80 Joceline Chabot is a full professor of history in the Department of Histo- ry and Geography (Moncton University, Canada). Her current research focuses on humanitarian and socio-health aid to Armenian and Greek refugees in Asia Minor after WWI. Email: joceline.chabot@umoncton.ca Sylvia Kasparian is a full professor of Linguistics in the Department of French Studies and Director of the Textual Data Analysis Laboratory at the University of Moncton (Canada). Her main research focuses on rep- resentations in the media, in particular representations of the Armenian Genocide from press corpus and testimonial literature (survivors and humanitarian and health workers). Email: sylvia.kasparian@umoncton.ca 81 “ON THE HIGH SEAS WITH NO PLACE TO LAND”: THE SMYRNAEAN INFERNO AND HUMANITARIAN AID TO AR- MENIAN AND GREEK REFUGEES FROM TURKEY (1922-1923) Prof. Joceline Chabot Prof. Sylvia Kasparian Université de Moncton, Canada In September 1922, the great fi re of Smyrna drove more than 200,000 Armenian and Greek refugees to the wharves of that port city. They had fl ed to Smyrna to escape the massacres perpetrated by Turkish nationalist troops and now urgently needed humanitarian aid to relocate them to safety in Greece. In this article we examine the actions and the roles of humanitarian workers of the Near East Relief (NER) and the American Women’s Hospitals (AMH) working in Greece among these refugees deported from Smyrna. We highlight the central role of women doctors and nurses in their humani- tarian efforts to save this population. Their actions, and the gratitude of their peers and government authorities, solidifi ed their professional status in the context of profound changes to transnational humanitarianism after 1919. Keywords: Humanitarian aid, Near East Relief, American Women’s Hospitals, Smyrna’s catastro- phe, Armenian refugees, Greek refugees The article was submitted on 10.03.2021 and accepted for publication on 29.04.2021. How to cite: Joceline Chabot and Sylvia Kasparian, “On the High Seas with no Place to Land”: the Smyrnaean Inferno and Humanitarian Aid to Armenian and Greek Refugees from Turkey (1922- 1923),” International Journal of Armenian Genocide Studies 6, no. 1(2021): 81-91. 82 International Journal of Armenian Genocide Studies: Volume 6, No. 1, 2021 https://doi.org/10.51442/ijags.0018 Introduction As the Great Powers of France, Great Britain, Italy and the United States occupied the vanquished Ottoman Empire following WWI, some 13,000 Greek soldiers disembarked in Smyrna, fully sanctioned by Great Britain and France. These two allies believed that a Greek military presence in the cosmopolitan city would prevent the further massacres of Christians.1 What is more, British Prime Minister David Lloyd George appeared to support the creation of an eastern Greek Empire to defend British interests in the region.2 The Greek army occupied Smyrna from mid-May 1919 and sought to subdue the Anatolian territory. The Greek government, led by Prime Minister Eleftherios Venizelos, dreamed of reoccupy- ing former Greek lands in Asia Minor and thus unify all Greeks in one Nation-State (Megali Idea).3 Faced with the occupation of the Ottoman Empire and the decision of Sultan Mehmed VI to cooperate with the allied forces, the offi cer Mustapha Kemal (later, Atatürk) rallied the nationalist forces and declared war on both the Sultan and the occupying armies.4 Even as early as the autumn of 1921, Greek soldiers were threatened by Kemal’s men.5 The follow- ing year, in August 1922, the Greek army suffered a catastrophic loss at the hands of Turkish nationalist troops. Disoriented, the Greeks beat a hasty retreat; according to eyewitnesses, the fl eeing soldiers followed a scorched earth policy as they withdrew, burning villages and killing Turkish civilians.6 The retreating Greek troops were joined by nearly 150,000 pan- icked refugees fl eeing retaliation by Turkish forces.7 On September 8, 1922, Greek author- ities in Smyrna left the port city; the following day, Turkish troops arrived, reinforced by irregular armed groups. Christian districts of the city were soon pillaged and their citizens massacred. On September 13, fi re broke out in the Armenian district and quickly spread to 1 Michelle Tusan, Smyrna’s Ashes: Humanitarianism, Genocide, and the Birth of the Middle East (Berkeley: University of California Press, 2012), 154. 