The Diary

Three months since the last entry - where on earth has that time gone? I've bee working fairly hard, and with the addition of Christmas have found that I had to give something a miss - hence, no Blog. So, an update.
In September I finished the transcription of the official war diary of the Matron-in-Chief, France and Flanders, the original document being held at The National Archives in class WO95. Many unit war diaries run to a couple of hundred pages at the most, but this is a truly massive document, with more than 3,600 pages and over a million words; perhaps it can be more easily understood as the length of about 13 average length novels joined back to back. There are not many official documents which outline the day-to-day life of nurses in France during the Great War, and this certainly seemed a great opportunity to make available information about the workings of the nursing services during the period. Publication in book form rapidly became a non-option; unless it was stripped and edited within an inch of its life, it would remain an unwieldy beast, and such an editing process would veer completely away from my original intention of making even the 'boring bits' available to all, leaving just its skeleton behind.

So I decided to put it online on my Scarletfinders website (link on the right-hand menu) and began the process of turning my Word document into web pages. Unfortunately this isn't a simple job of cutting and pasting from one into the other, but I've managed to work at a steady rate and am currently working on June 1917, so nearly three years down and a couple more to go. From the beginning of 1917 the content of the diary expands massively, so three years of the diary isn't even half the work, and it means a great deal more to come, but on the whole I'm happy with the way it's going. I've already received quite a few emails from people who are finding it interesting/helpful, and I hope it will become a useful resource for all sorts of different reasons. But if I am a bit quiet here, it's just a sign that I'm usefully occupied elsewhere!

Etaples and Camiers

Here are three photos from the aforementioned trip - I did warn that they are not the most exciting ever taken! The top one is taken looking straight across the site of 24 General Hospital, Etaples from Avenue du Blanc Pavé - this was where Vera Brittain worked as a VAD during her time in France.
The middle one is 20 General Hospital, Camiers, now a piece of waste land, but the scene of a lot of hard work and suffering 90 years ago.
The bottom photo is taken from the footbridge over Dannes Camiers Station, showing the old sidings running alongside the road which bordered 8 Canadian Stationary Hospital, and Nos.4 and 20 General Hospitals.

Etaples - the hospitals today

I've just returned from a few days in France, where two friends and I walked the area around Etaples, Camiers and Le Touquet. We had some 1917/1919 maps of the area, showing the positions of all the hospitals, and by overlaying modern maps we had a look at the ground today. Our first stop was the museum in Etaples, where they have a room showing the town during the Great War. On one wall is a really excellent map, showing not only the positions of the hospitals, but also every hut, cookhouse, laundry and latrine! It was prepared by the Royal Engineers in 1917, but it's not one I've come across at The National Archives, and it will definitely be worth another search to try and uncover it. A great pity it wasn't possible to remove it from the museum wall, but I think they might have noticed!

Many of the sites are now covered with modern housing, and the rest either forested, scrubland, or building plots, but the layout of the roads is almost identical, so it's at least possible to say 'No.46 Stationary Hospital was here', or 'No.51 Officers' Hospital was there...'
Camiers, three or four miles north of Etaples is rather different, as it has not been subject to the same amount of building, and the old sidings running in at the side of the station, parallel to the site of the hospitals, are still there, and standing on the station bridge it's possible to let your imagination flow backwards to a time when it was filled with ambulance trains, stretchers and casualties. It was certainly an unusual few days which produced an odd assortment of photos - suburban roads, houses, dense forest and piles of builder's spoil, but well worth it for someone who wears two anoraks at a time.
One warning though - if you intend to visit Etaples, please make sure you enjoy fish. The restaurants are good - some are very good - and they are very proud of their fishing history, and their fish, and their fish market, and their fish restaurants, and the fish starters, and the fish main courses...

Up and Running

After a couple of weekend's work, I've now added quite a few new pages to the Scarletfinders website - a whole range of accounts of the Nursing Services written in July 1919 by the Matron-in-Chief with the British Expeditionary Force, Maud McCarthy. They are all unpublished documents held at The National Archives, and as Crown Copyright items can be freely reproduced as long as their source is acknowledged. I'm still contemplating the best way to deal with the Matron-in-Chief's official war diary, as its size makes it a massive beast to get under control. I shall probably put a small extract up soon as a trial, and to see if it helps clear my brain about how to proceed.

To see the new content, go to the Scarletfinders site, and follow the links for 'Great War Accounts'.

Scarletfinders

On the Horizon

Over the last three or four years I've spent a lot of time transcribing original, unpublished documents relating to the nursing services during the Great War, which are held at The National Archives, Kew. Most of these documents were originally stored at the War Office, and transferred to TNA over the past twenty years; since then the majority have never been looked at [except by me]. A year ago I decided to undertake a massive project by transcribing the official war diary of the Matron-in-Chief with the British Expeditionary Force during the war, Maud McCarthy, which runs to well over three thousand pages, and almost a million words. It took over my life for twelve months, and knowing what a treasure house it is, I intended to edit and publish as much of the content as I could fit between two covers. I really wanted to show what the basics of life were like for the women who served in France and Flanders - not the blood and bandages bits necessarily - but the ordinary comings and goings, and minutiae of their day to day existence. However, as I started to edit, and cut large chunks out, I realised that because of the size of the complete work, too much would end up on the cutting room floor, and I wouldn't achieve what I set out to do.

So I've recently taken the decision to publish many of these documents, including the diary, on the web, and am just in the process of trying to work out what form they will take, and how to get them into readable shape. Because they are Crown Copyright documents, I'm free to do with them what I wish [more or less], as long as I don't use any actual images of them, and I acknowledge their source in full. Besides the diary, there are many accounts of the various nursing services during the Great War, including all the overseas nursing services who worked alongside the British. In addition, I've recently acquired copies of many WW2 personal accounts, written by members of QAIMNS and the Territorial Army Nursing Service, and one document giving the locations of all British General Hospitals at home and abroad between 1939-46. I'm not sure how long it will be before the first bit appears online, but hopefully not too long - in view of both the length and depth of the work, it will be a long, ongoing process, but I feel very excited at the thought that the documents will be available for all to read, learn from, and enjoy.

A 'V.A.D.' at the Base (Part Two)

A long gap since Part One, caused by seeing too much of the inside of hospitals [on behalf of my aged mother], but here are the remaining paragraphs at last.

A 'V.A.D.' at the Base
by K. M. Barrow

On the other hand, in spite of all the pain and heartbreaking tragedy, the humorous side of life is never far away in hospital. One recalls the dummy – carefully charted and hideously masked – which was tucked into bed for the benefit of the V.A.D. and orderly when they came on night duty, and the stifled laughter under the bedclothes in adjoining beds. One recalls, too, the great occasions when some Royal or notable person came to visit the wards. Then we spent ourselves in table decorations, emptied the market of flowers, or ransacked the woods and meadows for willow or catkins, ox-eyed daisies or giant kingcups. Incidentally, we made the boys’ lives a burden to them by our meticulous care in smoothing out sheets, tucking in corners, and repairing the slightest disorder occasioned by every movement on their part, till the occasion was over. Sometimes the expected visitor did not turn up, and when another rumour of a projected visit was brought into the ward by a V.A.D., she was hardly surprised to find that her announcement was greeted on all sides by the somewhat blasphemous chorus of “Tell me the old, old story.” It was a curious coincidence, too, that on one occasion when the Queen was going the round of one of the wards in France – which was crowded with men fresh from the trenches – Her Majesty should have happened upon a patient standing stiffly to attention, and when sympathetically inquiring how he received his wound, was doubtless slightly surprised at the brisk reply, “Kicked by an ‘orse, mum.” On another occasion, when a visit from Sir Douglas Haig was momentarily expected, an intrepid Australian, concluding that there was time to spare, and greatly pleased to find that there was no competition, had placed a tin plate containing an egg to fry on the newly polished stove, which shone with inky radiance – the combined effort of orderly and patients. The decoration caught the eagle eye of sister, who demanded its instant removal, and while the discomfited cook seized his plate, the announcement, “Duggie’s here” was whispered; in his agitation the Australian turned the contents on to the polished surface. As the gallant Commander-in-Chief entered the ward he was confronted with a strong smell of cooking “gang agley,” and a stifling thick blue smoke rising like incense from the top of the stove. These Royal visits were much enjoyed by the men, and in the case of an Irish lad were the cause of much boastful comment as to the ease of manner with which he intended to greet the Royal visitor. These usually began with, “Sister, I shall just say to her” – and so on; but when the gracious and kindly lady did in fact stop to greet the boy, he was frozen stiff with shyness and terror; the flow of conversation with which he had intended to greet Her Majesty was conspicuous by its absence.

