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The beginnings of public health nursing started hundreds of years ago. The early Israelites and Egyptians hired women, later called midwives, who assisted at births. Noblewomen, including the wives of emperors, helped care for the ill in ancient Rome. During the Crusades, military nursing orders of monks and knights tended the sick and wounded. During the 1600s to mid-1800s , wealthy people never went to hospitals. They were nursed at home.

The titles and job descriptions of nurses who have functioned within community-based roles have changed frequently. Titles have included visiting nurse, public health nurse, community health nurse and home health nurse. These transitions have been consistent with the political, economic and sociological changes in society that have affected the delivery of health care. Direct patient care and health teaching have been vital components of community /public health nursing.

From its founding, St. Joseph had countless women who tended to the medical needs of the community. There were no pharmacies stocked with antibiotics, salves, creams, ointments, or pain relievers. Traveling medicine men sold a variety of elixirs and snake oils. Most frontier women in St. Joseph used family recipes handed down from one generation to the next for the treatment of wound infections, fevers, rashes, sores, aches and pains. Knowledge of the use of herbs, roots, teas, plants and tree bark had been passed from early settlers to the pioneers and from native American Indians.

The town doctor depended on trusted women in the community to minister to the needs of the ailing, whether it was disease or childbirth. Though these local “angels of mercy” generally had no formal training ( nursing schools were few and only in the East) they learned to clean wounds, apply a poultice, mix herbs and plants to relieve pain and swelling, nourish the weak, make bandages, serve as midwives in the delivery of babies and much, much more. The wounds they tended were often caused by bullets, knives or Indian arrows. These types of wounds often became infected, so the frontier nurse frequently assisted in the amputations of limbs. The death rate was high. The nurse often served as a grave digger.

Children, and adults alike, fell victim to diseases like measles, smallpox and cholera. Tuberculosis claimed thousands of lives. Prayer, a soothing touch, a cool drink and soft words were often all the would-be nurse could offer her patients. Death stalked the old frontier taking the lives of the weak or unfortunate. Native American Indians had no immunity to the white-man’s diseases. Indians died by the thousands. Entire villages were wiped out by tribes infected with measles.

Knowledge of how diseases were spread was limited and medical supplies were few. The frontier nurse put herself and her family at risk by caring for others. But, St. Joseph was moving into a new era. The 1900s would usher in fresh knowledge of diseases-their cause and how they were spread. There would be a change in how doctors and nurses cared for the sick, including the indigent population.

The earliest established record of public health nursing in St. Joseph was sponsored by St. Ursula’s Guild of the Christ Episcopal Church. In 1900, this Guild began visiting sick indigents in their home or in their hospital room.

As in many places, tuberculosis blazed the trail for public health nursing in St. Joseph. In 1910, a decision was made to employ a nurse for the care of tuberculosis patients. Through subscriptions and entertainments conducted by Christ Episcopal Church, a nurse was engaged.

By 1912, due to the general appeal of visiting nursing, it was decided that no one church or organization should be relied on for support. As a result of a group effort, a second nurse was employed to give special attention to ill babies. The success of this venture prompted the establishment of the St. Joseph Visiting Nurse Association in 1913. A governing board of 9 women and 6 men were chosen to oversee the operations of the nurse’s association. The association was supported through memberships of $1.00 per year; a sustaining membership was $5.00 per year. These funds were the principal means of support for the organization during the early years. The Association also supervised school nursing until 1919 when the Director of Hygiene of the Public Schools assumed those duties.

In 1915 the Visiting Nurse Association and the Tuberculosis Society combined. But, in 1922 the Tuberculosis Society split away from the Association. They hired 2 nurses to care for tuberculosis patients. By now there was also a Baby Welfare Association to care for ill infants and they hired 2 nurses.

