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Kofoworola Abeni Pratt - one of the first Black nurses in the NHS and nursing pioneer in Nigeria

Updated: Mar 6

Black History Month UK 2023 'Before Windrush' - exploring the lives and stories of Black Britons who were living in the UK before the arrival of Empire Windrush in 1948.


Chief Kofoworola Abeni Pratt Hon. FRCN was born into a wealthy family in Lagos, Nigeria in either 1914 or 1915. She was the second of four children - two girls and two boys - of Augustus Alfred Scott and Elizabeth Omowumi Scott (née Johnson). Her paternal grandmother was the daughter of Chief Taiwo, alias 'Olowo', who became the Olofin of lsheri in Lagos State. Brought up in the Anglican faith, she attended St John's Secondary School and CMS Girls School in Lagos.


Kofoworola's desire to work within the nursing profession was fired by a tragic event from her early youth. At the end of the First World War in 1918, an influenza epidemic swept across the globe. The cosmopolitan city of Lagos was ravaged by the infection. One morning, the young Kofoworola wandered into her young sister's room to find her father holding her sister to his chest and crying. Her aunt who was also in the room grasped the young Kofoworola and ordered her to go to the room next door. She later learned that her sister, Ayoka, had died at the tender age of two-and-a-half years from influenza.


But Kofoworola's wish to become a nurse was thwarted by her father who felt it wasn't a position befitting of a daughter from the Nigerian elite. At that time, in colonial Nigeria, senior nursing posts were only open to white immigrant British women, with the menial tasks delegated to Nigerians.


After passing the Cambridge senior school certificate in 1933, she instead went on to study teaching and returned to her old school to teach British history. From 1936 to 1940, she taught at the CMS Girls School.


On 3 January 1941, she married Eugene Samuel Oluremi (Olu) Pratt, a pharmacist for the Colonial Civil Service. Her husband was posted in Enugu, Warri and Forcados, so the couple moved around a lot. Their first son died in infancy and their second son, Babatunde, was born in Lagos in 1943. Unsatisfied with their nomadic lifestyle, her husband moved to London the following year to study to become a doctor. Whilst there Olu Pratt made the introduction for his wife to the matron at St Thomas' Hospital in 1946. The matron accepted her, subject to the arrival of the required documents, which proved to be in order.


At that time, it was unusual for a married women from the middle classes to enter the nursing profession. Society norms dedicated that married women stayed at home to raise their family, particularly amongst the middle classes. But Kofoworola’s husband Olu strongly supported his wife’s commitment to nursing and provided an unobtrusive support to her achieving her dream career in nursing.


In August 1946, Kofoworola moved to England to study nursing at the Nightingale School at St Thomas’ Hospital in London. Her son was left with foster parents in Nigeria while she attended the St Thomas’ Preliminary Training School. Kofoworola arrived to, a London still reeling from the Second World War. St Thomas’ Hospital had been bombed in the war, and so her nursing training took place in temporary quarters across London.


During her time at St Thomas’s Hospital, Kofoworola experienced racial discrimination, when a patient refused to be treated by a Black nurse. She was active in the West African Students' Union (WASU), an association of students from various West African countries who were studying in the United Kingdom, and which, in 1942, had called for the independence of Britain's West African colonies.


Kofoworola passed her preliminary state exams in 1948 and her finals in 1949, qualifying as a State Registered Nurse on 25 November 1949. Ambitious and driven by learning, she followed her nurse training with a succession of further achievements. She qualified as a midwife (and worked as a midwife), then gained a certificate in tropical medicine. Back in the early 1950s, the Royal College of Nursing ran a ward sister course which she completed before moving into children’s nursing. She worked for the NHS for four years from 1950 to 1954. With the NHS beginning in 1948, she is recognised as one of the first Black women to work in the NHS.


Kofoworola is often incorrectly cited as being the first qualified Black nurse to work for the NHS. It seems this first appeared in her biography by Justus A. Akinsanya and was then repeated. Recent research shows that Black nurses worked in the UK prior to the founding of the NHS in 1948, such as Annie Brewster and Princess Ademola. By 1948 trained Black nurses predating Koworola's qualification in 1949, were working for the NHS; however, their stories are under-researched and have only recently come to light such as Lulu Coote. Kofoworola broke through many barriers in her lifetime. She was the first Black student at the Nightingale School for Nurses and later became the first Nigerian-born Chief Nursing Officer in Nigeria. (1)


The 1950s also marked another milestone in the lives of the Pratt family with the birth of their third child, a boy they named Olufemi in 1952. He was three months old when his mother decided to take advantage of the Nightingale Fund grant previously offered to her. She completed the Ward Sister’s Day course at the Royal College of Nursing while Femi was cared for by Dr Pratt's cousin, Mrs Akerele. She completed the course and obtained a distinction in the final examination. By now, Dr Pratt had been appointed as medical officer with the Commonwealth Development Corporation and was later posted to the Cameroons. Leaving their family divided between England and the Cameroons. (2)


In 1954, Kofoworola returned to a Nigeria still in the grips of British colonial rule. She applied for a post as ward sister at the University College Hospital in Ibadan but was turned down, despite her numerous qualifications and considerable experience as a ward leader in the UK.

