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Feature Article 2018 Journal

Wars and Wanderlust

Introduction

Many years ago, while working in London, an illustrious, senior member of our profession [whose actual identity I have long since forgotten] on learning that I am a Pelican exclaimed ‘I always knew that Royal Infirmary of Edinburgh nurses could be assigned anywhere and you always knew they would cope’.

Needless to say, I was, to put it mildly, highly chuffed, albeit rather cynical, attributing this ability to the way in which as students we undertook quite a lot of relief duties. Nights ‘on the tiles’ for a sister endeavouring to provide support to an over-stretched ward, most often after a death, among many other assignments where we found ourselves, often in a previously unknown ward, expected to meld into the team and ‘get on with it’ – whatever ‘it’ was -  doubtless played a big part.

A chance encounter with a story from an RIE trained nurse during the South African Wars [long before State Registration and Pelican badges] opened up a new world for me, and I came to realise that there were aspects of our training days which related closely with our predecessors of the very distant past.

This article is the outcome; it involves a mix of personal stories and extracts from the archives; where necessary names have been withheld.

 

RIE Nurses in the Military:

Early 20th Century

A 12th March 1900 entry in the Minute Book of the Royal Infirmary, which records meetings of the hospital’s governing board, states:

‘On the motion of the Lord Provost it was unanimously agreed to grant leave of absence from this date to…’

There follows a brief list of names of nurses to be released for service in the Edinburgh South African Hospital and a resolution that they were to be re-instated on their return. This was the first of several similar policy decisions. Not unlike more modern arrangements for QARANC [V], i.e. Army nurse reservists, the nominated nurses served in South Africa for around 8 months before returning to duty at the Royal.

My interest in this history was triggered by a brief entry in a 2017 edition of the QARANC Association Gazette which outlines the demise of Florence Nightingale Shore who in 1920 was murdered on a train in SE England. She is described as having trained in RIE and nursing in the Princess Christian’s Army Nursing Reserve in South Africa, and later in the First World War in the Queen Alexandra’s Imperial Nursing Service [QAIMNS].

I found the younger Florence Nightingale Shore [a goddaughter of the original Flo, who was cousin to her father] in the RIE nurse training archive. There followed a prolonged exploration where I was able to match QA and RIE records for nurses of the time.   

What has emerged is a pattern of training very different to our experiences of the second half of the 20th century. Miss Shore typifies the way in which new nurses were prepared for their role. They were contracted for 365 days during which there was a minimum amount of leave granted, if any. Miss Shore, aged 27, commenced on 1st January 1893 and completed her training on 31 December the same year, having worked ‘almost 26 weeks in medical wards, nearly 26 weeks in surgical wards, and was on leave for 3 days.’ She was then employed as ‘an extra night nurse’ then as an ‘extra day nurse in various wards’ before leaving to pursue district nursing in London in September 1896. Records show that many of her contemporaries undertook a proportion of their surgical experience in the gynaecology department.

Despite her superiors recording that Miss Shore was ‘not very bright or thoughtful or possessed of tact’ during her training she won second prize for Anatomy and Physiology.  Enlisting in 1900 she was posted to the Imperial Yeomanry Hospital, Deelfontein. The Boer War ended in 1902; but in 1914 Miss Shore was back with the military, serving with the French Red Cross in France before joining the QAIMNS Reserve, with whom she remained for 4 years, working in various hospitals, casualty clearing stations and ambulance trains in France. In her final posting she volunteered to remain with casualties during bombing of Etaples, rather than taking shelter. She was decorated as an Associate of the Royal Red Cross [ARRC] on completion of her service in 1919. Meanwhile a fellow ‘Royal’ nurse, Jeanne Barclay Smith, who had become Acting Matron of No 24 General Hospital in Etaples, died there on active service in 1916.