One of the things which struck one most was the eager championship of Tommy towards any patient of different nationality to himself. The black man was an especial pet and was treated by the boys as something between a spoilt baby and a pet dog. Sweets and cakes were showered upon him, and his simplest remarks were greeted with appreciative and indulgent laughter. Though “Darkie” was occasionally asked whether he had “been robbing the hen-roost lately,” or mildly ragged, he knew perfectly well that, had he got into trouble, the ward would have been solid in his defence. I have seen the men rush to get bread and jam for an immense, and I must own unattractive coloured man who would shout lustily for the latter, and would clear out a tin of “plum and apple” at a sitting – if he could get it. On one occasion, in Malta, when a valuable watch was lost, there was a regular chorus in defence of “Jose,” the little Maltese who scrubbed the verandah.
"It wouldn't be our old Jose, sister," they declared with conviction; although later this particular Jose proved, alas, far from being above suspicion. Even the foe came in for this kindly feeling in hospital when he was down and sick. I have heard a V.A.D. tell how she found a little group laying an unfamiliar game of cards with the quondam enemy.
"You see, sister," they explained, "we're playing it the German way, because of Fritz. Poor old Fritz".

Christmas is a delightful time in hospital, and though it was always specially gay in France for nurses, V.A.D.’s and patients alike, it was perhaps eastward on the other side of the Mediterranean, where gifts were not so numerous, and where Blighty was so far away, that the men looked forward to it most. It would be hard to forget the sound of the Christmas carols in the crystal beauty of the winter night in Malta, as a party of amateur performers, with swinging lanterns, went round from block to block of the great hospital buildings, while the patients hung over the verandahs or lay still and quiet listening in their beds. It would besides be difficult to forget how, as sisters and nurses went as quietly as possible from bed to bed during the night hanging the Christmas stockings over each, one head after another popped up like children, when they fancied no one was looking, to examine their little dole of presents – men who would, perhaps, never see another Christmas, and who had just been through the most awful experiences that man ever suffered.

It is, perhaps, the very simplicity and childishness of the British Tommy when he is sick and helpless, that has held so many V.A.D.’s to their posts in days gone by. Everyone who has been in hospital has noticed how even the middle-aged man seems to return to first principles in his last hours, and how the mother’s name was on his lips far more often than was either the wife or children’s name.
“Married, nurse?” said an Irishman, “Faith, and I’ve never met a woman yet who could be as much to me as my old mother!” And he was only one of countless others to whom “my old mother” represented Blighty, hope, and happiness all rolled into one. One saw this on night duty more especially, and it is of night duty in France, more than of any other time, that one thinks when one recalls old memories. Outside it was black as pitch, and the wind howled in the telegraph wires like the witches on Walpurgis Night, with perhaps the added sound of a bomb or the fall of shrapnel on the roof. Suddenly, through the war of sea and tempest, one caught the sharp piercing sound of a whistle, and after that the tramp of feet and the first soft thud of a stretcher being lowered to the ground gently for a moment. It was then that sisters, nurses and patients came into closer relation; it was then that the V.A.D. had wider scope in her work, and greater opportunities for learning and acting. Those on night duty were practically isolated from their fellows and thrown entirely on each other for companionship; and very pleasant was the morning walk and the morning bathe in summer, before bed claimed its sometimes unwilling victim, and the bright day was shut out and turned into night.

What we, perhaps, treasure most of all, now those times are over, are the autograph books which contain the signatures, artistic efforts, original or copied verses, which the patients supplied as souvenirs. These were more popular in the East than in France, and in one of the wards in Malta, an old volume of the Girl’s Own Paper, dating back to the “eighties,” provided the inspiration for many efforts. The picture of big men with a world of experience behind them, artlessly and laboriously copying pictures of apple-blossom and sparrows, or of an unattractive child with the legend, “Daddy’s blue-eyed boy” inscribed below it, represented a study in contrasts which was frankly touching. These were, however, real artists, and real poets who blossomed into eulogies of hospital and staff, or straightforward comments on their own experiences. Here is a sample which, as far as I know, is original:-

"There's a little place out East called Salonique,
Where they're sending British Tommies every week,
When you view it from the sea
It's a fine sight, all agree,
And you think you'll have a spree,
At Salonique!"

"When you're dumped upon the quay at Salonique,
And the smell that meets you there seems to speak,
You begin to feel quite glum,
And to wish you hadn't come,
For there's every kind of hum
At Salonique."

Another effor, which every V.A.D. will appreciate, began:
"The Red Cross Sister so demure,
On any chaps would work a cure,"
and ended up wittily and eminently satisfactorily from our point of view:
"To part from you will be a loss,
For you were never Red or Cross."

A 'V.A.D.' at the Base

This is another extract from 'Reminiscent Sketches,' and as it's quite long I've divided it into two parts - reading long accounts right through on the screen might result in the loss of the will to live! It's actually written not by a VAD, but by a trained member of Queen Alexandra's Imperial Military Nursing Service, so perhaps not quite a 'horse's mouth' memoir, but interesting for its small detail not found elsewhere.

A "V.A.D." AT THE BASE
K. M. Barrow

“Keep the large things large and the small things small,” is a fine American motto which the V.A.D. abroad might well have adopted as her own. No matter what type of home she had left behind, every girl in the great military hospitals or elsewhere was living under strange, and at first, bewildering conditions. She was up against new problems and experiencing new sensations; she was confronted with new barriers and restrictions; but she was enlarging her horizon and expanding her outlook. Like Alice, it was as though she had stepped through the looking-glass into a new world. In spite of the pictures which it breaks the heart to remember; in spite of the little jars and frets and anxieties which seemed Gargantuan at the time; every V.A.D. all the world over could honestly write against the record of those days the words “very happy." Life in a military hospital is a school within a school. Inside the big school of experience there is a type of school life which is not unlike that life which we lived in our “teens” with its friendships, its “shop,” its frenzied activities, and its recreations.

On the long white road which stretches from the slippery quay-side at Boulogne to the little distant villages clustered around tiny churches; fringed on one side of the road with ugly grey hospital huts or tents set in pleasant gardens, and on the other side with the chalk cliffs and great sparkling blue roadway to “Blighty,” we all lived much the same life. We all knew what it was to wait with beating hearts to hear our fate in the prim hotel sitting-room, with its faint smell of dust and roasted coffee-bean; then to be carried by the great lumbering ambulance – in the silver summer dusk or the bitter winter cold – into the unknown. We knew what it was to struggle with our flimsy camp furniture in the little wooden hut for two, or the narrow confines of a dark tent; and to wake to our first hurried breakfast surrounded by strange faces, with very much the sensation of a swimmer who has forgotten his stroke. The old mess hut or tent has very pleasant recollections for most of us. Breakfast was too hurried a meal to permit of much conversation except for the early arrivals, who toasted or burnt their bread at the stove, according to the position which they secured. So it was with nine o’clock “tea and biscuits” breathlessly snatched perhaps when convoys were rolling in; but at lunch all the plans for afternoon or evening “times off” were discussed, and arrangements made for eagerly anticipated “half-days.” The most pleasant meal of all was, perhaps, the “first dinner” when those who were free for the evening might wear out-door uniform and hats, instead of the regulation caps and aprons.

Sunday was marked by two domestic features, namely, boiled eggs for breakfast, and afternoon tea in the sitting-room when we all ate French patisserie and home-made cakes like hungry school boys; and when even those on night duty sometimes made a belated appearance. It was by no means an infrequent occurrence up on the cliff, when a mess tent was used in place of a hut, for the whole to collapse when the wind blew “unco’rudely,” and to be found in the morning in a crumpled ruin like a collapsed pack of cards. On summer “half-days” we scoured the countryside for flowers for the wards, drank coffee and ate omelets in the old farm houses, or enjoyed tea and ices at the Club or in the cheerful French shops with their tempting confectionery, unless food restrictions happened to be acute at the time. Thousands of tired or convalescent V.A.D.’s will think more than gratefully of peaceful days in the lovely woods at Hardelot or in the Villa at Cannes; when expeditions were planned and everything that was possible done to give mind and body a real rest and a chance of recuperation.

