section_path: History/19th century
section_name: 19th century
paragraph_text: 19th century
  
  During the Crimean War, Grand Duchess Elena Pavlovna called for women to join the Order of Exaltation of the Cross (Krestodvizhenskaya Obshchina) for a year of service in military hospitals. The first section of twenty-eight "sisters", headed by Aleksandra Petrovna Stakhovich, the Directress of the Order, reached Crimea early in November 1854.
  
  Florence Nightingale laid the foundations of professional nursing after the Crimean War, in light of a comprehensive statistical study she made of sanitation in India, leading her to emphasize the importance of sanitation. "After 10 years of sanitary reform, in 1873, Nightingale reported that mortality among the soldiers in India had declined from 69 to 18 per 1,000".
  
  Nightingale believed that nursing was a social freedom and mission for women. She believed that any educated woman could help improve the care of the ill. Her Notes on Nursing (1859) was a popular call to action. The Nightingale model of nursing education led to one of the first schools of nursing to be connected to a hospital and medical school. It spread widely in Europe and North America after 1870.
  
  Nightingale included five factors that helped nurses in her time who worked amidst poor sanitation and little education. These factors included (1) fresh air, (2) clean water, (3) a working drainage system, (4) cleanliness, and (5) good light. Nightingale believed that a clean working environment was important in caring for patients. In the 19th century, this theory was ideal for helping patients, providing a guide for nurses to alter the environment around patients for the betterment of their health.
  
  Nightingale's recommendations built upon the successes of Jamaican "doctresses" such as Mary Seacole, who like Nightingale, served in the Crimean War. Seacole practised hygiene and the use of herbs in healing wounded soldiers and those suffering from diseases in the 19th century in the Crimea, Central America, and Jamaica. Her predecessors had great success as healers in the Colony of Jamaica in the 18th century, and they included Seacole's mother (Mrs. Grant), Sarah Adams, Cubah Cornwallis, and Grace Donne, the mistress and doctress to Jamaica's wealthiest planter, Simon Taylor.
  
  Other important nurses in the development of the profession include:
  
  Red Cross chapters, which began appearing after the establishment of the International Committee of the Red Cross in 1863, offered employment and professionalization opportunities for nurses (despite Nightingale's initial objections). Catholic orders such as Little Sisters of the Poor, Sisters of Mercy, Sisters of St. Mary, St. Francis Health Services, Inc. and Sisters of Charity built hospitals and provided nursing services during this period. The modern deaconess movement began in Germany in 1836. Within a half century, over 5,000 deaconesses had surfaced in Europe.
  
  Formal use of nurses in the military began in the latter half of the nineteenth century. Nurses saw active duty in the First Boer War, the Egyptian Campaign (1882), and the Sudan Campaign (1883).