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Christian. Nurse. Dedicated. Self-sacrificing. Martyr. All these words describe Clara Louise Maass, a young woman whose service to humanity a century ago makes her a significant figure in nursing history. Through a career dedicated to helping others, Clara Maass improved the quality of life around the world.

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As a young girl, Clara's never-ending dream was "to one day be someone and do something worthwhile."1 It was a lofty goal for a teenager, but she was no ordinary dreamer. She achieved her aspirations through years of nursing service to the sick in North America and abroad, as well as through great personal sacrifice for the advancement of medical science.


Clara Maass was born in 1876 in East Orange, New Jersey, the eldest of nine children born to German immigrants. Her father, Robert Maass, held a seasonal, low-paying job in a hat factory in Orange. As the Maass family grew, Clara realized that she needed to help provide for the family. She was often a substitute mother, unpaid nurse and housekeeper, which left her little opportunity for a genuine childhood.


As a teenager, Clara hired out to be a mother's helper. This job required her to perform myriad tasks, from "scrubbing floors to tending babies, to carrying in wood, to building a fire, to weeding gardens, to rubbing clothes by hand on a washboard, to mending clothes, to running errands to the store."2 As a mother's helper, her compensation included board, her own room and time off to attend school. As she finished three years of high school, she also learned to provide for herself.


In 1891, when she was fifteen, Clara began working at the Newark Orphan Asylum. As a housekeeper, she received ten dollars a month for working seven days a week. After two years at the orphanage, seventeen-year-old Clara had known little in her life except work. Those years of hard, grinding work had prepared her for the next challenge she would face.


Notices calling for women between the ages of twenty and forty to apply for training at the Christina Trefz Training School of Nurses at Newark German Hospital aroused her interest, and Clara decided this was a good opportunity to move on. Although three years too young, she applied. The head nurse emphasized the hard work involved and told her, "It has been said of nurses that those who look the most worn out, and those who give tirelessly of themselves for others, never thinking of themselves, are the best nurses."3 Clara's red, chapped hands gave proof to her years of hard work; she was accepted.


The two-year training consisted of long shifts on the units, coupled with hours of classroom lectures in German. This education brought the graduate three options. She could do private duty nursing, continue working at the German Hospital or volunteer for military duty, caring for wounded soldiers.


In 1895, at age nineteen, Clara graduated from nursing school. Along with three classmates, she repeated the Nightingale pledge, then received the white muslin cap and nursing pin of the German Hospital.


Following graduation, Nurse Maass stayed on staff at the German Hospital and augmented her salary doing private duty. She was promoted to head nurse by the hospital directors in less than three years, and, as a teacher, she passed along the lessons she had learned in the classroom to her student nurses.


Clara explained, "All times, as nurses, we consider the welfare of our patients. We nurse people, not diseases. A good nurse not only cares for people but also cares about them. Nursing is an art. The health of the soul and the health of the body are equally important, both for you and for your patient. We must not forget either the mighty impetus the Christian church gave to nursing, following the example of Christ, who healed."4


At twenty-one, Clara's dedication to the nursing profession seemed endless. When the cry arose for nurses during the Spanish-American War, without hesitation, Clara volunteered for duty. Nurses could not enlist in the military, so she served as a contract nurse with the United States Army.


In 1898, the Surgeon General's Office of the War Department sent her to Jacksonville, Florida. By this time the fighting had stopped, but hundreds of soldiers were ill from malaria, typhoid fever and dysentery.5 Although her engagement was brief, and she was discharged the following year, this was only the beginning of her nursing service in the United States Army.


In fall 1899, Clara, citing her past experiences, wrote to the surgeon general asking to be sent to the Philippine Islands. She was quickly accepted and sent to the Field Reserve Hospital in Manila, where she cared for soldiers who had freed the city from the Spanish in the recent war. Once again, her patients were sick with typhoid, pneumonia, malaria, dengue fever and, perhaps the worst, yellow fever.


We nurse people, not diseases. A good nurse not only cares for people but also cares about them. Nursing is an art.


This mysterious yellow fever ravaged her patients with high temperatures that made them hysterical and, before death, induced el vomito negro, the Spaniards' term for the black emesis that resulted from blood in the stomach from broken blood vessels.6


While nursing these dying victims, Clara was shocked by the devastation yellow fever had wrought both in the Field Reserve Hospital and around the world. After seven months of nursing the sick and dying, she became ill with dengue fever, a disease marked by agonizing pain in the joints and muscles, and nicknamed break-bone fever. Her recovery was slow, so in 1900 the army sent her home to recuperate.


Clara rested for three months, but her relentless courage and dedication led her to volunteer to help fight the war against yellow fever in Cuba. The Secretary of War had appointed a Yellow Fever Commission, headed by Major Walter Reed, and nurses were needed to attend to yellow fever patients.