In France, when convoy after convoy poured in, and when one piteous wreck after another, whose bandages were stiff with mud and blood, had been deposited on a clean white bed; the extent of a V.A.D.’s work was bound to be decided far more by the measure of her capacity than by rule of seniority, or red tape. Matron and sisters soon discovered those whose skill, quickness and level-headedness, justified trust. In every new venture there are few who have not to walk for a space some time or other in the Valley of Humiliation, the military hospitals in France were a magnificent school, not only for actual nursing, but for self-control and nerve. Naturally, there were some sisters more trusting, more patient, and more ready to teach than others. Though there could not fail to be occasional jealousies and occasional bitterness among the V.A.D.'s, a strong esprit de corps, and a strong sense of discipline prevailed. In all hospitals everyone was quite ready to undertake the smallest task as well as tasks of a more responsible nature. Let no one imagine that even the humble care of lockers is a task in the nature of “sitting in the sun.” To satisfy the Sister-in-Charge, and at the same time to deal faithfully with the daily dole of cigarettes and matches – cherished like gold-dust – the photographs, the little brown pay-book, the melting toffee, the mouth organ, the presents from home, and above all, the cause of the fractured limb or the bandaged head, which was wrapped in a fold of newspaper to be dispatched to mother or wife, is no light task. “Did you see a little bit of shrapnel, nurse, when you were tidying out my locker?” asked a worried gunner to a newly-arrived V.A.D., and she realized, with a pang of remorse, that the tiny morsel of lead which she had swept away with broken ends of matches and cigarette stumps, was the most sacred item among “Jock’s” possessions.

Of the patients’ kindness and keen sense of gratitude, of their readiness to help in the wards, their goodness and unselfishness to each other, of their pluck and grit, and their cheerful assurance that they were “in the pink,” “not too bad,” or “fine,” even when the Angel of Death was standing close at hand, one need not speak. Had one had time to think, or the right to indulge one’s own feelings, the pathos of some of those scenes might have been unbearable. Pictures of a pale lad, singing “Annie Laurie” right through in a quavering voice, in his efforts to distract his mind from his sufferings during an agonizing dressing; of a “jaw-case” on the D.I. list with his poor mouth smeared with the crumbs of a home-made plum cake sent by his wife, which he had tried unavailingly or surreptitiously to eat; of a dying gardener with his face irradiated with joy when Sister handed him a flower, pass before one to be succeeded by another and again another, each unforgettable in its turn.

Canaries

'Canaries' is the title of this often seen image, but I've never been sure whether the canaries were carried on ambulance trains as gas detectors, or simply for the entertainment of both staff and patients. I suspect the latter is more likely.

Life on an Ambulance Train 1917-18

This is the second part of the account of Ambulance Train life - this one during the later years of the war, when things had become a little more sophisticated.

WORK ON AN AMBULANCE TRAIN IN FRANCE, 1917-1918
by J. Orchardson

I joined an Ambulance train at Rouen in December, 1917, proceeding up the line to the Somme Valley. My first impressions were the extreme cleanliness, order, and brightness of everything on the train. The sisters’ mess, planned out of an ordinary railway carriage, was cosy and pretty, and our bedrooms most comfortable. Each train carried three sisters, usually a happy and contented trio. Our life was never dull, for those railways were the highroads of the war. Wherever we went there were troop trains, ammunition trains, food supplies, guns, tank stores; the never-ending accompaniments of a great campaign. Seldom were two days alike, no one knew where we might be sent next, or what adventure awaited us on the road. Our train might be in garage somewhere up the line, awaiting orders. All day nothing would happen and we would retire to bed at the usual hour. Suddenly there would be a bump, the signal that our engine had come on, and away we would go into the night wondering as to our destination. Wonder, however, soon gave place to sleep and we were content to leave place of call for the morning to disclose.

On loading at a Casualty Clearing Station, I was always struck by the rapidity and ease with which the patients were taken on and put to bed. I marvelled at their unfailing good humour, even when seriously wounded. They seemed to be so delighted to be on their way to the base, or perhaps to England, that they never failed to don a brave disguise. Somehow, I always felt more sorry for the walking wounded – that slow procession of pain with their white tired faces – but never a grumble or complaint. When loading was finished, our immediate duties were to inspect all the medical cards, diet the patients, and take a not of all treatments to be given during the journey; after this had been carried out, cigarettes, sweets, and books were handed round, and the sisters usually had time for a chat with the patients. On reaching the base the train was quickly unloaded, beds changed and made up again, wards scrubbed out and everything made ready for the next journey. The train usually remained for a few hours to take on stores, which gave us the opportunity to go shopping for our mess. Then up the line again, or best of all load up with patients for England. The latter was a joyous thing. We would take them to Calais or Le Havre and see them safely aboard the “ship that was bound for Blighty.” Our train life was often very exciting, air raids were frequent and not seldom we had narrow escapes, when the windows of the coaches were shattered with the concussion of the explosives. Upon running into an air raid, all lights which were always well shaded, were put out and the train brought to a standstill. We could not help tremendously admiring the splendid bravery of the poor wounded men. They never once appeared afraid or complained, all they wanted was a cigarette. Their wonderful spirit gave us the courage to carry on. Had it not been for their dauntless spirit I feel certain that we should often have given in. Although badly wounded, they never seemed to turn a hair amid the most awful bombing and shelling. It was truly magnificent.

Our train was in the Somme Retreat of 1918, when the roads were crowded with retreating French civilians, leading their horses and cattle, and taking away what household goods they could carry. Old men and women, young women and children made a pathetic spectacle in that picture of retreat. The retreat began on March 23^rd, 1918, and on the 25^th the train was sent to Edgehill – a few miles from Albert – to load. We took the last patients from the Casualty Clearing Station at Edgehill and many straight from the field. The train was loaded to its full capacity; stretchers were put on the floors, in the corridors, in the two kitchens, and in the medical officers’ and orderlies’ beds. The train was held up for thirty-six hours but eventually reached Rouen. In April, the train was up north when the German offensive began and on several occasions took down a number of French civilians. ON incident was most pathetic. When the enemy broke through at Merville there was the usual retreat of French people. The train was stopped by some soldiers who asked us to take an old French woman whom they had found lying on the roadside. She must have walked many miles and was in a pitiful state. She said she was eighty-two years of age, and we recalled the old Hebrew’s saying about the years that only bring labour and sorrow. In June the train was sent to the Marne to assist the French, and took several loads of French wounded, with a few British, from the French advanced hospitals. The poilu is a most grateful patient and so appreciative of the smallest thing done for him. When they came on to the train and were given English cigarettes their delight was great. I asked a few if they would like to write home, and soon was busy supplying pencils and paper, so keen were these men to write to their people. Late June found the train at Charmes, near Nancy, and as this was the first khaki train to do this trip, we had a wonderful reception the whole of the way. Everywhere the French people were most enthusiastic. On the return journey the train stopped at a junction for an hour or more, and several French ladies asked permission to visit the patients. They brought baskets of fruit and sweets for the patients and presented the sisters with a bouquet of crimson roses, tied with the colours of fair and gallant France. Although at times a strenuous life, it was always a bright and happy experience, with just a touch of sadness when “good-bye” was said at the journey’s end. Looking back on those unforgettable days, I shall always see their faces, even as the faces that look out of some old and treasured picture book.

Life on an Ambulance Train in 1914

This is the first extract from 'Reminiscent Sketches' and is a brief, but vivid account of life on one of the early ambulance trains. All these extracts are written by trained nurses, most of them members of the 'Regular' Queen Alexandra's Imperial Military Nursing Service.

LIFE ON AN AMBULANCE TRAIN IN 1914 by M. Phillips

The ambulance trains in 1914 were not the trains of joy and beauty which they developed into later in the war, anything that ran on wheels and could be attached to an engine was utilized in the early days of 1914. They were chiefly trains composed of wagons bearing the legend “Hommes 40, Chevaux (en long) 8,” so that the staff of No.7 Ambulance train thought itself lucky. The front half of the train consisted of the 1^st class French “couchette” or carriages fitted with sleeping berths, so that at least the patients had a comfortable couch on which to lie; the rear half of the train simply consisted of ordinary third class railway carriages with their hard narrow wooden seats, but these were always reserved so far as possible for “sitting cases.”

