society for the Welfare of Mothers and Babies and the Renwick Hospital for Infants.

The society had the support of influential business people in Sydney. John Fuller, who owned the St James Theatre, encouraged the society to purchase the house at 23 Nelson Street, Woollahra, in 1927. The head of Mercantile Mutual Insurance, Sir Kelso King, and his wife, were among a large group of volunteers who raised funds by organising theatre shows, bridge parties and fêtes. In the 1920s and 1930s the Australian Mothercraft Society joined with other organisations, such as the Orient Shipping Line, which raised funds for charity. The clinic at 283 Elizabeth Street was headquarters, running a correspondence service used by mothers from all states and overseas. They could order Plunket baby patterns, Truby King's books, and the Karitane Products Society infant food supplements imported from New Zealand.

Expansion

In 1930 Miss Vida McLean, another World War I veteran, was appointed Matron. She had been matron of New Zealand's largest military hospital in England. Under her management, the Australian Mothercraft Society opened community clinics in suburbs like Mosman, Gordon, Bondi and also in Newcastle, and at Farmers Department Store in Market Street in the city. A travelling clinic was instituted to visit chemists' shops, and community committees worked to support these clinics. McLean started a Plunket Nurses Association and at the Home she instituted nursing procedures that operated for the next 20 years.

The Australian Mothercraft Society tried again to obtain a State subsidy in the 1930s, but the department wanted all available funds for its own baby health clinics. The society weathered the Depression largely due to staff pay cuts and assistance from Karitane Products Society. Finances were stretched to the point of selling frangipani flowers from the Karitane garden to a Taylor Square florist. Karitane Products Society in New Zealand was a lifeline: it was an Industrial Provident Society and any profit was used to support organisations using Truby King's methods. Karitane Products Society took over the mortgage on the Karitane Home, sent a regular stipend and later supported the travelling clinic.

Staff salaries did not return to previous levels until after World War II broke out, and the demand for Karitane's services increased during the war. Matron Bertha Warneke lamented the difficulties for mothers when their husbands were serving overseas. [1] They often had to live with parents or in-laws and there was little money for good food and baby clothes. The Nelson Street building was extended during the war but this did not relieve the pressure on occupancy. This was the busiest time ever for the Australian Mothercraft Society. During World War II, the Karitane Home was admitting about one-third of all mothers using a mothercraft home in New South Wales. Its Truby King clinics provided between 10 and 15 per cent of the baby health clinic visits in Sydney, and the Farmers clinic also employed a full-time sister giving prenatal advice. Food rationing limited some fundraising activities; however, clinic visits were free until 1948, when a one shilling fee was reluctantly instituted.

During the 1930s the Australian Mothercraft Society had a high media profile. Matron McLean, Sister Jacobs, the clinic sister, and Mary Truby King, Truby King's daughter, all gave radio talks and wrote for newspapers and magazines. Mabel Filmer, Radio 2UE's 'Auntie May', ran a supporters' group that continued through World War II. Mary Truby King's Mothercraft , a manual for Australian parents, was published in 1934 with further editions into the 1940s.

Postwar doldrums

After World War II, the Australian Mothercraft Society clinics saw fewer mothers and their proportion of clinic visits dropped to around 5 per cent. A number of factors contributed: the expansion of the Health Department's Baby Health Clinics; a shortage of nurses; a better educated community; a decline in breastfeeding; the proliferation of baby care information; and fewer women with the time to dedicate to voluntary work. The clinics at Farmers, and in Newcastle, Northbridge, Elizabeth Street and Double Bay all closed in the 1950s, although a mobile service started. This was a custom-built bus for a sister to visit new housing areas in the north and west, such as Berowra, Mt Colah and Toongabbie.

The numbers of mothers using the Home fell in the 1960s when the postwar baby boom petered out. Karitane's share of mothercraft admissions settled at 20–25 per cent. The mail order services ceased, and the telephone became the main way mothers sought advice. The annual Karitane Fête at Nelson Street became a community institution but financial concerns continued. Applications for a state subsidy were turned down again by the department, and another threat came from the New South Wales Nurses' Association, which campaigned for Karitane's trainees to be paid.

