In 1909 Henrietta Szold was worn out.  She was 49; the love of her life Louis Ginzberg, who was 13 years younger than she, had just proposed marriage to an 18-year-old; her work as a translator and editor with the Jewish Publication Society was time-consuming as well as physically exhausting.  She had studied and tutored for years at the Jewish Theological Seminary, a training school for rabbis, on the condition that she not seek the rabbinate herself.

She obtained a leave of absence from JPS, and with her 70-year-old mother Szold went to Palestine.  Travelling in a horse-drawn cart to visit struggling agricultural settlements around the Galilee and in the poor quarters of Jerusalem, they were appalled by the poverty and disease rampant among the residents—Muslim, Christian, and Jewish.  In Szold's later recollections, she credited her mother's response to these conditions as one of the inspirations for turning Henrietta's New York Zionist study circle into Hadassah, "This is what your group ought to do … You should do practical work in Palestine." 

On her return to New York, Szold plunged into Zionist activities, taking on another set of responsibilities as the secretary to the Federation of American Zionists.  She likened the burden of bringing order to its woefully disorganized files and finances to "cleaning up other people's augean stables."  But she also spoke to enthusiastic crowds about her travels and her ideas to bring relief to the region.

Convinced of American Jewish women's potential to help create a Jewish homeland, Szold turned to New York's Zionist women's study groups.  On the holiday of Purim, February 24, 1912, thirty-eight women gathered at Temple Emanu-El to create "a large organization of women Zionists" devoted to "the promotion of Jewish institutions and enterprises in Palestine, and the fostering of Jewish ideals."  Naturally, Szold was elected president.

When philanthropist Nathan Straus offered partial funding to establish district nursing in Palestine, the fledgling organization "Daughters of Zion" realized its purpose.  On New Year's Day 1913, Szold presented the Hadassah board with the challenge of raising $2,500 and finding a skilled nurse able to depart for Palestine within a few weeks.  Ultimately two nurses, Rose Kaplan and Rachel Landy, sailed with the Strauses on January 18.  In March 1913 they opened an office in a rented Jerusalem house identified by a Hebrew and English sign that read "American Daughters of Zion, Nurses Settlement, Hadassah." They saw 5,000 patients in their first year.

Representatives from chapters in New York, Baltimore, Chicago, Cleveland, Newark, Boston, Philadelphia, and St. Paul attended the first Daughters of Zion national convention held in 1913.  At the second convention in 1914, the group formally adopted the name associated with the group's medical efforts in Palestine—Hadassah.  Szold would go to Palestine herself in 1920 and spend most of her final 25 years there.

Sources: “Our History,” Hadassah; “Henrietta Szold,” Women of Valor.