Embarking on a four-week train journey through Central Europe, Turkey, and Damascus, Schwester Selma arrived at Shaare Zedek in December 1916. Several weeks later, Jerusalem was hit by a year-long typhoid epidemic, and typhus and meningitis also raged in the city. The 40-bed hospital, which added another 110 beds to accommodate patients, was inundated. The hospital recruited untrained workers, whom Schwester Selma outfitted in "overalls and hoods" to protect them from infection; she ordered all incoming patients washed and shaved over their entire bodies. Schwester Selma also introduced German standards of nursing to the wards, including white uniforms for all hospital personnel, changing of uniforms and bed sheets daily, and daily bathing of all patients.