Macedonia and Thrace---Moslem Exiles---Tobacco of Great Price---Starvation---
Animals with Personality---Revolutions---Earthquakes and the Evil Eye

FOLLOWING the Greco-Turkish War and the burning of Smyrna, the flood of refugees sweeping from Turkey toward the mainland of Greece had temporarily swamped the Ægean Islands. Month after month, year after year, thousands upon hundreds of thousands moved from island to island and shore to hinterland seeking places of permanent settlement. The Greek Government had agreed to receive them, but they were a burden to local communities and about as welcome as a horde of poor relations with the smallpox. As a matter of fact, they were carriers of pestilence, and their relationship and nationality were centuries removed. They had been Turkish subjects for about six hundred years, but they claimed descent from the Greeks of the Golden Age when Alexander the Great ruled the world and wept for other worlds to conquer.

Speed the parting guests was the dominant idea on the islands and in the coastal cities. Get these refugees onto the outlands where they can be absorbed advantageously, and as quickly as possible without upsetting the whole country. Every effort was made to help them out. "Move on! Move on!" In all the languages spoken on the face of the earth, this order is issued to the destitute, and by the beginning of 1924 the emergency work of the American Women's Hospitals on the Ægean Islands was finished.

Meanwhile, a call which has echoed through the ages was being received by letter, cable and personal appeal: Come over into Macedonia and help us! There was no denying this call. The faith of our fathers resounded in it. Our physicians and nurses had become part of the migration. They moved with the refugees and it was time to move. Providing a small subsidy and leaving supplies, we turned our island service over to local authorities and transported part of our equipment in sailing vessels to Thrace and Macedonia, where we organized hospitals and clinics and worked for several years.

In September, 1924, Dr. Ruth Parmelee and I visited the refugee camps at Salonica, and the American Women's Hospitals' stations in other parts of Macedonia and Thrace. Thousands of Moslem people were encamped at Salonica waiting to be transferred to Turkey. These people had never been in the country to which they were being deported under the terms of the "Convention Concerning the Exchange of Greek and Turkish Populations." But they were Mohammedans in religion, therefore they had to go. Most of them were the descendants of people who had "accepted the Faith" during the hundreds of years that Turkey ruled over the Balkans.

The flight of the Christian people from Turkey to Greece, and the "compulsory exchange of populations" afterward arranged between these countries in order to facilitate the settlement of refugees in Greece and to restock their homeland in Turkey with human beings of the Moslem Faith, incidentally settled the Macedonian question---perhaps. A "voluntary exchange of populations" based upon nationality was arranged at a later date between Greece and Bulgaria, and now the people of Macedonian and Thracian Greece are supposed to be Greek.

Two years had passed since the burning of Smyrna, but Christian refugees, those who had lingered in their Anatolian homes because of favorable local conditions, were still coming through the quarantine station at Salonica on their way to the interior of Macedonia. These people, mostly women and children, were carrying enormous loads on their backs, and their chief reliance against further misfortune was some sort of a talisman, probably a blue bead.


Dr. Angenette Parry at Kokinia Hospital, where she served as a volunteer for four years.

Western Macedonia was not new territory to the American Women's Hospitals. Our first work was done at Vodena, near the Salonica front, in coöperation with the American Red Cross during the World War. After the Armistice, this service was discontinued, and in 1924-25 we returned and established hospitals at Djuma, Tchaldjilar and other places, with village clinics and motor medical service. American nurses had charge of these stations, which were conducted with the help of partially trained refugee nurses, and refugee physicians, some of whom were highly qualified.

In Eastern Macedonia, medical relief service was conducted in the Drama District, and hospitals with outlying clinics and healthmobiles were carried on at Pravi and Prosochani. Miss Emily Petty, an American nurse of marked initiative, courage and adaptability, had charge of our work in Thrace. She had been the director of the American Women's Hospitals' service on the islands of Chios and Mitylene, and after the flood of outcasts had swept over these islands, she shipped our equipment on a Levantine freighter, a sailing smack, and followed her refugees to Thrace. At the request of the local government, she opened the American Women's Hospital at Xanthi and established clinics and child welfare work at Yenidje and other villages.

Who ever heard of Xanthi and Yenidje? Darius, Phillip of Macedon, Alexander the Great, and all modern tobacco men. Yenidje was an ancient town when Xerxes invaded Greece. These places were forgotten for about two thousand years and rediscovered by the modern world after the introduction of tobacco from America into European countries, including Macedonia. If pearls of great price were found occasionally on a remote reef in the Mediterranean, all the jewelers in the world would know about that reef. And all the well-informed tobacco dealers in the world know about Xanthi, because in a limited district around about this old town, the sun casts an ardent glance upon a peculiar soil, and produces tobacco of great price. The Yenidje tobacco is the very attar of roses, the choicest leaf that grows in the way of the noxious weed.

