The Humane Work Of Nurses

& Voluntary Aid Detachments During WW1 Essay, Research Paper

The dictionary describes the word ? humane ? as ?

??humane adj. Kind, compassionate, merciful.?

and this was indeed so in the case of the volunteers who worked tirelessly to ease the suffering of the wounded soldiers of all combatants in the fields of northern France and Belgium, during the First World War. In the early days of the war, army nursing was strictly a male preserve, until it was necessary to recruit female nurses from the ranks of middle and upper class ladies. The warm summer days preceding the outbreak of war lent an air of adventure to the proceedings, and the feeling was that the coming conflict would be fought in a similar fashion to the previous cavalry and infantry- based battles of the nineteenth century. A few months intensive combat would be sufficient and everyone would be back in time for Christmas dinner. Similarly, these ladies were caught up in the initial fervour of patriotism, and being prohibited from fighting at the Front, were keen to ?do their bit? for their country and their soldiers. Tired of knitting items of clothing destined for the trenches, they wanted to do something a little more substantial. The concept of `noblesse oblige` was suddenly revived as many stately homes and country houses opened their doors to wounded officers in need of convalescence, and everyone wanted to be seen in a nurse`s uniform. Indeed there were many well- connected aristocratic ladies who set up their own private ambulance groups, much to governmental consternation.

The Dowager Duchess of Sutherland, through her contacts and single-minded determination, assisted the wounded at Namur, and used the fact that she was previously acquainted with both the German commandant and aide-de-camp to pester them for safe passage to Maubeuge. She wanted to get through the enemy lines to tend the Allied troops, but the commandant of Maubeuge put an escorted charabanc at her disposal and sent her to Ostend. The Millicent Sutherland Ambulance reached Renaix where the officer in charge sent them with a military escort to Brussels, where the American Ambassador, arranged for an American journalist to escort the party, with two German soldiers, to The Hague and thence Flushing and home. The publicity generated by her escapades set up an efficient and much- needed Red Cross hospital outside Calais.

Women especially were keen to take up ?the great adventure? because, for them, that` s exactly what it was. Many ladies lived very stifling lives, barred by society `s Edwardian ideals of conventional female behaviour, ?The Angel of the Hearth? became ?The Angel of The Trenches?. These women now possessed a measure of economic and social independence away from home, and the awareness that they were performing dangerous and arduous tasks, thus gaining a sense of self-consciousness and status. This fact did not find favour with the older generation, who feared that the experiences of war would ?de-flower? their daughters, in all senses of the word.

So it was that many middle and upper class daughters found themselves as VAD s (Voluntary Aid Detachments), learning to assist medical staff as best they could.

?Now the VAD s , whose hands `this time last year` had seldom touched anything so down to earth as a dish cloth or sweeping brush, were scrubbing and polishing until their arms ached; running at the beck and call of harassed nurses and sisters until their feet swelled through the laces of their sensible shoes; emptying bedpans with hardly a wrinkle of their dainty noses; sterilising instruments in operating theatres ; holding kidney trays of instruments, and looking on as nurses and doctors probed wounds so terrible that only the most hardened of stomachs could look on them with equanimity. Now they were accepted in war hospitals that were desperately short of staff- though not always with good grace.?

McDonald ,L. 1980, p 69.

A volunteer nurse could expect to work under fully-trained nurses, under the direction of the Officer in charge and the Matron of the hospital. Her duties would include sweeping, dusting polishing of brasses, cleaning of ward tables and patients’ lockers, cleaning of ward sinks and ward utensils, washing of patients’ crockery and sorting of linen. These, and any nursing duties which they were considered qualified to perform, would be allotted to them by the Matron of the Hospital. They would be required to ?live in? and be between 21 and 48 years of age. For Foreign Service, the age range changed to 23 and 42, but of course many of the younger women under 23 lied about their age in order to gain a foreign posting.

