Carrying, caring, comforting: the people behind medical evacuations

In this guest blog, Jessica Meyer introduces the many people a wounded soldier would meet on his evacuation from the front.

A regimental aid post somewhere on the Western Front during World War I. Wellcome Library. CC At 2.0.
A regimental aid post somewhere on the Western Front during World War I. Wellcome Library. CC At 2.0.

The first people a soldier was likely to encounter after being wounded would be very familiar. Regimental stretcher bearers were drawn from combatant units and were trained in basic stretcher drill and first aid.  During action, they exchanged rifles for stretchers and stood ready to bring wounded men in from No Man’s Land. They would help apply field dressings, and carry the injured to the Regimental Aid Post. The men there would, again, be familiar figures as part of the man’s regiment. The Regimental Medical Officer, a Royal Army Medical Corps (RAMC) officer, was the military equivalent of the GP, dealing with day-to-day illnesses and accidents as well as wounds sustained in action. Servicemen regularly encountered their medical officer and the orderly who accompanied him on sick parade or during inspections for trench foot and the like.

From there, the wounded man would be entrusted to a less familiar group of men, the stretcher bearers supplied by a field ambulance.  These men were members of the RAMC rather than a combatant unit, and their wartime role revolved entirely around the transport of sick and injured men. They had better levels of training in both wound care and stretcher drill than regimental bearers.  Indeed, as Emily Mayhew has argued, by the end of the war they had developed what might be defined as a professional identity as care providers, something they took great pride in (Emily Mayhew, Wounded: From Battlefield to Blighty 1914-1918 [London, 2013], 6). George Swindell, for instance, recalled in his memoirs the experience of transporting a man with an abdominal wound for two hours, only for him to die within ten minutes of arriving at an aid post when an infantry sergeant gave him water:

‘on our way back we looked up the men who had shouted at us, and told them we knew our work, that was why we were there, and as the result of an individual, who did not understand, that case was lying dead, we told them how his life would probably have been saved, but for the water opening up the wound again, and we also asked them to help us in future, not hinder us’

George Swindell, In Arduis Fidelus: Being the story of 4 ½ years in the Royal Army Medical Corps, Ts. Memoir, Wellcome Library, RAMC 421, p.151.

The stretcher bearers transported men to the aid posts where they were treated by RAMC officers and tent units of a field ambulance. Tent orderlies increasingly developed care-giving expertise with a focus on wound care, first aid and the dispensing of pain relief.  Like the stretcher bearers, they served under the authority of officers who were all medical professionals drawn from civil practice and the medical schools.

Women Urgently Wanted for the WAAC (IWM PST 005476)
Women Urgently Wanted for the WAAC (IWM PST 005476)

From the dressing stations, transport shifted from manual bearing to vehicles.  Motor ambulances replaced horse-drawn ambulance wagons in the early years of the war, resulting in a change in the character of the transport providers.  Instead of drivers drawn from the ranks of the RAMC, motor ambulances were primarily provided by the Motor Ambulance Convoys. Established in 1915 drivers had as much mechanical as medical knowledge.  From 1916, as the war went on, and the manpower shortage grew more acute, female drivers from the Women’s Army Auxiliary Corps increasingly replaced male ambulance drivers.

At the Casualty Clearing Station (CCS), the next stop along the line of evacuation, the wounded man would again encounter medical officers and tent orderlies.  This was also the first place he might expect to encounter female nurses, exclusively professional nursing sisters serving with the Queen Alexandra’s Imperial Nursing Service. As the war progressed, he might also encounter female anaesthetists and radiographers, as medical dilution in response to the army’s demands for manpower brought more women into these roles.  In exceptional cases, a man might find himself in one of the few hospitals run entirely by women, such as those provided by the Scottish Women’s Hospitals, although these units were under the authority of the British Red Cross or allied military commands, rather than the War Office. Indeed, Dr Elsie Inglis, who led the Scottish Women’s Hospital, was famously told by the War Office to ‘go home and sit still!’ when she offered her services to the war effort. The role of women working close to the front line remained a deeply contentious issue for British military authorities throughout the war.