The Xanthi tobacco crop is secured by the great tobacco companies, sent to Egypt and other countries, where a flavoring of this precious foliage is mixed with the common garden varieties, and used in the manufacture of the most expensive brands of "Turkish" and "Egyptian" cigarettes. This fine leaf grows only in favored spots, but the country is covered with the ordinary weed. We were in Eastern Macedonia and Western Thrace during the harvest season, and wherever we went to visit sick refugees, many of whom were suffering from tuberculosis and malaria, we found their wretched hovels, sometimes in old khans, festooned with tobacco leaves strung on strings to season and develop the famous Yenidje flavor.

The great need of medical service in Macedonia during the winter of 1924-25 was indicated in the following cables sent to the United States from that country:

There is much slow starvation. One cannot walk through the refugee camps without seeing hundreds, whose pale, pinched faces show lack of nourishment. Such as these are in physical condition to catch any form of disease. Cabled words cannot describe the real downright misery and terrible suffering that daily confronts those of us who are in the midst of it.

Chairman, American Mission Relief.

I would say that one-third are slowly starving. The relief need in Salonica and Macedonia is more urgent than I have ever seen before during my thirty years residence in the Near East. They are without adequate food, clothing, shelter or employment; are anæmic and easy prey to disease.

American Mission Board.

Our personal inspection refugee situation reveals most distressing conditions . . . . Scores of thousands, mostly women and children, undernourished, malarial, living in indescribably crowded unsanitary barracks, hovels and shacks. Greatest need we have seen in any country since World War.

Teachers College, Columbia University.

Director, Serbian Child Welfare Association.

Similar cables testifying to suffering due to undernourishment and sickness were sent by Morgenthau, Refugee Settlement Commission; Lambros, Governor-General; Treloar, League of Nations; Milward, Save the Children Fund; Oerts, Danish Industrial School; House, Thessalonika Institute and by Dr. Ruth Parmelee, head of the American Women's Hospitals, Salonica, Greece.

Entrance to an A.W.H. compound, Macedonia.


Mabel Power, R.N., director, A. W. H., Tchaldjilar District, Macedonia.

Admitting a patient at Tchaldjilar Hospital, Macedonia.

Note the Yenitza tobacco drying on the wall.

Adah Butts, R.N., director A. W. H., Djuma, Macedonia, crossing the plain in an uncovered wagon with a load of American old clothes for refugees.

At that time, ours was the only American organization conducting a general medical relief service and maintaining general hospitals for housing, feeding and caring for the sick among the refugees to which all of these cables referred. Specific reports were received month after month from our representatives in outlying districts: "Maternity cases are infrequent, fortunately, and the few babies born during the past six months have not lived long." This came from Parga in January, 1925, where we were distributing food, and in November, 1925, the following was received from the physician at our hospital at Grevena: "No one knows how many are dying singly in these villages, but in one place named Pinar eleven persons died lately from hunger and it was found upon investigation that the whole village had been living for days on wild pears."

The Refugee Settlement Commission, Henry Morgenthau, chairman, with over a million acres of land placed at its disposal by the Greek Government, and a loan of ten million pounds (English) guaranteed by Greek assets, began to work about the end of 1923, and succeeded beyond expectations in settling refugees in Macedonia and Thrace.

Houses were built, wells drilled and water secured for communities. Thousands of acres of land were plowed by tractors and assigned to refugees. Seed and farm implements, breeding stock, poultry and vines from America and elsewhere were distributed. Refugee towns were built and industries fostered. But it will take at least one generation and the helping hand of Death to complete the task.

Goats, sheep, pigs and donkeys were supplied by the Commission to some of the refugee families on long period loans. These animals represent a small investment and survive where cattle and horses starve and die. Ages of torture have manifestly immunized the donkey against cruelty. Apparently, he has no sensory nervous system. Regardless of ill treatment, he pursues the even tenor of his ways, and his agonizing, bronchocavernous heehaw seems like a habit left over from the ages when donkeys were sensible to pain. Goats are animals with personality---dual personality. They have a solemn cast of countenance, but the tilt of their tails gives a waggish expression to the hard, unyielding face of the Macedonian landscape. They laugh at tuberculosis and other scourges, and temper their confidence in man with intelligent suspicion. All farm animals are milked, and the mixed flavor of Macedonian butter strongly indicates that sheep, donkeys, goats and water-buffalos have contributed to its production.