There were 4 agencies delivering some type of health care in St. Joseph until 1933. In order to provide more efficient service and more economic stabilit, the 4 agencies combined to form the St. Joseph Organization for Public Health Nursing. The nurses and clerical staff of these agencies combined to form the new staff. During the first few years, funding for the newly merged services was adequate. But, by 1937, income from several funding sources decreased sharply and the fledgling health department found itself struggling to survive. Times were not good for organizations dependent on the charity of others.

In 1938, the Public Health Nursing Organization was holding 3 clinics a week for infants and children. The clinics were located at the Wesley House on Cherokee Street; at Community Hall (later called Patee Hall and now called Patee Market Health Center), 10th and Olive; and at Humboldt School at 2nd and Cherry. The children received examinations and shots for diphtheria and smallpox. Vaccines for pertussis (whooping cough) and polio were still years away from development. Cod liver oil was supplied for children whose families could not afford to buy it. The staff consisted of a doctor, a nurse, a Red Cross nutritionist and 2 volunteer workers from the Junior League.

A 1939 editorial in the local newspaper addressed the financial needs of the nursing/health organization . . . “the problem should not be alone that of the city. The county government could not exist were it not for the heavy taxpaying interests of the city. Most county governments recognize this responsibility as to public health nursing. Public health nursing is here and it is here to stay. American counties and cities never would go back to the neglect of the sick that stamped our cities and towns and hamlets thirty and forty years ago. We believe the county court will give the Public Health Nursing Organization the fullest support possible. It is not only a humanitarian project that will have a strong appeal, it is good business.” Bishop C. H. LeBlond said: “Public health nursing is a very necessary need in the city and without it the health situation is placed in serious jeopardy.”

Although the organization had asked for $10,000, the City Council gave them $2000. While it was less than what was needed, this $2000 was the first step toward nursing services and health care for citizens paid for by tax dollars instead of private philanthropy. In years to follow, the cost of public health programs would be born by local, state and federal funds. The health department continues to receive funding from these sources as well as grants, donations and some fee for service programs.

In 1939, the Public Health Nursing Services consisted of clinic services and home health services. Money continued to be scarce. There were many poor. The poor got sick and needed care. Doctors made home calls. There were many who could not afford hospital care. St. Joseph had Methodist Hospital (formerly Ensworth Hospital), St. Joseph’s Hospital (popularly known as Sister’s Hospital as it was run by Catholic nuns) and Sunnyslope, the city charity hospital. Later the General Osteopathic Hospital would become another place for people to go for care. A newspaper article of the late 1930s tells the sad story of a family being cared for by the health department. The father made $12 a week working for a coal company. There was also a wife, 3 boys ages 20, 18 and 12 and a 14 year old girl. During the summer, a 9 year old boy and a 6 year old girl from the family had died of tuberculosis. Now the mother lay seriously ill.

Sunnyslope, the city’s isolation hospital was meant to house those adults and children that had a contagious disease and needed to be quarantined. A separate building was constructed on the hospital grounds to care for patients with tuberculosis. The poorly constructed structure quickly fell into disrepair and was torn down. With tearful faces and broken hearts, people left their loved ones to the caring hands and compassionate ways of the nurses who worked there. Many never returned for them.

Children who were abandoned at Sunnyslope either died from their illness or were turned over to one of the city’s 3 orphanages of the time. The orphanage known has the Home for the Little Wanderers is now called Noyes Home for Children. The other 2 homes were the Sheltering Arms and the Catholic Orphanage. The health nurses gave care to the children in all 3 homes.

The advent of World War II caused many changes in family life in every city and farm across the nation. The job market expanded as the war effort got underway. Able-bodied men marched off to war leaving behind the young, the old, the women and those unable to serve in the military. Nurses were recruited into the armed forces to serve at home and abroad. This left a void in the number of nurses left to work in hospitals, schools, doctor’s offices and public health. In 1941 in quick response to the depletion of trained nurses, the St. Joseph Junior College offered a vocational class on public health nursing. This new course included 80 hours of instruction. An auxiliary firemen course was also offered.