All the coaches on the train were entirely unconnected, and those nurses who have only carried out nursing duties on trains whose entire length it was possible to walk without once going outside, can hardly realize the inconvenience, sometimes amusing but at most times vexatious, to which one was put in 1914. Quite a number of teapots and cups and saucers came to an untimely end from the habit which the batman had of placing those articles on the footboard of the train when bringing the early morning tea; then, leaving them while he went back for something which he had forgotten – the train would start with a jerk – and “goodbye-ee” to tea for that morning. The greatest inconvenience of all was the difficulty of attending to the patients, and the vexation of spirit occasioned when you had settled up one coachful of aching weary men, by the knowledge that there were still hundreds to be attended to. Climbing from coach to coach by way of the footboard was a practice absolutely forbidden, though, like more than one other rule, it was more honoured in the breach than in the observance. Frequently this means of passing from one coach to another was an absolute necessity in the interests of the patients. No doubt a French stationmaster in a little out of the way French village will probably remember to this day the sight that met his amazed gaze in the very early hours of a beautiful September morning in 1914. An ambulance train was flying through his station with an English sister clinging like a limpet to the side of the train. She had, I remember, a moment of horror when the train dashed into the station, wondering whether the platform would be higher than the footboard; but luckily all French country platforms are very low. After the Battle of the Aisne the train was garaged for a few days in a little village called Crepy-en-Valois; while the British armies moved north. Movement of troops took place only at night, and whether the whole British Army passed through this little town, we, of course, did not know; but at least one member of the staff of the train will never forget the continuous, apparently endless, procession of men, horses and guns. The men never spoke a word, either to us or among themselves. The only noise was the low, deep rumble of the procession itself, seeming to fill the autumn night with fear and foreboding.

On the night of October 31 to November 1, No.7 Ambulance train had the luck, or ill-luck, to be on Ypres station – the date that marks the beginning of the wonderful first Battle of Ypres. The train received its baptism of fire that night – poor train – it could not have run away had it wanted to; the engine had returned down the line for water. A neighbouring improvised train loaded with minor wounded had better luck and secured an engine from somewhere, and, as it pulled out of the station into safety, I expect poor old No.7 heaved a small sigh of envy, although I like to think that even had a second engine been handy, No.7 would have stuck to her post; but with what feelings of great thankfulness and relief she hooked herself on to her engine the next morning, and gave him a graphic description of those horrid shells which had made holes in her sides and broken her windows, while he was away at Hazebrouck imbibing water.

After the establishment of Casualty Clearing Stations the work on ambulance trains was not nearly so arduous. In the first days patients were entrained with all the dirt, mud, and blood of battle on them. All were fully dressed. Many had not had their boots off their feet for five or six weeks. Only those who have experienced it, know what it means to undress a heavy man, badly wounded and lying on the narrow seat of a railway carriage. Never before had it bee brought home to me what a quantity of clothes a man wears. On many an occasion it has seemed a task worthy of a Hercules, but when the deed was done, the man undressed and in soft dry pyjamas, even though maybe there had only been time to sponge his face, hands, and feet – then indeed labour had its reward – the gratitude, the patience, the infinite endurance of the men was a constant marvel to behold. One felt that the utmost one could do was but a drop in the ocean of their discomfort, and their gratitude for that drop was sometimes more than one could bear. When the Casualty Clearing Stations were established the men came on board washed, fed, and in pyjamas; so that we did not have to begin on the bedrock of things as it were, but had only to carry on the good work already commenced. It was with very mingled feelings that the writer gave up that particular kind of “good work” after three months’ service on the train; three very happy months where such minor personal discomforts as difficulties with one’s laundry, and even sometimes with one’s personal cleanliness, were all lost sight of in the feeling that one was doing real work.

Reminiscent Sketches

About a year ago, I managed to get hold of a copy of a book called 'Reminiscent Sketches, 1914 to 1919', published by John Bale, Sons and Danielsson in 1922. It's a small collection of personal accounts written by members of Queen Alexandra's Imperial Military Nursing Service, and gives great insight into day to day life during the war; in hospital, on trains and boats, and in many different locations. Over the next few weeks I'll include a selection of them here - they make a very enjoyable read for anyone with even a small interest in nursing during the Great War.

Back to Heilly again for a moment...

A recent comment on my previous post about Heilly Station Cemetery led me to return there for a moment. In the past, I've done some research on my local war memorials in Sussex, and about five years ago, long before my first visit to Heilly, I started a website to record the results - it's at:

Unchanged By Time

I added snippets of poetry to many of the pages, choosing each one to reflect some aspect of the man's life or service, and for the front page of the website I chose some lines which I had seen used in the 'In Memoriam' column of a local newspaper:

And now they are sleeping their long last sleep,
Their graves I may never see;
But some gentle hand in that distant land
May scatter some flowers for me.

I thought it summed up the feelings of families all over the world, particularly those who would never have the money or opportunity to visit the last resting place of their loved ones.
On my first visit to Heilly, a year or so later, the weather was stormy. The sky was ever-changing, with huge black clouds and heavy squalls accompanied by thunder and lightning. My daughter and I ran into the cemetery, and sat on the seat by the screen wall, sheltering until the current blast of rain had passed. Suddenly it stopped, and the sun broke through, shedding shards of light across the cemetery. I suppose my natural instinct was to follow the sun, and walked up to where it picked out vividly two or three headstones. As I stood in front of them I realised that I was looking at MY inscription [or a version of it] on the grave of Sapper David Simpson of the Australian Engineers:



in that distant land/will some kind hand/lay a flower/on his grave for me

I've visited a lot of cemeteries, but that day I did feel a very emotional attachment to Sapper Simpson, and hoped that for the sake of the family who left that message, I would remember on future visits to the cemetery to honour their wish.

Assistant Nurse

When I wrote last month about 'The Difference Between' the various grades of nurse, I put:

The grade of 'Assistant Nurse' became increasingly common, and these were women who had previously undertaken formal nurse training, but not to a standard sufficient to join Queen Alexandra's Imperial Nursing Service Reserve or the Territorial Force Nursing Service. They were women who had completed a set training as a fever nurse, a children's nurse, in a women's hospital, or as a midwife. Their pay fell half way between that of the VAD and the trained Staff Nurse, and they were likely to be given more responsibility in line with their training and experience.

While transcribing the war diary of the Matron-in-Chief with the British Expeditionary Force, I've now come across entries which show that this changed in 1918. The diary entry states:

V.A.D. Assistant Nurses: Received from Director General Medical Services copy of Army Council Instruction 214 of 1918 relating to the promotion of V.A.D. Members to the rank of
Assistant Nurses. Before being promoted they must have served two years, must be in possession of the Red Efficiency Stripe and must be recommended by the Officer Commanding and Matron. The letters "A.N." are to be worn on the apron in indoor uniform and on the shoulder straps on outdoor uniform.

The Red Efficiency Stripe was awarded to VAD members who had completed 13 months continuous service in a military hospital under the control of the War Office, and who had satisfactory confidential reports by their Matron and Commanding Officer. After another years' service they could qualify for a second stripe. These stripes should not be confused with the white stripes often seen on the sleeves of VADs, which signified length of service alone, not that they had necessarily reached a high standard in their work [although of course they might have done!].

Who has the truth?

I’ve got used to reading a fair amount of inaccuracy about nursing during the Great War. Well, that’s not quite true – I almost expect it now, although I’ve never got USED to it – and when I come across bits that are blatant rubbish, they really rankle, especially if they’re written by academics, as these are the accounts that may well be digested and then repeated as the absolute truth.

As a member of the Royal College of Nursing, the newsletter of the associated History of Nursing Society dropped through my letter box last week. Inside was a short article written by a prominent member of the nursing profession, titled ‘Who has the truth?’ In it she expresses regret that the health care professions are failing to keep much of their paperwork and written archive material, and also of the transient nature of electronic sources which are too easily deleted, a process that she describes as ‘throwing our “truth" away’. She makes a comparison with the diaries and letters retained by Vera Brittain, which allowed her, nearly two decades later, to ‘write an accurate testimony’ of her life as a VAD during the Great War.

How accurate those original diaries were, and whether we are throwing out history away now, any more than we did a hundred years ago, are both subjects which could be long debated, but I was interested in one paragraph, in which she writes:

A Testament of Youth kept us fixed to our TV screens in the 1970s as we followed this amazing woman through her Voluntary Aided Detachment (VAD) experiences in the First World War. Through her memory, supported by diaries, letters and “artefacts”, she gives subsequent generations insight into the experience of living through those times. She lost her fiancé, her brother, their friends and many, many patients. She nursed on the Western Front, in Malta and everywhere in between in field ambulances and hospital trains.

