in some important ways , mh both replaced and replicated the social and economic networks 
 that families , at their most basic level , constitute .
nineteenth - century missionaries were 
 slow to make converts of zulu - speakers and some of the earliest to come to the mission 
 stations and undergo baptism were those who had fled from or been rejected by their 
 families , homesteads or communities . nor were african patriarchs and matriarchs immediately 
 keen for their daughters to become nurses , for their labour was needed for homestead 
 production , and guarantees of their virtue uncertain outside the direct control of the 
 family , including peer groups who provided companionship , and who monitored sexuality and 
 reproduction .
the first converts  amakholwa  often stressed in similar 
 ways to their  western counterparts the gendered propriety of conduct of sons and daughters 
 and it is not surprising therefore that it was the first and second generations of 
 kholwa families which would encourage their daughters to take up 
 schooling and then , as positions gradually opened , the professions of teaching and nursing . 

thus , from the first intake of trainee nurses in 1909 to the 1960s , the majority of mh 
 nurses were recruited from inanda seminary , the american board s ground - breaking school for 
 girls . of the first african women to be trained ( from 1911 ) by margaret mccord and martha s. 
 macneill three
, nomhlatuzi bhengu , julia magwaza and edna mzoneli , had been pupils at inanda 
 seminary .
the first nurse recruit , elizabeth njapa however , had been brought to the notice 
 of the mccords earlier , since she had been forced to leave school when it was discovered 
 that she had at the age of fourteen had an illegitimate  half - caste child , and who was then 
 rejected as 
rejection by natal family or  adopted community and 
 subsequent acceptance at a new mission - based site , though with the requirement of submitting 
 to the authority of a new familial order  echoed that of many of the first converts , other 
 nurse trainees increasingly came from 
lineages of prominent kholwa 
 families , whose fathers were preachers within the congregationalist churches ( after 1897 the 
 zulu congregational church ) , or lawyers , teachers , traders and artisans , and later , doctors 
 and political leaders . amongst the most prominent of these families by the 1940s were those of goba , ngcobo , 
 gcabashe , msimang , and luthuli .
beatrice gcabashe ( ne msimang ) was the first african 
 registered nurse in natal to obtain joint general nursing and midwifery registration .
the 
 daughter of a prominent politically active amakholwa family , she was at mh 
 from 1927 .
her son , dr v m gcabashe , was later an intern at mh in the 1950s .
to further 
 illustrate the interconnections between such families and mh , selby ncgobo ( a political 
 activist and academic who received a master s degree from yale university in 1940 and a phd 
 in economics from the university of london in 1964 ) and chief albert luthuli ( who is most 
 well - known for his role as president - general of the african national congress from 1952 to 
 1967 ) were both members of the mh board by 1946 and taylor and luthuli shared a close 
 relationship .
when the latter went to oslo in december 1961 to receive the nobel peace 
 prize , it was taylor who lent him a warm coat . during luthuli s detention in pretoria the 
 previous year ,
when this was granted , and 
 after taylor s suggestion that luthuli be transferred to mh for treatment was declined , 
 taylor confined the content of his letter to assurances of support for luthuli from  his 
 friends and passing on news about luthuli s daughters , hilda and eleanor , who trained as 
 nurses at mh . in his letters , taylor manages to convey his own in loco parentis role and 
 the wider support for luthuli in natal s liberal circles :  they have taken your trouble very 
 well , he added ,  and  like the rest of us  look forward to your return in time. 
  in a letter franked by the prison authorities on 6 june , after sending personal 
 greetings to dr and mrs taylor and asking that these be extended to the mh staff and to the 
 mission council of churches and congregations , luthuli wrote : 
i do nt know if i am 
 professionally correct to ask you , a senior , but may i ask you to send my greetings and best 
 wishes to my two daughters  hilda and eleanor . assure them i am not dying. 
  soon after this correspondence , hilda was to marry thulani gcabashe at groutville . 

white guests were barred from attending the wedding , however . 
  it could be argued that the notion of  the mccord family was hierarchically constructed 
 and in practice recognised as equals only fellow missionaries , and other formally appointed 
 senior staff 
matrons , later additional doctors and health professionals ( none of whom 
 until the mid - twentieth century were black )  while the largely female , black nursing , 
 cleaning and other staff were merely subordinates , or 
children. lived experience , however , 
 was far more complex and involved feelings , frictions and reciprocities that were played out 
 through the notion of being part of  a family. for instance , especially in the late 
 nineteenth and early decades of the twentieth century , the missionary doctors and their 
 families were also cut off from their own natal and extended families . nor , for many years 
 after their arrival , were james and margaret mccord welcomed into durban s elitist and 
 racist professional or social circles . while an instant  community could be found with 
 their fellow missionaries and congregationalists , these circles were not without their 
 difficulties and rivalries .
family was significant for the 
 mccords themselves as well as for the young women who came to train as nurses , the first 
 group of whom were more - or - less the same age as the mccords elder daughters , who had not 
 lived with their parents for some years .
as was the practice at the time , the mccords 
 children ( except their youngest , also margaret , or peggy ) were sent 
home to the usa for 
 their education . in 1911 for instance , the mccords return to durban after their first 
 furlough leave was saddened by leaving their three eldest children , jessie , mary and robert , 
 behind to receive their schooling .
their next home leave , in 191819 , was the final occasion 
 on which all the mccord family would ever be together , for both jessie and laura died in 
 1919 . 
 