Disease hampered the migration and settlement of refugees. Smallpox and typhus fever, epidemic during the exodus, were succeeded by wholesale infection with trachoma and malaria. Tons of quinine were provided by the American Red Cross, and the Refugee Settlement Commission carried on a valuable anti-malarial work in spite of difficulties peculiar to the country. Water was so precious. Every ditch was regarded as a blessing because it promised fertility and a bane because it bred mosquitoes and spread malaria. During the year 1924, some of the refugee colonies on the Chalcidice Peninsula lost a fifth of their population from this disease.

The Allied and Central Armies occupied Macedonian territory for about four years during the World War, and it is reported that for every man killed by bombs, bullets and poison gas, twenty died from the bite of the deadly anopheles. Since the Great Powers, with all their resources, failed to save their soldiers from Macedonian mosquitoes, it is not likely that little Greece, alone, can save the refugees.

Greece is not suffering much from revolutions, but from mosquitoes.

Greece suggests revolutions, but she is not suffering from them. She is suffering from mosquitoes. The revolutions during the past decade have been beneficial. This is merely the Hellenic way of changing the government without loss of time or use of corruption funds. The Greeks are poor, and necessarily unpretentious, politically. Powder is cheap, and they don't use much. Only a few people are killed and most of these by accident. At the recorded rate of mortality, they could keep right on with their revolutions for five hundred years without killing as many people as are murdered annually in these United States. The Greek peasant plants, reaps and milks his goat regardless of revolutions, but quinine costs money, and if the wrong mosquito bites him, he lies down and dies.

Dr. Elfie Richards Graff was appointed director of the American Women's Hospitals in Greece, in February 1926. Before taking charge of the field, she and her assistant, Miss Mabel Phillips, visited every station in order to acquaint themselves with the work. According to their reports, the suffering among refugees in the outlands of Greece was far greater than among the people in the remote regions of Russia where they served for three years.

This observation agreed with my own. Under the scorching summer sun, or snowbound in Thrace during the terrible winter season, it was hard to realize that the country was once covered with kindly forests which tempered the climate. And, in the presence of a hungry people shifted without their consent into wretched malarial districts to live or die, it was harder to realize that Macedonia was once the dominant power of the world. But, on account of personal loyalties and cherished opinions, it was hardest to realize and acknowledge, that those among the Christian minorities of Turkey who had turned Communist and accepted Russian protection in Soviet territory were better off than those who had put their faith in the Allied Powers and finally found themselves refugees in the rural districts of Greece.

Surely the evil-eye was upon these outcasts. Fire, sword and exile were not enough. The malign forces of nature combined against them: floods when they trekked out of Eastern Thrace; drought when they needed water, and disastrous earthquakes for good measure.---But sickness, which always follows want, was their worst enemy. Herded in overcrowded hovels, devitalized by hunger and malaria, they readily developed tuberculosis, which passed from victim to victim until it reached the proportions of a plague.



Practical Application of the Hippocratic Oath---Pioneer Nursing in Ancient Lands---
Holy Men of Athos---Exclusion of Hens and Hen-Medics

ON the Ægean Islands and mainland of Greece, the American Women's Hospitals' service for refugees expanded beyond all expectations. During the past eleven years, 39 hospitals (including Near East Relief orphanage infirmaries) have been organized and conducted at different times and places. Scores of inlying and outlying clinics, a quarantine island, camps and barracks for pestilential diseases, food and clothing depots, health and child welfare centers, maternity service and nurses' training, have been carried on in connection with these hospitals.

Pitiful crowds suffering from all kinds of diseases attended our clinics, and accessory tents were frequently used to house the overflow at our hospitals. Expectant mothers, without so much as a manger at the time of their confinements, took refuge in our maternity wards where over 5,000 babies were born during and after the migration of the Christian people from Turkey. Hungry, shivering children---all eyes, skin and bone, hair and rags---stood in line for hours at our stations, and, little as they had to eat, they were hosts to all varieties of intestinal parasites from pin worms to tape worms. Hundreds of thousands of sick and destitute people were cared for, and literally millions of treatments given for trachoma and other sight-destroying eye diseases.

Most of this work was done by native and refugee doctors and nurses under American supervision. As an association of women physicians, we were glad to be able to give work to our colleagues in distress. Many well-qualified medical men were saved from the breadlines and appointed to care for the sick among their fellow refugees. Paid employment meant food for their children, and in the land of Hippocrates, this opportunity of fulfilling, in small measure, the fraternal obligations of our Hippocratic oath gave special meaning to the proverb---before honour is humility.