A uniform allowance was payable at a rate of ?2 10s per six month engagement, after a month`s probation, and recruits were required to sign an agreement to serve for six months, with a salary of ?20 per annum, rising to ?22 10s after the initial six months. Those who signed up for as long as required would earn an extra ?2 10s each half year up to a maximum of ?30 per annum. A nurse`s leave was seven days in the first six months, and fourteen days during the second six month period, and unless there was a very good reason, she was expected to renew her contract in the hospital to which she had been appointed, if asked by the Matron, who was not keen on VADs moving about to other hospitals every six or seven months. The feeling being that she had spent a great deal of time and effort in bringing along her recruit and did n`t want another matron to get the benefit, plus the new ones took some getting used to.

The major difference with this war, as the example of the actions on the Marne, Aisne, and at Mons exemplified, was that the technological advancements were such that men could be killed more effectively, and indeed more horrifically with such innovations as chlorine and phosgene gas, and ?liquid fire?. The skin of victims of mustard gas blistered, the eyes became very sore and they began to vomit. Mustard gas caused internal and external bleeding and attacked the bronchial tubes, stripping off the mucous membrane. This was extremely painful and most soldiers had to be strapped to their beds. It could take as long as four or five weeks for a victim to die of mustard gas poisoning.

The new kinds of munitions rendered accepted military strategy obsolete.

Sir John French, Commander in Chief of The British Forces, wrote;

?No previous experience, no conclusion I had been able to draw from campaigns in which I had taken part, or from a close study of the new conditions in which the war of today is waged, had led me to anticipate a war of positions. All my thoughts, all my prospective plans, all my possible alternatives of action, were concentrated upon a war of movement and manoeuvre.?

(Lord French,1914, 1919 p.11).

Initially, the medical profession were ill -equipped technically and logistically to deal with the incidence of new types of wounds, most notably the incidence of ? gas-gangrene?, a bacterial infection caught via the soil in the trenches, previously unknown and consequently claiming as many lives as the combat itself. Modern antibiotics, sulphonamide drugs and penicillin were notably absent from The Front, but the research borne out of necessity accelerated, as it almost always does, the process of discovery and application. Probably the most notable developments were made in the field of plastic surgery, where a number of skilled specialists would come together to rebuild a soldiers`s face. Dr. Kazanjian was a dentist, but his knowledge of the jaw, his talent and interest in the subject meant that although unqualified as a surgeon, he was acknowledged as a top specialist in the field. Upon his return to America, he took the necessary surgical and medical degrees and became a founding father in American plastic surgery.

In England the techniques of skin-grafting and bone- transplanting were in an experimental stage, but many men had their faces re-built as well as possible, by the pioneering work of Francis Derwent Wood, sculptor and Associate of the Royal Academy who as an RAMC orderly came up with the solution of creating a mask based on the soldier`s own photographs. The painstaking work at least gave these disfigured soldiers a measure of dignity when they eventually came to face the outside world again.

The war ground to a stalemate, and the flower of European youth faced each other across a barren landscape of mud and carnage in the fields of Flanders and Northern France, with neither side prepared to negotiate. The ill- fated and ill- conceived Gallipoli campaign, served only to drain the already stretched resources at the Western Front, and there was a desperate need for female doctors and nurses.

The Scottish Women`s Hospital at Royaumont was started by the tenacious Dr. Elsie Inglis and was completely staffed by female doctors and specialists. Not only had they battled to get into the medical profession, they had to battle to get involved in the war, as it was felt that they would be unable to exert sufficient `military discipline`.

Drs. Louisa Garrett Anderson and Flora Murray, were familiar with the prejudices of the Home Office in their dealings as suffragettes, and offered to equip a surgical unit in France for the French wounded, where they would be most needed, instead. The French Red Cross formally accepted their offer. The same prejudices faced them when they opened the Endell Street Hospital in May 1915 although the twenty six thousand patients who passed through the doors were eternally grateful.

?They (the patients) were offered the chance of transfer to hospitals run by male medical staff, but the offer was always refused?