2 Great Britain needed a solid ally in the Middle East. Greece seemed well positioned to fi ll this role. Eleftheria Dalizou, Britain and the Greek-Turkish War and Settlement of 1919-1923: The Pursuit of Security by “Proxy” in Western Asia Minor, PhD Thesis in History (Glasgow: University of Glasgow, 2002), 72. 3 Erik Goldstein, “Greater Britain and Greater Greece,” History Journal 32 (1989): 345-346. Ioannis-Dionysios Salavrakos, “The Economic Forces of Victory versus those of Defeat: An Analysis of the Greek Economic and Military Mobilization of the 1903-1923 Period,” Journal of Military and Strategic Studies 18, no. 1 (2017): 2-14. 4 Leyla Neyzi, “Remembering Smyrna/Izmir: Shared History, Shared Trauma,” History & Memory 20, no. 2 (2008): 107. 5 Hervé Georgelin, “Un cosmopolitisme à détruire,” in La fi n de Smyrne: Du cosmopolitisme aux nationalismes [online] (Paris: CNRS Éditions, 2005), at http://books.openedition.org/editionscnrs/2528, accessed 02.02.2021. 6 At the time, a delegate from the International Committee of the Red Cross prepared a report detailing his in- vestigation of the events: Maurice Gehri, “Mission d’enquête en Anatolie (12-22 mai 1921),” Revue internatio- nale de la Croix-Rouge 31 (1921): 721-735. The historian Arnold J. Toynbee was present in Anatolia during the Greco-Turkish War and denounced the crimes committed by both sides as the Greek army withdrew, in his book entitled: The Western Question in Greece and Turkey (London: Constable and Company Ltd., 1922), 259-319. It remains a controversial topic to this day. Peter K. Jensen, “The Greco-Turkish War, 1920-1922,” International Journal of Middle East Studies 10, no. 4 (1979): 563; Norman Naimark, Fires of Hatred: Ethnic Cleansing in Twentieth Century Europe (Cambridge, London: Harvard University Press, 2001); 45-46. Jeremy Salt, The Unmaking of the Middle East (Berkeley, Los Angeles, London: University of California Press, 2008), 77-78. 7 Harry J. Psomiades, “The American Near East Relief (NER) and the Megali Catastrophe in 1922,” Journal of Modern Hellenism 19 (2001): 135. 83 Joceline Chabot, Sylvia Kasparian: On the High Seas with No Place to Land other Christian quarters. The Armenian doctor Garabed Hatcherian described the blaze that destroyed his home and a large part of the port city: Gradually, the fl ames approach our house. The crackle of burning materials and the transformation of explosives into fl aming clouds produces an infernal sight the likes of which I have never seen before. […] During the battles in the Dardanelles and in Romania, I have witnessed the burning of so many cities and villages, but none of those fi res has made such a strong impression on me. This fi re in Smyrna is indescrib- able and unimaginable.8 Like Dr. Hatcherian, other witnesses of the fi res – victims, but also consuls and Amer- ican and British schoolteachers and missionaries – believed the blaze to be the work of Turkish troops.9 The Smyrnaean devastation forced its residents to escape to the piers on the waterfront, where they met Greek and Armenian refugees fl eeing from the interior of the country, waiting for rescue at the harbour.10 At that time, the city of Smyrna (today known as Izmir) was a port city where Greeks, Armenians, Jews, Levantines and Turks lived peacefully alongside each other. An Arme- nian population was recorded in Smyrna as far back as the 13th century.11 In the mid-1800s, the Greek population in Smyrna, predominately Orthodox Christian, surpassed that of the Muslims, who thereafter renamed the city Smyrna, the Unfaithful. The city prospered from the 19th century onwards, thanks in large part to the economic power of the local Christian population. The fi res that devastated the city would destroy the second largest city after Constantinople and one of the Ottoman Empire’s most cosmopolitan centres.12 Witnesses and western bystanders watched the fi nal chapter of the Greco-Turkish war and the last act of the Turkish solution to the problem of the Ottoman Empire’s Christian mi- norities on the Smyrnaean piers in September 1922. The immense humanitarian crisis took place before the eyes of powerful foreigners there on the piers, where 21 French, British, Italian and American warships were anchored in the bay. Every ship declared its neutrality and their crews received orders from their respective governments to save only their own nationals.13 The Turkish authorities announced, on 24 September 1922, that refugees who were not evacuated within one week would be “deported to the interior.” As witness Dr. Esther Pohl Lovejoy,14 director of the American Women’s Hospitals (AWH), recalled, all were aware 8 Garabed Hatcherian, An Armenian doctor in Turkey: Garabed Hatcherian, My Smyrna Ordeal of 1922 (Mon- treal: Arod Books, 1997), 15. 