Wherever conditions improved and local agencies were able to care for the sick, our work was discontinued, but all too frequently we were obliged to close hospitals and clinics in needy fields for financial reasons. This service depends upon popular subscription, which is always influenced by the newspapers of the country. An unprecedented calamity is front page news, and, therefore, it is easy to gather funds for emergency work. But a continued story of suffering is not news, and as the refugees disappeared into the remote districts of Macedonia and other parts of Greece, they also disappeared from the front pages of the newspapers throughout the world, and it became increasingly difficult to secure funds.

Life was hard in refugee centers, and the closing of our doors in many instances seemed the last straw. It is easy to be brave on a full stomach, but to face winter without proper food, shelter, clothing, bedding and fuel, requires courage of an enduring quality, and this spirit was sustained somewhat by the presence of an A.W.H. station---a place of refuge, a guarantee of food, shelter and care in case of sickness.

Which place shall we close? This perennial question involved suffering, life and death. Rumors of closing in different fields brought hundreds of refugees to our centers pleading for their sick: "We shall die this winter if you close the hospital." There was truth in this statement, and life seemed desperately dear to those poor things clinging to the fringe of it. But year after year, one place after another, we were obliged to close and the greatest need was the determining factor in the order of survival.

Dr. Ruth Parmelee (American Board Foreign Missions) with a refugee mother and child. Dr. Parmelee was head of the A.W. H. service in the Salonica District from 1922 to 1925, when she was transferred to our Kokinia Hospital.


Near the end of 1925, it was necessary to choose between our large hospital and nurses' training school at Salonica and several smaller hospitals and clinics in the "wilderness" of Macedonia and Thrace where no other help was provided for the destitute sick. That settled it. The student nurses were deeply disappointed. Several of them had been enrolled at the American College for Girls at Smyrna, which was burned during the great fire. Disaster and disappointment were not new to them. After all, they were among the lucky ones. With life, strength and time, obstacles could be overcome. They were thankful for the work already done, and glad of a chance to carry on in the small hospitals and clinics of outlying districts.

They were refugees themselves---Christian refugees, and they accepted their duty as Christians, nurses and refugees: the fundamental duty of following and serving the helpless sick, and the special duty of caring for the sick among their own people. But for the presence of the American Women's Hospitals, these young student nurses might have been sick and destitute themselves in some of the remote malarial districts of the poverty-stricken country in which they had been obliged to take refuge. And at this point, a tribute is due to Dr. Ruth Parmelee and the American trained nurses in our service, who, in teaching the theory and practice of nursing, had not failed to inculcate the spirit of this high calling.

Calling---is the word. Nursing is a profession, but like medicine, in its highest sense, it is a calling which crowns the practical business of qualifying and professing. Our student nurses answered the call from the outlands of Macedonia and Thrace in the same spirit as our American nurses had answered the call of the refugees for help while the sky over Smyrna was still red from the flames of that city.

No one should feel sorry for the A.W.H. nurses---American or of other nationalities. They were living dangerously---but they were living, and luck was with them. Pioneer nursing in ancient lands was not always dull. Thrills were personal experiences, not picture show productions. Hard work and high adventure spiced with plenty of romance were on the unwritten calendars of many of our nurses---and romance was not limited to the young nurses. Some of our staid physicians, slipping inevitably over the border into the sear and yellow leaf, are not without memories of bright autumn foliage.

From several of our stations in Macedonia, the historical background and outlook were highly inspirational. Near the Pravi Hospital were the ruins of old Phillippi, where the Christian religion was preached for the first time in Europe, and the preacher, Saint Paul, was beaten and put in the stocks for his subversive doctrine and freedom of speech. In the mountains between Prosochani, Greece, and Strumnitza, Serbia, where we conducted hospitals, Ellen Stone was kidnapped and held for ransom about forty years ago when that territory was Turkish. Alexander the Great was born at Pella, not far from the site of our Tchaldjilar Hospital, and from this same soil sprang Ptolemy, a Macedonian soldier, whose dynasty, established in Egypt, carried on for three hundred years and ended with Cleopatra. Stagira, the birthplace of Aristotle, was in the neighborhood of our New Mudania Hospital, with Olympus, the Mountain of the Gods, towering on one side, and Athos, the mountain refuge of holy men, reaching into the sea on the other. Women are not allowed on Athos. Nothing female, not even a hen, has defiled that sacred mountain for over a thousand years.

The acts of Gods and Goddesses on the slopes of Olympus were limited only by the imagination of our American physicians and nurses as they stood on the roof of the hospital and gazed at that glorified, snow-crowned mountain in the glow of the setting sun. The natives were used to Olympus. They said he had always been there, and so had Mount Athos, but the latter was usually hidden by mists from the sea.