although according to katie makanya s reminiscences neither james nor margaret ever 
 mentioned their dead daughters again , it is impossible to read james s account of the death 
 of edna mzoneli of influenza , during the mccords absence from durban , without imagining 
 that this poignant description was in part drawn from the death of his own daughters . 
  one further account of the relationship between james and margaret mccord and edna mzoneli 
 is suggestive of how the close association between these self - identified parental figures 
 and young person could be influential in the moulding of a sense of self . as a school girl 
 and young woman , edna who had a cast in one eye , was regarded by both missionaries and her 
 own father as  weak and  stupid , and she was subject to bouts of hysteria .
demented , margaret physically shook her and 
 then instructed her to go to her room and not to return until she could behave  as a nurse. 
 thereafter , edna devoted herself to her studies and was later appointed assistant matron at 
 mh .
there , she saved her wages and in a remarkable statement of affirmation told margaret : 
  i am a person  you have always been a person .
now i am a nurse. 
  even so , when during a severe outbreak of measles she addressed the people of her 
 natal family home on basic preventive and hygiene measures she felt it necessary to subdue 
 this sense of personhood :  
in the closing chapters of his memoir , my patients were zulus , james 
 mccord devotes some pages to considering the significance of  the mccord family. central to 
 this , he believed was  the mccord nurse , a  composite picture of whom , he said , was a 
 woman who is  well - balanced 
conscious of her duty to her patients ( and )  of her own 
 personal dignity. indeed , she was  neither self - conscious nor servile  ( and ) the only walls 
 or bars to restrain her were her own dignity and self - respect , her knowledge that as a 
 trusted member of the hospital family , she must be worthy of trust. 
  sixty years later , these sentiments were strongly echoed during interviews with the 
 researcher penny watts .
for instance , in 2006 sister mary jane molefe spoke for many mh 
 nursing staff when she stated that in her view 
what made mccord different was ( 1 ) prayer ; 
 ( 2 ) staff selection ; ( 3 ) discipline  . 
  in their view , mh s staff selection  of nurses largely from inanda seminary , and 
 later of medical and surgical staff who may have been of faiths other than christian , but 
 who nonetheless had a strong sense of spiritual calling and service  made for a dedicated 
 and hard - working staff complement in which nurses were valued and who valued themselves . 

sister molefe went on to add that ( at inanda in the 1950s and 1960s )   they did not just 
 give us academics but they were able to give us ammunition to be assertive , to work hard , 
 the ethos of standing up  you know inanda seminary gave us that. 
  thus , discipline applied both to an internal disposition and to outward 
 manifestations of control , and both mccord s memoir and the oral testimony of long - service 
 mh senior nurses , record a strong sense of pride in being a mh nurse , and an active embrace 
 of its moral and behavioural codes .
as at other hospitals , discipline was predictably strict , went hand - in - hand with spiritual 
 instruction and was intimately connected to the vision of mh as a 
family. for instance in 
 1955 long - time mh gardener and sometime patient aide , baba dube recalled that : the 
 strictness enforced on the nurses and myself was rigid and unbending . on sundays it was part 
 of my duty to escort the nurses to and from the church , with dr on his motorcycle likely to 
 be around the next corner .
he told me openly that the parents of these children had 
 entrusted them to his care . and
it was his duty that his girls must be properly looked after 
 as they would be in their own homes .
he did his duty with the able assistance of mrs 
 mccord  . 
  particularly under the stewardship of taylor
, discipline could be harsh . in a letter 
 written by taylor to friends dated 16 december 1945 , quoted in shula marks s
book 
 divided sisterhood : mine is more than the medical superintendent to nurse 
 relationship .
it is that and it is the father - daughter relationship as well  it has numerous 
 ramifications which i would gladly pass on to the matron if we had one who knew the language 
 and customs as well as i do . with 125 daughters all potentially amorous and capable of 
 making a bad match , to watch one
comes perforce either a cynic or a philosopher or a better 
 christian  . 
 
 martha the midwife  was expelled from her course only three weeks 
 before its end because she was  staying over  with a boyfriend and was already pregnant 
 taylor explained that he had not done this lightly and , he said , would have preferred  to 
 work something out , but that he and the matron felt they had little alternative since 
 martha expressed no contrition or  signs of change of heart. tellingly , however , martha s 
 condition had only come to their notice after an anonymous letter had reported  the 
 misbehaviour of one of our nurses who was shaming herself , the hospital and her fellow 
 nurses. 
  if , as seems likely , this letter had been written by one of martha s peers , it 
 points to the conservative expectations of many women themselves at the time .
indeed , when , 
 a year earlier , another young woman had been sent home from mh by taylor when he discovered 
 that she had married  a man that has a wife , her mother ( or sister ; it is unclear which ) 
 wrote thanking him  for all the fatherly trouble ( he )
had taken in this matter of disgrace 
 to our family. 
  dismissal and discipline were not however necessarily mh s immediate or only means of 
 interacting with wayward or fractious staff ; and nor were more senior white women always 
 favoured over their black subordinates .
we can see this in another letter from taylor , in 
 june 1955 , which is full of praise for several nurses , and then goes on to describe how he 
 had intervened in a disagreement between two white sisters and a number of african nurses . 