9 Turkish history attributes the destruction to Greeks and Armenians. On this debate, see Georgelin, “Un cos- mopolitisme à détruire”. 10 Psomiades, “The American Near East Relief,” 136. 11 Marie-Carmen Smyrnelis, “Les Arméniens catholiques de Smyrne aux XVIIIe et XIXe siècles,” Revue du monde arménien moderne et contemporain 2 (1995-1996): 27. 12 Tusan, Smyrna’s Ashes, 144. 13 For example, the evacuation of British citizens was undertaken on 4 September 1922. As many as 1,200 British subjects embarked that day, aided by British soldiers on the piers. Tusan, Smyrna’s Ashes,147. 14 For more on the life and work of Dr. Lovejoy, see Kimberley Jensen, Oregon’s Doctor to the World: Esther Pohl Lovejoy and a Life in Activism (Seattle: University of Washington Press, 2012), and Kimberley Jensen, 84 International Journal of Armenian Genocide Studies: Volume 6, No. 1, 2021 that this expression clearly meant a death sentence for the majority of those there.15 Shortly afterwards, the Kemalist authorities allowed Greek (Hellenic) boats and British and Amer- ican sailors to assist the refugees and organize their evacuation with the support of human- itarian organizations in the area. Among these were the Near East Relief (NER), one of the largest American humanitarian organisations at the time, the American Red Cross (ARC), the Armenian Red Cross, the American Women’s Hospitals (AWH) and the Young Men’s Christian Association (YMCA). The Disaster Relief Committee in Smyrna got all the Amer- ican humanitarian organisations to coordinate the urgent aid effort.16 Our goal in this article is to examine the role of individual humanitarian aid stakeholders in the Smyrnaean refugee crisis in the context of the massive population migrations from Asia Minor to Greece. We are interested in the following questions: by what means and concrete actions did humanitarian organisations – particularly the NER and the AWH – help deliver this defenceless population? What challenges did these organisations face and over- come in the wake of the Smyrnaean catastrophe? Using reports and memoirs of witnesses in Smyrna and the archives of the American Women’s Hospitals, we try to answer these questions here. “Every Night there came those Blood-curdling Shrieks that Swept along that Terrible Quay.”17 On the Piers of Smyrna, a Major Humanitarian Crisis More than 200,000 refugees huddled on those piers in Smyrna in September 1922 without food or water, in inconceivably squalid conditions: “The scenes on the quay and the wharf are beyond the possibility of human imagination; they cannot really be described; they can only be expressed as they were expressed, in shrieks and groans and wild prayers and pleadings.”18 The writer was Dr. Esther Pohl Lovejoy, one of the rare American women in Smyrna authorised by the Kemalist armed forces to tend to the refugees. Dr. Lovejoy as- sisted women in labour that would give birth on the piers. In a text penned later for a radio speech delivered in New York in early 1923, she wrote: There were a large number of pregnant women in this quarter of a million people and their labors were precipitated by the horrible experiences through which they were passing. A British surgeon at the end of the wharf was taking care of a great many sick and injured people. He told me he knew nothing about maternity work and asked me if I wouldn’t watch the crowd for the women in labor and help them. Day after day I “Esther Clayson Pohl Lovejoy (1869-1967),” in The Oregon Encyclopedia, at https://oregonencyclopedia.org/articles/lovejoy_esther_clayson_pohl_1967/, accessed 13.09.2020. 15 Dr. Lovejoy Talk 1922. AWH ACC 144 box 3, folder 25. Lovejoy Esther Pohl talk 1921-1928. American Women’s Hospitals records. Drexel University, College of Medicine Legacy Center. Philadelphia, 1. 16 Antonis Klapsis, “American Initiatives for the Relief of Greek Refugees, 1922-1923,” Genocide Studies and Prevention 6, no. 1 (2011): 101. 17 Dr. Lovejoy Talk 1923. AWH ACC 144 box 3, folder 25. Lovejoy Esther Pohl talk 1921-1928. American Women’s Hospitals records, 2. 