Athos was a captivating prospect at which we peeped through strong glasses on clear days, and, perhaps, the holy men peeped at us, for we were strange invaders: female hospitalers, and our presence strongly indicated that something was wrong with the world. The buildings we occupied and the grounds upon which we appeared in a dilapidated car had belonged to Athos for hundreds of years. This was one of the outlying monasteries recently taken from the holy order by the Government, and afterward assigned to our use.

Emily Petty R.N., director A. W. H., Xanthi Area, decorated by the Greek Government.

Sister Sara, refugee from Turkey, served with the American Women's Hospitals at Salonica, and Kokinia, Greece, 1922-27. She was graduated from the Bellevue School of Nursing, New York City, in 1933.

The American Women's Hospital, New Mudania; these buildings formerly belonged to the Holy Men of Athos.

Food, clothing and medicine provided by the American Women's Hospitals for earthquake sufferers.

We felt at home in that converted monastery. Our tenure was authorized by the existing government, supported by the best traditions of the Eastern Orthodox Church, and, by a slight stretch of the imagination, warranted by Saint Paul himself---Romans XVI-1 and 2: "I commend unto you Phebe . . . in whatsoever business she hath need of you, for she hath been the succourer of many, and of myself also."

Phebe, the shining, was one of the first deaconesses of the Mother Church, and her sick relief service, which began in Greece, finally spread all over the world. Were we not her natural heirs? For several hundred years the early deaconesses nursing and succoring the destitute sick were encouraged by the Eastern Church and attained positions of honor and authority, especially under the rule of the greatest of Greek Fathers, the martyred Archbishop Chrysostom (345-407) who established hospitals in Constantinople and elsewhere. His successors must have been anti-feminists, for the deaconesses were demoted as the centuries passed and the dark ages followed. But the question is not yet settled, and in securing this monastery after a thousand years or so, we felt that we were coming back into our own.

The Bishop of the diocese, one of the former occupants of the monastery, presided at the formal opening of the hospital. He was a gentle soul and manifestly glad that the buildings were to be used for the care of the sick. In the ceremony of re-dedication he waved a flowering olive branch from the grove near-by, and his spirit was so gracious that it transcended the boundaries of language.

Dr. Elizabeth B. Thelberg, of Vassar College (the first woman who had ever spoken from the pulpit of that monastery chapel), represented the Board of the American Women's Hospitals. The lack of fluent Greek, vestments, and the flowering olive branch, plus the accident of sex, were heavy handicaps, but she was not to be outdone in the courtesies of that occasion. She made all the polite gestures, figuratively extended the olive branch, tactfully disregarded the age-old injustice to our professional predecessors, the early deaconesses of the Mother Church, expressed the appreciation and gratitude of the women physicians she represented for all present and future favors, and referred graciously to the Holy Men of Athos----even though they wouldn't let a hen, or a hen-medic, set foot on their sacred mountain.

The American Women's Hospital at New Mudania was conducted in coöperation with the Refugee Settlement Commission, under the direction of one of our American nurses, Miss Isabelle Norkewicz. Called to another field she was relieved by Dr. Jane Robbins, who served as a volunteer in different parts of Greece. Miss Norkewicz was succeeded in 1928 by Dr. Lilla Ridout. Situated in the center of a volcanic district where devastating earthquakes have recently occurred, this hospital, which had been taken over by local agencies, was of great service to the injured and homeless.

Macedonia has not been born again, but the country is in travail and the forces of rebirth are in action. Malaria is the constant curse of the land, and the cry of the refugee is for help against this scourge. The glory of old Macedonia was forgotten by most of the world long ago. For the past five hundred years, the pall of Turkish rule obscured the light, and the very name has been remembered chiefly because of one verse in the New Testament, which has been used as a text, generation after generation, wherever the Christian religion has been preached:

And a vision appeared to Paul in the night; there stood a man of Macedonia and prayed him, saying: Come over into Macedonia and help us.

The Fate of Christendom was in the balance. Paul, the Apostle, crossed the Ægean Sea from Asia Minor to Europe in answer to this call---and Luke, the Beloved Physician, went with him.



Saving Yedi Koule Hospital---A Prince out of Time---Armenian Dispersion---
Confusion of Tongues---Refugee Nurses

WORK was always waiting for the American Women's Hospitals, because, as a policy, our physicians and nurses sought the places where no other help was available---in short, the places where nobody wanted to go. American travelers were rarely seen at some of our stations along the Macedonian border, where it was hard to tell whether the natives were Greek, Albanian, Serbian or Bulgarian. Salonica was the outpost for most of the Americans visiting Macedonia, and even those who made "surveys" and wrote intimately about out-of-the-way places usually based their stories upon second-hand information.