That last sentence made me sit up and take notice, and, very concerned that my memory might be failing me in advancing years, it had me running to grab my copies of “Testament of Youth” and “Chronicle of Youth.” Vera Brittain certainly served on the Western Front and in Malta, but where was this ‘everywhere in between’ that is mentioned. No VAD member working under the auspices of the War Office [as Brittain was] ever served in a casualty clearing station, let alone a field ambulance, their service being restricted to military hospitals only, and military ambulance trains carried a staff of three trained nurses, not VADs. So did VB make any claims in her writing to working in field ambulances or on ambulance trains? Did the filmed version of “Testament of Youth” use artistic licence to include scenes that could not be substantiated by original sources? Or has the writer included that sentence to make more interesting reading without having intimate knowledge of her subject? I’d be glad for any further insights into this.

‘Who has the truth?’

Marriage

I often see queries asking whether nurses serving with the British Army during the Great War could be married. The answer is, of course, rather a complicated one. Prior to the Great War, women training to be nurses were required to be either single, or widowed, although it was not too difficult for a married woman with no dependants and living apart from her husband to stretch the truth. But in general, nursing, like teaching, was a profession of single women, and they were required to resign their appointments on marriage.

At the outbreak of war, all the members Queen Alexandra’s Imperial Military Nursing Service, numbering just over 300, were single, and although there were a few members of the Territorial Force Nursing Service who were married, this had occurred during their civil employment, and on mobilisation many chose to resign, or were retained for home service only. The intention of the Matron-in-Chief at the War Office was to keep the services staffed by single women, but this proved to be impossible. By the middle of 1915 the shortage of trained nurses, both at home and abroad was acute, and it was obvious that it would be necessary to retain the services of women upon marriage, unless they wished to resign. At first they were sent home from France, for ‘Home Service only’, and Maud McCarthy, the Matron-in-Chief with the British Expeditionary Force thought that she would never get hard work and devotion to duty from women who had more than nursing on their minds. She was particularly opposed to married nurses and VADs who wished to work in France because their husbands were serving there, and described them as women with ‘their baggage at the Front.’ As the manpower shortage increased, marriage was looked upon rather more benevolently, and it was eventually agreed that as long as a woman informed the military authorities of her forthcoming marriage; observed all the correct formalities, and had good reports, she would be allowed to continue to serve, and remain overseas if she wished. Any woman who went on leave, and married in England without permission, would find herself looked on unfavourably, and probably refused permission to return to France, especially if she was a VAD, who were more easily recruited and not in such short supply.

Reading through the war diary of the Matron-in-Chief, it often seems as though there were many marriages happening at extremely short notice – the sort of ‘spur of the moment’ occurrences that wartime is famous for. I suspect that the phrase ‘marry in haste, repent at leisure’ haunted many a nurse throughout her life! And if the British military nursing authorities seemed very straight-laced about marriage, they could not compare with the Australians. Until the middle of 1917, a member of the Australian Army Nursing Service did not even have to bother to resign on marriage, as at that point her contract was automatically terminated, and she was returned to the UK, to continue her life as she chose – but of course, eventually the shortage of trained nurses changed that as well, and marriage became a necessary wartime evil for the AANS.

After the war, as the demobilization of nurses working on the QAIMNS Reserve was complete, the service returned to one of single women, a situation which lasted until the 1970s. Even married members of the Territorial Force Nursing Service, who returned to their civil employment, were not allowed to remain in the service – what was useful in wartime was found unacceptable in peacetime.

The Difference Between...

Having written about the WO399 run of files at The National Archives, it's worth mentioning that included among them are some records relating to untrained nurses; VADs, Special Probationers and Assistant Nurses who worked in military hospitals [rather than Red Cross hospitals] during the war. Why some files have been retained isn't clear, but all those that I've come across refer to women who were employed in Territorial General Hospitals in the United Kingdom - some of them later went on to work abroad, but most started off serving alongside the Territorial Force Nursing Service. So although a long shot, it's always worth checking for an untrained nurse in the WO399 index at The National Archives. The 'VAD' is familiar, but what were the differences between her, and the less common Special Military Probationer [SMP] and the 'Assistant Nurse'?

VADs were employed by the British Red Cross Society through their headquarters at Devonshire House, and the majority worked in Red Cross and auxiliary hospitals, but if employed in British military hospitals at home or abroad, they would work under the control of the War Office, and take their day to day orders from the Matron of their hospital or her deputies.

Special Military Probationers were also untrained, and the terms and conditions of their contracts were virtually identical to those of the VAD. But they were employed by the War Office specifically to work in military hospitals, and had no connection with the BRCS. There is some evidence to suggest that the War Office did some 'cherry picking' - during the 3 month initial training undertaken by VADs in civil hospitals from 1915 onwards, some of the most able were offered contracts as SMPs, and the result was the perception that these 'War Probationers' formed a more elite group than the VADs. In fact, except for the difference in employers, their contracts and conditions of service were identical, but there always remained the inference that those employed by the War Office were superior as nurses.

As the need for trained nurses grew during the war, shortages began to cause great difficulties, particularly overseas, where the need for skilled nurses in forward areas resulted in Base hospitals becoming top heavy with VADs, and seriously lacking in experienced women. The grade of 'Assistant Nurse' became increasingly common, and these were women who had previously undertaken formal nurse training, but not to a standard sufficient to join Queen Alexandra's Imperial Nursing Service Reserve or the Territorial Force Nursing Service. They were women who had completed a set training as a fever nurse, a children's nurse, in a women's hospital, or as a midwife. Their pay fell half way between that of the VAD and the trained Staff Nurse, and they were likely to be given more responsibility in line with their training and experience.

As the war progressed, there were certainly VADs who became very skilled nurses and took on great responsibility. Many had hopes that their wartime work would qualify them for a reduced training as a nurse after the war, and that was a question that caused great unrest and discussion within the nursing profession. And was definitely not to be...

Nurses' Service Records at TNA

Class WO399 at The National Archives contains all surviving service records for members of Queen Alexandra's Military Nursing Service, the QAIMNS Reserve and the Territorial Force Nursing Service who served during the Great War. In all, there are 15,792 files in WO399, but there are a number of files missing from the run which were destroyed during the 'weeding' process of the early 1930s. At that time all the files were thinned out, and most now contain only a selection of papers, mainly relating to things such as pensions and gratuities.

But quite a number were totally destroyed - no-one really knows how many, or why certain files were chosen for destruction, while others survived. It's been suggested that there might be as many as 5,000 missing, but I find that difficult to believe, otherwise I would find that about 1 in 4 of those I look for are missing, which just isn't the case. I frequently draw a blank with service records, without understanding the reason, but recently I've failed to find a couple, which has proved quite helpful in one way, as it's highlighted one class of woman whose files are likely to have been scrapped. Both these women were members of the Territorial Force Nursing Service; they served during wartime, but were discharged from the service soon after the war; they had no entitlement to pension, and they both died during the 1920s from causes unrelated to their war service. As they were not going to serve at any time in the future, no pensions, and a non-attributable cause of death, it looks as though retention of their service files was considered unnecessary.

It will be interesting to try and pinpoint other groups of women whose files were similarly afflicted - finding a whole missing group would be a useful aid understanding the system.

Heilly Station

When I'm in France I try to visit some of the places that were home to Casualty Clearing Stations and hospitals during the Great War. They are now quiet retreats, and off the route normally taken by visitors to the battlefields, giving no hint of what toil and drama took place there. One of my favourites [if that's the right word] is Heilly Station, situated at Mericourt-l'Abbe, just north of the River Somme, and about 6 miles south-west of Albert. In July 1916, during the first days of the Battle of the Somme, the CCSs at Heilly were closest to the battlefield, but the last on the route taken by ambulance trains on their journey taking casualties back to hospital. They admitted thousands of men during those first few days, but the shortage of trains meant that no casualties could be evacuated for more than 72 hours. During that time, the death toll at Heilly was so great, that to save both time and space, men were often buried on top of each other, three to a grave. As there was so little room on each headstone for three names, the regimental badges of the soldiers had to be omitted, and instead the insignia of 117 separate units are incorporated into a cloister and screen wall at one end of the cemetery.