18 Ibid 4. 85 Joceline Chabot, Sylvia Kasparian: On the High Seas with No Place to Land went to the dock early in the morning and remained until the ship-loading ceased at night. Children were born on the quay, some on the wharf, but most of the women we got abroad ship before their babies came.19 Despite the presence of westerners, the refugees were the victims of violence by Ke- malist armed forces: they were taken hostage and beaten; girls and young women were kidnapped. Their immediate evacuation was the only way to save them. Most of the evacu- ees – 177,000 in all, mainly women and children – embarked on boats between September 26 and 29.20 The refugees’ evacuation took place in conditions so utterly chaotic that Dr. Lovejoy, years later, as she wrote her memoirs, could not fi nd the words to describe the crisis: “The description of that frantic rush to reach the ships is beyond the possibility of language. Pain, anguish, fear, fright, despair and that dumb endurance beyond despair, cannot be expressed in words.”21 The exiles were mostly women, children, and the elderly.22 Men aged 15 to 45 years were separated from their families and sent to the interior to forced labour battalions. The historian Harry J. Psomiades states that the life expectancy in these battalions was about two months.23 The majority of the women and children thus found themselves without their men, the traditional breadwinners and family providers. To fully understand the violence suffered by the refugees, it is important to understand the role gender played in the perpetration of ethnic cleansing by Turkish authorities. According to Dr. Lovejoy, the separation of families and the deportation of the men had even more terrible consequences for the women and children left defenceless: This enforced exodus of the Christian from Anatolia is one of the greatest movements in the history of mankind. It involves problems which challenge the possibilities of human imagination. The fact that the young men of this nation were separated from their women and detained in Asia Minor has more than a military and economic ef- fect. Men were not born [to] live without women, nor women to live without men, and the absence of young men normally belonging to this group of migrating human beings naturally entails far-reaching social and biological problems.24 This excerpt should be put into context: Lovejoy’s depiction here of the relationship between men and women was commonplace for the times and not simply one individual’s perspective. In other words, Lovejoy – who keenly felt the plight of the refugees and, in particular, that of the women and children in distress – was expressing a worldview shared by the vast majority of her contemporaries: that women were dependent on men to ensure their survival. That being said, violence against the refugee women and girls took place 19 Ibid 5. 20 Tusan, Smyrna’s Ashes,151. 21 Esther Pohl Lovejoy, Certain Samaritans (New York: The Macmillan Company, 1927), 153. 22 Klapsis, “American Initiatives,” 99. 23 Psomiades, “The American Near East Relief,” 142. 24 Dr. Lovejoy Talk 1923. AWH ACC 144 box 3, folder 25. Lovejoy Esther Pohl talk 1921-1928, 1. 86 International Journal of Armenian Genocide Studies: Volume 6, No. 1, 2021 throughout the deportation, to which Lovejoy was a witness during her time in Smyrna. According to her, two facts were clear to everyone: “The Turks are determined to get rid of the Christian population in Turkish territory, and Greece is the only country within reach which will receive them.”25 To compound their miseries, even if the transport of hundreds of thousands of refu- gees by sea to continental Greece and her offshore islands happened quickly, it still took place under perilous conditions. The refugees, some of whom were already suffering seri- ous health problems brought about by their long journey across Anatolia, were crammed onto ships, often without food or fresh water. Sanitary conditions were deplorable and the weakest among them fell prey to typhus and smallpox. Correspondence between Dr. Mabel Evelyn Elliott of the AWH, medical director in charge of the NER’s refugee health unit, and Dr. Lovejoy, highlighted the enormous challenges of the mass exodus and the transport of close to one million refugees in the space of a few weeks. In her letter dated January 16, 1923, Elliott described