after this , sister evard had agreed to apologise to nurse sarah keswa and they had then all 
  prayed together. the same afternoon , he noted , he was called to 
another 
 indaba , this time between nurses mary mselku , mildred mnene , miriam ngidi 
 and atchison kuzwayo .
lectured them he said , but was pleased that these  interviews 
 ended on a higher note than treats  [ sic possibly he meant 
threats  ] and 
 punishments. 
  even before the hospital itself had been built , prayer  the third element identified by 
 sister molefe as being central to mh  had been a part of daily practice . in the early years 
 of the twentieth century , zulu - speaking evangelists worked with the mccords at their cottage 
 hospital and dispensary in the centre of durban to persuade sometimes dubious patients of 
 the value of biomedicine .
the practices of preaching and praying continued even after the 
 hospital had been established and expanded , with evangelists and nurses also leading prayers 
 in the out patients department and wards . in turn , this christian ethos did much to help 
 build the unifying 
going against the growing trend towards 
 secularisation underway in many other mission hospitals in south africa during the 1950s and 
 1960s , where the mission s goal of healing the soul had become secondary to the growing 
 pressures of providing professional medical services to heal the body , mh continued to place 
 as much , if not more emphasis , on the importance of the christian faith in healing . 
 
although professing to be a  non - denominational hospital that did  not restrict 
 staff appointments to professing christians , 
  in practice during these middle decades of the twentieth century , the hospital 
 continued to choose christian candidates as their preferred trainees and employees . from the 
 election of hospital board members for their 
christian backgrounds , who started and ended 
 every meeting with prayers ; to the appointment of christian medical superintendents , as well 
 as medical and nursing staff ; to a hospital constitution , which emphasised the hospital s 
 duty to  carry on a ministry of health and healing  to make known to hospital workers and 
 patients by word and by life , the gospel of christ , christianity remained a driving force 
 shaping the identity and work of the hospital . 
  during the 1940s through to the 1970s , medical superintendents taylor and orchard were 
 particularly responsible for the strong christian influences they brought to the hospital . 
 of taylor , mccord wrote that his religion : was nt something ( he ) accepted on sunday and shed 
 on monday .
and when he took charge of the hospital , religion and 
 healing went hand in hand .
we had always had religious services for the staff  and he 
 continued this , but he also allowed religion to play an even larger role in the hospital 
  without question his influence 
ma(de ) the nurses and the staff look upon their work as 
 both spiritual and medical .
professor sam fehrsen , a doctor who had worked at mh during the early 1960s , concurred .
for 
 him , the strong christian family ethos was created by the senior staff , who he said 
  actually lived what they believed in , who infused christianity into the hospital s daily 
 routines , and importantly , their long periods of service provided the continuity needed to 
 nurture and sustain this christian culture . 
 
in addition to the efforts of these medical superintendents , as watts argues , mh s nurses  
 who formed the majority of the staff , who had the most interaction with patients on a daily 
 basis , and many of whom worked for decades at mh  formed the backbone of the expanding 
 christian mission at mh . 
 
indeed , the medical superintendents , matrons and nurse tutors devoted much effort to 
 nurturing and sustaining within their nurse trainees a deep sense of christian devotion and 
  every morning before classes commenced , prayers were held. 
  christian messages , themes and stories , including those about the importance of 
 family , were published in isibuko newsletters ; formed the core of plays and 
 other entertainment events ; 
  appeared on the back covers of nurses song books , 
  and formed a cornerstone of the candle - lighting service at the graduation ceremony 
 held annually at the nurses home .
christian beliefs were also extended to patients and other workers and medical staff . in 
 1966 for instance , dr lasbrey described how the  heart of the hospital is its religious 
 life .
zulu prayers for workers , ward services for patients , and a service in the out - patient 
 department for nurses and staff , are held every morning .
then there are the sunday night 
 services in the nurses home , the staff fellowship , the nurses christian fellowship and 
 quiet time for prayer  . 
 
quiet time ( or hour ) was introduced by taylor in the 1930s ;  it was held at 5:30 a.m. 
 on a weekday and , as mccord recounted : dr .
taylor would pass around slips with perhaps five 
 scriptural questions from one of the books of the bible . for fifteen minutes , while the room 
 glowed brighter with the rising sun , the staff and nurses would meditate on the questions ; 
 then for another quarter hour discuss problems they had raised .
prayers closed the meeting 
 at six , and the nurses would then slip from the room , their faced composed and at peace  . 

attendance at quiet hour was optional , but any of the staff , medical aides or nurses not on 
 duty were expected to be present at the ( daily ) eight oclock morning services .
 the staff 
 and nurses left ( these morning services ) with an inner calm and a spirit of friendship for 
 each other and for their patients . 
 
what this passage does not relate is how such sessions were also spaces in which staff and 
 nurses could explore their own spiritual and individual identities , even to raise questions 
 about their faith or public or private conduct .
one nurse asked the following existential , 
 political and spiritual questions out loud during quiet time in may 1960 : 
why not an insect  a flower  a tree : if i am to be a person then why not a 
 white , or a brown , or yellow person ? or if i am to be an african , why not an african in 
 angola or in the congo ? if i am to be an african in south africa , then why not a man  or a 
 rich person  or a school teacher , etc . ? 
 
