Nurse in Hualong Holy Light Hospital—The story of Ruth Duncan

The SS Marine Lynx sailed from San Francisco 15 December 1946 carrying 650 missionaries bound for the Far East. Among them was Ruth Duncan, one of the fifty-eight CIM members on board. Ruth had graduated in May 1945 as the highest-ranking senior from the nursing program at the Lubbock Memorial Hospital School of Nursing. After six months of language and culture learning, and an interview with the CIM General Director Frank Houghton, Ruth was assigned to Tianshui, Gansu. In 1948, when a Christian medical clinic was opened in Hualong to meet the tremendous medical needs of the Tibetans, Ruth joined the team there. She took charge of nursing, missionary doctor Rupert Clarke visited from Lanchow every two months, and Norman and Amy McIntosh took care of maintenance and preaching. During the first six months of clinic work, the clinic staff saw 1,441 new patients and carried out 160 surgical procedures. How did this young lady come to love the Tibetans and happily immerse herself to serve in an isolated town situated 10,000 feet above sea level? Read on to find out.


Nurse in Hualong Holy Light Hospital—The story of Ruth Duncan

By Zi Xuan and Ci Zi

Read the article in Chinese in the free ebook 淨光高處開江河_五個關於西藏宣教的單元故事 (2022).


The youngest of three siblings, Ruth Duncan was born on 16 April 1921 in Amarillo, Texas. Ruth had two older siblings: Markus Homer Jr., and Dorothy. The family moved to Lubbock, Texas where their father (Markus Homer Duncan) served as Superintendent of Public Schools from 1925 until 1934. Studying at Lubbock High School, Ruth, like other school girls, enjoyed life and dancing. At fifteen, after responding to God’s calling, her life changed drastically. Growing in her love for Bible reading and prayer, Ruth determined to become a missionary. On 6 March 2004, during an interview, Ruth was asked to explain how she decided to invest herself in missionary work. She replied, “Missionary work is a journey that I have not thought of earlier. But when you see people in pain, it’s so uplifting when you could tell them about the King of Kings and His glory, missionary work is rather appealing.”[1] Among the missionary books Ruth enjoyed reading, many were on mission service to China. The word “Go” stood out to her. For the first time, Ruth was thinking of doing missionary work in China, and had begun praying to God for his guidance.

Ruth enrolled in Hardin Simmons University after her graduation from Lubbock High School, but transferred to Moody Bible Institute for missionary courses after one year. In spite of war conditions, 40% of the thirty-seven students in her graduation class of 3 April 1942 pledged to serve in foreign lands. Because of World War II and as preparation for her missionary work in China, Ruth enrolled in a three-year nursing program at the Lubbock Memorial Hospital School of Nursing. Graduating in May 1945, Ruth received the ninth annual Dr. J. T. Krueger cash award, which was presented to the highest-ranking senior. Ruth immediately joined the China Inland Mission (CIM) candidate course in Philadelphia, which was held during May and June. While waiting for departure to China, she also worked with her older brother, Rev. Markus H. Duncan Jr. (1913–2006), pastor of the Highland Baptist Church (Utica, New York), as well as at St Luke’s Hospital.


On 21 November 1946, a farewell tea party was held in honor of Ruth for her departure for medical missionary work in Tibet. Both her mother, Mrs. Mattie Annie Duncan (1881–1947), and her sister-in-law, Mrs. Charlotte Duncan (1921–1991), were present at the reception. Ruth’s decision to become a missionary received firm support from her mother and brother. In fact, her brother served as the primary liaison for communication between Ruth and congregation. He would also invite her to share the needs of the people group whenever Ruth was back in the US for furlough. Despite this support, Ruth’s father found her decision incomprehensible, as he had high expectations of her in becoming a teacher after completing her university education.

Ruth departed from Lubbock on 11 December, arriving in San Francisco on 15 December, and Shanghai on 2 January 1947. The SS Marine Lynx carried 650 missionaries bound for the Far East. Ruth was among the fifty-eight members of the CIM, and was expected to stay in China for seven years.