the situation in which the survivors found themselves, on board ships leaving Turkey: To try and picture to you conditions on these boats is beyond human description. You have seen boats loads of refugees, doctor, no need to describe, if I could, the horror of human beings jammed onto these boats. But remember, these people, before embark- ing have travelled for days and weeks over the snow-covered mountains of Anatolia, they have traveled on these boats down the Black Sea, through the Bosphorous [sic], Marmora and Aegean Sea and now stand in the harbor. Not one of these boats but what have on board smallpox and typhus besides all the other diseases which develop [sic] from such hardships. In the harbor it is not permisible [sic] to throw the dead overboard, so there is nothing to do but burn the bodies in the ship’s furnaces. […] Added to the rest of the stench which, you know, always accompanies the ships of horror, is now added the distressing odor of burning fl esh.26 Note that in 1923, the Greek population was approximately 5 million, added to by the nearly one million refugees arriving on their shores.27 The Greek government and humani- tarian organisations were overwhelmed. In a telegram dated 11 October 1922, Dr. Fridtjof Nansen, High Commissioner for Refugees of the League of Nations and envoy to Asia Mi- nor, wrote about the critical situation of the refugees in Greece: There are probably no fewer than 750,000 refugees, the greater part of whom are women and children, scattered over every part of Greece, Thrace and the Islands. The evacuation of the refugees from Asia Minor was carried out with admirable thor- oughness and effi ciency and undoubtedly saved innumerable lives, but their present 25 Ibid 7. 26 Letter from Dr. Mabel E. Elliott to Dr. Lovejoy. January 16, 1923. AWH ACC 144, box 10, folder 82 Mabel Elliott, 1922-1923, 1. 27 Félix Sartiaux, “Le problème des réfugiés d’Asie Mineure et de Thrace en Grèce,” Journal de la société statistique de Paris 64 (1923): 30. 87 Joceline Chabot, Sylvia Kasparian: On the High Seas with No Place to Land condition is deplorable. They are without money, clothes or shelter and frequently without food […].28 Their needs were overwhelming. There was a dire and urgent need for reception camps and socio-health care clinics, which were undertaken by the NER and the AWH with the support of the Greek authorities. On Camps and on Islands: Humanitarian Aid to Greek and Armenian Refugees and Orphans Faced with the infl ux of refugees, the Greek government set up makeshift camps around Athens and on numerous islands, wherever the refugees landed. Some were housed in build- ings made available to them by the government, while others were temporarily placed in crude shelters. Still others, mainly Armenian women and children, built mud houses on lands allocated to them by the Greek government. Dr. Lovejoy expressed her admiration for the women’s resilience and courage: These heroic women are not conscious of their own heroism. They have accepted their burdens and instinctively dedicated themselves to the task of securing food and shelter for their children. The mother who has lived in the open with her little ones through fair and foul weather knows the meaning of shelter. And when she has dug a home out of the earth and built it brick on brick with her own hands, she has built her soul, hopes and fears, into that home.29 The local Greek population was by and large welcoming, but the presence of so many refugees in some poor urban and rural areas created tensions within communities with al- ready limited resources. Refugees who were ethnic Greeks and who considered Greece to be their motherland had adopted Turkish customs over the centuries.30 Furthermore, some of the refugees were Armenians and did not share the Greek language or religion with their new hosts. They were seen as complete outsiders. Finally, whether Greek or Armenian, many refugees were simply women and children, all alone, without husbands or fathers: “Native women are afraid of this infl ux of females. They are dangerous. In this connection a prominent Greek woman said to me: “We want help these Smyrna women, but don’t want them in our homes. We must consider our families – our sons and brothers and even our 28 “Relief for Refugees from Asia Minor,” League of Nations Offi cial Journal 3, no. 11, part 1 (1922): 1141. 