why s   i can only 
 believe god knows , and that he has a plan for my happiness , and through me , for the 
 happiness of others. 
  taylor himself was a staunch , but soul - searching , christian and , perhaps more so in 
 his later years , neither immune to self - doubt nor the need to identify his own 
 short - comings . in one letter , he wrote of the centrality of prayer and quiet time in his own 
 life as well as revealing some of the strains experienced within 
the mccord family : more 
 than anything else were the times i had to go to god to get the answers to the problems 
 presenting here in the hospital .
yesterday i had occasion to count up and realized that last 
 year among eleven ( interns ) there were seven who were real problems outside of their work 
  to be more explicit two got to taking dope , three got into triangles ( tangles ? ) and two 
 others got involved in a love affair that shook the hospital .
it was a case of praying for 
 them and for myself at nearly every quiet time .
it is these decisions that have to be taken 
 as an executive affecting others that i find hardest .
formerly , i could harden my heart and 
 cut people off from the hospital without too much trouble .
( now ) there is always a sense of 
 conviction of failure if that has to be done . 
  to stretch the analogy ,
such reflections are testament to the inevitable ruptures and 
 conflicts that are the almost daily experience of families .
further confidential 
 correspondence reveals too how mh nurses and doctors were just as prey to the full range of 
 social and individual troubles as anyone else . in letters between taylor and dr  paul
keen of 
 the  non - european hospital  in johannesburg written in 1961 , harrowing details of drug 
 addictions , overdoses , alcoholism and suicides amongst black doctors , nurses and midwives  

several of them mh graduates  are itemised . 
  for a small number of staff and patients who came to train or work , or convalesce at mh
, 
 the pervasive conservative christian orientation was experienced as restrictive , even 
 suffocating .
not all patients in particular succumbed to the proselytising ; and some nurse 
 trainees objected to the  prison - like 
  discipline and regimented structures within the hospital , as well as regular monthly 
  weigh - ins and strict monitoring of their movements and their visitors , which invaded their 
 personal privacy and treated them like children . 
 
although  weigh - ins were ostensibly to track bodily changes that could suggest 
 serious illnesses , such as tuberculosis , in a strict christian mission hospital , such 
 measuring techniques could also alert nurse supervisors to illegitimate pregnancies , which 
 remained strictly forbidden amongst mh staff . on the other hand , there is much evidence in correspondence , board minutes , 
 isibuko newsletters and interviews that many of mh trainees and staff 
 actively embraced this ethos .
this is apparent in the numerous references to the taylors and 
 orchards as the  parents or  fathers and mothers of the big 
home. 
  familial terms of endearment were also extended to another long - serving senior 
 doctor on the staff , dr aldyth lasbrey , who was affectionately known as 
auntie. 
  the deep effect this family atmosphere had on some individuals who trained at mh , 
 even extended to attempts to propagate it elsewhere , such as mrs athee pillay when she 
 worked at the friends of the sick association ( fosa ) tuberculosis settlement after her nurse 
 training ; in the efforts of the young dr cecil orchard , who tried to build a  mini mccords 
 in the rural district of hammanskraal in the then transvaal after completing his internship 
 in the 1950s ; and dr  mohammed mayat , whose private hospital , shifa , was created as a 
if james mccord and alan b. taylor were patriarchs tasked with the spiritual , moral , 
 educational and physical well - being of their staff , a complementary role as  mother was 
 often fulfilled by their marital counterparts , margaret mccord and mary taylor , and arguably 
 in a less direct manner in later decades by ruth christofersen and then mavis orchard . 
 
while margaret mccord herself assumed the role of matron ( as well as nurse and 
 fund - raiser , and occasionally dispenser and anaesthetist ) , in part reflecting shifting 
 twentieth - century ideologies of the appropriate role of middle class wives , mary , ruth and 
 mavis worked in other , though equally important ways , to build  the mccord family. these 
 included organising hospital social functions , such as annual christmas lunches  where the 
 medical superintendent , the matron , doctors and nurse supervisors acted as waiters to the 
 great delight of the nurses  as well as annual easter parties and usa - inspired thanksgiving 
 dinners , regular hamburger suppers and braais ( barbeques ) , sunday teas , annual prize - giving 
 and candle - lighting services , and many fund - raising events . 
 
often , these events were hosted in the homes or gardens of the incumbent 
 superintendent and his wife . indeed , as recently , as 2009 ,
mavis orchard recalled how she 
 had frequently  worked herself to a frazzle in entertaining the numerous visitors who came 
 to mh , as well as the hospital s staff who were often invited to their home so as to 
create 
 a family atmosphere. 
  at the 2009 mh centenary celebrations , dr zweli mkhize , spoke of mavis orchard as 
 being  like a mother to us. 
  the 
for , not only did discipline and 
 hard work characterise mh , but so , too , did the regular expression of gratitude , grace , joy 
 and celebration .
while these were often articulated via religious commemoration , the 
 hospital has long had a vibrant culture of levity .
this dates back at least to both the 
 mccords and taylors own sometimes jocular and sometimes wry sense of fun , which on 
 occasion , such as the new year s eve festivities in 1953 , saw alan taylor wearing his wife s 
 dress and a wig in a 
sketch he had designed with other doctors to make his  contribution 
 in the way of fun to the party , 
  and also from the interactions between mh s first superintendent of nurses  martha 
 s. macneill  and the first nurse trainees .
not much older than her charges when she took 
 her position at mh in 1911 , james b. mccord described 
mac as sometimes being  more likely 
 than the probationers to giggle at amusing mishaps ; she relieved discipline by mischievous 
 pranks ; and she was more effective than an older , more dignified superintendent would have 
 been with young girls. to lighten routine , mac staged plays that frequently satirised the 
 more serious parts of hospital life . and she planned and rehearsed plays and other 
 entertainments with fully as much zest as the student nurses . 
  while the humour displayed in these mh 
skits on hospital life may be part of what mikhail 
 bakhtin has dubbed the 
carnivalesque release of tensions , in a context where few other 
 avenues existed to release personal and larger structurally - induced tensions between 
 different people , 
  they also highlight a close sense of familiarity and certain level of comfort 
 between staff members , which enabled them to tease and laugh at each other .
these became 
 traditions within the hospital and while decorous by most standards , they permitted both 
 light - hearted and sometimes more trenchant commentary on the characteristics  even the 
 prudishness  of the senior staff , most especially the superintendents . 
 