Several years ago, a "survey" of the activities of American relief agencies in Constantinople was made by an "expert" sent overseas for this purpose. Our work was not discovered, although we were carrying a larger service for the destitute sick than all other American agencies combined, and our chief activities were maintained at the Yedi Koule Hospital, the oldest and most important place of the kind in the Near East. This remarkable institution belongs to the Patriarchate and its extensive grounds, with separate enclosures for different diseases, seem like a city set apart for the sick. But it is not so easy to find. It stands outside the walls of old Stamboul, far from the tourist trail, the bazaars, and the most interesting mosques.

The American Minister to Greece, addressing a graduating class, at the A. W. H. School of Nursing, Kokinia.


Wards for refugees of all nationalities, fifty beds, have been maintained by this organization at the Yedi Koule Hospital during the past decade. These beds are free---therefore, they are always occupied. But there is a more important phase to this service. Without help at the most critical period of its history, this great institution would have closed its doors. Nine years ago, the Bishop of Pera and the trustees of the Yedi Koule Hospital sent the following statement to our board:

Our Greek hospital of Constantinople, founded in 1753, increasing little by little for two centuries, was on the point of closing when you came to our rescue. Your help in giving us courage to fight for the continuance of its free clinical and surgical work, the home for the aged, the section for the nervous and insane, the sheltering of the refugees of the interchange, a home for our orphans, and industrial work for our people.

Under the present difficult conditions the number of our sick is increasing daily, and the closing of our hospital means death to the sick poor of the city.

You have come to our rescue when we knew not where to turn.

Sick and destitute people---Russian, Turkish, Serbian, Greek, Armenian and other nationalities---have been received and cared for in the A.W.H. wards of the Yedi Koule Hospital. Charteriski, the artist, whose symbolic representation of the A.W.H. service appears on the jacket of this book, died of tuberculosis at the age of 29 in one of our beds. This illustration was made as an expression of appreciation for care during his last illness. Such a fine, gifted young man! But luck was against him. He was a Russian prince at the wrong time.

In addition to these wards still maintained at the Yedi Koule Hospital (1933), we are contributing to the support of a center for destitute women and children at Pera, and the child welfare station, conducted by Turkish women, at Stamboul.

Among the refugees received in Greece, there were about a hundred thousand Armenians. During the World War and the consequent Greco-Turkish War, these people had suffered terribly as a race, but always with the hope that in the end their traditional fidelity would be rewarded. And this was the end. To be sure, there was an Armenian state for the first time in ages, but it was a communist state belonging to the Union of Socialist Soviet Republics, and these Armenian outcasts were not yet communists.

Citizenship in Greece was available and some of them accepted it reluctantly, but in large measure they were gradually dispersed. Disappointed in their hopes of a homeland, the majority of them wanted to come to the United States, but this was out of the question, so many of them went to South America, others to Egypt, and discouraged by seemingly endless suffering, thousands of them finally became communists and reshipped across the Black Sea to Soviet Armenia---a comparatively rich country.

Separate settlements were organized by the Armenian refugees in Greece, and for almost ten years the American Women's Hospitals cared for the sick in some of these places. The following letter was received from the representative of the Union of the Armenian Evangelical Churches of the Athens area:

To the governing board of the American Women's Hospitals.

Respected ladies:

Seeing on every hand numerous evidences of the generous philanthropy of the American people, the Union of the Armenian Evangelical Churches of the Athens Area, hereby officially brings to you, as the representatives of these kind-hearted donors, their heartfelt thanks and appreciation.

You have saved our decrepit, old and sick from disease and sure death, for after the tragic catastrophe of Smyrna and the loss of our home nests and earthly goods, we were at the mercy of infectious diseases and the rigors of winter. At these critical hours you acted as veritable angels of mercy by taking us into your hospitals, relieving our sick, as well as feeding and clothing them. So that you have been the saviour of this remnant of the Armenian race.

The memory of this, your service, will ever last in the hearts of not only the direct recipients whom you have saved through your hospitals and clinics, but also by the entire Armenian nation which has witnessed no greater deed of charity than your efficient ministrations.

Praying that Almighty God will continue to bless you, that you may always be able to aid suffering humanity,

Yours gratefully,

(Rev.) G. H. Stambollian
On behalf of the Armenian Evangelical Churches of the Athens Area.

Gradually the pressure of emergency needs in outlying districts was relieved, and in 1927 our nurses' training school, which was opened at Salonica in January 1923 and temporarily suspended at a later date, was reopened at the American Women's Hospital, Kokinia. Several members of the original class were enrolled and graduated in 1929, after six years work under great difficulties and peculiarly tragic conditions.