Language and culture learning

Complying with the usual practice, Ruth underwent an orientation for new members and then proceeded to Anqing in Anhui province for a six-month Mandarin language course and examinations. One of the language school teachers, Ruth Nowack, was a classmate of Ruth Duncan’s aunt, Lillian Norris. Ruth was one of the forty-three students of the second post-war session of the language school, sixteen of whom were from the United States.

On 15 February 1947, six weeks after Ruth’s arrival in China, a message arrived that her mother, who, after suffering and bravely enduring pain and illness for several years, had gone to be with the Lord. Pouring out her heart to her uncle, Dr. J. Frank Norris, an evangelist from Fort Worth, Texas, Ruth wrote, “There are tears in my eyes as I write, but there is also joy and praise in my heart to our loving Heavenly Father, for He doeth all things well.”[2] Although she had a deep longing to be home, she refrained from leaving, and expressed an even stronger determination to set herself even more diligently to the work before her.

The end of the six-month language and culture course was a momentous occasion in the lives of junior missionaries, as they each received the assignment for their designation. After an interview with Bishop Frank Houghton, the CIM General Director, Ruth was assigned to Tienshui, Kansu (Tianshui, Gansu), where she would continue her language study and receive training in pioneer evangelism.

Tibetans were in deep despair

Little is known of how God called Ruth to go to Tibet, but she had prayed for several years before leaving for China that the Lord would send her to “where millions are dying in deep despair.”[3]

The Tibetans particularly fit the description of her prayer. Though cataracts, hydatid cysts of the liver, venereal diseases, and leprosy were common complaints, medical facilities were scarce. The Borden Memorial Hospital was the only hospital located in Lanchow (Lanzhou), Kansu. Hundreds of sick people would take weeks, on foot or on yaks, to travel there in the hopes of receiving medical attention.

Those with leprosy faced enormous hazards traveling to seek treatment. It was common that when people saw them, they would set their dogs on them or stone them. One could picture the miserable condition they were in when they finally made it to the hospital.

Ruth Duncan (leftmost) atop the mission truck in North West China – China’s Millions, North American edition (April 1950): 57 – Photo by A. Mathews

Joint venture

Opening a clinic/hospital to meet the tremendous medical needs of the Tibetans had long been on the CIM agenda, but had repeatedly been postponed because of lack of resources and facilities.

In February 1948, CIM and Holy Light Rural Medical Service (a Chinese Medical Society) agreed to pool their resources to open a Christian medical clinic in Hwalung (Hualong), where the CIM had property. It would also provide an effective way of sharing the gospel.

While the Holy Light Rural Medical Service would provide medical equipment for the clinic, CIM would help to provide the staff. Norman and Amy McIntoshwere responsible for maintenance and preaching, while Ruth Duncan looked after nursing. A missionary doctor, Rupert Clarke, would visit from Lanchow every two months. A Chinese doctor and two Chinese graduate nurses from the CIM hospital at Kaifeng in Henan would also rotate their work between Lanchow and Hwalung.

A dream comes true

After celebrating U.S. Independence Day on 4 July, Ruth celebrated with others as the clinic was officially opened on 5 July 1948. The missionaries’ vision for a new medical center had finally become a reality.

Hwalung, an isolated small town situated at 10,000 feet above sea level, was only accessible by a road that was occasionally blocked by snow or impassible due to heavy rain. The ground in Hwalung was frozen most of the year, so hardier crops like barley, rape, and Chinese cabbage were the main produce. Donkey-loads of coal and wood had to be brought in from warmer areas for fuel. The conditions at Hwalung were harsh, the area barren, and life hard, but Ruth was happy to immerse herself in her work in the newly established clinic. Surely, nothing but the love of Christ would lead the staff to work there.

From darkness to a beacon of light

Hwalung was first settled by Tibetans. With the appointment of a Muslim Ma clique warlord as the governor of Qinghai in 1931, Moslems began to occupy centrally located lands, while the Tibetans were gradually forced into the higher altitude borderlands of the region. Still, two-thirds of the patients and almost all the surgical cases were Tibetans. Most had to walk for days to get to the clinic, and some were near collapse on their arrival.

