Elsie Smith was born in Kingstone Lisle, Berkshire, England, on 8 September 1881, the daughter of Charles Collins Smith, a farmer, and his wife, Mary Ann Danse. She was educated at Hemdean House School, Caversham. In the hope of becoming a medical missionary, she took a short training course as a nurse and completed the full theological training of the Church Missionary Society (CMS). She then trained as a general nurse at the Prince of Wales Hospital, London. At various stages her training was interrupted by ill health. During the First World War she was sister in charge of the wards given over to military work.
After further nursing experience, Elsie Smith appeared before the CMS medical board, but was not passed as medically fit. She decided to join the Ranyard Nurses and for three years was in charge of the St George's Mission, Lambeth. On being advised to give up nursing for a while, she became a church worker: in Lambeth, then in Newcastle upon Tyne for five years, and in Halifax for a year. At the end of this time she was deemed to be medically fit.
In 1926 she came to New Zealand, under the auspices of the Anglican church, to take up the position of matron at the recently opened Abbotsford Home for children in Waipawa, Hawke's Bay. However, she found she was unsuited to the work and in 1928 left to become deaconess at St Stephen's Church, Marton. She served in this district for two years.
In May 1930 Elsie Smith travelled up the Whanganui River to Koriniti, where she was to spend 33 years ministering as a nurse and missionary to Te Ati Haunui-a-Paparangi of the river's lower reaches, but mainly to Ngati Pamoana. A church (named Pepara) had been constructed at Koriniti in 1920 to replace a previous one burnt during the Raetihi bush fires of 1918. 'Sister Elsie' lived in the mission house, adjacent to Pepara, which had been built in 1925 by Thomas Chadwick and Tiaki Waitokia. In the 1930s Lord Bledisloe donated a dispensary and front bedroom.
Elsie Smith's district extended between Parikino and Pipiriki (a distance of 34 miles), and included Matahiwi, Ranana and Jerusalem. The river road, not opened until 1934, was unsealed, narrow and winding, frequently closed by slips. Sister Elsie travelled by foot, horse, bicyle, canoe and motor vehicle to attend to the spiritual and physical welfare of her people. She always wore a navy-blue belted smock with a white collar, black stockings and boots or gumboots. Before long she was a familiar and welcome figure up and down the river.
On Sundays she rang the bell for church and played the organ. However, it was the custom of the river Maori not to allow a woman to speak on the marae or, in those days, to preach in church. The elders were adamant: they would stay away from services or close their church altogether rather than have this small, dominant and outspoken woman break their rules. Canon W. G. Williams from Putiki smoothed the way towards letting her speak in church by telling Ngati Pamoana about Smith and her work. Although resistance to her ministering was gradually overcome by the example she set, and by her willingness to work with and for the people, a few elders remained reluctant to attend meetings or services where she was speaking.
In 1934 Elsie Smith started a play group for local Maori children – the first of its kind in the country and a forerunner of play centres. By 1935 she had begun an Anglican Maori boys' and girls' Bible class club, and had established the Koriniti branch of the Mothers' Union. Once the road was opened and district nurses began visiting the area, her nursing duties lessened and she was able to devote more time to the spiritual side of her work. A humble, cheerful, dedicated and dignified person, she fully deserved the tributes that were paid to her on her retirement in 1954. A year later she was made an MBE in recognition of her work, and in the late 1950s she was adopted as a member of Ngati Pamoana.
Following a visit to her English family in 1962, Smith returned to her home in Koriniti for a short while. In 1963 she went back to England, to nurse her sick brother. She never married, and died on 4 May 1968 at Bradenham, Buckinghamshire. In 1970 a gathering of 300 people celebrated the 50th anniversary of Pepara Church, and witnessed the unveiling of a memorial river-stone cairn to Sister Elsie.
In 1972 a photograph of Elsie Smith with her friend Hinekohurangi Te Ture, in a frame made by master carver Kohe Webster, was presented to the Wanganui Public Museum. Sister Elsie is still remembered with affection by all who came in contact with her during her work as a missionary and a nurse.