A different picture is recorded for Annie Warren Gill, CBE, RRC [in whose name a prize used to be awarded annually in the RIE School of Nursing]. 31 years old at the start of her training year [1894], Miss Gill was greatly acclaimed and rather than being employed subsequently in ‘relieving’ like her peers, in 1896 became assistant night superintendent, moving on to being home sister and teaching probationers administrative and management skills. 

In 1900 Miss Gill took charge of the Edinburgh and East of Scotland Hospital in South Africa, returning to the UK in 1901. On a second tour of war duty she was assigned to work in the concentration camps [see below]. Miss Gill’s illustrious career culminated in her appointment as Lady Superintendent of Nurses at RIE from 1907 to 1925.

In 2005 I participated in the QA Association tour of notable Boer War locations, coinciding with a copy being passed to me of the 1901 Report of the Royal Commission set up to investigate the Care and Treatment of the Sick and Wounded during the South African Campaign.  It is possible therefore to contemplate the circumstances which our indomitable forebears experienced in South Africa. The Army Nursing Service had been established in 1881, shortly followed by every military hospital of at least 100 beds being staffed with serving Sisters, and then in 1897 Princess Christian’s Army Nursing Reserve was formed. Despite these developments, it wasn’t until 1900 that trained nurses were regularly deployed in the S African war, and then only in fixed hospitals. The rationale for the innovation was deficiency in orderlies and the move was not without controversy. It is clear from the report that the volunteer nursing sisters were not always welcome, although their practice is exonerated. Recorded elsewhere is a death toll of 8,000 British soldiers in combat during the S. African Campaign, but a further toll of 14,000 from diseases, enteric fever and malaria being the most common.

Being in ‘fixed’ hospitals implies nursing patients some distance from the front, in well-established buildings. However, it is apparent that a diverse range of tentage formed many wards; these structures were not fit for this purpose and hence not ideal. This war involved much movement of troops, often at short notice, and ‘fixed’ was rather a misnomer. Problems of transportation impeded evacuation of patients to return to duty or onto hospital ships and also created shortages in re-supply of food, medicines and equipment. It was difficult to establish and maintain effective sanitation at many locations; limitations in, for example, latrine provision made the care of enteric fever patients particularly difficult. Malaria, even today, remains an intractable disease to manage. While it is doubtful that many of our nurses would have previous experience of such problems they are recorded as being ideal for nursing soldiers with these illnesses. Nevertheless, one wonders how they coped – as they clearly did – with the military environment, its unfamiliar infrastructure and discipline of soldiers. Princess Christian Nursing Sisters wore ankle length dresses and pinafores topped off with a short cape and boater; each was issued an umbrella. None of this garb would have been comfortable or suitable for the extremes of the South African climate. Some of our RIE nurse volunteers themselves succumbed to enteric fever.

Concentration camps were not invented during the Boer War but they were utilised for the first time against an entire nation, allied to Kitchener’s scorched earth policy which left Afrikaans women and children deserted, homeless and starving. Some indigenous Africans, too were similarly afflicted. They were rounded up into camps which were ill-equipped for the task. Dysentery, measles and typhoid were rife and starvation, it appears from the records, was a conscious policy. In all 26,000 Boer women and children died in the camps. Not a small number of RIE nurses found their way to service in these camps; it is hard to imagine just how difficult that work must have been.

Peace came in 1902, the same year that the Queen Alexandra’s Imperial Military Nursing Service was formed to replace and enhance the services provided by nurses in South Africa. Cross-referencing RIE nurses’ records with the QA archive, it is clear that many of the RIE trained nurses who had joined the Princess Christian Army Nursing Reserve returned to the military during the First World War where they served with distinction; a significant number were awarded decorations. Many became matrons; in the early 20th century there was at least one Matron-in-Chief of the QAIMNS who began her professional life at RIE.

Second World War

In living memory, I have known Pelicans who served in the Second World War.  Two great friends joined up at Peebles Hydro in the early days of the war, much to the chagrin of the Lady Superintendent of the day who was reluctant to spare them.