a bolder form of challenge to authority was exercised when regular holidays were shared by 
 mh doctors and nurses at umnini holiday camp , located about 40  km south of durban .
opened in 
 september 1952 on mnini tribal trust land and with sponsorship from charitable organisations 
 such as the rotary club , this seaside holiday camp , though not exclusively used by mh staff , 
 provided a safe space where , in defiance of racially separatist apartheid laws , mh s doctors 
 and nurses could relax and spend time away together . 
 
staff members would spend weekends there to mark special occasions , such as the end 
 of year nurse trainee results , or to encourage bonding amongst new nurse recruits . though 
 their leisure time was structured and supervised , such as being  given a lecture on 
 fractures by dr taylor , nurses enjoyed their experiences there immensely , as nurse martha 
 diaho remembered : we certainly enjoyed our swim times ! 
it was fun to see baba taylor 
 trussed up in his life saving gear , waiting for one of us to drown ! in the evening we played 
 games by the seaside until 8:30 pm , after which we had our evening prayers and sang 
 choruses .
 it really was a very pleasant weekend and  we would love to repeat the 
 experience  
 
while the number of staff remained relatively small , the medical superintendents and nurse 
 supervisors kept a personal interest in all of their trainees , who were known by name and 
 whose families , careers , marriages ( hospital romances were no less frequent then than now , 
 perhaps more so given the limited opportunities for young people from 
respectable 
 conservative families to meet eligible partners ) , children , illnesses and fortunes were 
 tracked .
the mccords and taylors , as well as other mh members of staff , were often invited 
 to funerals and weddings of existing or former employees , to share in their sense of loss 
 but also moments of happy celebration .
bongi dlomo , who worked at mh between 1953 and 1973 
 asserted that when she got married 
dr  taylor was one of the 
 guest speakers on my behalf and most of the staff members came  so it was really a family 
  it was special. 
  in addition , the hospital s historical papers contain many photographs of weddings 
 as well as individual portrait photographs of the nurse probationers . 
 
this was a deliberate way in which taylor nurtured a sense of family - belonging and 
 involved taking and keeping photographs of each of his staff , as a proud father would do of 
 each of his children , as dr aldyth lasbrey wrote of the nurses in one of her letters to her 
 friends in america :  in ( our hospital ) she matters as an individual .
she knows that her picture is mounted in his 
 gallery of mccord nurses , and he has given her a print to keep or send home to her 
 parents. 
  these carefully planned and implemented activities and routines did much to strengthen mh s 
 particular family - inspired 
organisational culture , which was so vital to the functioning 
 of this mission hospital over the long term , with its high patient volumes , long hours of 
 work and low pay . however , these photograph album - building exercises and the multi - racial 
 
family social get - togethers at mh , or umnini , also importantly helped to build a strong 
 sense of camaraderie , harmony and 
team spirit , which , many felt , served to chip away , or 
 at least deflect , some of the worst excesses of racial inequalities and tensions that 
 plagued other hospitals at the time . 

the middle decades of the twentieth century were turbulent ones for mh as it had to weather 
 the storm of political change that accompanied the election of a more conservative 
 government , which after 1948 , promulgated legislative measures which promoted the greater 
 segregation of the country s 
race groups , worsened race relations , and worked to oppress 
 and further control the country s black majority .
individuals and organisations which did 
 not toe the apartheid - party line would feel the full wrath of the law . in the health care 

sector , these policies did not amount simply to idle threats . during this period , only about one - third of mh s
total annual expenses were covered by 
 government grants and subsidies ; 
  a scenario very different from most other mission hospitals whose heavy or complete 
 reliance on state subsidies led to their being nationalised and thus losing their 
 operational independence .
in addition to placing enormous strain on the hospital s managers 
 to continue finding the money from other sources to cover expenses , they were also forced to 
 walk a fine line between promoting a more liberal agenda , and facing state subsidy 
 withdrawals if they went too far . 
  on several occasions during the 1960s and early 1970s
, mh faced very real threats of 
 closure under the notorious group areas act for being  wrongly sited 
  in a white residential area , and for violating numerous apartheid policies . 
  nor was mh immune from the negative effects of race - based policies .
sometimes , white staff 
 and their families were made targets of racial abuse and even assault because they or 
 someone they knew worked at this 
kaffir hospital. 
  black staff and their families not living on the premises had no option but to live 
 in segregated townships , far from their work place and in inferior , under - serviced 
 accommodation , and were often harassed , humiliated and even arrested by the police if they 
 did not carry their 
passes. 
  in addition , within the hospital s corridors , racial inequalities and 
 discriminations were replicated .
this is evident in numerous ways . as a black hospital , 
 though one established many years prior to apartheid and with different humanitarian aims , 
 its race - based admissions policies dove - tailed with the state s separate development aims . 
 its practice , until the 1970s , of having white upper - level managers also kept 
 decision - making power in white hands .
paternalistic references made to adult african men and 
 women employees as  boys and 
girls respectively in mh documentary evidence also 
 infantilised the staff . 
  furthermore , for many years , differential salary scales based on racial 
 criteria , 
  as well as the perpetuation of hurtful racial segregation practices , including the 
 existence of separate residential , dining and toilet facilities for black and white staff 
 members , operated at mh . 
  however , mh s greater operational independence as a state - aided not 
 state - controlled institution  a status it was able to maintain throughout the apartheid era 
  enabled it to remain a  school of liberalism in trying times . 
  with regard to race - based admissions , mh was also able to flout rigid apartheid 
 policies . although it had started out with the aim to serve 
zulu patients , mh quickly 
 accepted and treated african patients from a variety of ethnic backgrounds , as well as 
 patients who were legally classified as being  indian and  coloured , much to the chagrin 
 of the state . in 1950 11% of its in - patients were made up of  indians and  coloureds : and 
 this had increased dramatically to about 40% by 1975 . 
  occasionally , white patients were also treated , such as members of missionary 
 families . and , unlike other provincial hospitals that were run on a racially - segregated 
 basis , mh s wards remained racially - mixed , enabling its patients to fraternise across racial 
 lines . 
 
