Welcome to part one of Three Trailblazing Hawaiian Nurses blog series – Mabel Isabel Wilcox, First Registered Nurse in Hawaii. 

Hawai’i’ is one of the most multicultural and ethnically diverse places on Earth. This rich blend is reflective of its nursing history. Pioneer Registered Nurses in Hawaii include nurses of Native Hawaiian, English, Chinese, Japanese, and Filipino heritage. Their lives and work create a beautiful kaleidoscope of service that has improved the lives of residents in this tropical paradise for over 100 years. The life stories of three groundbreaking Hawaiian RNs can inspire us all.

Mabel Isabel Wilcox 1882-1978 First Registered Nurse in Hawaii

The first Registered Nurse in Hawaii was Mabel Isabel Wilcox. Her maternal (David and Sarah Lyman) and paternal (Abner and Lucy Wilcox) grandparents were Caucasian Christian missionaries who traveled from New England to the Kingdom of Hawaii in the 1830s to establish schools and preach the Gospel.

Mabel was born on the island of Kauai on November 4, 1882, to the Wilcox’s son Samuel and the Lyman’s daughter Emma. She remembered a carefree childhood in a family that valued religion, philanthropy, education, and public service. When Wilcox was in her teens, there were no college preparatory high schools in Hawaii, so her parents sent her to California to complete her high school education. However, she stayed on the mainland, and in 1911 she graduated from the Johns Hopkins School of Nursing in Baltimore and passed her Registered Nurse examinations. Soon after graduation, Wilcox returned to Hawaii and began her career as the resident school nurse at the Kawaiahao Seminary, a Congregational Church-sponsored girls’ school in Honolulu, becoming the first Registered Nurse in Hawaii.

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An early photo of Mabel Wilcox Hawaii’s first Registered Nurse

Earned the Moniker “Kauku Wilikoki”

Wilcox missed her extended family on Kauai, so in 1913 she accepted an assignment to begin and head the Territorial Board of Health’s anti-tuberculosis (TB) campaign on the island. She was the only Board of Health nurse on the island and served approximately 5,000 people. Often on foot or horseback, she did case investigations, collected sputum samples, educated the community about the disease, and provided follow-up care to those diagnosed with TB. Wilcox quickly saw the need for a TB Hospital on Kauai. She convinced service clubs and business organizations on the island to support her idea and solicited most of the funds needed from her aunt and uncle, Emma and Albert Wilcox. After a year of construction, the Samuel Mahelona Memorial Hospital opened in 1917.

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Although Wilcox was hired to reduce the number of tuberculosis cases on Kauai, in 1920, Hawaii reported a 25% infant mortality rate, double that of the mainland. In addition, there were no maternal/infant health nursing programs on Kauai, so Wilcox added education on nutrition, sanitation, and healthy birthing practices to her rounds when she encountered pregnant women and young children. As a result, she earned the moniker “Kauku Wilikoki” or Doctor Wilcox for her work.

As soon as the U.S entered WWI in April 1917, Wilcox was anxious to do her part. She wrote the American Red Cross nursing service requesting an overseas assignment. Her work with maternal/child health in Hawaii gave her knowledge and experiences she would draw on during her war years.

Nurse Behind the Lines During WWI

Beginning in the winter of 1918, Wilcox was the Head Nurse of a hospital and outpatient clinic for women and children in Le Havre, France. The facility was relatively safe miles from the battlefront lines when Wilcox arrived. After that, however, the fighting grew closer. In September of 1918, Wilcox was sent into nearby Belgium, directly behind the advancing Allied troops, to inspect maternal and child health conditions and conduct clinics. While there during the final Allied campaign, she wrote to her family: “One night we were bombed, crawled under the bed, two of us trying to get into one helmet. Scared.” After the war ended, Wilcox spent another year in France helping mothers and children, many of whom were orphaned or refugees. Once the French government was stable enough to take over her work, she returned to Hawaii. She was awarded medals from the Queen of Belgium and the mayor of Le Havre for her service.

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Kauai’s First Territorial Maternity and Child Health Hygiene Nurse

In 1921 Congress passed the Sheppard-Towner Act providing funds for maternal-child health programs. With these new monies, Wilcox was hired as Kauai’s first Territorial Maternity and Child Health Hygiene Nurse to focus full-time on improving the health of women and children. As they began hiring more nurses, she became the Supervising Nurse, a position she held until her retirement in 1935. In the first year, public health nurses made nearly 1,000 home visits, and newly organized “demonstration clinics” recorded an attendance of 4,403 mothers. Infant mortality dropped by 14% in the first year of the program. The program successfully provided care to 8,398 mothers and infants in 1927.

Congress discontinued funding the Sheppard-Towner programs in 1929. Then in 1930,  Wilcox became the supervisor of the new generalized public health nursing program on Kauai. She oversaw tuberculosis, maternal-child health, and school and home health nursing programs on the island. During this time, Wilcox was a leader in many professional associations. She launched the Kauai Nurses Association, served as its first president from 1932-1946, served as the first executive director of the Kauai TB Association, and was on the Board of the Mahelona Hospital.

G.N. Wilcox Memorial Hospital

On Kauai, many sugar plantations maintained small, often inadequate, hospitals for their workers and families. After Wilcox’s father and mother died (1929 and 1934, respectively), she and her siblings decided to build a new, modern general hospital in their memory. She retired in 1935 and spent her time and energy making the G.N. Wilcox Memorial Hospital a reality for the next few years. It was dedicated on November 1, 1938, with 96 beds in wards and semi-private private rooms, 17 physicians and 50 employees, and 14 graduate nurses. The hospital provided more than 10,000 days of care in the first year of operation.

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Upon Wilcox’s retirement, Mabel Smyth, RN, the Head Nurse of the Territorial Board of Health, wrote a tribute to her in The Pacific Coast Journal of Nursing.

It read in part: “With clarity of purpose and wisdom in leadership Miss Wilcox has developed an unusual spirit of loyalty and devotion among her corps of nurses and superiors … every nurse … on the island turns to her for inspiration and leadership in matters pertaining to individual and community well-being.” (Smyth, M, “Public Health Nursing in Hawaii: A Tribute to Mabel I. Wilcox,” (1935) The Pacific Coast Journal of Nursing,  297-98).

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Mabel Wilcox circa 1911 and 1951

Influence of Wilcox Lives On

In her late 50s and 60s, Wilcox stayed active with the Wilcox Hospital in an unpaid capacity. She served on the hospital board, raised money for expansions, and recruited nurses. During this time, Wilcox also became very interested in historic preservation. Because both sides of her family tree had been missionaries and plantation owners in Hawaii for over 125 years, she and her living siblings began restoration efforts to preserve their ancestral homes and papers. Today the Waiolo Mission House, the Lyman House Memorial, and Grove Farm all stand as testimonies to their efforts, as do many manuscripts, records, and correspondence housed at the Grove Farm library.

After years of declining health, Wilcox died on December 27, 1978, at age 96. Before her death, the Kauai Tuberculosis Society honored her with these words: Through the years, there has been little in the health and welfare fields on this island that does not owe its beginnings to Miss Wilcox’s vision and active support. Her scope has been not only island-wide but territorial and even national.

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Wilcox is is buried on her beloved Kauai Island.

Check back next week for part 2 of the Three Trailblazing Hawaiian Nurses blog series – Mabel Leilani Smyth, First Hawaiian Registered Nurse with Hawaiian Ancestry.

Phoebe Ann Pollitt, RN
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