Young soldiers being killed or horrifically injured in brutal warfare is the classic image of the First World War.
The courageous women who worked tirelessly beside the battlefields to save the lives of the maimed soldiers are rarely considered.
Yet many of those brave nurses died as they performed their invaluable role near the bloody trenches in France and Belgium, and many others were left with mental scars that would last a lifetime.
But because their sacrifice was small compared to the millions of soldiers who lost their lives during the Great War, their contribution to the war effort has, to a large extent, been forgotten.
A new book, The Hospital In The Oatfield, and an accompanying exhibition, hopes to remedy that by telling the story of the First World War’s doughty nurses, focusing on a field hospital run by the society beauty, Millicent, Duchess of Sutherland.
The Duchess, who had always fought for social justice despite her privileged background, sailed to France to give medical help and “meet the war”, just five days after it started in August 1914.
Much of the initial care for injured soldiers was performed at Casualty Clearing Stations close to battlefields in France and Belgium.
They had limited medical supplies and were only able to give cursory attention to severely injured men, with the nurses often kneeling in mud as they did their best to administer first aid.
The soldiers were then transferred to more distant hospitals outside the battle and shelling zones, but many died en route.
For this reason, it was decided the hospitals should be brought to the men, and in the spring of 1915, the Duchess of Sutherland set up a temporary hospital under canvas in Bourbourg, inland from Dunkirk.
Known to locals as “the camp in the oatfield”, the tented hospital, which was thought to have around 100 beds crammed into it, was staffed by two doctors, a matron, 14 trained nurses, and four Voluntary Aid Detachment (VAD) nurses who came from a variety of backgrounds, some very privileged.
Natasha McEnroe, director of the Florence Nightingale Museum, which published the book and is currently running the Hospital in the Oatfield exhibition, says: “Nurses in the Great War experienced the true horrors of the battlefield first-hand.
“Even the experienced nurses wouldn’t have seen anything like the injuries they had to deal with in those hospitals. The amount of damage that was done to the soldiers was absolutely horrific.”
The First World War was Europe’s first experience of industrial warfare, and blast injuries from shrapnel shells could destroy limbs, lacerate flesh and leave deep holes in soldiers’ bodies.
Many of the wounded, it’s said, were unrecognisable as human beings.
As antibiotics had not yet been discovered, even if soldiers survived their initial battle injuries, infections often set in and caused an excruciatingly painful death.
As well as blast injuries to deal with, there were also the horrific effects of gas attacks, which burned soldiers both on the outside of their bodies and inside their mouths and lungs.
“It would have been terribly upsetting for the nurses – not just the awful wounds, but having to care for these distressed men, who were blinded and blistered inside and out by the burning gas,” says McEnroe. “The trauma of caring for men with this type of injury, and particularly those who had facial damage and couldn’t eat, was horrendous.”
Christine Hallett, Professor of nursing history at the University of Manchester, wrote one of the chapters in the book.
She says many of the nurses were totally unprepared for the horrors of the First World War military hospital.
“It is almost impossible for us to imagine just how shocking an experience nursing work must have been for many of these young women,” she says.
Indeed, describing her gruelling early wartime nursing experiences, the Duchess of Sutherland wrote that she “felt stunned – as if I were passing through an endless nightmare”.
One nurse in charge of a ward at a Casualty Clearing Station, who received 45 dangerously injured patients in one night, 15 of whom died before the morning, broke down emotionally and physically, and had to be admitted to a convalescent home herself.
The severely injured men arrived caked in mud from the trenches, and nurses had to clean the filth off them and pick out bits of shrapnel, dirt and clothing from their wounds, before liberally applying antiseptic, and using wound irrigation techniques such as the Carrel-Dakin method.
This involved using sodium hypochlorite to clean wounds, via jars of the fluid attached to tubes and rubber nozzles, which were placed at various wound sites, bandaged on and changed every two hours.
The treatment helped prevent the spread of infections such as gas-gangrene.
Other groundbreaking new treatments included the portable storage of blood for transfusions, and mobile X-ray equipment.
McEnroe explains: “The war was a time of medical breakthrough, because the medical staff had to improvise – things were so desperate, and there was such a high amount of casualties, that in this highly-charged atmosphere, new ways of helping them were discovered.
“The nurses would improvise medical equipment from anything that was lying around, like odd bits of wood.”
The nurses also did their best to create homely environments for themselves and the men, finding bits of furniture to bring to the wards and picking flowers, using shell casing as makeshift vases.
However, they also had to clean the wards themselves, and perform other menial tasks, like pegging down the hospital canvas on windy days.
“There’d been an emphasis on considering the patient from before the war, looking at the importance of hygiene and ventilation, and keeping the patient calm and happy,” says McEnroe. “But it was the theatre of war that brought that care to prominence.”
The book and exhibition are illustrated with photographs taken by one of the hospital in the oatfield’s surgeons, Oswald Gayer Morgan, and paintings by the French artist Victor Tardieu, a volunteer ambulance driver.
“The paintings and photos give a snapshot of what life in the hospital was like,” says McEnroe.
“When people think about the First World War, they think about the soldiers and the trench warfare, and don’t necessarily think about the role of women.
“Women were under physical and emotional attack as much as anybody else, and they were in danger. They were incredibly brave.”