Heilly today seems a hauntingly sad place, in countryside that looks untouched by tragedy. But life goes on, and when I was there last year, the station-master was proud to tell us that his station is on the present day route of the TGV [Train Grand Vitesse] and also sees the Orient Express go through twice a week [once each way], although neither actually stop there. No more casualties in or out of Heilly Station! He also said that field walking constantly turns up mementoes of those wartime days.

So here is Heilly today, the station; the site of the casualty clearing stations, and the military cemetery, the last resting place of 2,890 Commonwealth soldiers, and 83 Germans.
Just click on the photos to enlarge them

Heilly Station today - some of the smaller buildings were there during the Great War

And the view behind the station towards the fields that were home to three casualty clearing stations in 1916

Those vast expanses of land, so peaceful now, and giving no hint of a desperate former life

At the end of the site is the British cemetery

This is one of the many single graves containing three burials, but no room for regimental badges

And the cloister wall, with some of the 117 badges which couldn't be included on the headstones

**************

Where on earth was that?

If you've found mention of a hospital or casualty clearing station in France and Flanders by it's number, and have no idea where it was situated, there is a way to track it down. In 1923, the Ministry of Pensions published a booklet entitled:

'Location of Hospitals and Casualty Clearing Stations: British Expeditionary Force 1914-1919'

and it's now available online here:

http://www.vlib.us/medical/CCS/ccs.htm

It's quite a long document, and it takes some scrolling up and down to find what you're looking for, and remember it only covers the Western Front, not any other theatre of war, such as Salonika or Mesopotamia. Also beware that there are quite a few errors and omissions - wrong dates, places, and in a few cases entire units missing. But still a really helpful publication.

As an anorak wearer of some distinction, I've put the information into five spreadsheets - hospitals by number, hospitals by location, and the same for the casualty clearing stations, with the fifth being for British Red Cross units. As I find more information, I can then add corrections, and have ended up with some very workable documents.

Well, if that's the sort of thing that grabs you ...

The Casualty Clearing Station

There is little written about Casualty Clearing Stations during the Great War. What is written is often, as in Chinese Whispers, an interpretation of something taken from an already inaccurate account found on a web site, or glossed up magazine article based on the diary of a nursing nobody. What I find particularly distressing is the suggestion that a Casualty Clearing Station was a temporary collection of ramshackle tents, or, worse still, a dug-out under the Somme's chalk battlefield, or scraped into the Flanders mud.
The following page is a great example of appalling inaccuracy, with no easy way to contact the author to report their trial and execution (by ME!).
http://www.oucs.ox.ac.uk/ltg/projects/jtap/dce/ritchie/ClearingStations.html

[unfortunately, since writing this entry, the page at the other end of this link has been removed - obviously took fright at the thought of being hung, drawn and quartered]

It talks of the 'largely filthy conditions' of the CCS in which 'septicaemia and gangrene quickly set in' and that many operations were carried out in the 'primitive conditions' that existed there. We are also informed that 'many of the nurses were VADs' (Never, ever, did VADs work in CCSs) and more surprisingly, that they were joined by members of the First Aid Nursing Yeomanry (Give me strength!). Rather unfortunately, an internet search pushes this model of rubbish right up to the top of the pile, resulting in few readers going elsewhere. Of course, if they do go further, the situation does not necessarily improve, and if a picture tells a thousand stories, then this one is a rather unfortunate example:
http://www.chavasse.u-net.com/ccs.html
[Link now removed]

Entitled 'A Casualty Clearing Station at Trones Wood, August 1916' the photo is obviously genuine, but is not a Casualty Clearing Station, but some sort of medical facility right on the front line - an advanced dressing station, or regimental aid post. The amount of incorrect information is prodigious, but even reputable sites don't get it right - they have a go, but seem to be working from documents that simply don't reflect what was actually happening on the ground at the time.
The Western Front Association tell us that a CCS had 'a nominal capacity of 150' while the Victoria and Albert Museum describe them as 'small mobile hospitals' and a recent edition of The National Archives magazine 'Ancestors' carried a wonderfully illustrated article on the life and work of VADs in Casualty Clearing Stations on the Western Front. Just to emphasise the point, VADs were never allowed to be employed in any CCS. Never, ever. I did write to TNA just to let them know that their lead article was just not right, but unfortunately they neither replied to me, nor did they publish a correction.
In the autumn of 1914, when the war became static, Casualty Clearing Stations shed their extreme mobility and started to spring up in more fixed form, near enough to the front line to be easily accessible, but out of range of most of the German artillery. They were, wherever possible, established in buildings; convents, schools, factories and existing hospitals, often expanding into huts and tents to provide more accommodation. Later on, many became predominately tented and hutted, but only in the absence of suitable permanent accommodation. Trained nurses were posted to CCSs from October 1914, and to certain Field Ambulances from the autumn of 1915. Only the most experienced nursing staff were sent, and were immediately replaced if they proved lacking in the many qualities needed. In the early days, four nurses were considered adequate in addition to the RAMC staff, but by August 1916 some CCSs had nursing staffs of 25 to cope with the enormous casualties of the battles of the Somme.
At present I'm transcribing the official war diary of the Matron-in-Chief with the British Expeditionary Force in France and Flanders during the Great War. It runs to more than 4,000 pages, and hopefully it will provide enough material of interest to enable it to be published, albeit in much edited form. But just for the sake of waving the flags of both the Casualty Clearing Station, and it's smaller brother the Field Ambulance, here are some extracts taken at random from the diary, during the spring and summer of 1916. These are just a few of thousands of similar entries, but hopefully will provide an accurate snapshot of the set-up and conditions at CCSs and FAs at that time, as viewed through the eyes of the Matron-in-Chief, Maud McCarthy, on her visits of inspection. Although I have removed some of the diary entries not relevant to Casualty Clearing Stations, I have left the remaining text as originally written, and without correction or editing. I will let them stand alone, without further comment.

26.04.16

Left for 3^rd Army 9.30am. To 12 Stationary Hospital, just taken over from the French, a new Hospital built entirely on English lines, with various improvements. Most perfect in all respects. Hutted accommodation for all, including M.O.s, Nursing Staff and personnel. Every possible convenience, the position an excellent one. From there to DMS 3rd Army at St. Pol, where I had lunch and where the DMS told me of certain units shortly to open.

Visited 30 and 43 C.C. Stations, now both at Aubigny, the latter having just arrived from Lucheux. Both in house and a Hospice which is set apart for officers only. 30 C.C. Station running smoothly and well. Staff satisfactory, first rate operating theatres just completed. 43 C.C.S. run on same lines and is side by side with 30 C.C.S., the Hospice being at some distance, and in these grounds the Nursing Staff of 42 C.C.S. are accommodated under canvas.

From there to Chateau Habarcq where an emergency Hospital is about to be established, and where DDMS asked me to inspect with a view to another Staff being established there. The O.C. Major Carruthers took me round. A beautiful building with spacious accommodation, which will lend itself admirably for the purpose. Ample accommodation, also for the Nursing Staff on the top floor. Already in the grounds are several Huts and Marques for the reception of severe cases. From there to Avesnes – 37 C.C. Station. All going well. Then to Frevent – 43 C.C. Station, just established in French huts, and a school (where officers will be nursed). A great many badly wounded there – a great deal of work has already been done at all these Stations, the Nursing Staff are suitably accommodated and the reports of the work and behaviour of the Nursing Staff entirely satisfactory.

28.04.16

Left 9.30am for 4^th Army, having already rang DMS to let him know I was coming. Went first to St. Ouen, 3 C.C. Station, where I found the C.C. Station was about to move to Puchevillers. After lunch went to Heilly to 36 C.C. Station, which has just opened. Is entirely at present under canvas, but operating theatres and sterilising rooms are being built. Both O.S. and Sister in Charge spoke of the shortage of orderlies, and those entirely untrained.

From there to Warloy – 92 Field Ambulance, where 4 Nurses have just joined, Miss Whyte being in charge, established in a well built French Hospital with every convenience, and beautiful beds of flowers, forget-me-nots and pansies in the front - on their Staff among the Company are 2 Sandringham gardeners. Staff billetted in a little house opposite. Everything most comfortable, and the Nurses spoke of the welcome they had received from everyone, and the nice tea which was awaiting them. This Field Ambulance is not far from Albert.