The clinic started with no proper beds; the straw-filled mattresses scattered on the floor made the job of nursing difficult. As the clinic became established, more permanent staffing arrangements allowed for the clinic to become a six-bed, and then twenty-bed hospital, by 1949. The beds were constantly occupied. As more serious cases came in, the occupants had to be moved to a large, brick kang platform bed, on which about twenty to thirty patients slept.[4]

Smoke and soot seemed to seep into the very fabric of the clinic as the in-patients and their families used the fires under the kang for cooking. In addition, those waiting for treatment and their families living on the compound cooked over anopen fire of dried yak dung.

A very common disease among Tibetans was hydatid cysts of the liver or other organs. Living in close proximity with their animals (such as sheep and dogs), they were prone to this ailment as the small tapeworms that cause the cysts were easily transmitted from animals to humans. The cysts could grow to the size of a full-term pregnancy, largely destroying the liver. Nonetheless, the condition could be cured by an operation under local anesthesia. In a journal article, “A Tip for the Doctor,” Ruth Duncanwrote:

Dro Ma Tso, an elderly Tibetan woman, came to us with a large hydatid cyst of the liver. Her husband was present at the operation, and as more and more fluid and little cysts were extracted, his appreciation of the doctor grew. First he held one thumb up, to emphasize his approval, then he held both thumbs up to show he was elated. Then a sudden dive into the recesses of his sheep skin garment produced a silver dollar, which he planked on the operating table as a tip to the surgeon.[5]

But usually the patients were so poor that they were unable to pay even a small charge for treatment received.

During the first six months of clinic work, the staff saw 1,441 new patients, or 3,590 visits, and carried out 160 surgical procedures, often at very short notice. Once, a “Living Buddha” brought along about fifty nomads, forty-six of whom required surgical intervention. He further demanded that they be made fit so they could take their twenty-eight-day journey back in three weeks’ time. With the clinic already fairly full, surgery had to be planned strategically. Turning the dispensary-dressing room into an operating theatre, surgery began after lunch each day, usually finishing by early morning the next day. It thus took approximately ten days to operate on all forty-six patients, in addition to caring for all the other patients in the clinic.

Rendering medical assistance was an effective way to show the compassion of Christ. The number of Tibetans attending the clinic increased as time went on. Evening evangelistic services were held in the clinic chapel in conjunction with the local church. Many were healed and had the opportunity to hear the gospel message for the first time. Some even took copies of individual books of the New Testament home with them.

The team was hard pressed, but God rewarded their service with the joy they found in seeing people coming to Christ. As Ruth recounted:

A young Tibetan boy of seventeen or eighteen … came to me in the dispensary and told me that he was trusting Christ as his Savior. We have sought to teach him each time he has come in. His face literally shines when you talk to him of the Lord Jesus, and we trust that he has passed from death into life.[6]

Busy as they were, they would gather in the presence of the Lord and hold regular prayer meetings, augmented by days of prayer and fasting. To intercede for a people who embraced multiple gods and deities, they chose as their theme song, “Jesus, the Name High over All!” Their special emphasis was the verse,

His only righteousness I show,

His saving grace proclaim;

’Tis all my business here below

to cry, ‘Behold, the Lamb.’

In the midst of the hustle and bustle of daily work, Ruth continued her Tibetan study with a living Buddha, basing it on the Books of John and Acts. Ruth had also hoped that the light from the books would also shine upon her language teacher.

A tense and fragile peace

With the fast-changing political situation after the second Sino-Japanese War (1937–1945), people could feel the increasing political pressure and sky-rocketing inflation as conditions went from bad to worse. Ruth recounted that a bar of soap cost 950,000 Chinese yuan or about one dollar in American gold. By the time the missionaries received any currency, it had almost halved its value.

For the period 1945–1949, Hwalung was fairly peaceful, and work in the hospital went on with little interference, but the atmosphere was becoming increasingly tense.