We Pelicans and our predecessors have taken our training into nursing practice in many parts of the globe. In times of conflict the perception that RIE nurses always cope would appear to ring true in the records, as the exemplar [below] confirms.

Pelicans in the Military:

Air Force nursing in three different Services

A Pelican of 1956 was commissioned into the Princess Mary’s Royal Air Force Nursing Service [PMRAFNS] in 1959, serving for 6 years before emigrating to Canada. Encountering a group of Royal Canadian Air Force [RCAF] personnel in Montreal railway station, she recognised just how much she missed her military life [or ‘the Family’ as she puts it] and applied and was accepted as an RCAF nursing sister. Subsequently she was posted on an exchange agreement to the US Air Force to undertake a Flight Nurses’ Course.

All of her military career was set against a backdrop of the Cold War, when the NATO countries, massively out-numbered in comparison to the Warsaw Pact, set great store in its medical services to return fighting men to their duties as soon as possible. Many of the units she served in were later closed during Defence cuts.

This story is one of very varied professional experiences which makes interesting reading.  The distinguished career described supports the view that Royal Infirmary of Edinburgh nurses can be assigned anywhere and can always be relied on to cope.

Straight after gaining her Pelican in 1956, this nurse qualified as a midwife at Simpson’s, and whilst a ‘PM’ frequently was assigned to maternity wards. First posted to RAF Halton, Bucks where the hospital had been established in 1917, she ‘cut her teeth’ on military nursing, which included learning about ranks and how to manage the traditional but unwieldy Sister’s veil with starch and a longsuffering iron. This was followed by Nocton Hall in Lincolnshire, a former stately home turned American medical services facility during both World Wars and much later during the 1991/2 Gulf War. Between 1945 and 1991 it had become a large hospital which served the not insignificant RAF presence in Lincolnshire and also local civilians. She recalls not only the clinical work, including the regular Commanding Officer’s inspections, but also off-duty pursuits and a lively social life where the nursing sisters were entertained to parties at all the local RAF stations.

Moving on to RAF Germany, initially she was posted at RAF Jever, which was established with fighter capability to guard the North German plain, then at RAF Wegberg. The majority of her assignments were in maternity wards, [which could be a great deal more challenging than in UK, caring for mothers away from their own mothers and therefore often in need of support and guidance]. At Wegberg she acquired a Vespa scooter, a wise investment which allowed her freedom to get out and about when off duty, possibly an easier option than local public transport which would have required a reasonable understanding of the language and infrastructure.

Returning to the UK , she completed her service at RAF Cosford [maternity work again] and then finally back to Halton where, still at a very early stage, a tri-service renal facility was being developed; the plastics unit, established by McIndoe where he pioneered care of the Battle of Britain pilots, was to be her final Halton allocation.

In 1966, as an immigrant, our Pelican applied to join the RCAF and was finally accepted after a long wait; in the depths of the Canadian winter she found herself posted north of Toronto at Camp Borden which was the birthplace of the RCAF and remained an important facility for the service up until 1970. In the years before ‘gender-free’ military forces came into being, female personnel, especially nurses, had a relatively soft induction into all things military, at least in the UK. However, it soon became evident that the Canadians took officer training more seriously, the Service itself being a deal more rigorous than life for nurses in British Forces [UK or Germany]. 

On passing out, the new officer was posted to the prestigious National Defence Medical Centre where she cared for serving personnel, WW2 veterans, and civilians, in various general and specialised settings. However, 6 months later, despite her personal objections, she was given an exchange posting to the USAF for training as a flight nurse. Much of the course and its aftermath in assignments were determined by the demands of casualty care arising from the Vietnam War.  The commitments involved delivering patients, medivaced from Vietnam to a military airfield in California, onwards to a military hospital near their home. This work required travel widely in the US but provided opportunity for sight-seeing.