From there to Gezaincourt to inspect the Chateau which is about to be opened for officers, and a Staff being required of 6. 60 officers can comfortably be put up here. Beautiful building situated in beautiful grounds. Was taken round by Captain, as the O.C. was on leave here, gone off suddenly to Dublin in consequence of the Riots, as he was anxious about the safety of his wife.

02.06.16

Left for 3^rd Army. Visited: 39 C.C. Station at Frevent, only recently established and which had just received orders to pack up, to make room for 6 Stationary Hospital which is on its way up. This will be a hutted unit, handed over from the French. The Officers Hospital accommodation for 30 is in part of a school at some distance from the rest of the unit, and which should I think have its own separate Staff. These can be billeted near their work and the remainder will have to be under canvas in their own compound when the new tent arrives. I have arranged to make use of the present Staff until 39 C.C.S. re-opens, as the O.C. reports that his Staff was most satisfactory and adaptable in every way. The unit looks entirely satisfactory, and the patients on the stretchers were made as comfortable as possible. It was evident on all sides that the very best that could be done was being done for these men.

To Headquarters where I had lunch with the DMS, Surgeon General Murray Irwin, and where I was able to discuss certain matters with him, and mainly with the nursing arrangements in the units in his area, and the suggestion of having a certain number of Nurses ear-marked at 12 Stationary for emergency work at the C.C.S.’s in his area in times of stress, and also I told him of the fresh rules which were being circulated for the Sisters in Charge assistance and guidance while working at the Front, with which I heard that many at present were in doubt.

After lunch to Aubigny. 30 C.C. Station since my last visit has vastly improved and everything is working smoothly and well. The Sister in Charge Miss Cameron TFNS is an able manager. Miss Warrack TFNS unfortunately has asked for a transfer Home, which has been granted. She is an admirable Theatre Sister, and has done great work in equipping her theatre in an admirable manner. Now that the transfer is permitted, she is wishing she could remain till her time at the front has expired, but this unfortunately cannot be arranged. So many of these girls really do not know their own minds. The Staff is comfortably and suitably accommodated.

42 C.C. Station which is next to 30 C.C. Station is not by any means so satisfactory, it’s dirty, ill managed and a lack of interest and management everywhere. This I told the O.C. and said that I was not satisfied with the Nursing arrangements, and after reporting the matter to the DMS I would make certain changes which I hope may improve matters at any rate in my department I hope.

At Harbarcq I visited 14 Field Ambulance, where 4 Nursing Sisters under Miss Wood QA are working in a Chateau which is being set apart for seriously wounded men and officers, and where French women and children are also admitted sometimes. At the time of my visit there was a little French girl who was being nursed in one of the rooms near the Nurses quarters. She was doing well, and also a poor Sergeant who it was reported had been picked up in the trenches where he had been for 10 days without anything to eat. He had been in 2 days and was better, but still in a very serious condition. This unit should be a very good one later, at present only in the making. The accommodation for the Nursing Staff is good and the Staff keen and I think good Managers.

At Avesnes – 36 C.C.S. all was going smoothly and is much as it was the last time I visited it. All these units are very near the firing line. The sound of bombardment was incessant and one could see Taubes in the air. The C.O. here is a difficult and not an able one I should say.

At Le Quesnil 43 Field Ambulance, Isolation Hospital. This unit is situated in the most glorious park. The Chateau has been converted into a Hospital for the serious cases. Here we have 3 Nurses, Miss Baird in charge, accommodated in one of the wings. This is a beautiful unit, in beautiful surroundings, lovely tapestries and pieces of lovely furniture which is still left here and there. All these things leave a feeling of sadness, and thoughts for the poor owners. The avenues of wonderful trees are particularly beautiful here, and I was told that it is feared many of the trees are permanently damaged by the French Cavalry which have been recently quartered here since the beginning of the war until they recently moved their line. One cannot help devoutly hoping this is not the case – for the moment they are quite wonderful. The lavatory accommodation here as in most French buildings is the one difficulty here. Returned to Abbeville 8.30pm. After dinner went to office where much correspondence was awaiting me.

18.06.16

Left for 4th Army 8am, arrived at HQ 10am. Passed thousands of troops marching forward, each battalion with its band, all wearing masks. DMS very busy, many Clearing Stations opening and needing Staffs. Visited them all that I could in the time.

Heilly 34 and 36 C.C.S., both very busy, needing more help. Accommodation for Staff good.
Warloy 92 Field Ambulance. More help, only Staff of 4 and they had been working day and night.
Puchevillers 3 and 44 C.C. Station busy opening up under canvas. They are side by side, quite close to a railway side and both Staff will Mess together. Arrangements very good.
Authie South Midland Field Ambulance, in a Chateau, Staff not yet arrived, but everything being got into order, and good accommodation for Staff ready. Some very badly wounded there, who were being cared for devotedly by the orderlies – even flowers by their sides.
Doullens The Citadelle – a wonderful historic fort, inside which 35 C.C. Station is being established. Wonderful buildings, a Chateau, Barracks, etc., built 1618. Anxiously waiting for Staff which should arrive tonight.

On to GHQ with my particulars of staff with covering letter with which Colonel Morgan was quite satisfied. He said he had already applied officially for the Nurses, but he doubted whether we should get them. Well, if they don’t come, one must just carry on, but one can’t do impossibilities, and these people who work so hard, I am so sorry for them. However, they will not fail us I am sure, and leave will have to be stopped till more help comes. Got back to Abbeville 9pm.

24.06.16

Left 8am for 4^th Army, arrived Vequemont 10am. Visited 34 and 45 C.C. Station opening up side by side under canvas, near railway siding, everything getting in readiness for the coming push. Nursing Staff in both units increased to 10, accommodated in huts and to Mess together. Both units capable of taking 1000 each, and everything in readiness.

Then to DMS 4^th Army, where I learnt what was being arranged for the coming work, and he was extremely pleased how I had been able to supply all with nurses to the extent I had done. From there to Heilly to see 38 C.C. Station which was now working. Raining heavily, things going smoothly. This unit also under canvas, except operation hut, large enough for 4 tables to be working easily at once. Had lunch with Sisters 36 C.C. Station. All well settled in and glad of extra help in readiness for coming work.

On to Authie to South Midland Field Ambulance. 4 Sisters had arrived and were getting Chateau clean and workable. One of the dirtiest places I have seen and the difference since last Sunday quite remarkable. Unfortunately have not yet met O.C. – out each time I have been.

On to Doullens to Citadelle, where 35 and 11 C.C. Stations are now opening. Miss Toller and 6 others have only arrived so far. Have arranged for Miss Toller to be in charge of both, with a Staff of 14. A great deal had been done since I was there last Sunday. From there I went to Frevent, where 6 Stationary Hospital is just opening, and where the Staff is not sufficient, but where I am unable to send any more until the accommodation for them is available. This I am told will be ready in a few days

16.07.16

Left early for 4^th Army. To Headquarters first, where I saw DDMS Col. Fawcus, and from there Heilly, to 36 and 38 C.C. Stations, where I spend a long time. These units were extremely heavy, crowded with most dreadfully wounded men, many many who can never leave. The operating theatres with 4 tables in each are going day and night, and the work of everyone is continuous, heavy and sad. Everyone doing splendid work. Finding in both these stations that the Nursing Staff is not sufficient. I arranged to increase both Staff by 2, giving them each 14. Here an extra C.C.S. for walking cases has been established, not requiring Sisters.

From there to Vecquemont, 34 and 35 C.C. Stations. These like the 2 previous are under canvas, and near the railway line. Both these units had just evacuated and everything was satisfactory. An extra C.C.S. for walking cases here also.

17.07.16

Reserve Army - Where I saw the DMS, Surgeon General Nichols, and who will communicate with me direct always in connection with anything to do with the Nursing Staff, and I arranged to keep him informed of all matters needing his attention when visiting the C.C.S.s in his areas.

To Puchevillers to see 3 and 44 C.C. Stations, now much quieter, and where I found I was now able to take 2 Nurses from each to Warloy, where the Field Ambulances were just changing. The Hospital crowded with serious abdominal cases, a Staff of 8 not sufficient. Arranged to send another Sister at once, experienced in operating theatre work.
(Welsh F.A.) To Authie to Field Ambulance also just arriving, the predecessor just transferred to Warloy. Here the work had diminished considerably, and I found I was able to move 4 Nurses.
To Doullens to Citadelle, 11 and 35 C.C. Station. This place in the short time has become a most magnificent unit, more like a General Hospital than a C.C. Station in every respect. Miss Toller who is in charge of both units is managing most excellently. In all instances I saw the O.C.s who expressed entire satisfaction with the Nursing arrangements in all units.

