25 November 2020
Andrew Robertshaw looks at the role of volunteer nurses in the Great War.
In April 2014, on the eve of the centenary of the beginning of the Great War, the BBC screened a series about nursing in that conflict. The Crimson Field was set in a fictional hospital in France and followed the lives of the medical staff and patients over the course of the conflict. One aspect introduced early on in the series was the presence of members of the Voluntary Aid Detachment (VAD) and the attitude of the professional nurses in the ranks of Queen Alexandra’s Imperial Military Nursing Service (QAIMNS) to their wartime comrades. The relationship was, according to the production, very strained and the QAINMS were highly critical of the standards of discipline and training demonstrated by the VADS. Although this made good television the questions remain: what was the contribution of the VAD to the war effort, and did they play a major or ancillary role in the care of the sick and wounded in the Great War?
Right: The 2014 BBC drama, The Crimson Field, depicting nursing in the Great War
To understand the relationship between the various nursing and caring elements of the British Army it is necessary to look back a few years to the establishment of these services. The Army nursing service was born in the Crimean War, 1853-56, and Florence Nightingale was a founding figure. Having served in the United Kingdom and overseas, in both the Egyptian Campaign and Second Boer War, the QAIMNS was established by royal warrant in 1902. At the outbreak of the Great War in August 1914 there were just 297 carefully selected and trained nurses serving with the forces worldwide. In peacetime this nucleus of military nursing was supported by a much larger number of Army Nursing Service Reserves. The Reserves expanded to nearly 11,000 members during the course of the war and alongside their Regular comrades they served in almost every theatre of war. On the creation of the Territorial Force (TF) in 1908, based on the pre-existing Militia and Yeomanry units, the Territorial Force Nursing Service (TFNS) was established to provide nursing support for the TF in the United Kingdom. As with the Reserves this force expanded rapidly, 8,140 women having enrolled by the time of the Armistice. Of these 2,280 served overseas supporting the QAIMNS and the Reserve. Although these figures may appear impressive, the British Army was dogged by shortages of personnel at all levels during the course of WWI and this hampered the nursing services as much as the military forces.
Right: The staff at the Larches VAD hospital – there were over 3,000 auxiliary hospitals under the directorship of the Red Cross
The VADs were very much a Cinderella to the other nursing service, only being formed in 1909 in conjunction with the British Red Cross, which received its royal charter in 1908, and the Order of St John. The St John Ambulance Brigade had provided 2,000 men as orderlies during the Boer War and the needs of this conflict suggested very strongly that in the event of a future war the medical and nursing services would be unable to cope. However, the peacetime needs of the standing Army were relatively small. Therefore a scheme was needed to provide trained and experienced personnel at short notice. The creation of the TF offered the opportunity for co-operation between the voluntary agencies and the Army. On 16 August 1909 the War Office issued the ‘Scheme for the Organisation of Voluntary Aid in England And Wales’, followed by a similar scheme in Scotland in December. This scheme was intended to supply aid for home defence in wartime along the lines of similar organisations on the Continent. The aim was to provide clearing hospitals, stationary hospitals and ambulance trains for the Territorial Force. By early 1914 1,757 female and 519 male detachments had been registered with the War Office. By this time the VADs had over 74,000 members and of these two-thirds were female.
Right: Queen Mary of Teck and her daughter, Princess Mary (the current Queen’s aunt) who was an enthusiastic supporter of the VAD
On the outbreak of war the VAD members eagerly volunteered for overseas service. The British Red Cross was initially reluctant to allow civilian women to serve overseas in wartime and military authorities would not accept the volunteers at the front. Despite these constraints Katherine Furse managed to get two VADs to France in October 1914, though initially they were restricted to canteen work rather than nursing. However, shortages of help meant that they were transferred into hospital service and performed well as assistants to the regular and reserve nursing staff. This development took place as the growing shortage of trained nurses had become apparent. Only VADs were available to address this shortage and Furse was appointed as Commander-in-Chief, while the previous restrictions were removed. In February 1915, just six months after the outbreak of war, the War Office proposed that volunteers from the VADs could assist at Royal Army Medical Corps (RAMC) hospitals, previously staffed exclusively by Army nurses and men of the RAMC.
A dramatic expansion in the size of the force followed: by 1916 around 8,000 VADs were working in hospitals in the United Kingdom and there were around 4,000 working overseas in theatres of war as varied as the Western Front, Mesopotamia, Malta, Egypt, Italy, Salonika, Serbia, Romania and later the Eastern Front. By the end of the war there were about 80,000 VAD members with 12,000 nurses working in military hospitals at home and overseas, with a further 60,000 unpaid volunteers working as nurses, organising working parties, transport duties and as canteen workers in auxiliary hospitals. A General Service section of the VADs was established in September 1915 and volunteers were employed as clerks, dispensers, cooks and storekeepers. In this way women released over 11,000 men for active service, while male members were sent to work in transport, as ambulance drivers or as hospital orderlies on land and on board hospital ships.
