Alice's Report

Some experiences of work at Casualty Clearing Stations in France at different periods between 1915 and 1919 by a ‘Sister in Charge’.

As one who went to France in the first days of the war I have always felt to the fullest extent the privilege I had of working at Casualty Clearing Stations for two and a half years before Armistice was signed and during the heaviest fighting.

I can always remember how gladly I welcomed the order when, in February 1915, I was sent to my first C.C.S., one which the previous month, had been shelled out of Bethune, and had had to move a little distance back.

Here, I think, one fully realised for the first time, what the fighting really meant and what our men were passing through and enduring every day in the line. Here it was that great numbers of the Festubert and Neuve Chapelle casualties were brought.

Can one ever forget the difficulties of these days, when with everything limited to the very utmost, our resources were severely taxed. Yet these difficulties were all surmounted in a most marvellous manner by the unity with which all worked together, Medical Officer, Sisters and Orderlies, for I think never was the thought absent from any one of us that these men were fighting for us, and on us, now, that they were broken and helpless, they depended.

Well do I remember the first gas cases brought to us, and the indignation that we felt at this new and terrible form of warfare, and I can now recall that later, each patient admitted had been provided with a mask, at first the very primitive one of black net with wool encases, which had previously been submitted to some chemical treatment and this was worn round the service cap. It all seems so strange to look back on those days, when things were not as organised as they were later on, when surgeons worked day and night, snatching perhaps 2 hours out of 24, for sleep and then beginning again.

One thing, however, we were not then troubled with bombing, for although Zeppelins were often seen, we then were under the impression that the Red Cross would be respected by the enemy.

Later it was my privilege to be with one C.C.S. for 17 consecutive months, most of the time being stationed near Poperinghe, a very busy centre. Here it was that we lived together through the very trying winter of 1916 and 1917, sometimes getting the wounded down with their clothing frozen to them, so that one can realize how much the men welcomed the comfort of bed in a hutted hospital.

However, it was not until the spring and summer there that our real work began, when almost without ceasing until December, we were in the thick of it. When the very big battles were on such was the splendid organization further ahead of us, that we knew exactly when the first loads of wounded would arrive. Nearly always the gassed cases came first, followed by walking wounded and then came the stretcher and more serious cases.

These were all dealt with methodically and placed in the various wards according to the severity of the case. Of course at a time like this, the operating theatres were the greatest centre of work, where teams consisting of a surgeon, anaesthetist, sister and orderly would work consecutively and systematically for 16 hours out of 24, week in and week out sometimes.

It was during one of these busy times that we had the honour of His Majesty, King George and H.R.H. the Prince of Wales paying a visit to the hospital. With what looks of surprise and pleasure the royal visitors were greeted by these men, who perhaps only that morning, had been brought in from the line, and who then little thought that ere the day passed, they would be talking with their King. This was quite an informal visit and as the Royal visitors passed from ward to ward chatting here and there to the men, one could not help thinking how very much His Majesty had their welfare at heart. Even the operating theatre was not missed and here 4 surgeons were busy operating, but the visitors seemed intensely interested and watched for some minutes. Great interest was taken in some of the appliances for alleviating the suffering and a good deal of knowledge and heartfelt interest was evident from questions asked. I remember one remark made by His Majesty which pleased the Sisters greatly and that was ‘one might almost imagine one was in a London Hospital now’.

It was during this summer too that almost nightly we were visited by enemy aircraft and this necessitated the extinguishing of all lights and hindrance to the work. At this time no sister went on duty without carrying gasmask and shrapnel helmet and when the gas alarm sounded it was a busy few moments for the Sister and orderly, running round the ward, placing the gas masks of the helpless patients in readiness. All Sisters on day duty, if enemy aircraft was overhead at night, had to go to the dug-out which had been made for us and which we entered by a long flight of steps. If the bombing took place during the night, shall we ever forget the tread of our faithful orderly on the duck-boards calling to the Sisters to take cover, and waiting until he could account for each one, before taking cover himself. Then when all was over, he invariably appeared with hot coffee for us. But how dreadful the work one night when a neighbouring C.C.S. had 5 bombs dropped on it, resulting in over 80 casualties, many of the patients being killed outright. Their operating theatre being temporarily disorganized, the wounded were brought to us, where all night long the surgeons worked steadily, but unfortunately in many cases their efforts were in vain. How dreadful to see these once wounded men, wounded again and in many cases making the supreme sacrifice, through the awful ghastliness of these air raids. I wonder if many realise what it sometimes cost the Sisters in courage, energy and sympathy at a time like this.

At the beginning of February 1918 we moved to Noyon and took over from the French, a very large hutted hospital, each hut being capable of accommodating 40 beds. At first we were kept fairly busy, evacuations being few, but the work of getting the hospital equipped and planned to the idea of a British hospital proceeded satisfactorily. Little did we think we would have to leave it so soon.