29 Dr. Lovejoy Talk 1923. AWH ACC 144 box 3, folder 26. Lovejoy Esther Pohl talk 1921-1928, 8. 30 Katherine Nazloglou, “Problèmes d’intégration et quête identitaire des réfugiés grecs de Turquie en mi- lieu urbain (Athènes-Le Pirée) de 1922 au début des années 1930 : quelques exemples,” Cahiers balkaniques 42 (2014), at http://journals.openedition.org/ceb/5014, accessed 23.11.2020. Bayindir Goularas Gökçe, “Un exemple de la perception de la frontière en Méditerranée: l’étude de la frontière entre la Grèce et la Turquie,” Diacronie. Studie di Storia Contemporanea 23 (2015), at http://journals.openedition.org/diacroni.2383, ac- cessed 05.12.2020. Renée Hirschon, Heirs of the Greek Catastrophe: The Social Life of Asia Minor Refugees in Piraeus (Oxford: Clarendon Press, 1989). 88 International Journal of Armenian Genocide Studies: Volume 6, No. 1, 2021 husbands.” And what about the laboring men and women of Greece? We are sorry for these people, they say, but charity begins at home.”31 This wariness toward the refugees also came from the fact that some carried infectious diseases, and the risk of an epidemic was signifi cant. The AWH archives detail the list of affl ictions suffered by the refugees: malnourishment, typhus, smallpox, tuberculosis, dys- entery and trachoma, an eye disease affecting mainly children.32 Urgent humanitarian aid was desperately needed. Faced with the threat of contagion, the Greek authorities imposed a mass quarantine on the refugees. The island of Macronissi, tiny and without signifi cant infrastructure, was used as a quarantine station. The doctor in charge of setting up the station, Dr. Olga Stasny of the American Women’s Hospitals, wrote a very detailed report of the process, in which she lamented the lack of personnel and start-up resources on the island, uninhabited and without drinkable water as it was: I learned I was to organise and direct a large quarantine station on the island of Mac- ronissi […] Greece, which had been the only Nation to accept the unfortunate Greek and Armenian victims of Turkish wrath had closed the gates. Thousands in her midst were without shelter or food – would it not be better to save them already there than loose [sic] all? An American group of workers in touch with the situation pleaded with the Greek Government. […] The Government was urged and fi nally in answer to “Under what conditions will you take them” said “only if they could be rid of disease and come in clean.” The task seemed impossible to one who knew the condition of these people, but the American Women’s Hospitals were prevailed upon [to] attempt it. We accept and January 27th I left Athens to organize the Station for we were to receive our fi rst boat load of refugees in ten or twelve days. No telephone-cable or wireless. Our isolation was complete. The Government fur- nished the location – boats for necessary traffi c – water and fuel and the A.W.H. was to furnish all else.33 The Macronissi quarantine order lasted from January to June 1923. More than 20,000 ref- ugees from Turkey went through the tiny island’s station.34 Stasny’s reports testify to the challenges faced by the AWH on Macronissi, but also to the work accomplished there. The refugees were often moved from one island or camp to another, depending on the local resources available there. The humanitarian workers would follow these movements, trying to attend to the immediate needs of the masses over the short term and anticipate their longer-term needs as well. 31 Dr. Lovejoy Talk 1923. AWH ACC 144 box 3, folder 26. Lovejoy Esther Pohl talk 1921-1928, 5. 32 Rapport to the Managing Director of NER from Mabel Elliot. August 1923. AWH ACC 144 box 10, folder 81 – Mabel Elliott 1922-1923, 2. 33 Olga Stastny’s Report. November 1923. AWH ACC box 10 folder 83 – Stastny Dr. Olga Macronissi Island 1923, 11-12. 34 General Report to the Board, Dr. Esther P. Lovejoy, 1927. AWH ACC 144 box 3 folder 24 – Lovejoy Esther Pohl Reports 1926-1930, 2. 