Smallpox invoked fear in North Carolinians in the 18th century. Their proximity to the Lowcountry, which had many outbreaks, meant that North Carolina communities risked contracting the illness through trade and travel. The start of the American Revolution assisted in the spreading of the virus.
In April of 1779, when soldiers coming from South Carolina stopped in Salem on their way north, a sick soldier introduced smallpox into the community. A few weeks later, the congregation recorded two cases of smallpox, which occurred among an enslaved individual rented by the Salem elders, and an outsider woman hired to work in the tavern. Over the summer, Moravian adults and children began to contract the disease as well. The specter of smallpox loomed over the entire community; especially vulnerable were older members and the youngest generation. Moreover, as the community was situated on the frontier of North Carolina, it was isolated from the networks of medical care that could be found in larger cities. In a society that required everyone’s participation to keep up food production and their economy, this illness threatened their collective future.
With no precise treatment at this time, smallpox quickly spread. The town’s only doctor, Dr. Jacob Bonn, was trained by a German doctor in Pennsylvania and sent to Salem by the church elders to serve the community. However, with only one doctor and no others available to assist them in the surrounding towns, the Moravians were quickly overwhelmed by cases of smallpox.
By the following spring, the situation in Salem had become dire. Smallpox infected entire families, disrupting labor and leaving the ill with no caretakers. At this time, six Moravian women came forward to the elders and proposed a way to assist in the community’s medical care. They would come to be named the Sick Visiting Committee. As the records of the elders noted,
the married Sisters have established Sick Visiting among themselves, with one general sick-nurse, and other Sisters who will serve a week at a time in turn. These Sisters will have a conference, at which Br. Bonn will be present to give them instructions.
The six women who volunteered were all older community members and recognized the need for organized health care, which one doctor alone could not provide. The community listened to these women and supported their efforts by giving them further training and medical tools to serve as nurses for patients. One woman would serve as a permanent nurse, while the others would switch out each week. By creating a committee among themselves that could assign nursing duties while allowing them to take care of responsibilities in their own homes, these women could navigate the complications of illness in their community.
![Black and white photograph of an early 19th-century church.](https://i0.wp.com/nursingclio.org/wp-content/uploads/2024/06/service-pnp-csas-02600-02652v.jpeg?resize=640%2C514&ssl=1)