North Carolina Nursing History

Charlotte Brody spent most of her career in NC working on behalf of poor and vulnerable people. She helped create and worked for years with the Carolina Brown Lung Association for better working conditions for textile workers. For 12 years she was the Executive Director (the first women in that position) of the Piedmont Planned Parenthood Association. She was the founder and Executive Director of Health Care Without Harm, an international organization working to keep health care work places environmentally safe.

"It’s a dangerous myth to believe that you can make yourself into a healthy person on a sick planet. You can eat wild salmon instead of tuna to reduce your exposure to mercury. You can exercise and reduce your risk of heart disease and hypertension. But we can't shop our way or lifestyle our way out of being connected to everything else on our planet." -Charlotte Brody (as cited in Hukill, 2004, p.3)

Charlotte Brody, RN: Trailblazing Environmental Activist

As a young nurse in the late 1960s and early 1970s, Charlotte Brody was involved in many issues of the day.  A feminist and peace activist, she began her career working with vulnerable people who experienced disparities in the health care system. Charlotte’s commitment to making the world a healthier and safer place has expressed itself in her life and work in an Appalachian public health department, the Carolina Brown Lung Association, Planned Parenthood, Health Care Without Harm and most recently at the BlueGreen Alliance (www.bluegreenalliance.org).  Standing on the shoulders of nurses such as Florence Nightingale, Emma Goldman and Lavinia Dock, rarely has a nurse had such a profound effect as a change agent in our society as Charlotte Brody. Reflecting on pivotal experiences in her nursing education as a Diploma student at the University of Tennessee at Nashville, Charlotte notes:

"I had one med-surg instructor who really stressed the role of nurses as community educators and advocates. That made a big impression on me. I was also lucky enough to be in Nashville when the [Vanderbilt University] Center for Health Services was organizing nursing and medical students to spend their summers in Appalachia and West Tennessee doing one day screening clinics. My volunteer work with the Center and at the Nashville Free Clinic taught me so much about the difference health care providers could make." (Charlotte Brody, e-mail communication, May 12, 2011)

Charlotte’s first job was as a public health nurse in the Appalachian region of Georgia providing care to women and children.  Just as continuing government funding for her position was put in jeopardy, she read an article about cotton textile workers becoming sick with an environmentally induced lung disease called byssinosis or Brown Lung Disease (Charlotte Brody, e-mail communication, May 12, 2011).  Brown Lung Disease is caused by inhaling cotton dust in inadequately ventilated cotton mills. Through her student work with the Vanderbilt Center for Health Services, Charlotte was aware of the environmental/occupational disease pneumoconiosis or Black Lung Disease, a similar condition caused by breathing coal dust in poorly ventilated coal mines that harmed many Appalachian coal miners and their families.  She knew that a coalition of miners, health care providers and the United Mine Workers of America Union successfully worked to strengthen air quality measures in the mines and to increase services and disability pay to miners affected by Black Lung Disease.

This undeniable link between human health and environmental/occupational conditions motivated Charlotte to take a new job working to improve the health of southern textile workers. In 1974, she joined the Carolina Brown Lung Association (CBLA) as a chapter organizer in Roanoke Rapids, North Carolina. Roanoke Rapids was, at that time, the site of the effort to organize a chapter of the Textile Workers Union of American (TWUA) at the JP Stevens Company, memorialized in the movie “Norma Rae” (http://www.crystalleesutton.com).

As the only nurse of the staff at CBLA, Charlotte quickly became invaluable to the organization.  She used her nursing skills to assess the workers, coordinate screening clinics, organize volunteers, refer people for appropriate follow up care and collaborate with diseased workers to advocate for better working conditions. The collaboration between textile workers,  CBLA, TWUA, health care providers, resulted in reforms in workers' compensation laws and industrial standards improving air quality in textile mills (Southern Historical Collection, Wilson Library).  Charlotte’s understanding of the relationship between human health and environmental conditions deepened as did her respect for collaborative practice and patient advocacy. She later stated in a video interview, “It’s Good Science,” that “it’s not the environment and us … the environment is in us.  There’s no physical separation between the external world we create and the world inside our bodies …. Everything is connected to everything” (www.globalonenessproject.org).

 In 1982, after Charlotte had moved to Charlotte, North Carolina, she became the state public affairs director for Planned Parenthood affiliates in North Carolina. For twelve years she worked to provide health care services for women while advocating for increased access to family planning services across the state, eventually becoming the Charlotte-based affiliate’s executive director. In 1994, the US Environmental Protection Agency issued a report about medical waste incineration that would change her life. The study “Medical Waste Incinerators – Background Information for Proposed Standards and Guidelines” found that a byproduct of burning medical waste was dioxin, a deadly carcinogen (National Service Center for Environmental Publications [NSCEP]). In fact, medical waste incineration was the primary source of dioxin in the United States and around the world.  Hukill (2004) reported Charlotte’s reaction to this report:

"The thought that Planned Parenthood had been poisoning the air sent Brody reeling. "We thought the more waste we could incinerate, the safer we were making our patients, because incineration burned up all the hepatitis and HIV bugs" … Brody was stunned to learn that the waste was coming back into the hospital clinic as dioxin lodged in the breasts of women "whom we were trying so hard to keep healthy until they were ready to become mothers. I was particularly floored because I was very attached and proud of my breastfeeding of my sons," Brody recalls. "And the idea that I downloaded 20 years of toxic chemicals into my firstborn was just shocking and outrageous and deeply depressing." (p. 1)

These revelations were so appalling that Charlotte left Planned Parenthood to participate in the founding of Health Care Without Harm (HCWH), whose mission is to “transform the health care sector … so it is no longer a source of harm to people and the environment” (www.noharm.org, para. 5).

