Lydia Holman

Lydia Holman
Community Health Pioneer

Biographical Sketch by Phoebe A. Pollitt

Reprinted with permission from Nursing Outlook
Citation: Pollitt, P.A. (1991). Lydia Holman: Community health pioneer. Nursing Outlook, 39(5), 230-232.

Lydia Holman came to the mountains of North Carolina in 1900 to provide private duty care for a wealthy woman, who was very ill with typhus at her vacation home in Mitchell County (Hawkins, 1998). Holman looked around and saw many people suffering from blindness, deafness, orthopedic deformities, premature deaths and illnesses that could be prevented and she realized she had to do something about these conditions. Traveling on horseback over tortuous mountain roads, up stream beds and over the high mountains, she delivered hundreds of babies, performed minor surgery and dentistry, immunized folks against typhoid and fought epidemics of tuberculosis, pellagra, smallpox and measles. This “wiry little woman” spent 58 years caring for rural, Appalachian families in and around Mitchell, Yancey and Avery Counties (Rosner, 1924). The range of Holman’s accomplishments is staggering. She was a nurse, midwife, health educator, dentist, social worker and sometimes physician for hundreds of people in a sixty mile area. Despite improving the health and well being of hundreds of people over three generations, she is buried in an inconspicuous grave and her story is virtually unknown (Pollitt, 1991).

Not long after the emergence of professional hospital nursing, nurses including Lillian Wald and Lavinia Dock took their new skills into the community to serve those in need. In the days before government funding for public health services and public health departments were yet to be established, some early community health nurses created the “Settlement Movement”. Some nursing pioneers chose to share housing with each other and settle in the squalid neighborhoods and forgotten rural areas among the very people who were their clients. “Settlement movement” nurses organized visiting nurse associations which provided rudimentary home health services, they initiated school nursing programs, set up milk stations for mothers and infants to provide nutrition and nutrition education, initiated immunizations campaigns and they worked to change the social conditions which contributed to ill health. Most of the nursing settlements were located in the slum and immigrant neighborhoods of large Northern and Midwestern cities. However, a noteworthy exception to this pattern was the work of Lydia Holman and the Holman Association for the Promotion of Rural Nursing, Hygiene and Social Service in Mitchell County, NC (The spread, 1912).

In December, 1900, Lydia Holman, a recent graduate of the Philadelphia General Hospital School of Nursing, arrived in Ledger, North Carolina to provide private duty nursing care to a wealthy local woman who was very ill with typhus. Ledger, at that time, was an isolated Appalachian village about thirty miles from the nearest railroad, with no paved roads, no electricity, no running water, no newspaper, no hospital, and no trained nurses. As her patient’s health improved, Holman was increasingly called on by local residents to attend to their illnesses (Wyche, 1938). Wyche writes about Holman this way:

“Miss Holman made a study of the living conditions of the people and found them lacking in many respects. She became attached to the mountain folk and felt that she could be of use to them in combating disease and in teaching hygiene and dietetics … For many years she not only did her housework and cooking, but cared for her horse as well. At any hour of the day or night she answered the calls of the people, riding alone for miles to attend a person in need. Her arduous duties have been attended by danger and discomforts…” (p.59)

Holman was a professional nurse and active in many nursing organizations of her day. She was elected to the first Board of Directors of the National Association of Public health Nurses in 1912. In 1907 she gave an address to the Nurses’ Associated Alumnae of the United States (the precursor to the American Nurses Association) describing her work but also discussed her exhaustion and the overwhelming need for personnel and supplies in order to continue her efforts. With no government funds for public health and without the backing of a church or civic organization, Holman spent a good deal of time appealing for money, supplies and staff to help with her work. Articles about Holman and her work were published in numerous magazines including the American Journal of Nursing, Public Health Nurse, Outlook and the World’s Work. Dr. William Welsh, a pathologist at John’s Hopkins Hospital in Baltimore, Maryland took an interest in Holman’s work (Lydia Holman dies, 1960). Together they formed the Holman Association for the Promotion of Rural Nursing, Hygiene and Social Service in Mitchell County, NC. Chapters of the Holman Association formed in Baltimore, Pittsburgh, New York, Washington, Boston and Philadelphia. Chapter members raised money and sent funds and supplies to her. They also recruited volunteers, including medical and nursing students from John’s Hopkins University, to spend varying amounts of time in Ledger helping with the work (Pollitt, 1991).

Deposits of kaolin, mica and other minerals were discovered in Mitchell County in the early 1900s. Companies were formed to extract and export these minerals. The Holston Corporation built a railroad to transport the minerals to markets. Building and maintaining a railroad in the treacherous, mountainous terrain caused many casualties. Holman convinced the officials of the Holston Corporation of the benefits of having a local hospital to treat injured workers and their families. The Holston Corporation donated 15 acres of land and the Holman Association chapters supplied the money to build and equip the twenty four bed hospital. A delivery suite and operating room were incorporated into the building (Pollitt, 1991). The Holman Committee in Boston reported the hospital recorded 1,800 visits during its first year of service (Hawkins, 1998).