Regeneration

From the 1950s, the Australian Mothercraft Society's services integrated slowly with the state's health services. This was facilitated by bipartisan political support and a generational change in the Health Department's management. The Australian Mothercraft Society started to receive financial assistance from the Hospitals Commission in 1959 when the Karitane Home was gazetted under the Hospitals Act. [2] Dr FW Clements, an internationally recognised paediatric nutrition specialist, became an Honorary Medical Officer at Karitane, and he worked with the department to bring about standard infant feeding policies in New South Wales. When a review of state baby health centres showed an acute shortage of clinic sisters, Karitane started training registered nurses for the Health Department. In the early 1960s Karitane's matron Eileen Wilson and FW Clements worked with Tresillian and the Department to broaden mothercraft nurse training. The course for registered nurses was extended and in 1966 Karitane nurses became registered mothercraft nurses. The Nurses' Registration Board conducted the examinations. Karitane nursing was a popular option for young women and all trainees were paid from 1972. A pilot training program was developed for young Aboriginal women in the early 1970s, but the Karitane model proved unsuitable.

Prenatal classes were reinstituted in the 1960s, incorporating physiotherapy and including fathers. The Health Department acknowledged the contribution of the Truby King baby clinics in areas where there were no state baby health clinics. From 1969 the number of clinics stabilised and mobile services increased with a bus in the Sutherland Shire. Karitane Product Services withdrew the bulk of its financial support in 1966 but state support was not straightforward, and the Nelson Street Home was sold to reduce debt.

In 1970 the name of the organisation was changed to the Karitane Mothercraft Society and in 1974 the Karitane Home was relocated to Avoca Street in Randwick. For a while in the 1970s, Karitane was home to babies waiting for adoption and provided courses for adopting parents. A Karitane social worker liaised over adoptions and assisted increasing numbers of mothers for whom baby-feeding problems were only part of the stress in their lives. The nursing, medical and allied staff at Karitane recognised the role of depression some new mothers suffered.

In the 1970s and 1980s, admissions to the Home exceeded World War II demands. The Home was seen as a therapeutic environment and waiting lists developed. A day facility in Avoca Street opened 1985, in part so that mothers could get more immediate assistance. This became the Randwick Family Care Cottage. Staff roles changed, Matron Marianne Erlanger became the 'Nursing Director' and Dr Gertrude Angel-Lord moved from being an 'Honorary' to being a paid employee in 1983.

However, in this period New South Wales's health services were being constantly restructured and changes in nurse training caused radical changes for Karitane.

New fields in the 1990s

A move to western Sydney where the wider community's needs were greatest came in 1994. Karitane's building, designed for family accommodation, opened at Carramar in Fairfield. This Residential Unit was a joint venture with the Health Department that required Karitane to sell its Randwick home and close its clinics. In 1992, area health services absorbed the Karitane clinics at Roselands, Sylvania, Waterfall and Guildford. They were superseded by two new joint-venture community services, a Family Care Cottage in Liverpool and Jade House, a Counselling Unit in Carramar. Telephone advice became a dedicated 24-hour service called Careline .

When nursing training moved to the education sector, the Nurses' Registration Board downgraded the qualification of registered mothercraft nurse to enrolled nurse. From 1990 trainees were no longer the majority of the workforce. Trained nurses replaced the young trainees who had characterised Karitane care for more than 60 years. Karitane ran postgraduate nursing courses and students gained work experience at the Residential Unit. Karitane had approximately 20 per cent of New South Wales beds for mothers and babies in 2000.

In the 1990s the volunteers were a small group of professional men and women providing governance. A new role for volunteers came in 1998, when experienced mothers were recruited to individually mentor new mothers. Again Karitane was part of a worldwide public health trend in assistance for mothers; this time towards supporting parent–child emotional bonding and improving social networks for potentially isolated parents.

Karitane largely delivered on the Plunket slogan they adopted in 1923 – 'To help the mothers and save the babies'. From 1924, 200–300 mothers a year found help with baby feeding at Karitane and the clinic sisters reassured many more about baby care. Karitane did not suit all but most were satisfied. More than 1000 nurses trained at Karitane and for many this was the start of a career in nursing. Karitane used the media of the moment to provide parents with information about infant care.

Karitane's survival is an example of the constant renegotiation that is the moving frontier between the state and voluntary community organisations.

References

Clare Ashton, 'Karitane's contribution to Public Health in New South Wales 1923–2000', unpublished MPhil thesis, University of Sydney, 2009, available online at http://hdl.handle.net/2123/6101

Notes

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