Dr. Ruth Parmelee was, of course, the moving spirit in the reopening of the nurses' training school. In addition to her Greek staff of teachers, she was assisted by Mrs. Power, superintendent of the hospital, who had served with us in Serbia, Armenia and Turkey, and by Dr. Angenette Parry, a beloved physician, who worked at Kokinia, as a volunteer, for almost four years. The gracious personality of Dr. Parry pervaded that refugee medical center, and was a help and inspiration to the patients, physicians and student nurses.

Language presented unusual obstacles in teaching. The official language was Greek, but the refugee student nurses were from Asia Minor, and, although they were considered Greek, their native tongue was Turkish. Many of them had been educated in the American and English mission Schools of Turkey, and now they were required to use Greek, with the result that English and Turkish sentences sometimes appeared in Greek script. Textbooks on nursing were non-existent in Greek, so all the lessons had to be worked out in English and translated. Clinical instruction was given in the wards of the hospital and in the outpatient departments, where the confusion of tongues confounded the American born. Fortunately, Dr. Parmelee was born in Babel. She changes from one language to another with the facility of a Levantine, and her patience is inexhaustible.

Five years ago, soon after Dr. Parmelee became director of our service in the Near East, Miss Emilie Willms, a nurse of wide experience along institutional and public health lines, appeared upon the scene. That was a lucky day. There are a great many able women who cannot work well together, but Dr. Parmelee and Miss Willms make a perfect team for that field. Complementing each other at every point, they have made the best of a hard job, and have improved the service in all its departments.

In the process of selection and elimination of hospitals and clinics, carried on year after year in Greece, the Kokinia Medical Center, with its hospital, nurses' training school, out-patient service, and large number of clinics, is our surviving station at the present time (1933). Eleven years have passed since this center was started in a portable barracks given by a tourist to the American teachers from the Girls College at Smyrna, which was burned during the holocaust.

There was nothing at Kokinia at that time but barren ground, tents, and all sorts of shelters made of sacks, oil cans, bits of board from boxes, and other waste. But the site attracted a flood of refugees, and in 1923-24 the Greek Government planned and partly constructed a refugee city, which afterward came under the ægis of the Refugee Settlement Commission. Thousands of two-roomed houses were built of adobe, and a section about 400 feet square, with one-story buildings surrounding a central court inside of which two-story buildings were afterward erected, was set apart for the American Women's Hospitals.

The volume and quality of work carried on in these buildings substantiates the idea that medical service should be established not too far above the financial level of the people it serves. We dug in at Kokinia with the refugees, and sharing their hardships, we have learned a lot. From a health standpoint, our medical center is the core of their community, and they flock to it by the thousands, for care during sickness, and at all times for advice on the important business of keeping well.

Dr. George Lorando, surgeon, American Women's Hospital, Kokinia, Greece.


These people feel at home at this center. It is peculiarly their own. It reflects their status, and indicates on every hand that they can be clean, healthy, happy, intelligent and mutually helpful on a low financial plane. Dr. Parmelee has a strong staff of well-qualified physicians and nurses who are demonstrating every day that, with special exceptions, the best medical and surgical principles can be applied without costly equipment and surroundings.

As superintendent of Kokinia Hospital and Training School for Nurses, Miss Willms has her hands full of work and her head full of ideas. That spreading institution with primitive equipment and an everlasting line of patients, does not run automatically. There are new problems to be worked out every day, and the doctors and nurses exhibit remarkable talent in improvising substitutes for modern conveniences.

Miss Hazel Avis Goff, of the health section of the League of Nations, visited Kokinia Hospital in 1932. Having worked in the Balkans for years, she understood the difficulties to be overcome---the self-sacrifice and enduring patience required to conduct that hospital and nurses' training school under existing conditions. In a letter received after her visit, she makes the following comment:

My impressions of the work done were excellent, and I am confident that the nurses trained in that hospital are going to be far more useful to their country for the reason that they have been taught to do work properly under primitive conditions.

Wherever they go at home or abroad, our refugee nurses are a credit to their school. Some of them hold positions of trust in Greece, and they all belong to the International Council of Nurses. The graduates sent to the United States for special work did well at the Philadelphia General Hospital and at Bellevue Hospital, New York. And just for good measure, before returning to Greece to serve their own people, they passed the Pennsylvania State examination. Cordial relations have been established with nurses in this country, and the student body of the Bellevue School of Nursing has extended, a friendly hand across the sea to their refugee sisters from the land where modern nursing had its inception under the personal supervision of Florence Nightingale.