Holman continued her work in public health. The 1914-1915 report of the Holman Association describes some of her activities as teaching classes in hygiene and nutrition, working to control epidemics of chicken pox, scarlet fever, measles and camp itch, holding an immunization campaign against typhoid and distributing donated toothbrushes and toothpaste while teaching the importance of dental health in the community. In addition to her nursing work, Holman established a small lending library, kept a demonstration garden so local people could learn to grow a wider variety of fruits and vegetables to supplement their diets and distributed hundreds of donated toys at Christmas time to local children (Lydia Holman, 1960).

As the years went by progress came to western North Carolina, including Mitchell County. A few physicians moved into the area and were upset by the breadth of Holman’s work and had her arrested for practicing medicine without a license. Holman later wrote about the experience this way: “It was nicely done. He [the arresting officer] read his warrant and said “Now, Miss Holman, don’t let it worry you … It will cost you every cent of fifty dollars, and I would not do it. There ain;’t no reason why you should pay anything”. I took the man’s advice and spent the whole day waiting for the people in the courthouse to decide what was to become of me. The Solicitor read a very nice little piece of scripture and dismissed the case … After court, twenty mountain men or more took credit for having the case thrown out. Then they came to assure me, all the neighbors and people I had never heard of, that I should go on with the work … they would be quite willing to hire teams and come to my defense.” (An informal report, 1915).

She did continue with her work. By the 1920s, state and federal monies were starting to become available for public health work and Holman was put in charge of administering these funds in Mitchell County. An article in the May 11, 1924 New York Times reflected on Holman’s activities:

“One of the most wonderful and successful experiments in alleviating distress and averting disaster in maternity cases … is conducted by Miss Lydia Holman, a registered nurse, down in the mountains of North Carolina … Miss Holman did not wait for the passing of congressional acts. A quarter of a century ago, with nothing but her nursing kit, she, a little woman, a stranger to the community, unaided and without guidance or applause, set herself to the task of relieving those needs. She knew but one thing – she was in the midst of human beings who were suffering from lack of something her trained hands and eager spirit could provide … while she ministers to every man, woman and child for miles around, the lives she has saved by her pre natal and post natal care represent one of the most encouraging signposts of what intelligence and care can do.” (Rosner, 1924)

In addition to intelligence and care, Holman also demonstrated ingenuity. By 1930 there were sufficient paved roads in the county to make traveling by car faster and easier than horseback. Holman had no extra funds with which to purchase a car so she wrote President Herbert Hoover saying if she had a nice car she would be able to drive voters to the polls to vote for him in the upcoming presidential election. Soon, a brand new 1931 model A Ford was delivered to Holman from the White House (A model “A” angel, 1990). In 1936, at age 68, Holman was elected the Mitchell County Board of Education becoming the first female elected official in the county. She was appointed to the Mitchell County Board of Health, was Chair of the local Red Cross chapter and in 1943 she was even appointed the County Farm Agent. Holman spent her retirement years in her beloved Mitchell County, dying in 1962 in the VA hospital in nearby Asheville. She is buried with a plain military headstone in the Spruce Pine cemetery close to where she spent her life in unselfish service to her fellow citizens (Lydia Holman dies, 1960).


  1. The great work of a little woman. Outlook, Dec 24, 1910 pp.909-910.
  2. A model "A" angel. Mountaineer Times. Summer 1990.
  3. Hawkins, J.W. in Dictionary of American nursing Biography, ed. by Martin kaufman and others. New York, Greenwood Press, 1988, pp 199-201.
  4. Holman, L. Visiting nursing in the mountains of western North Carolina. AJN. 7:831-836, August 1907.
  5. Wyche, M.L. the History of nursing in North Carolina. ed. by E.L. Heinzerling. Chapel Hill, UNC Press, 1938, pp 59-60.
  6. Obituary; Lydai Holman Dies at 92. the TriCounty News, March 3, 1960, p.16.
  7. Two Christmas Stories. Public health nurse, 29:702-703. Dec 1937.
  8. The spread of rural nursing. the World's Work. pp 615-616. Oct. 1912.
  9. The Holman Association, Boston Committee. An Informal Report of the Work of Miss Lydia Holman. Boston, the Assocaition. 1915.
  10. Holman, L. Civic Conditions in our Mountain Communitites. Paper presented atthe second annual meeting of the Holman Association held in Baltimore MD, Oct 1915.
  11. Rosner, R. Toll of childbirth greater that wars. NY Times, May 11, 1924, p.6



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Compiled by: 
Phoebe Pollitt