British army operating theatre at Wimereux, near Boulogne. Wellcome Library.
British army operating theatre at Wimereux, near Boulogne. Wellcome Library CC At 2.0.

It was on the next stage of his journey that the wounded man would be treated predominantly by voluntary, as opposed to military, medical units. The British military regarded medical volunteers, who did not come directly under their authority, with some suspicion and did not allow them too near the front line. Voluntary units did, however, provide staff for the hospital trains, barges and motor ambulances which transferred men between CCS and Base hospitals.  These included both male units, such as the Friends’ Ambulance Unit, often formed of conscientious objectors, and female units of nursing Voluntary Aid Detachments. In 1914 there were 551 male detachments, as well as 1,823 female detachments; by 1918, there were 836 male and 3,247 female detachments. These units also served aboard the hospital ships, and volunteer units also provided ambulance transport between trains and hospitals in Britain, a service described as ‘a double role which truly merits the country’s admiration’, as it was carried out in addition to whatever regular work the volunteer did. (Ward Muir, Observations of an Orderly: Some Glimpses of Life and Work, in an English War Hospital [London, 1917], 207.)

In military hospitals, volunteers might provide nursing and general service, the latter performing the tasks of cooking, cleaning and mending that allowed the hospital to function while the former aided professional nurses and doctors in providing medical care.  Red Cross hospitals were supervised by professional nursing sisters and all doctors were honourary officers.  Those serving in home hospitals had probably been judged as unsuitable in some way for overseas service.  This could be related to age, health, areas of expertise (in the case of medical officers) or character (often cited in relation to volunteers).  As the war went on, home hospitals became increasingly feminine spaces, as women took on the roles of male orderlies who were increasingly combed out for combatant service.  At Base hospitals, men deemed unfit for frontline service, often having suffered wounds or illness, were substituted for fitter orderlies.

In Britain, further social care was offered. Groups of women provided the food and cigarettes at train stations, similar to the comforts, while committees such as the Leeds War Hospital Entertainment Scheme, founded in 1916, provided entertainment to men confined by the tedium of recovery.  The ‘lady visitor’ was mocked in hospital journals, personifying civilian ignorance and inconsequentiality.  She was, however, only one of the many people who cared for wounded men both medically and emotionally on the long journey from battlefield to hospital.

Find out more about how the line of evacuation functioned in another post on this blog.

3 thoughts on “Carrying, caring, comforting: the people behind medical evacuations”

  1. Please correct me if I’m wrong, but I’m pretty sure the women of the Scottish Women’s Hospitals never tended British soldiers. The War Office and the British Red Cross having rejected their offer of a hospital, they were caring for French poilus under the auspices of the French Red Cross.

  2. You are quite right that the Scottish Women’s Hospital never served under the authority of the British War Office or the British Red Cross. There was real resistance to women’s service in any role, although nurses served as far forward as CCSs and I have recently come across War Office-authorised female doctors who served in Malta and Egypt. I had no idea such women existed and I would love to know more about them.

    That being said, I would be wary of saying that no British soldier was treated by the SWH. The nature of battle meant that any medical unit further forward than the Base could (and often did) end up treating the sick and wounded of all armies, both ally and enemy. The best example I have of this is actually from the American Field Service Unit (an ambulance unit) which was officially attached to the French Red Cross. One diarist recalling an amazing trip where he carried French, British, German and American wounded to a single hospital. There are also lots of nurses’ memoirs which include recollections of treating a variety of nationalities, including, of course, local civilians.

    I don’t know enough about the SWH to say if they definitely did not treat British soldiers, but there were other all-female units (Elsie Knocker and Marie Chisolm’s Poste de Secours Anglais is another example). I’m afraid I used the SWH as a symbol for all these units as it is one of the best known.

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