Colonial Nigeria was managed by the British under a system known as ‘indirect rule.’ Credited to Frederick Lugard who took the idea from the Songhai and Ashanti Empires. Lugard’s interpretation became a political doctrine which held that Europeans and Africans were culturally different to the extent, Africans had to be ruled through the African’s own institutions. In practice, this meant that the African colonies were ruled directly by the Colonial Office in London and an apartheid-style system in which the vast majority of the native populations were condemned to work in menial jobs.


At the time, the position of ward sister was only open to white British nurses. Kofoworola fought the decision and with the support of her colleagues at St Thomas’ Hospital got the position. Not surprisingly, the staff weren’t very welcoming and when she arrived at the hospital, she discovered that her accommodation was in a separate block from her white British colleagues. Even more maddening, the professor of medicine wouldn’t let her work on the hospital ward because she was a native Nigerian. However, the matron of the hospital overturned the decision and Kofoworola was moved to a medical ward at the newly built Adeoyo Hospital in Ibadan.


When Kofoworola arrived at Adeoyo Hospital was still under construction and she used the opportunity to impose new standards for hygiene, care and nutrition, and reformed the administration of the ward. She was promoted to administrative sister in 1955 and the following year, she returned to London to study for a diploma in hospital nursing administration from the Royal College of Nursing.


This transition from white British nurses, doctors, and other professionals and administrators to Nigerians was called “Nigerianisation”. It was a policy of training and posting Nigerians to positions of responsibility previously occupied by white Britons in the public service of the government of Nigeria. The process started and was largely implemented in the 1950s becoming more important as Nigeria marched towards independence in 1960. It was shaped as a fight against racial discrimination and colonialism by Nigerian nationalists. Shockingly, but not surprisingly, when the first independent Nigerian government took power, they had to agree to giving financial compensation to all the white British workers who had lost their jobs to native Nigerians.


After becoming the first Nigerian ward sister, Kofoworola, then, successively, the first Nigerian assistant matron, deputy matron, and in 1964, matron, at the top hospital in Nigeria, University College Hospital, Ibadan.


Later in 1959, she travelled to the United States, Puerto Rico and Jamaica on a Carnegie Grant to gain broader nursing experience. In the United States, she was impressed by training based at universities. She would later lead in the introduction of university-based training in Nigeria, achieved in 1965.


In 1964, Kofoworola was appointed matron at University College Hospital in Ibadan, the first Nigerian nurse to hold that position, which was previously only open to white British nurses when Nigeria was under colonial rule. The following year, she became chief nursing officer in the Nigerian Ministry of Health and was later made commissioner of health for Lagos. (3)


Committed to public service and raising the profile of nursing, she helped establish a professional association for nurses in Nigeria and founded a journal, Nigerian Nurse. She led in the establishment of nursing schools and did some of the training herself.


There were many broader accomplishments too, which helped cement Kofoworola’s place as a nursing leader of international significance.


She led Nigeria’s first delegation to the congress of the International Council of Nurses (ICN) and was the first African to serve as a vice president of the ICN. As an advocate for the rights of women and children, she also headed the Nigerian delegation attending the United Nations’ first world conference on the status of women, held in Mexico City in 1975. (3)


And for a decade she was a member of an expert panel that advised the World Health Organization on nursing. (3)


In October 2021, Guy’s and St Thomas’ Hospital launched The Kofoworola Abeni Pratt Fellowship for nurses, midwives, and allied health professional from across the Trust who wanted to undertake personal and professional development. The one-year programme and was based in the Nightingale Academy where Kofoworola started her nursing career.


Kofoworola has been dubbed the ‘African Florence Nightingale’ and there are certainly many similarities between the two. Both came from middle class backgrounds and were discouraged by their parents to pursue a nursing career. Both fought and overcame the discrimination of the day to pursue their nursing careers and revolutionised the nursing industries in their home countries.


Rightly so, Kofoworola is well known throughout Nigeria because of the legacy she left. She’s a role model to the thousands of women who choose to enter the nursing professional in Nigeria each year. And by highlighting her story throughout Black History Month UK we hope that she can inspire Black nurses here in the UK too.


In 1979, surely in a full circle moment, Kofoworola was awarded the Florence Nightingale medal by the International Committee of the Red Cross and made an honorary fellowship of the RCN. (3)


Kofoworola died in Lagos in 1992.



Sources:

An African Florence Nightingale by Justus A. Akinsanya (2)




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