although discrimination in pay and in some other policies remained in place during the 
 segregation and early apartheid years , by the 1960s , mh managers worked hard to achieve 
 parity in the doctors and nurses salary scales across racial lines , and tried to eliminate 
 petty apartheid practices in the hospital , such as segregated eating and ablution 
 facilities .
in fact , in 1959 , taylor had persuaded the mh board to vote in favour of paying 
 all of its first year medical interns on the natal provincial administration 
 ( npa)-determined  white salary scale. 
  taylor s  equal pay for equal work policy for interns was taken up and extended by 
 dr cecil orchard when he took over as medical superintendent in 1965 . balancing limited 
 hospital finances and a contentious 1966 npa decision to increase the salaries of white 
 interns and doctors by 20% ( a move which threatened to provoke staff unrest at mh similar to 
 that which was disrupting health services at other provincial hospitals at the time ) , 
 orchard , however , knew that compromises had to be made . 
  in june 1967 , he persuaded the hospital board to accept the middle figure salary 
 scale that had been stipulated by the npa for indian medical employees , for 
 all interns and doctors working at mh . for its nurses , who were mostly made 
 up of african women , the hospital decision - makers decided to follow the scale set out by the 
 npa for african nurses . 
 
thus , although mh s managers were not able to remove the race issue from affecting 
 salaries at their hospital completely , their carefully thought - out salary compromises , which 
 resulted in the same salaries paid for the same levels of qualification and work done , 
 helped prevent the divisive race issue from having an all - determining effect , allowing for 
 the development of closer interracial staff working relationships .
what is more , captured in numerous official hospital documents , but also in the words and 
 opinions of countless staff members employed at various levels of the hospital s hierarchy , 
 was a sense of belonging and value they felt as employees in a hospital that provided an 
 inclusive and supportive space where opportunities abounded for both professional promotions 
 and friendships .
following 1930s and 1940s  firsts  , such as the appointment of one of the 
 first african sisters in the country to assume responsibility for a major hospital ward , and 
 using an african sister tutor to conduct nurse training , in 1953 mh appointed durban s first 
 african theatre sister . 
 
two years later , mh had  african sisters in charge of the whole hospital at night , 
 of the children s ward , of one of the two maternity wards , of the operating theatres , of the 
 large out - patient department  and all district midwifery services. 
  by 1958 , dr taylor could boast :  we have more senior non - europeans in proportion to 
 the european staff than the provincial hospitals , and by 1962 , of the ten sisters posts 
 available at mh ,  seven were held by african sisters , two by whites and one by an 
 indian. 
  mh was also one of the first hospitals in the country to open up internship 
 positions and employment opportunities for black interns and doctors from the late 1940s 
 onwards . 
 
for many medical interns and doctors , the work experiences they had at mh were 
 life - changing . in 1962 , taylor wrote :  again and again , interns tell us they leave ( or 
 later ) , how much their year at mccords has meant to them  not only professionally , but in 
 achieving racial understanding and goodwill. 
  having come from different cultural backgrounds , often from diverse locations across 
 the country , and having been brought up in racially - segregated environments , many doctors 
 and nurses remember establishing some of their first close friendships across racial lines 
 at mh .
as one african doctor who did his internship in 1981 aptly captured it : at 
 mccords  everybody was community , nobody was seeing each other as different and it was  ideal . 

i ca nt think of a better situation for one to have worked in than mccords  because there was 
 no racial issue at all .
even the number of interns they took was a balance of all the races . 

orchard was intentional about making sure that he created an 
 environment that ( was ) as close to normal as possible and he did well . 
 
sometimes these relationships led to open displays of anti - apartheid solidarity , such as mh 
 nurses marching together in public protest against the nursing act in 1957 , which instituted 
 further racial inequalities in the nursing profession , and which would bring additional 
  heat down on mh managers . by the 1960s , increasingly the hospital s white managers knew 
 that they were being watched by security police , and , threatened on occasion with 
 closure . 
 
at times , the development of interracial friendships led to deep personal levels of 
 support for individuals going through difficult times in their private lives . during the 
 1960s ,
sister bongi dlomo s husband , a laboratory technician , was arrested for his 
 involvement in anti - apartheid 
terrorist activities and sentenced to three years 
 imprisonment on robben island . according to sister dlomo : that is when i appreciated 
 mccord s ( be)cause they ( mh supervisors ) were very , very supportive  at the time he was 
 detained , mccord ( hospital ) would give  transport to take food down ( to the jail ) or take 
 him , you know , a change of clean clothing . and during the trial , they would make sure i 
 attended without saying you know 
you must pay back the time   and it proved that as a 
 family they were very , very supportive in problems like that  they supported those people 
 that were in trouble , that had problems like me . 
 