A New Social Deal---Quality at Low Cost---A Modern Agora---The Seat of Xerxes

THERE are about 70,000 refugees in Kokinia---pioneers of a new order. Many of them were formerly in affluent circumstances, but times have changed. They are indebted to Mustapha Kemal Pasha for a new social deal. Thrown violently out of their ancestral nests, the survivors have become adjusted to present conditions. Starting even at one of the hardest places in the world, the strong and intelligent are coming to the top, and justifying their former positions of leadership by developing positions of leadership in the new order of life. These people are not sinking into the Slough of Despond. They reached the bottom of the abyss long ago and are on the upward grade. There is a lesson at Kokinia which other parts of the world may yet be obliged to learn.

Poverty is the common portion of the refugees. Most of them live in small two-roomed cottages, many of which are already covered with vines and shaded by graceful pepper trees. These cots have a little space for air and sunshine between them. Social life is being established along old lines, and that traditional institution, the agora, the market place, has appeared in the center of the town.

Traders with all kinds of things to sell, including live poultry, sheep and goats, occupy the square during the morning hours, and the women of the settlement are busy buying food for their families. It is a case of cash and carry, and sometimes lead if the commodity is alive and able to walk. Before evening all this has changed. Cheap tables and chairs have replaced the pushcarts full of vegetables, and the men of the town are hobnobbing together and haranguing according to their lights, just as they did in the time of Socrates. Men still love to get away from home and Xanthippe.

Around and around on its axis the world continues to move, and while the archæologists are busy digging up the old market place, the Agora, at Athens, which was developed during the Golden Age, a present-day agora of the concrete, oil and tin age, is beginning to function at Kokinia, six miles away.

But life in that community is not without beauty, which is said to be in the eye of the beholder, and certainly is in the soul of the creator. Fine needlework is done, and wonderful fabrics are woven by refugees from Turkey. Exact designs of old and priceless rugs and tapestries are sent by the owners of the originals from different parts of the world, in order that they may be copied. These reproductions embellish the drawing-rooms of the owners, while the originals are preserved as museum pieces. The unknown artists, who do this work, are poorly paid. They have no selling rights in their productions, but they own the artistry, a finer and more intimate ownership than that of those who afterward walk upon the finished products in London, Paris or New York.

From the top of the nurses' quarters during the past decade, the A.W.H. personnel has watched modern Athens stretching out toward Phaleron, Piræus and in other directions, forming one great city surrounded by a crown of purple hills. The Acropolis, with its jewels of architecture, dominates the view, and is glorified morning and evening by the splendors of the rising and setting sun.



Color has accumulated year after year. Rapidly growing pepper trees with crimson berries and red-roofed cottages stretch for miles from the busy hub of the settlement to the foothills of Mount Ægaleos overlooking the Bay of Eleusis and the Gulf of Ægina. Boats with colored sails are always passing between the islands and mainland, and ships of all nations are steaming to and from the Corinth Canal.

Mount Ægaleos is not far from the American Women's Hospital at Kokinia, and on holidays the student nurses sometimes climb the mountain and sit on the Seat of Xerxes, the rocky promontory from which the Persian King of Kings witnessed the defeat of his navy---the greatest navy in the world twenty-five hundred years ago.

The Seat of Xerxes is a good place from which to view the pageant of the ages. Forward to the present century, and backward to the Pharoahs and the Flight of the Children of Israel from Egypt. How clear it all seems in the distance of time! But the Greco-Turkish War of yesterday, and the flight of the Christian people from Turkey, lacks perspective.

Our refugee nurses and their families were in that debacle and they cannot see it as a whole. Each one sees the part in which she was personally engaged. A young widow with three children, who has served at our Kokinia Hospital for over ten years and who was graduated in the class of '31, sees only the fire at Smyrna during which her husband was killed before her eyes, and her youngest child was born. All these nurses have tragic family histories, and their present status is one of the many by-products of the American Women's Hospitals' service.

During this generation of war, revolution, widows, orphans and exiles, American women physicians and nurses have served the destitute sick in different countries. They have personally participated in the hardships and dangers. They have put their fingers into the wounds.

The Exodus of the Christian population from Turkey, with its suffering, sickness and death, was an epochal opportunity for medical service. Approximately two million people (including the Moslem deportees from Greece) were involved in this terrible migration. Our personnel met the outcasts from Turkey on the islands and shores of Greece, and moved with them from place to place, conducting hospitals and caring for the sick throughout the years of shifting and settlement in a strange country. These activities are confused in the general movement, and too near to be seen separately and distinctly. Time will clarify the picture.

How wonderful it would seem if it were written in the Book of Exodus, as a detail of the flight of the Children of Israel from Egypt, three thousand years ago: And women from a far country went with them and ministered unto the sick.

And this is just what happened in connection with the Exodus of the Christian people from Turkey and their settlement in Greece during the present generation.

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