The memorable 21st March approached; the night before being suddenly deafened with the guns. On this morning early, the Sisters of an advanced abdominal operating centre arrived, having been shelled out of their hospital and a few hours later great numbers of wounded arrived. For the following 3 days there was an endless stream of wounded arriving night and day, and all the time we were constantly evacuating to the Base. On Saturday the 23rd the work seemed almost overwhelming and even now I can hardly think how the Sisters stood the stream of those awful 4 days. Patients were accommodated in every corner of the hospital and when night came our numbers were over 3,000. It was just at this moment that an aeroplane swept don very low and dropped a bomb through a small hut, (next to the officers’ ward), which fortunately at the moment was not occupied, only one slight casualty being the result. The strain of Sunday the 24th seemed almost greater than the previous days and the congestion never appeared to get any less. It was during these days that we realized to the very utmost the splendid work which the Field Ambulances have always done, for at this stage all these units in front of us had been put out of action, most of them having been captured. In this way the patients we were now getting, were being brought to us directly after being wounded. By evening the tension was most acute, the noise of the guns deafening, the depression of the patients almost unbearable and rumours were rife of a possible hasty retreat. During these few days and nights there had been little sleep, the pressure of work being so great, and on Monday morning early instructions were received that the Sisters were to leave. I can safely say that so far this was the hardest thing that the sisters had been asked to do, but it was an order and one which had to be obeyed quickly, as it was explained to me that this was simply the beginning of the evacuation of the whole hospital. In about 10 minutes all the 36 Sisters had been collected from their various wards and operating theatres and left in ambulance cars with only some hand baggage and I am not ashamed to say, many of us shed tears as the cars left the drive of the hospital. Our destination was Amiens and as the cars flew along one even now wonders how we escaped, the shelling for a time being so near. Our suspense for the next 24 hrs was acute, until we heard the joyful news that every patients had been got away safely excepting 17 German patients who, upon being told they could remain, as the Germans were by this time closing in, refused to remain and marched out of Noyon, with the personnel of the unit, the Germans by this time being actually at the other end of the town. I believe before long, part of the hospital was in flames, but whether this was done by our people before leaving or by the Germans I cannot tell.

Then one can remember the anxious and unsettled time through which we passed and it was a month after leaving Noyon when I was sent to another C.C.S. Here at first we had numbers of wounded passing through and then for a time the majority of our patients were chiefly sick.

Then commenced again the almost nightly air raids, but we always felt a certain amount of security for the patients, as being under canvas all the wards were dug in to a certain depth and at 8 pm every night the collapsible legs of the beds were folded in and the beds laid on the ground. In the Sisters’ compound the sleeping tents were also dug in, there being a small ladder placed at the entrance to each. But even in spite of these precautions there was always a feeling of great relief when the ‘all clear’ whistle sounded.

Then came the days of moving forward with the army and our first move was to a place just outside Peronne, To this we went by car through all the recently devastated area and it almost appalled one to see the destruction and what it had cost our Army to retake this ground. We arrived at our new camp late in the evening and almost immediately had to take shelter in a dug-out, which only a few days previously had answered the same purpose for the Germans. This air-raid was very extensive and lasted for a considerable time but, before it was over, we saw 5 enemy machines brought down. Next day was employed getting the wards equipped, immediately the canvas was erected and the following day we were busy admitting patients. We remained here for nearly 3 weeks, busy all the time and then our next move was to Tincourt in September.

We went there by car, arriving about midday and spent the afternoon getting the wards ready as each was erected. The following morning we were awoken by shells coming over us in quick succession and landing just beyond the Sisters’ compound. All forenoon we were very busy preparing and getting ready in the hospital as we were to be prepared to take casualties the following day. However, just about lunch time the shelling was in such close proximity to the Sisters’ quarters that cars arrived and we received orders to go at once to a C.C.S. a little further back for the night and for safety. However, by 10 a.m. the following morning we had returned to our own C.C.S. and at midday a constant stream of wounded began to arrive, chiefly Americans. Here the work for almost a fortnight was ceaseless and can one ever forget under what difficulties the work was carried on, especially at night when the whistles sounded intimating the presence of enemy aircraft and all lights in the camp had to be extinguished. Convoys were arriving and evacuations taking place all night long and the work had to be carried on without the help of lights, even to guide the stretcher bearers, these bearers being mostly Australians belonging to a Battalion out on rest, and who came and offered their services voluntarily. Here sometimes too, batches of civilians. released from their own villages after 4 years of German occupation, sought shelter.

Then as the Army advanced we moved to Busigny about the end of October and here it was that we took in our last wounded, for as we were still stationed in this camp when the Armistice was signed. The day following our arrival at Busingy, the shelling for a time was so constant that it was deemed advisable to send the Sisters for a night to a C.C.S. a short distance behind, especially as patients were not expected to arrive until the following day. During the first week of November large numbers of casualties passed through and the work of resuscitation extremely heavy, but it was not until after Armistice had been actually signed that the last of these arrived.

But with the signing of Armistice our work did not cease for we had yet to face that dreadful malady influenza which carried away so many or our men, after the fighting had stopped. It all seemed so dreadful that so many made the supreme sacrifice through this illness after coming through so much. It was there also that great numbers of released prisoners of war began to arrive and, really, sometimes we beheld most pitiful sights and listened to the most appalling tales it was possible to conceive.

Although still with the same unit the work now is so very different, mostly sick being treated and these comprising British, French civilians, Chinese and Germans. But this will not be for long as very soon we expect the work to have diminished to such a small degree that we will no longer be required.

In conclusion I would like to say how quite impossible it would have been to have carried on the work of these busy days without the aid of the Queen Mary’s Needlework Guild and the different Red Cross associates who so very kindly supplied us with all the needful articles of clothing etc. One was sometimes appalled at the quantity used during one busy week alone, and yet, somehow, we always managed, but this could not have been done but for the work and sympathy of the women at home.

A Duncan, QAIMNSR
12 Casualty Clearing Station.
August 1919