 provided a possible  answer to south africa s ( race ) 
 problem   
  that staff strikes , industrial disputes or serious disciplinary measures were not a 
 serious feature of the mh landscape until the 1970s , says much about the strength of bonds 
 forged by 
this  sense of family 
  also extended beyond mh staff to incorporate many people who appeared to have 
 tenuous links to the hospital , because of actual distance or because they no longer worked 
 or trained at this institution . by the 1940s , however , by which time several hundred nurse 
 and midwife trainees , as well as a number of medical interns had been trained at mh and had 
 moved on to live and work in other places , the close in - person  family connections 
 initially built within the walls of the hospital could no longer be maintained so 
 intimately ; something which was lamented by the mccords and taylor in their correspondence 
 and reminiscences . nonetheless , an extensive network of letter writing , both to and from the 
 hospital , ensured the continued circulation of news , and the preservation for those far away 
 of an interest and concern for their 
beloved mccords. 
  taylor was very much a  family man and worked hard to maintain close links with all his 
 biological children by writing weekly letters , because as adults , they lived far from their 
 parents either in the usa or rhodesia ( now zimbabwe ) , where his son boardman went to 
 practise as a doctor .
his value of these family - building letter - writing exercises can be 
 seen in his weekly  letters to the kids , which amount to hundreds of pages which he 
 carefully preserved almost in lieu of a diary . often composed late at night or in the early 
 hours of the morning ,
either in his home or in his office , and sometimes waiting to be 
 called in to perform a surgery , these letters were written whenever he could carve a moment 
 to write in his busy schedule . in 1969 , reflecting back on his working with dr taylor , dr 
 mohammed mayat highlighted how many a time as i crept exhausted to bed after a hard day s 
 work with dr taylor , doing many operations , i would notice the light in his office still 
 burning and see him setting up the typewriter trying to catch up with correspondence he had 
 had no time to attend to in the day  
 
these letters kept his family informed of the people and goings - on at mh , including 
 people they had met as children growing up in durban .
however , they also served to show how 
 despite missing them enormously , both he and their mother had managed to become part of a 
 surrogate 
mccord family at the hospital , which helped them to feel a sense of belonging 
 too .
the familial investments they placed on getting to know their staff , and their 
 conceptualisation of staff doctors and nurses as their  sons and  daughters , helped 
 soften , to some extent , their feelings of loss of their own sons and daughters .
what is more , during the 1950s and 1960s , dr taylor wrote many letters addressed to  the 
 mccord family in the hospital s isibuko newsletter , which accompanied 
 other  newsworthy articles , stories and interest pieces to keep graduates , ex - employees and 
 other supporters of the hospital  around the country and overseas  informed about matters 
 affecting the hospital . 
 
for example , in 1962 , taylor wrote in an editorial entitled  greetings to the mccord 
 family everywhere about the strong bonds members of  the mccord family shared , despite the 
 distance :  it is a grand feeling to know that though we may , some of us , have left the 
 hospital , we have not left the  family and so wherever you are this christmas - time i would 
 like to wish you a very happy christmas. 
  some of his letters also made a concerted effort to keep  the mccord family 
 informed of developments in his own family , including career achievements , marriages and the 
 arrival of new grandchildren . 
 
the taylors shared the news of their family s lives with many people whose lives 
 they regarded as intertwined with their own .
many nurses living hundreds if not thousands of kilometres away from mh greatly appreciated 
 this written umbilicus , capturing their internalisation of  the mccord family ethos in 
 their numerous supportive  letters to the editor section in successive editions of the 
 isibuko . for example , in 1959 , mavis zondi ( nee ndaba ) wrote how she 
 still regarded mh as her  home , despite starting a new life as a sister in a small hospital 
 in pietermaritzburg , some ninety kilometres ( fifty - five miles ) away . 
 
further afield , in london , muthulumi pillay , who was undertaking a post - graduate 
 course in paediatric nursing , wrote in 1964 of how much she had enjoyed seeing the taylors 
 who were visiting london at the time , especially  pop , who in her opinion ,  hasnt changed 
 a bit. 
  for many of these nurses , while making them   feel home sick remembering all the 
 happy days  spent at mccords , reception of regular copies of this mh newsletter provided 
 them with a vital connection to this hospital . 
 
furthermore , on various trips , including after their retirement in 1964 , the 
 familial affection that the taylors had helped mould at mh saw members of their  extended 
 family ( by then working across the wider southern african region ) greet them with 
 gusto . 
 
josephine matondo , writing from luanshya hospital , zambia , in a 1964 edition of the 
 isibuko exclaimed :  we were so delighted to see dr and mrs taylor before 
 they left and it was very kind of them to visit the family so widely spread here in rhodesia 
 and zambia. 
  finally , although this wide network helped to preserve for many an interest in mh , its 
 purpose was not only the communication of news or the ideological extension of  the mccord 
 family ethos .
over the years , the mccords and taylors actively crafted an extensive network 
 of personal and professional 
friends for mh , some of whom were wealthy and influential , 
 such as government officials , legal or financial experts and powerful business - people . 
 
the taylors particularly built and maintained many friendships with various people 
 both in south africa and overseas by writing numerous  letters to friends , and , for those 
 based in the durban region , or visiting the durban area , inviting them to formal or informal 
 social gatherings hosted at the hospital or at the medical superintendent s home . 
 