(Mitchell.D, 1966 p.193)

The scarcity of hospitals in France meant that many men ?copped a Blighty? and were sent home as there were no facilities to treat their wounds. Many nurses grumbled that they had volunteered to serve abroad at the Front and there was a great deal of jealousy and resentment aimed at those who were posted to France. As regards nursing, they were told that England should be regarded as the Front, and the home hospitals should be regarded as an extension of it. Nevertheless, the volunteers carried out their duties to the best of their abilities and their attitude to the task at hand can perhaps be best illustrated by the often neglected poetry written by women at the time.

? Her (May Sinclair ` s) testimony and that of other nurses or VADs is fascinating since they knew, if not the fighting, at least its immediate results- the extraordinary stream of casualties ?.. Such `service` poems feel active- part of the action. Some positively burst with praise for the `grit` and `pluck` of the men, marching or wounded or dying?

Reilly Catherine ?Scars Upon My Heart? 1981 Virago London preface xvii.preface by Judith Kazantzis

Christmas 1916

Thoughts in a VAD Hospital Kitchen

There`s no Xmas leave for us scullions,

We`ve got to keep on with the grind:

Just cooking for Britain`s heroes.

But, bless you! We do`nt really mind.

We`ve scores and scores of potatoes,

And cabbages also to do ;

And onions, and turnips, and what not,

That go into Irish Stew.

We re baking, frying and boiling,

From morning until night;

But we`ve got to keep on a bit longer,

Till Victory comes in sight.

Then there`s cutting the thin bread and butter,

For the men who are very ill;

But we feel we`re well rewarded;

For they`ve fought old Kaiser Bill.

Yes! We`ve got to hold on a while longer,

Till we`ve beaten the Hun to his knees:

And then `Good-bye` to the kitchen;

The treacle, the jam, and the cheese!.

M. Winifred Wedgwood p124 Scars Upon My Heart.

Despite the privations of the job, morale appeared to be high, and a cheerful countenance in turn kept the badly wounded soldiers in a better frame of mind than could be expected under the circumstances. The sights, sounds and smells of the wards, and some of the heart rendering stories would test the resilience of the nurses and VADs to the limit.

However, the health of the nurses was also at risk, as a septic wound could discharge into the smallest of cuts and cause major problems for the nurse herself. Given that a nurse would be working flat out, eating food of a poor standard, at irregular intervals, and getting hardly any sleep, it was no wonder that a nurse`s immune system seldom worked properly, making her susceptible to all kinds of viral infections. The shortage of staff meant that she would have to carry on regardless.

Many VADs became superstitious, in that if she did something in a particular way and the day turned out to be particularly successful, the same routine would have to be followed precisely or the day would become a disaster.

A volunteer nurse, Sybil Harry, wrote to her friend, a Mrs. Cooke, from the Salles Militaires Hospital Unit at Saumur in October of 1914.

?It would amuse you to see some of the improvised utensils in the wards-I do n`t think the hospital has more than five small basins for the two hundred wounded! As to a bucket it is unheard of, and we use anything from teapots to dustbins. Hot water is as scarce as whisky, and one only gets about one pint daily, so the cleaning has to be done cold. There is no installed hot water system or lights of any sort. The water is heated on gas rings, and the wards by tiny oil lamps I am sure were used by Henri II who lies buried near here.?

Marlow.J. 1998 p.48

It is doubtful if Ms. Harry`s cheerful demeanour would have continued during the ensuing years, and it seems that the privations were similar wherever the nurses were working. Tilla Durieux , was a volunteer nurse in Berlin and the ?madness? had begun to seep into her consciousness,

?Yes, I had given and helped wherever I could, but I had never been conscious of how many people were sacrificed on the whims and errors of those in power. I had great difficulty in carrying out my duties without crying or running from this immense misery. My work is very hard and I fell exhausted into bed in the evenings. Because time was so short we often ate our meals standing up and in the first weeks my feet swelled so severely that I had to wrap them in wet towels at night.?

