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Constance (Ethel) Cousins was born on 22 September 1882, in Antananarivo (Tananarive), Madagascar. She was the daughter of the Rev. William Edward Cousins, missionary to Madagascar with the London Missionary Society, 1862-1899. By 1885, Constance and her siblings had returned to England, where they attended the Walthamstow Hall School for the daughters of missionaries. Constance then attended Oxford University, gaining first class honours in Physiology in 1904.
In 1911, Constance Cousins' application to serve with the London Missionary Society was turned down on the grounds that she displayed the symptoms of latent epilepsy (a diagnosis never subsequently confirmed). In November 1911, she went to the Almora Sanatorium for Tuberculosis in North India as an unpaid medical assistant. The Church of Scotland ran the Sanatorium and in November 1913 she transferred to the Church of Scotland's medical mission at Kalimpong (North India). Her appointment to the mission staff was confirmed in January 1914. During her period of service at Kalimpong (1913-1923) she was requested to help combat a cholera epidemic in neighbouring Bhutan. Thus, in August 1918, she and her assistant, Nurse Brodie, became the first European women to be admitted to that country. In 1923 Cousins returned as a permanent member of staff to the Almora Sanatorium. She also obtained a diploma from the School of Hygiene and Tropical Medicine in London. She continued to work at Almora until her death in May 1944.