Health department nurses gave countless inoculations to men, women and children against smallpox. Those same nurses would traverse the city helping families set up “croup tents” in their home. Today children are protected against tetanus, diphtheria, polio, pertussis (whooping cough), hepatitis B, meningitis, chickenpox and more. The threat of chemical and biological warfare has health departments once again facing the possibility of giving smallpox vaccine.

August 15, 1946 - St. Joseph has its first case of infantile paralysis - polio. The 6 year old girl had been brought to Sunnyslope Isolation Hospital from Cameron, Missouri. She survived. A 19 year old boy from Clarksdale infected about the same time, did not . Nurses were trained to work with polio patients. Hospitals purchased equipment such as covered tubs, physiotherapy machines, hot pack machines and iron lungs. Camp Geiger closed early for the season in 1946 as a precautionary measure against an outbreak of polio. Frightened parents kept their children home from swimming pools. Family gatherings were postponed for cooler months. Picnics were held in backyards, not in parks with masses of other people. Research is being done on polio and hopes for a breakthrough fuels dedication to the cause. But, no breakthrough comes.

In 1949, Missouri Methodist Hospital decides to add a top story at an approximate cost of $225,000. A third elevator is added. This unit is dedicated to caring for children and adults with contagious diseases. The old Sunnyslope Hospital is torn down.

1955 - Dr. Jonas Salk discovers a vaccine to cure polio. Children receive the injectible vaccine culminating the end to the grip of the “great crippler” of mankind.

1965 - the health department holds two “Sabin Sundays” on March 28 and May 23. Local officials urged parents to take their children 3 months old to 20 years old to one of the clinic sites to receive the oral polio vaccine. The oral vaccine was given to each person by placing 2 drops of vaccine on a sugar cube. Small infants were given the drops directly into the mouth. A donation of 50 cents was requested, but no one was turned away if they could not pay. The clinics were held in the high schools. People turned out by the thousands. The elimination of polio is considered one of the greatest medical victories of all time.

1976 - The Swine Flu clinics of 1976 would once again see large numbers of local citizens standing in lines to receive vaccine for protection against a deadly flu virus. But, the vaccine was not pure enough and many people had severe reactions to it. Some people contracted "Guillain-Barre” Syndrome. Public confidence in vaccines was shaken.

The public health department used to have a lab to do water and milk testing. They also did much of their own labwork for sexually transmitted diseases. Those tasks are now done by the state. Lack of space and cost of the programs helped make the decision to discontinue these programs locally.

Patee Hall was first designed to house a city market. The building was constructed in 1906 and added to in 1909. A fire destroyed part of the building in 1911. The building was repaired and in 1916 the Social Welfare Board moved to Patee Hall where they have remained . The health department ‘s home health nursing division and clinic services had been in different locations over the years. The nursing services were once located in the Corby building , and later in City Hall. In 1976 the home health nurses and clinic nursing services were combined at Patee Hall. Municipal Court was moved from City Hall to Patee Hall in the early 1970s where it remained until it was moved to the Buchanan County Courthouse in the early 1990s. After years of controversy over what to do with the building and where to relocate the city’s health services, the City Council decided to renovate Patee Hall and keep the health services in the building on 10th street. Work was completed on the north half of the building housing the Public Health Clinic and WIC (Women Infants and Children nutrition program) in February of 1994; and the south half was completed in August of 1994 for the use of the Social Welfare Board. In May of 1996 the north half of the second floor was renovated and became the home of the health department administrative offices, the sanitarians and environmental services. In September of 1995 the Youth Health Center (now the Family Health Center ) opened its doors in the south part of the second floor. After the renovation it was decided to rename the building Patee Market Health Center. All the health services now located in the building serve as primary care providers for various health needs or as a referral source to other agencies.

The St. Joseph - Buchanan County Health Department is a combined city/county health department. It serves as the local extension of the Missouri Department of Health and Senior Services and the United States Public Health Service.