The Reed Commission was conducting research as part of the American occupation force in Cuba, in the wake of the Spanish-American War. Clara received her assignment and set sail for Cuba to work at Las Animas Hospital, a civilian hospital where the Reed Commission was setting up experiments.


The experiments were a response to a Havana physician's speculation that yellow fever was transmitted by mosquitoes. Members of the Reed Commission, as well as other volunteers, offered themselves for human research to confirm the mosquito as the carrier of yellow fever. By the time Clara arrived in 1900, the Commission had confirmed the mosquito's bite as the source of yellow fever, and the chief sanitary officer of Havana, Major William Gorgas, was working to control the disease in the city. He isolated yellow fever patients, improved the sanitation of the city, enforced the use of window screens and attempted to rid the city of stagnant water where mosquitoes could breed.


Although Major Reed and other members of the Commission had left Cuba, Major Gorgas began an inoculation experiment at Las Animas in the hope that a controlled infection by the bite of an infected mosquito would produce a controllable case of yellow fever, followed by immunity.


In the spring of 1901, the United States Army offered one hundred dollars for volunteers willing to be bitten. Clara, the only woman, as well as the only American to volunteer, was one of nineteen participants. By offering herself, she was given a chance to help advance medical science and to develop an immunity which would help in her work with yellow fever victims.


In the next few months, she was bitten several times in the laboratory by mosquitoes that were believed to be infected. Finally, on June 24, 1901, she contracted a mild case of yellow fever and recovered quickly. Clara offered her blood to be used for a vaccine, but her case was thought to be too mild to provide blood for inoculation.


Driven by her commitment to helping others, Clara submitted to the mosquito's bite again on August 14, and four days later she became ill with yellow fever. As headaches and fever tortured her, and body aches restricted every muscle, she wrote in a letter to her mother, "Goodbye, Mother. Don't worry. God will care for me in the yellow fever hospital the same as if I were at home."7


Finally, with the projectile dark red emesis came death. Clara Maass died on August 24, 1901, at the age of twenty-five, a martyr for the advancement of medical science. Her death in the fight against yellow fever brought the lasting significance of which she had dreamed. The experiments ended with her death, since the hypothesis about the etiology of yellow fever had been proved beyond question, and it was evident the bite of infected mosquitoes could not be used as a safe way to provide immunity.


Due to the tropical climate in Havana, Clara was buried quickly, but a year later the army disinterred her casket so she could be reburied in Newark, New Jersey, with military honors. A small army stone marked her grave.


It was nearly thirty years before Clara Maass's nursing service and sacrifice for humanity were brought to light again. Through donations, her small marker was replaced with a large granite headstone, bearing her likeness and the story of her service. It was dedicated in May 1930 as a perpetual reminder of her heroism.


In 1949, to further honor Clara's memory, the Newark German Hospital (renamed Lutheran Memorial Hospital in 1945) established two nursing scholarships in her name for Cuban students.


Fifty years after her death, Cuba issued a postage stamp in honor of Clara Maass. It bore her portrait and a drawing of both the German Hospital and Las Animas, the hospital where she had cared for yellow fever patients.


Clara's legacy continued to grow. In 1952 the hospital trustees renamed the former student's and head nurse's alma mater the Clara Maass Memorial Hospital. Today the Clara Maass Medical Center carries on her spirit of caring and adventure, administering quality health care in her name.


In 1976, in honor of the centennial of her birth, Clara Maass was inducted into the Nursing Hall of Fame and a U.S. postage stamp was issued commemorating her contribution to yellow fever research.8


Had Clara Maass been present for the honors and recognition bestowed upon her, she would have been astonished. She would have viewed her actions as following what Christ calls all of us to do-to love our neighbor as ourselves, and not to hold our lives as dear to ourselves.9



The Reed Commission's experiments gave Cuba and the world the knowledge to control yellow fever. Once infected people and infected objects (fomites) were ruled out as carriers of the disease, and the Stegomyia fasciata (Aedes aegypti) mosquito was identified as the culprit, measures were taken to control its breeding. Research began to isolate the virus responsible for yellow fever and to develop a safe serum for immunization. After many years of searching, the virus was identified. In 1937 a safe vaccine, grown in the eggs of chickens, was developed. The vaccine, called 17-D, finally provided the means to control the dreaded yellow fever.-MW


1 Mildred Tengbom, No Greater Love: The Gripping Story of Nurse Clara Maass (St. Louis, Missouri: Concordia Publishing House, 1978), 18. [Context Link]


2 Ibid., 17. [Context Link]


3 Ibid., 21. [Context Link]


4 Ibid., 56. [Context Link]


5 Clara Maass Medical Center (1998): [Context Link]


6 John T. Cunningham, Clara Maass: A Nurse, a Hospital, a Spirit (Cedar Grove, N.J.: Rae Publishing Co., Inc., 1968), 40. [Context Link]


7 Ibid., 44. [Context Link]


8 Tengbom, 150-54. [Context Link]


9 Ibid., 155. [Context Link]