From a beacon of light to darkness

The missionaries were excited to see more Tibetans coming to Christ, but they also began encountering resistance, with the increasingly tense political atmosphere and Tibetan priests frightening people away from the gospel. The team visit to the village might be warmly welcomed one week, but met with the cold shoulder a week later. The number of church attendees, though never large, was dwindling. Similar experiences were being reported in other localities. They had come to realize that missionaries were becoming a hindrance rather than a help to the local churches. The decision was made in December 1950 that it was time to leave. “The sooner we get out, the better.”[7] After eighty-five years, CIM was to withdraw completely from China. The hospital at Hwalung had to be closed. Ruth and the other five missionaries—Dr. Rupert Clarke and his wife, Mr. and Mrs. Hemmingby, and Ruth Gaardlas from Norway—were to relocate to Xining as soon as possible.

Still waiting for permission to leave, Ruth wrote on 18 February 1951 that things were happening fast and that she would be most thankful if she could get out alive. Although the situation was serious, Ruth was filled with God’s peace and had deep faith that the Lord reigns. She trusted her entire self to the Lord. She received further reassurance from Romans 11:33–36 and knew that his loving hand that had led her for so long, would lead them out of the long dark tunnel. Ruth later recounted, “Never before was I so impressed with the power and presence of God as during these days of waiting and travelling out of China.”[8]

Disappointment followed disappointment. Ruth’s heart was torn when she heard that the local church leaders had been imprisoned or regarded with grave suspicion, but she was comforted by the hymn, “If we could see beyond today as God can see.”

On 23 June, the missionaries were told to leave and travel to Xining in three days, a trip that would normally take at least four days. All left on that day, except Dr. Rupert Clarke. God spared them from making the eighty-mile trip by foot, by providing—through the man who had been their water carrier—four little two-wheeled coal-laden carts drawn by miniature, pony-sized horses. The missionaries traveled through rain and mud and over the high mountain passes. One of the horses collapsed when they reached the top of a 13,000 foot high mountaintop. They arrived in Xining after four days. From Xining, Ruth travelled for five days by a commercial truck to Xian, and then four days by train to Hong Kong. The flight to the US from Hong Kong took thirty-six hours by way of Manila, Guam, Wake, and Honolulu. Ruth arrived in San Francisco on 17 August 1951.

Writing to her friends two weeks after her safe arrival in San Francisco, Ruth expressed the longing that remained in her heart—to return to Hwalung. Having been there and seen the tremendous physical and spiritual need, she prayed, “Lord, please let me go back, please send me back.”[9] Moreover, Ruth knew in her heart that people who lived in other localities could still hear the gospel from Chinese Christians, pastors, and other workers. This was not so in Tibet. None would preach to them after the missionaries departed.

During the months waiting to leave China, the missionaries had learned as never before to apply the precious truths of the Bible to their everyday experiences with a new meaning. Ruth summarized, “At first we cried, with the Psalmist, ‘Deliver me, O God, out of the hands of the enemy,’ and then we read that we are to love our enemies and to pray for them that despitefully use us and persecute us.”[10]



“Arrivals,” China’s Millions, North American edition (October 1951): 146.

“Breakfast is to be Given for Visitors,” Lubbock Avalanche-Journal (24 November 1946): 17, (accessed 15 June 2021).

Chi Ya Chang, “The Study of Lin-An Presbyterian Church” (MA thesis, University of Tainan, 2005), (accessed 1 June 2022).

Rupert M. Clarke, “The Plight of the Tibetan,” China’s Millions, British edition (March-April 1948): 17.

Norah Conway, “The Language School Staff,” China’s Millions, Australasian edition (1 October 1947): 297–98.

Ruth Duncan, “A Missionary Cry,” China’s Millions, North American edition (February 1950): 21.

Ruth Duncan, “A Tip for the Doctor,” China’s Millions, North American edition (June 1950): 90.

Ruth Duncan to Uncle Frank and Aunt Lillian, 18 February 1947, J. Frank Norris Papers, Southern Baptist Historical Library and Archives AR. 124, Box 11.529, 6675.