89 Joceline Chabot, Sylvia Kasparian: On the High Seas with No Place to Land On account of the moving refugee population which we serve, our work is transferred from place to place in accordance with the greatest needs. Over one and a half million alien, homeless people driven from Asia Minor were received in Greece. The task of replanting an uprooted nation within an impoverished neighbour nation is colossal, and it [will] probably be several years before it is complete.35 The doctors and nurses of the Red Cross, the AWH and the NER set up various facilities in order to care for this destitute population and restore them to health. On the island of Mytilene, for example, Director General Dr. Mabel E. Elliott coordinated the NER’s entire medical aid service to the refugees. According to an AWH report, within two days of Dr. Elliott’s arrival in Greece in October 1922, she opened a hospital, and cared for 80 patients in a single day. Two weeks later at the end of October, she inaugurated the Piraeus hospital and three urgent care clinics. In addition to caring the sick, Elliott raised funds from donors, managed the donations sent to Greece, recruited staff and oversaw the proper functioning of services. In early 1923, as many as 39 doctors and 113 nurses worked under her super- vision, among them Greeks and Armenians.36 Like her colleagues and the nurses deployed in Turkey and Greece, Dr. Elliott proved to be entirely capable of managing a transnational health and relief effort. More than 80,000 of the refugees were Armenian and Greek orphans, residents of NER orphanages built in Turkey following the 1915 genocide and the post-genocide massacres. The NER orphanages had been established under crisis conditions. Katherine McFarland, a nurse working for the AWH and the NER, witnessed, fi rst-hand, the arrival of the fi rst or- phans from Oropos: “Can you imagine 1,000 children arriving at such a place and fi nding only an empty building? Our hospital had nothing for about three days, until the freight could be unloaded and landed. Unfortunately two little bodies have been taken to the grave- yard, but I hope they are the last.”37 The AWH set up, directed, and fi nanced all the hospitals connected with NER orphanages which had been displaced from Anatolia to Greece.38 In her written report, the medical director Elfi e R. Graff confi rmed the central role played by the AWH on behalf of the NER orphanages:“From November 1922 to August 31, 1923, the American Women’s Hospitals did the medical work for the Near East Relief Orphanages, taking care of 12,287 patients and giving 1,499,529 treatments.”39 The NER orphanages had two primary objectives. The fi rst was to care for and ensure the survival of the children, 84% of whom were under the age of 14. In its annual report to 35 Report from Dr. Esther P. Lovejoy to the Medical Woman’s National Association, May 19 1925. ACC 144 box 3 Folder 23- Lovejoy Esther Pohl Reports 1923-1925, 2. 36 Report from Mabel Elliott to the AWH, March 5, 1923. AWH ACC 144 box 10, folder 81 – Mabel Elliott 1922-1923, 1-2. 37 Letter from Oropos, December 28 1922. News from Abroad, Letters of Katharine Adele McFarland 1921- 1925, Grim-McFarland-Woodbridge family history collection, Collection 3706, The Historical Society of Penn- sylvania. 38 Report from Esther P. Lovejoy to the Medical Woman’s National Association, June 1923. AWH ACC 144 box 3 Folder 22- Lovejoy Esther Pohl reports 1922-1923, 2. 39 Report from Elfi e R. Graff, September 1922 to September 1926. AWH ACC 144 box 14 folder 113 – Near East 1921-1930, 1. 90 the American Congress, the NER reminded its readership that: “The largest medical work of the year has been done in connection with the refugee camps and in fi ghting typhus and oth- er epidemics among refugees in their fl ight from the interior of Anatolia, in refugee camps and aboard ships where they have frequently been detained in harbours, unable to land.”40 The NER workers paid a high price indeed: during the forced relocation of the orphans to Greece, a dozen of the workers died after contracting typhus or smallpox.41 The second objective of the NER was to enable the orphans to quickly become indepen- dent so that they could care for themselves. To expedite this independence, the workers had to train the orphans in a trade. In fact, the training was centred on traditional trades found in communities of the Middle East: rug-making, embroidery, ironwork and agriculture. These trades were also common in Greece, where the economy was not yet industrialised. According to historian Michelle Tusan, the training in trades also recalls early means of self-sustaining by missionaries to the Ottoman Empire, who would support their work in the fi eld by selling hand-crafted items made by the workers they trained.42 For the NER, this longer-term goal was ambitious, because