Unable to get accommodation in any Hotel, so went to 19 C.C. Station where I had dinner and where they found me a billet where I was more than comfortable in a charming room, and a nice old French lady, the owner, was most kind and welcoming.

Not what is required

Having written about nurse training, and the Army's insistence on only the best, I thought I'd say a bit about the other half of the picture - social status. Until the second half of the nineteenth century, even the London teaching hospitals employed some women of dubious character and morals to care for their patients. It was hard, dirty, and unrewarding work, and not until the late nineteenth century did it become an acceptable profession for educated, middle-class women, and then only slowly.

From the first days of the Army Nursing Service, the Army had insisted not only on a good training, but in addition, that their candidates should have good social standing. After the formation of Queen Alexandra's Imperial Military Nursing Service in 1902, and the expansion of the military nursing service, many women applied to enter, but so few were considered acceptable that it was always a fight to maintain the required establishment. With their form of application they had to supply three references, one from the Matron of their training institution, and at least one other from a 'lady' known personally to the candidate, and who could vouch for her suitability.

Some candidates fell by the wayside because her even her 'lady' was not considered adequately furnished with the right qualities, but many, having been invited to interview, fell foul of all sorts of social prejudices. The minutes of the Nursing Board, held at the National Archives, report in detail on the reasons for non-acceptance of candidates in 1902-4:

* Miss L. D. Apparent want of social standing, and appearance unsuitable.
* Miss M. F. Social status and behaviour not suitable.
* Miss M. M. Social status unsuitable from all reports, and education imperfect.
* Miss L. V. Her appearance and style not at all what is required in an Army Nurse.
* Miss M. M. Quite unsuitable. Father an iron-plate worker, mother cannot sign her name.
* Miss E. S. Unsuitable from her parentage. Father a shoemaker.
* Miss M. B. Common style and manner.
* Miss W. Unsuitable for the service. Is a coloured lady from America.

And so on - columns of them. Many of these women had already served with the Army Nursing Service Reserve during the Boer War, but mention of their past nursing abilities rarely occurs. Perhaps this lack of tact and discretion finally dawned on them, as in June 1904, an entry in the minute book states:

The Board resolved that in the remarks as to the cause of rejection of candidates, observations as to their social status should in future be replaced by a statement such as 'Not considered suitable' or 'Not recommended'.

The practice continued, of course, but was simply no longer written about. And it continued right up to the Great War, that great comma, that changed a lot of things in British life. But it always amuses me to realise that perhaps not as much changed as it seems. When I joined Queen Alexandra's Royal Army Nursing Corps in the 1970s, my father, an ex-Army Warrant Officer, was working as a stores manager at Vauxhall Motors. Looking over my shoulder, while I sat filling in my application form, my mother jumped six feet:

'No dear, you can't possibly put that - it sounds so common'.

So after much deliberation and discussion, my form was submitted, and written in the space for father's occupation was 'Account Manager, Motor Company'. Definitely not the first, and surely not the last to supply a white lie to the War Office?

The V.A.D.

I used to think I didn't like VADs very much. After all, I'm a trained nurse, and felt a bit put out that they barged their way into the war without a please or a thank you, and later wrote rather prolifically about how they were pivotal in the winning of it. Since then I've mellowed considerably, but at the time, they came in for plenty of flack from some quarters.

In 1914, the nursing profession was in a state of upheaval, with various factions campaigning for the training and registration of nurses to fall into line with their particular views. A three year training in a large general hospital had become the accepted gold standard for the professional nurse - three years of long hours, strict discipline, and extreme hard work, followed perhaps by more years of the same; climbing the ladder of experience and responsibility.

So hardly surprising that when it was first mooted that untrained women (whisper it... VADs...) would be employed in military hospitals at home and abroad, there was great unrest among most trained military nurses, and by the nursing press. They were adamant that they simply would not allow their patients to endure the second class care that would be dished out by these clueless young upstarts - 'Ils ne passeront pas' springs to mind.

The VADs, for their part, were often well-bred, educated young women, with attributes (to their eyes) unknown in the ranks of the Army nurse. They were enthusiastic, and the War Office took care to select only the best to go overseas, but there were frequent conflicts between the two factions. It seems one of those strange facts that while VADs wrote many memoirs about their experiences during the Great War, the trained nurse left virtually none, so the picture that remains is a bit one-sided. Perhaps the VAD looked on the experience as a special time in her life, which stood out, and was worthy of reflection and description, whereas to the professional it was just another aspect of an already full career. There are several stinging descriptions of Army nursing sisters by Enid Bagnold, Olive Dent, and Vera Brittain - about those I will expand another time.

But do I like VADs now? Yes, I have to admit that we couldn't have kept our military hospitals running without them, and the nursing services both at home and abroad would have collapsed if they had relied solely on the professional. Trained nurses took three years to produce. VADs took, at most, three months. There are good and bad in all walks of life, but the VADs came forward in abundance, gave of their best, and in the main were simply splendid.

Training

Most nurses practising today have gone through a three year training. Some have extended that period with a few additional bells and whistles, but in the main, a three year training has been the 'norm' for a long time, although the content of that training has varied, and gone up and down with the hemlines. But training wasn't always like that. In fact, there was a time when training 'wasn't' at all.

Until the Nurses Registration Act of 1919, there was no registration of nurses, no regulation or standardisation of training, no examination to prove, or dis-prove competence. Anyone could call themselves a nurse, and as long as they worked within the law, that could not be challenged.
Florence Nightingale fired the starting pistol of nurse training when she opened her school at St. Thomas' Hospital in 1860. Her mixture of 'ladies' and probationers underwent a one year training in order to receive their hospital certificate, and until the 1880s, this one year was considered adequate time to produce a woman capable of meeting all the challenges that hospital and home nursing would throw at her. But by the 1880s, suggestions came from several quarters that this period should be extended, and in 1887 the British Nurses Association started to campaign both for a three year training, and also for national standards to be laid down.

At the turn of the century, there existed a confusing mixture of women, some of whom had a one year's certificate; some a three year training, which could have been good or bad; some a one or two year training in children's or fever nursing; some in the words of Brian Abel-Smith had learned their trade 'on the hedgerow of experience.' But there had developed an unofficial 'gold standard' which laid down that a full training of the best kind came from three years in a general hospital of more than one hundred beds.

When Queen Alexandra's Imperial Military Nursing Service came into being on 27 March 1902, it employed the strictest standards. Not only did it insist on the full three year training, but also that it's applicants met the highest standards of educational attainment and social standing. With so few women in Great Britain even coming close to meeting that standard, they always struggled to maintain their full establishment. But they were never willing, for a moment, to let those standards slip. In 1902, there was already an Army Nursing Service, many of the nursing sisters had years of devoted service in military hospitals, but even they had to re-apply to be accepted by the new service, and prove that they were fit to continue to serve the Army.
One of those women, Isabella Jerrard, was in for quite a shock, when she applied to transfer to the new service in 1902. At that time she had served for 24 years and 2 months in the Army Nursing Service, reaching the rank of Superintendent (equivalent to a Matron), but (Oh horror!) it was discovered that she had never received nurse training of any kind, and therefore could not be allowed to transfer to QAIMNS.
However, shortly afterwards, her case was reconsidered, and the Advisory Board recommended:

In admitting candidates from the existing Service, the Advisory Board thinks that regard should be paid rather to the manner in which they have performed their duties as Army Nursing Sisters than to the qualifications required of them at the date of their admittance to that Service.

The Nursing Board had to make a U-turn, and find a place for this middle-aged maverick, and in confirming her position as a Matron in QAIMNS stated:

The Nursing Board desires to inform the Advisory Board that Miss Jerrard was declined for QAIMNS, not only on the grounds of insufficient training, but because the evidence before the Selecting Committee made it clear that she was not suited for the post of Matron – the only position in the Service for which she could be considered eligible after her 24 years’ service. On reconsidering the case the Nursing Board, on account of her age and long service, is willing to recommend that Miss Jerrard be retained in her present position until she has completed the period necessary for the pension due at 50 years of age.

This case is a good example of how a three year training had become the standard for the professional nurse, and one which even in 1902, the Army would insist on above all other considerations.