Betsi Cadwaladr

Betsi Cadwaladr (24 May 1789 – 17 July 1860), also known as Beti Cadwaladr and Betsi Davis, worked as a nurse in the Crimean War alongside Florence Nightingale, although their different social backgrounds were a source of constant disagreement. Her name today is mostly synonymous with the Betsi Cadwaladr University Health Board (Welsh: Bwrdd Iechyd Prifysgol Betsi Cadwaladr), the largest health organisation in Wales. In 2016, she was named as one of "the 50 greatest Welsh men and women of all time".

Elizabeth 'Betsi' Cadwaladr was born in 1789 at Llanycil, near Bala, Wales, one of 16 children to Methodist preacher Dafydd Cadwaladr. She was christened in May 1789 at Llanycil Parish Church. She grew up on Pen Rhiw Farm, Llanycil, and her mother died when she was only five years old. Very soon after this she was given a copy of the Bible as a present from Thomas Charles (a Welsh Calvinistic Methodist clergyman who had famously also given a copy to Mary Jones), something which Betsi appreciated greatly, and which she felt now gave her some purpose to life.

Cadwaladr got employment locally as a maid as Plas yn Dre, where she learned housework, to speak English, and to play the triple harp. She was not happy there, though, and aged 14 she escaped through a bedroom window using tied sheets, and left Bala. She subsequently entered domestic service in Liverpool. At some point in her life she changed her surname to Davis because it was easy to pronounce, though some sources state that she was actually born as Elizabeth Davis. She later returned to Wales, but subsequently fled to London to avoid marriage, living with her sister. Here in London she first encountered the theatre, which became a great interest to her.

Working as a maid and assistant, she had the opportunity to travel widely around the world, which gave her a taste for travel. She was in France at the time of the Battle of Waterloo, and she visited the battlefield where she was moved by the plight of the injured. In 1820, aged 31, she again returned to Bala, which she now considered 'dull', so she became a maid to a ship's captain and travelled for years, visiting such places as South America, Africa and Australia. At times she performed Shakespeare on board ship, and met such people as William Carey, the missionary, and Bishop Heber, the hymn-writer. At this time she was not trained in nursing, but during the course of her time on board ship she became involved in the care of the sick, and she also delivered babies. Despite her stubbornness and independence, Cadwaladr herself claimed that in the course of her travels she was proposed to by over 20 men.

On returning to Britain, having read in The Times newspaper of the plight of British soldiers in the Battle of the Alma (1854) who were dying of typhoid and wound infections, she then decided to train as a nurse at Guy's, a London hospital. Following her training, at the age of 65 she joined the military nursing service with the intention of working in the Crimea, despite the attempts of her sister Bridget to dissuade her. Florence Nightingale (who came from a privileged background) did not want the Welsh working-class Cadwaladr to go, saying that if Betsi went to the Crimea, it would be against her will, and that Betsi would have to be made over to another superintendent. Betsi responded, "Do you think I am a dog or an animal to make me over? I have a will of my own." (Nightingale's opinion of the Welsh stemmed from the publication of a report into the state of education in Wales – the so-called Treachery of the Blue Books – which portrayed the Welsh as lacking both basic education and morality.)

Cadwaladr was subsequently posted to a hospital in Scutari, Turkey, a hospital being run by Florence Nightingale. Cadwaladr worked there for some months, but there were frequent clashes between the two; they came from very different social backgrounds and were a generation apart in age (31 years). Nightingale was a stickler for rules and bureaucracy, some of which she set up; indeed, she was also famed as a statistician. Cadwaladr often side-stepped regulations to react more intuitively to the ever-changing needs of the injured soldiers. Whilst Nightingale subsequently acknowledged Cadwaladr's work and the progress that she made against the unhygienic conditions, the two fell out to such a degree that Cadwaladr, by now aged over 60, moved by choice from the hospital, nearer to the frontline at Balaclava. Here, apart from her nursing work, she again gained notoriety for her fight with bureaucracy and red tape to ensure that necessary supplies got through. She also took charge of the kitchens. Nightingale visited Balaclava twice and, on seeing the changes brought about by Cadwaladr's methods, gave her the credit she was due.

Conditions in the Crimea eventually took their toll on Cadwaladr's health, and she returned to Britain in 1855, a year before the war ended, suffering from cholera and dysentery. She lived in London, again at her sister's house, during which time she wrote her autobiography. She died in 1860, 5 years after her return, and was buried in a pauper's grave (with 4 others) in Abney Park Cemetery in north London. Her death certificate recorded that she died of an internal abscess.

• Autobiography of Elizabeth Davis, 1857. Republished as Betsy Cadwaladyr: A Balaclava Nurse Honno, 2015. ISBN 9781909983274