it involved creating a policy of education with the hopes of ending, for good, the confl icts which had raged for decades in the Middle East: “The real test of our work is yet before us. The children must not be merely so many lives saved; they must become so many forces for righteousness, progress, world brotherhood and peace, permeating and transforming the industrial and social life of the Near East.”43 As a fi nal observation, it is important to point out that the doctors of the AWH and the nurses of the American Red Cross quickly established schools to train Greek and Armenian nurses in modern medical practices originally developed in Western hospitals. These new nursing recruits later served in important intermediary roles between Western professionals and the refugees.44 Conclusion It cannot be denied that the humanitarian workers, the majority of whom were women, played an extraordinary role in the mass migration of Middle Eastern populations after the First World War. Indeed, they were forced to contend with war, famine, contagious disease and the despair of a traumatized population. They had to mobilize material and human resources for their work, and train others to aid in the urgent care of refugees. As for the women doctors of the AWH and the nurses of the Near East Relief and the Red Cross, their humanitarian work with women, mothers and children, was vital in saving a great many lives. Thanks to their selfl ess acts and with the gratitude of their peers and the authorities, 40 Near East Relie. Report of the Near East Relief for the year ending December 31, 1923 (Washington: Wash- ington Government Printing Offi ce, 1924), 13. 41 Ibid. 42 Michelle Tusan, “The Business of Relief Work: A Victorian Quaker in Constantinople and Her Circle,” Vic- torian Studies 51, no. 4 (2009): 633-661. 43 Near East Relief,18. 44 Isabel Kaprelian-Churchill, Sisters of Mercy and Survival. Armenian Nurses, 1900-1930 (Antelias-Lebanon: Armenian Catholicoste of Cilicia, 2012). International Journal of Armenian Genocide Studies: Volume 6, No. 1, 2021 91 their professional status as women doctors, nurses and medical health administrators – and their legacy – endures. This fascinating research is still in its early stages. We want to better understand the journey of those women actively engaged in humanitarian health and social work with Armenian and Greek refugees and orphans in the 1920s. We hope to shine a light on their professional and religious motivations, and analyse their actions in a transnational frame- work. It would be illuminating, for example, to compare our fi ndings to those of researchers examining the role of Scandinavian missionaries providing humanitarian aid both during the Armenian Genocide and among refugees and orphans after 1919. Three notable exam- ples come to mind. First, there is Maria Smaberg’s study on the missionary Alma Johansson, who pushed back the boundaries of her role as a single woman while maintaining the socie- tal norm of motherhood among Armenian orphans.45 Second, we could examine Inger Marie Okkenhaug’s work demonstrating that for several female Scandinavian missionaries such as Karen Jeppe, Maria Jacobsen and Alma Johansson, their humanitarian work with Armenian refugees transformed their own personal and professional lives so much so that they are part of the collective memory of Armenians today.46 Finally, we would include Matthias Bjorn- lund’s work, which allows us to understand how the Armenian Genocide and the refugee crisis that followed the war ethically affected women missionaries and how their faith gave purpose to their transnational humanitarian commitment.47 Ultimately, we would explore the social systems and the human milieu in which these women moved, grew, changed, and shaped their own and others’ lives. 45 Maria Smaberg, “Mission and Cosmopolitan Mothering. Saving Armenian Mothers and Orphans, 1902- 1947,” Social Sciences and Missions 30 (2017): 44-73. 46 Inger Marie Okkenhaug, “Scandinavian Missionaries, Gender and Armenian Refugees during World War I. Crisis and Reshaping of Vocation,” Social Sciences and Missions 23 (2010): 63-93. 47 Matthias Bjornlund, “If I die, I die”: Women Missionary Workers among Danes, Armenians, and Turks, 1900-1920,” International Journal of Armenian Genocide Studies 4, no. 1 (2019): 55-79. Joceline Chabot, Sylvia Kasparian: On the High Seas with No Place to Land