Right: Grace Durant (right) was a Red Cross VAD nurse who served at St David’s Hospital on Malta
A glance of the list of units at which VAD members served in France between 1914 and 1918 gives an idea of the scope of the organisation. There were 33 different types of VAD units in France at any one time, including five rest stations, two detention hospitals, six hostels for the relatives of wounded officers, six convalescent homes, nine recreation huts for soldiers, six ambulance convoys, 20 sick bays for members of the Women’s Auxiliary Army Corps (WAAC), later the Queen Mary’s Army Auxiliary corps (QMAAC), seven Red Cross hospitals, seven rest clubs for nurses plus other locations that had closed by the end of the war. These units varied from tented to hutted camps, and converted private houses of various sizes, in addition to the odd chateau. Although some members were employed in nursing others spent their service on railway stations feeding, tending and transporting the wounded that were being evacuated. Some were engaged in the clerical work generated by the task of keeping track of these casualties and trying to trace the missing. Hospitals produce vast amounts of laundry and some VADS ran the linen stores and associated laundries in all weathers. VADS working on motor ambulances could be drivers or motor mechanics, while others ran simple canteens producing tea, coffee or cocoa for tired soldiers on long marches. The number of personnel in these units varied from a handful to hundreds serving the needs of thousands of service men and women.
Left: The Technical Institute which was turned into an Auxiliary Red Cross Hospital, in Hungerford
The work of the VADs did not just take place overseas and the majority of personnel were engaged in service in the United Kingdom. Once again the work was varied and demanding. The wounded returning by ship to the United Kingdom were received and cared for by VADs and they ran the dockside hospitals for those who required immediate care. The next part of the evacuation chain was by rail and VADs ran the hospital trains in co-operation with the RAMC. Hospitals were established close to ports such as Southampton, but to use the resources of Britain fully others were opened or converted in virtually every major town and city. For example, in East Lancashire alone there were 61 hospitals run by the Red Cross and Order of St John providing 4,227 beds for sick and wounded servicemen. To get the wounded from the station to the hospital itself VADs ran motor ambulances. Some hospitals were established in pre-war civil establishments while others were converted from what had been workhouses or stately homes such as Wrest Park in Bedfordshire. Here the sister of the owner, Nan Herbert, who had previously served at a London hospital, became the Matron and the house could accommodate over 150 patients at a time.
Left: Soldiers preferred VAD hospitals as they were less formal and used for re-cooperation as well as treatment (National Army Museum)
Not all VAD members were involved in nursing care or transport: many thousands were engaged in fundraising for medical supplies, specialist vehicles and humble stretchers. Others were engaged in rolling bandages, making medical ‘comforts’ or the vast amount of administration required for what had become a gigantic organisation. During the war the VAD organisation was run from Devonshire Hose in Piccadilly, which had been loaned for the war by the Duke and Duchess of Devonshire. At the outbreak of war there were about 50,000 VAD members and it has been calculated that between 70,000 and 100,000 women served in Volunteer Aid Detachments at some point during WWI.
Uniforms of the VAD
The VAD uniform for men and women was strictly controlled by the Joint War Committee of the Red Cross and Order of St John, and it changed very markedly between 1909 and the end of the war. One feature of the early female uniform was the Red Cross worn on both aprons and hats; the latter disappeared during the war. Initially it was difficult to distinguish trained military nurses from VADs and in consequence the Joint War committee introduced a new type of cap in late 1915. This was of the handkerchief type and was tied at the nape of the neck. This style of headgear became strongly associated with the Great War VAD. However, trained nurses still tended to wear the army-style ‘veil’ to signify their status. To distinguish between the two organisations, the female VAD members who were part of the Order of St John wore grey dresses while the Red Cross members wore mid-blue. In 1917 a series of white stripes, worn on the sleeve, was introduced for VADs to wear, indicating length of service. Later these were accompanied by stripes in red or blue, indicating that their Matron or Commanding Officer had certified them as ‘efficient’.
Right: Violet Jessop was a volunteer nurse who had the misfortune to be on the Titanic when it sank but had the good fortune to survive
Volunteers for the Nursing Service of the VAD had to be at least 21 years old for home service and 23 for service overseas and of a maximum age of 42 for those overseas and 48 at home. In return they received a uniform allowance, accommodation, food and travel. As volunteers gave their services free and received no salary.
Although VADs were not involved in combat there were casualties. Of the Red Cross’s 128 nursing members, eleven general service members and six Joint War Committee hospital members were killed, together with over 100 VADs not working directly for the organisation. Eight VAD members died in the sinking of the SS Osmanieh in December 1917. Others deaths were due to disease, infection and the flu epidemic of 1918-19, and 498 War Committee Members are listed on the Red Cross Roll of Honour. Of the Order of St John, 1,077 members lost their lives during the course of the war from similar causes.
Right: The annexe at Wardown Park VAD hospital shows these soldiers on the way to recovery
Two of the most famous VADs are Vera Brittain, who wrote Testament of Youth, published in 1933, which recounted her experience serving as a member of the VAD, and the crime novelist Agatha Christie, who wrote of her experience in a posthumously published autobiography. As she had worked as a pharmacy dispenser it may be no coincidence that she had expert knowledge of poisons. Other famous volunteers include aviation pioneer, Amelia Earhart, Carry On actress Hattie Jacques and Violet Jessop who was on the Titanic when it sank.
COLLECTING THE VAD
The hardest things to find are genuine uniforms, as anything worn during the war is at least 100 years old. For the re-enactor, Soldier of Fortune carries replica outfits for under £100 and you can get a repro of a WWI VAD recruiting poster for just £3 or repro badges for £6-£15 on eBay. Note that most of the badges advertised on eBay, even if the listing says ‘Used’ are reproductions. Easier to find original items include period photographs, from around £6, and VAD uniform buttons from £5. There are genuine badges, from £25-£110, depending on the type and rarity. St John’s and Red Cross VAD cloth insignia and VAD armbands can be found for around £25. Another option is that many VAD members were awarded medals for their service so you can find British War and Victory medals to a named person. Typically expect to pay around £15-£25 each.
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