Marlow. J. 1998 P.324

Perhaps the best-known book of a woman’s World War I experience, is Vera Brittain `s haunting autobiography Testament of Youth, first published in 1933, it remains heartbreaking in its account of love and, wrenching loss. In keeping with a typically Victorian female upbringing, it was taken for granted that her younger brother Edward would attend Oxford, treating her own intellectual aspirations with scorn. Nevertheless, she won a scholarship to Somerville College, Oxford in 1914, and at this time, she re-met Edward’s school friend, Roland Leighton. Despite conventions that dictated a constant chaperone, they fell in love. At the outbreak of the war, Roland was called to the front, followed by Edward and his two friends, Geoffrey Thurlow and Victor Richardson. Fearing that the war would leave “a barrier of indescribable experience” between her and Roland, Brittain left Oxford, much to her tutor`s disgust, to volunteer as a Voluntary Aid Detachment nurse, first in England and then in Malta and France.

?She performed the most menial tasks in a redeeming glow of patriotic emotion. She felt somehow ?worthier? of her fianc?.?

(Mitchell D. 1966 p.197)

Whilst Roland was on leave from France, he and Brittain became engaged. He was killed by a sniper’s bullet in December 1915; his death was followed by Thurlow’s death in April 1917, and Richardson’s blinding at Arras. Brittain returned from Malta intending to marry him but was forestalled by Richardson’s death in June 1917. The final blow was her brother Edward’s death in action in June 1918.

After the war, suffering from what is now recognized as post-traumatic stress disorder, Brittain returned to Oxford. As a result of her war experiences, she decided to read history instead of English.

“It’s my job, now, to find out all about it, and try to prevent it, in so far as one person can, from happening to other people in the days to come”

Brittain V. 1933 (p 471)

Vera Brittain was very much the daughter of an upper middle class family whose sons were recruited into the officer corps in the British army, as indeed, they were in all the other major armies. The officer corps had a social composition that was elitist, and the mode of trench warfare dictated that the officers were at greater risk than the men that they led. The heaviest incidence of loss in the First World War, was amongst the social elites whose men — brothers, husbands, fathers, sons — fell in disproportionate numbers, throughout the war, and Vera Brittain’s entire male company, her social world was stripped from her because of her social situation, where she was and who she was. As in the case of many daughters of her social class and convention, her experience of men was limited and she felt grateful that her knowledge of the masculine body was increased and thus she was released from the sexual inhibitions that beset her contemporaries.

As the War ground on, the nurse`s initial wave of patriotism ebbed, to be replaced by a hardening of attitudes and the feeling of the helpless futility of it all, when in effect all that they were doing was to patch up their charges in order to send them back to an uncertain fate.

Lesley Smith, the eldest daughter of a middle class Scottish family worked as a VAD wrote that on the day of the Armistice,

?I was dressing a man who was covered with painful boils, and he looked at me dully and said, ?It`s over then?? ?

(Mitchell D. 1966 P.201)

This quote encapsulates the weariness felt by the whole of Europe who were sick of the death, destruction and futility of the conflict. It is noticeable that he did n`t say ?Did we win?? because in effect, nobody won. In fact, it could be argued that the millions who died in the conflict were probably better off out of it, those who survived carried the mental, physical and emotional scars for the remainder of their lives, not to mention the bereaved families who struggled to come to terms with the senseless loss of life. Perhaps a mixture of emotions kept the VADs at the makeshift hospitals on the front, the hope that somewhere one of her nursing sisterhood was tending to the needs of her own wounded husband/ boyfriend. Perhaps there was a feeling of guilt, in that they had cheerily waved their loved-ones off to the front in the early months of the War, they had taken part in recruitment drives and had liberally button-holed seemingly able-bodied young men with a single white feather. They simply had to make up for it now that they learnt of the horror of the situation. When it was all over, the aftermath was distinctly unappealing. No-one could go back and pick up where they left off , that world did n`t exist anymore.

BibliographyFrench, Lord ?1914? (London,1919)p.11 in Marwick p41

Macdonald, L. ?The Roses of No Man`s Land? (London,Penguin,1993

Marlow. J. ?The Virago Book of Women and the Great War? (London, Virago, 1998)

Marwick, A. ?The Deluge? (London, Pelican, 1967)

Mitchell,D. ?Women on The Warpath? (London, Jonathan Cape, 1966)

Reilly, C. ?Scars Upon My Heart,- Women`s Poetry and Verse of The First World War? (Virago 1981)