HCWH’s first project was to reduce and ultimately to eliminate hospital waste incineration.  "Since there were alternatives to incineration, there was a sense that this was a problem we could solve if we just educated people and created an effort to make social change," Brody said. "And we've done it” (Hukill, 2004, p. 1).  The estimated number of medical incinerators operating nationwide has dropped from 6,000 in 1994 to less than 100 today. (Hulkill, 2004, p. 1) HCWH has grown into an international coalition representing over 470 agencies in 52 countries collectively working to eliminate pollution in health care practices without compromising patient safety or quality of care. HCWH members are leading the global movement for environmentally responsible health care.  Constituent agencies promote environmentally friendly practices, technologies and products and educate administrators of health care institutions, health care providers and consumers about the health and environmental consequences of current health practices and policies.

In 2003 Charlotte became one of eight people who had their body burden of toxic chemicals tested as part of a study led by Mount Sinai School of Medicine in New York. She wrote in a blog (www.grist.org):

I am one of eight people who got their body burden of chemicals tested … So I know about the pesticides and other pollution in me. My tests showed that my body was carrying 85 contaminants, including 45 carcinogens and 56 chemicals that can impact the brain and nervous system. My blood and urine contained two organochlorine insecticides and four organophosphate pesticides, including the now banned Dursban, made by Dow Chemical.  How did these chemicals get into me? I never use pesticides in my house or garden and I try to buy organic. But the pesticides still could have been on something that I ate or the chemicals may have been sprayed in a room that I walked through. I don't know. What I do know is that no one knows what the combination of pesticides and dioxins and furans and PCBs and phthalates and metals and volatile organic compounds that I am carrying around is doing to my health.  The chemical industry issues press releases assuring the public that these levels are too low to be dangerous. But the testing that these press releases are based on does not look for the effects from combinations of chemicals or for the subtle or long-term health effects of chemicals on people and the environment.  As a nurse who has spent many hours going over informed consent forms, I get riled up thinking about how the chemical industry enrolled all of us in this giant experiment on our health without having to get our permission. I never got the form. (p. 1)

To inspire nurses to work for cleaner, safer and healthier environments, Charlotte helped launch the Luminary Project in 2005 (www.theluminaryproject.org). This web based project tells the stories of nurses who are “creatively, strategically and courageously addressing issues related to human health and the environment and illuminating the way toward safe hospitals, communities with clean air, land and water, and children born without toxic chemicals in their bodies” (www.theluminaryproject.org).

The American Nurses Association, the Public Health Nursing Section of the American Public Health Association, the American Journal of Nursing and numerous other professional organizations support the Luminary Project.  The very next year, 2006, the Luminary Project sponsors created the Charlotte Brody Award which is given annually to an individual nurse “for lighting the way to a healthier environment and inspiring other nurses to do the same” (www.theluminary project.org).

One hundred and fifty years ago the founder of modern nursing, Florence Nightingale, was one of the first scientists to study the relationship between human health and the environment.  While caring for the casualties of the Crimean War she concluded that pure air and water as well as proper waste disposal systems were necessary for the maintenance of good health and healing from disease (Nightingale, 1860).  Charlotte Brody has enhanced Nightingale’s ideas by infusing them with both 21st century science and a deep understanding of how political, economic and ethical considerations influence human wellbeing.  Charlotte’s life and work are a testament to the power of what nurses can accomplish.  Her story instills hope and encouragement in other nurses to create a healthier, safer world both inside and outside the workplace.  Feminist, peace activist, organizer, educator, environmentalist, mother, nurse – Charlotte Brody exemplifies the best of holistic nursing.

References

Brody, C. (2003, May 12). Blog. Grist: Environmental News, Commentary, Advice . Retrieved January 16, 2012, from http://grist.org

[Collection Number: 04463], in the Brown Lung Association Records # 4463, Southern Historical Collection, The Wilson Library, University of North Carolina at Chapel Hill.

Hukill, T. (2004, December 3). The Godmother of green health. AlterNet. Retrieved January 16, 2012, from http://www.alternet.org/brody-hcwh

It's Good Science. (n.d.). GlobalOnenessProject. Retrieved January 16, 2012, from www.globalonenessproject.org/videos/charlottebodyclip2

Kerr, L. E. (1971). The united mine workers of America look at occupied health. A.J.P.H., 61(5), 972-978. Retrieved January 15, 2012, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1529817/pdf/amjph00740-0089.pdf

The Luminary Project. (n.d.). www.theluminaryproject.org. Retrieved January 16, 2012, from http://theluminaryproject.org

Medical Waste Incinonerators-Background Informati. (n.d.). NSCEP. Retrieved January 16, 2012, from nepis.epa.gov

Nightingale, F. (1860). Notes on Nursing. London: Harrison.