Ruth Duncan to friends, 9 August 1948, J. Frank Norris Papers, Southern Baptist Historical Library and Archives AR. 124, Box 11.529, 6672.

Ruth Duncan to M. H. Duncan, 22 March 1951, J. Frank Norris Papers, Southern Baptist Historical Library and Archives AR. 124, Box 11.529, 6680.

Ruth Duncan to friends, 30 August 1951, J. Frank Norris Papers, Southern Baptist Historical Library and Archives AR. 124, Box 11.529, 6684.

Andrew Martin Fischer, Close Encounters of an Inner Asian Kind: Tibetan-Muslim Co-existence and Conflict in Tibet Past and Present, Crisis States Research Centre, Working Paper no. 68, Crisis States Programme Working Papers series no. 1 (London: London School of Economics, 2005), (accessed 1 June 2022).

Linnet Hinton, Never Say Can’t (Singapore: OMF, 1987).

“Holy Light Hospital, Hualung,” China’s Millions, British edition (November-December 1949): 64.

“Miss Duncan Plans to Go to Mission Work,” Lubbock Avalanche-Journal (4 December 1942): 10, (accessed June 15, 2021).

“Miss Ruth Duncan Arrives in China on Jan. 2,” Lubbock Evening Journal (6 January 1947): 6, (accessed 15 June 2021).

“Nurse Speaks Here Tonight,” The Amarillo Globe-Times (16 October 1946): 2, (accessed 15 June 2021).

“New Workers Designated,” China’s Millions, British edition (September-October 1947): 56.

“Prayer Pointers,” China’s Millions, North American edition (November 1950): 174.

“The Withdrawal,” China’s Millions, North American edition (September 1951): 130.

“Rites Conducted for M. H. Duncan,” Lubbock Evening Journal (6 March 1956): 9, (accessed 15 June 2021).

“Spiritual Guidance Stressed as 36 Nurses Given Diplomas Here,” Lubbock Morning Avalanche (16 May 1945): 12, (accessed 15 June 2021).

Phyllis Thompson, No Way Back: The Biography of Dr Rupert Clarke (Surrey: Highland, 1992).

“Miss Duncan to Leave Here Wednesday To Do Medical Missionary Work in China,” Lubbock Avalanche-Journal (3 November 1946): 24, (accessed 15 June 2021).

Ralph Toliver, “The Holy Light Rural Medical Service,” China’s Millions, British edition (May-June 1948): 26–28.

“Word from Ruth Duncan in China,” The World-Wide Missionary Crusader, July DNK, 1947: Page DNK. In Duncan to Frank and Lilian, 9 August 1948, J. Frank Norris Papers, Southern Baptist Historical Library and Archives AR. 124, Box 11.529, 6672.


[1] Chi Ya Chang, “The Study of Lin-An Presbyterian Church” (MA thesis, University of Tainan, 2005), (accessed 1 June 2022).

[2] Letter from Ruth Duncan to Uncle Frank and Aunt Lilian Norris, 15 February 1947.

[3] Letter from Ruth Duncan to friends, 30 August 1951.

[4] The traditional Chinese kang is an integrated domestic system for cooking, sleeping, heating, and ventilation. For details, see Zhi Zhuang, Yuguo Li, Bin Chen, and Jiye Guo, “Chinese kang as a domestic heating system in rural northern China—A review,” Energy and Buildings (2009): 111–19.

[5] Ruth Duncan, “A Tip for the Doctor,” China’s Millions, North American edition (June 1950): 90.

[6] Ruth Duncan, “A Tip for the Doctor,” China’s Millions, North American edition (June 1950): 90.

[7] Phyllis Thompson, No Way Back: The Biography of Dr Rupert Clarke (Surrey: Highland, 1992), 74.

[8] Letter from Ruth Duncan to friends, 30 August 1951.

[9] Letter from Ruth Duncan to friends, 30 August 1951.

[10] Letter from Ruth Duncan to friends, 30 August 1951.

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