Returning to the National Defence Medical Centre in Ottawa as a general duties nursing office, she continued with this specialised nursing on an on-call basis. Then for her final posting she was sent to Trenton, on the shores of Lake Ontario, nowadays one of the busiest Canadian air transport units.  She was treated to a self-selected ‘swansong’, a flight to Cyprus, as her final farewell in 1972.

A Pelican Missionary:

In 2016 the League was gifted a very old Pelican badge, awarded in 1925. Happily, it was passed on to a current member to replace her own which sadly she had lost. However, the story of the original recipient is worthy of attention.

Alas, little is known about how this Pelican ‘always coped’ – but it is clearly evident that she did.

Born into a missionary family serving at the Wuhan Union Hospital in China, an establishment founded in 1866 and which had grown to a 240 bed facility by 1928, Jean Gillison undertook her general training at RIE and gained her Pelican, before going on to qualify as a midwife.

She arrived at the Union Hospital in 1929 to work alongside her father and brother, both doctors. Jean built up a busy obstetric unit, thought to have delivered more than a thousand babies. Accounts from the time describe a formidable midwife, held in high regard by those in her care and on one occasion scaring a group of bandits who, accosted her and, in search of money, opened her obstetric bag, putting at risk the sterile contents she had carefully prepared for the difficult delivery she was on her way to conduct. Jean’s shouts apparently sent them rushing away from the ‘mad foreigner’!

These were difficult times; female infants in poor families, regarded as a disappointment when a boy was wanted, were often abandoned on the hospital doorstep. There was internal strife; the Chinese Communist Party was fighting the Nationalist Government. The hospital did not take sides but treated a large number of casualties [both sets] from the fighting as well as refugees. Then in 1931 the River Yangste burst its banks. Despite the temporary loss of the ground floor to the influx of filthy water, the staff coped and again provided health care to the many refugees made homeless by the floods. Cholera and dysentery were the main diseases, while opium addiction was rife.

The Second Sino-Japanese War began in 1931 and continued until 1945. Japanese troops reached Wuhan in 1938, following a period when they bombed the region extensively. [Bombing was again an issue in 1944-5, but this time by Sino-US aircraft.]

In 1937, as the conflict hotted up, Union Hospital staff decided they would stay put and keep the hospital going for as long as possible. This commitment saw them working extended hours, often in bombed out buildings which were taken over for fresh war casualties. This continuance, working alongside Chinese clinicians, greatly annoyed the Japanese [who were not as yet at war with the Allies].

Eventually the Japanese took over the Union Hospital, staffing it and making it a facility for their own military personnel. The original Union team, ever resourceful, transferred their patients and equipment to smaller annexes and also makeshift accommodation.

Eventually in 1942 all foreign staff were interned by the Japanese; Jean Gillison went to a prisoner of war camp. When the armistice was signed the staff returned to find the hospital building had withstood the bombing but the environment was chaotic. Within days of leaving their internment a committee of the Union Hospital Board was set up with the objective of re-opening the hospital. Jean Gillison was an active participant. The eventual outcome was the establishment of a teaching hospital, training doctors, nurses and midwives for China’s future. Great progress was made, despite the ongoing civil war and the gradual imposition of regulations from the Communist regime. One of their demands, to develop over a 5-year period the autonomy [religious and medical] of Chinese in operating every mission hospital, was consistent with the strategy of the Union team. The work continued, until in 1950 when the outbreak of the Korean War ultimately led to all foreign nationals, including Jean Gillison and her family, having to leave China.

Back in England Jean remained in midwifery, specialising in the care of unmarried mothers abandoned by their families. She spent her retirement happily in a home for missionaries, living to the age of 99 when she died following complications of a fractured neck of femur.

Reference: Gillison, W 2015 Wuhan Union Hospital: The First 84 Years

 

Lorna Numbers

                  

 

 

 

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