here taylor , whose affable personality was often noted , served to charm innumerable 
 guests to the work he and his staff were doing at mh . carefully chosen because of their 
 interest in  non - european affairs , in christian missionary work , or because they could 
  assist the hospital in their professional capacities ; some of these mccord  friends also 
 provided considerable material support for the hospital . 
 
receipts of private donations from sponsors , as well as the provision of political 
 and legal support services when needed , were just some of the actual benefits accrued . 
 having
an  extended family of loyal supporters played an enormous role in enabling the 
 hospital to survive and expand in difficult times .
for more than a century , mccord hospital has self - consciously moulded its own identity  
 and that of those who have studied , worked and been tended to there  in christianity and in 
 public service .
it has also actively constructed and nurtured a skein of relationships that 
 were based on the ethos of the middle - class family that had first emerged in 
the west in 
 the nineteenth century . within this familial order , gender , generation and rank were to be 
 observed and there was great investment in creating the belief that the family and the home 
 were  private spheres , distinct from the public world of politics and power .
similarly , 
 hospitals and their hierarchies were strongly influenced by the ideology of the domestic , 
 particularly with regard to the position and value of nurses , most of whom in south africa 
 ( but unlike much of other colonised regions of the continent ) were women . over the last several decades however , historians have shown just how intimately connected 
 were the public and the private ; they have demonstrated too that hospitals  in africa as 
 elsewhere  reflected and reinforced the wider social orders of which they were a part . and , 
 as has been observed by marks , amongst others , in south africa s missionary - initiated 
 hospitals and nurse training programmes , this world could be deeply conservative and 
 reinforcing of patriarchal and patronising behaviours and attitudes
we have however argued that in considering the 
 different ways in which the notion of  the mccord family has been experienced it seems that 
 the world within mh was more complex .
generally more respectful of the 
 value of professional service and individual human dignity than was usually the case at 
 state hospitals where 
white bodies and where 
 working conditions were highly discriminatory and exploitative , mccord hospital also offered 
 to many a space and an identity where they could feel part of a larger 
while mh has certainly not been without its internal inequalities , frictions , frauds , 
 strikes , protests , rivalries , tragedies , and critics  some of whom regard it as having a 
 conservative ethos ( or being prepared to work closely with those who do ; for instance , 
 pepfar under george w. bush )  this does not mean that the majority of doctors or nurses 
 were or are  depoliticised and  see the individual rather than the social origins of ill 
 health. 
  rather , mh management and medical staff have long been at the forefront of 
 progressive health care in the region ; and with its  extended family this impact has been 
 wider still .
even as the discourse of  the family with its implications of a naturalised 
 sense of hierarchy has increasingly , in recent decades , given way to that of  the team with 
 its own resonances of professionalised equals competing with their peers , importantly , it is 
 clear that even many patients  whose testimonies are so seldom directly detectable in the 
 records  have continued to identify with the central tenets of mh , of christianity and 
 family . as one wrote recently : thank you kindly for the extremely positive experience that 
 we had with mccord hospital on monday , 8 february 2010 .
this was visible from the security guards at the parking entrance and right through to our 
 site visit in the hospital .
we both 
 experienced a feeling of  being home. mccord definitely displays a calmness , being 
 contended , working together for a larger cause , helping one another and care as a heart 
 matter .
being both reborn christians , our visit to mccord brought us back to basics . 
  with the impending state takeover of mh
significantly , however , at a time when both south african government officials at the 
 highest level are calling for a return to  traditional values in nursing and medicine , 
  and nursing and management ( including human relations ) professionals and scholars 
 are investigating how to  build supportive environments for health care workers and 
 patients , 
  in a context of the hyper - commodification of hospital - based care , rather than being 
 irrelevant , or a reflection of an out - dated ideology or 
organisational culture , it may be 
 that a critical history of the ways in which individuals , hospitals , faith and 
families 
 intersect may be of value for the future of hospitals in africa as well as of interest in 
 their past .
 for more than a century , mccord hospital , a partly private and partly state - subsidised 
 mission hospital has provided affordable health - care services , as well as work and 
 professional training opportunities for thousands of people in durban , a city on the east 
 coast of south africa . 
 this article focuses on one important aspect of the hospital s 
 longevity and particular character , or  
 organisational culture : the ethos of a  
 mccord 
 family , integral to which were faith and a commitment to service . while recognising that 
 families  including  hospital families like that at mccord  are contentious social 
 constructs , with deeply embedded hierarchies and inequalities based on race , class and 
 gender , we also consider however how the notion of  a mccord family was experienced and 
 shared in complex ways 
 . 
 indeed , during the twentieth century , this ethos was avidly 
 promoted by the hospital s founders and managers and by a wide variety of employees and 
 trainees . 
 it also extended to people at a far geographical remove from durban . 
 moreover , 
 this ethos became so powerful that many patients felt that it shaped their convalescence 
 experience positively . 
 this article considers how this  
 family ethos was constructed and 
 what made it so attractive to this hospital s staff , trainees and patients . 
 furthermore , 
 we consider what  
 work it did for this mission hospital , especially in promoting bonds of 
 multi - racial unity in the contexts of segregation and apartheid society . 
 more broadly , it 
 suggests that critical histories of the ways in which individuals , hospitals , faith and 
  families intersect may be of value for the future of hospitals as well as of interest in 
 their past . 
McCord Hospital and Family (Dis)Connections
What made McCord different? (1) Prayer; (2) Staff selection; (3) Discipline.
A Sense of Belonging: Fun, Friends and Family
The McCord Family and Apartheid
Extended family Networks
Conclusion