Prior to 1944, with the exception of midwife services, there was an organised Community Nursing Service in Saint Vincent and the Grenadines. This aspect of nursing began with the establishment of The Belair Health Centre or Belair Health Institution. The function of this centre was to provide care for infants and pre-school children and the eradication of YAWS. This clinic, however, closed six and a half years later.
With the establishment of the Belair clinic other small health centres were built in South Rivers, Lowmans Windward, Biabou, Mesopotamia, Stubbs, Calliaqua, Campden Park, Barrouallie, Cumberland, Bequia and Union Island.
These clinics had one examination room, a small area to do dressings and deal with any emergencies and a small pharmacy. In those days the facilities were described by one Sister as being primitive - in that they did not have the necessary equipment and drugs to perform their duties.
Services offered by the lone nurse were as follows:
- Domiciliary deliveries
- Doctor’s clinic
- Care for minor emergencies
The nurse was accommodated in a small unfurnished one bedroomed house with her family. Her means of transportation was to ride a donkey or to walk to conduct home visits and deliver babies: at night she had to use a flambeau. The clients had their blood pressure taken mainly on demand or if the doctor requested.
In 1949 the domiciliary services increased and women from different areas were trained at the Colonial Hospital for a period of six months. For example in Canouan, if any other care than midwifery was required, persons had to travel to the Union Island Hospital or Clinic. In those days there were also women who assisted in delivering babies: they were called “Quacks” or "Birth Tradition Attendants".
The Matron of the hospital was still the overall supervisor of the staff in the district. There was great conflict between the two departments as the Matron had no Public Health training, while the supervisor of the district staff superintendent was trained. The Senior Medical Officer in those days -Dr. Gideon Cordice- worked in the district, in the Immunization Campaign and Investigation of Communicable Diseases.
The nursing staff who worked in the district was transferred from the Hospital as a form of punishment. Twenty years later, (1960), the World Health Organization (WHO) saw the need for building more clinics with better health facilities. The Government at that time was responsible for the physical structure and WHO's responsibility was to assist with scales, examination beds, just to give a few examples. This did not fully materialise: the Government did not see the need for community nursing and the role it played in preventable care.
Another category of worker was identified in the system as nursing assistant. This worker was trained for eighteen (18) months to assist the nurse, but none were sent out in the community. The Superintendent was then accountable to the Senior Medical Officer. She had one senior nurse to assist her. Her responsibilities were to:
- supervise health
- prepare policies related to Public Health
- collate records of milk distribution
- prepare requisition and monthly reports
- supervise Kingstown Day Nursery.
- train nurses to care for the pregnant woman
- supervise and conduct home visits
- periodically inspect all ward-midwives in Government and Non-Government service.