Tuesday 10 November 2015

Flanders Fields and Bluebirds


To the sound of distant shelling and close screams, they assisted in surgery, cleaned wounds, and comforted the dying. Canada's World War I nurses were as tough and brave as any soldier.

When the "war to end all wars" erupted in 1914, just over 100 nurses with the Canadian Army Medical Corps (CAMC), led by Matron in Chief, Margaret MacDonald, set sail for England.  By 1918, more than 3-thousand women - one third of the all the nurses in Canada - had volunteered, serving in dressing stations near battle fields, casualty clearing stations, and hospitals.  They endured the long hours of exhausting work, and the stress of emergency and intensive care nursing, in rat and lice infested locations in France, Belgium, Greece, Turkey, Egypt and Malta.  Some gave their lives.

The Red Cross in England, recruited volunteers throughout the Commonwealth, and many Canadian women answered the call.  The need was great, and it didn't matter if they were not trained nurses. The Red Cross volunteers were taught first aid, and given white uniforms emblazoned with a large red cross.  They learned hard lessons - fast.  

By contrast, the trained and experienced CAMC nurses, recruited from hospitals and religious nursing orders, were fully integrated into Canada's armed forces.  The nurses were given the rank of Lieutenant, and earned $4.10 a day, compared with Infantry Men on the front lines who's daily earnings were only $1.10. Margaret MacDonald became the first woman in the British Commonwealth to rise to the rank of Major.  With their light blue uniforms, white aprons, and white veils, the CAMC nurses were affectionately known as Bluebirds.   





Entrenched in the war, nurses were never actually in the trenches.  They would be near enough to the battle zone to meet the Stretcher Bearers carrying the wounded on foot, or by ambulance.  Emergency surgery could be performed in Dressing Stations.  Soldiers who survived that ordeal, were then moved to Casualty Clearing Stations.  From there, patients would be taken by truck or rail to Stationary or General Hospitals in France or England.  

Hospitals were not safe from attack. In May of 1918 two Canadian hospitals in Etaples, France were attacked, leaving 66 patients and hospital staff dead, and another 73 injured.  Many patients couldn't move.  Nurses who stayed with immobile patients, were later awarded medals for courage.  

One month later, a German U-boat torpedoed and sank a hospital ship, Llandovery Castle, as it crossed the Atlantic from Halifax, Nova Scotia, Canada to Liverpool, England.  The explosion, sinking and machine-gunning down of anyone who escaped, left 258 crew and medical personnel dead, including 14 nurses.  The war crime was illustrated by G. W. Wilkinson, on the one-year anniversary of the tragic event.



The description of the October 3, 2015 bombing of the neutral Doctors Without Borders/Medecins Sans Frontieres hospital in Kunduz, Afghanistan, by American forces, is eerily similar to the accounts from the survivors of the WWI hospital bombings, nearly one hundred years earlier.  The bombings were relentless, patients who couldn't move, burned to death on hospital tables, doctors and nurses were shot from above, as they helped patients evacuate.





In the Great War, bullets and explosions tore limbs and faces off soldiers, yet, it was infection and contagious disease that killed the most people.  The trenches were dug from manure laden farm fields, and even the smallest open wound was susceptible to infection.  In the years before antibiotics, nurses applied Sodium Hypochlorite directly over wounds.  Wound cleaning and inspection was one of the most important nursing duties.  Keeping a sterile environment was nearly impossible.

Soldiers shot in the torso, rarely survived, so few are even listed in hospital records.  As for head injuries, the war was already a year old before someone thought to give the men helmets.  Explosions maimed soldiers so badly, that limbs were frequently amputated.  Nurses were helpless to deal with both the surgical pain, and the long term phantom pain of lost limbs.  Sometimes, all they could do was keep up a soldier's spirits with talk of life back home.

Soldiers died of something as relatively simple as a broken femur.  At the start of the war, 80% of soldiers with a broken femur, died.  Then, Dr. Hugh Owen Thomas, a Welsh Surgeon invented the Thomas Splint to secure a broken leg.  Two years later, a soldier nursed back to health with the aid of a splint, had an 80% survival rate.

Looking at a soldier being brought in on a stretcher, a nurse could quickly tell by his pale face, and cold sweat, that he was experiencing hemorrhagic shock.  Blood loss was a serious issue.  The British Army came up with a way of transferring blood on the spot, from a healthy person, to the injured.  In 1917, an American Army Doctor created the first blood bank, enabling doctors to keep blood for up to 28 days.  Demand led to innovation - advancements welcomed by nurses.

If a soldier survived a blast, and the wounds healed, Tuberculosis or Typhus could kill him. Tuberculosis quickly spread in the cramped trenches.  Typhoid Fever was spread by lice.  Standing in water-filled trenches, soldiers' feet would get "Trench Foot", an infection which led to tissue decay, and death.

Post Traumatic Stress Disorder, or as it was then called, "Shell Shock" would give wounded soldiers terrifying nightmares, and high anxiety, with sometimes violent mood swings.  Nurses had to be strong enough to defend themselves and other patients from attacks from mentally ill soldiers.

As the war drew to an end, weary nurses could not imagine the horror of the Spanish Flu, which they were about to face.




In the last months of World War I, the Spanish Flu swept around the world, killing 50-million people. It was called "Spanish" because Spain was the only country allowing uncensored dispatches on the disease.  The disease's origins were at first believed to be the battle grounds of Etaples, France, which suffered the devastation of air raid bombings in 1918.  Then, researchers thought the deadly flu strain started with soldiers at the US central training base of Camp Funston, Kansas.  In March of 1918, a new strain of flu, had killed 48 men, just as new recruits were shipped out to France.

New research by Mark Humphries, an Historian at Newfoundland's Memorial University, points to the tens of thousands of Chinese labourers brought in to work behind the British and French lines. Humphries says officials ignored plague restrictions, and brought in workers from a region of China which had an epidemic.  The labourers arrived in Vancouver, and were shipped across Canada in sealed rail cars.  Of the 96-thousand Chinese labourers who worked behind the lines, 25-thousand arrived by rail, and of those, three-thousand ended up in quarantine with the flu.  Racist doctors labelled them lazy, and sent them out to work among the healthy soldiers.  Spanish Flu targeted the immune systems of healthy, young people - much like SARS - and nurses were susceptible.       




Every Canadian school child learns to recite, In Flanders Fields, the hauntingly beautiful poem by Guelph, Ontario-born physician, Lieutenant Colonel John McCrae.  More than half of the doctors in Canada, served overseas in the First World War, and McCrae was one of them.  A 41 year old veteran of the South African War, the Montreal pathologist and McGill University lecturer, enlisted in WWI primarily as a Gunner, and secondly as a Doctor.  He thought he could do more to win the war, by being in the trenches.

He and his close friend, Alexis Helmer fought in the second battle of Ypres, in Belgium's Flanders region.  Canadian troops were attacked with chlorine gas on April 22, 1915, and the Canadians fought a battle that lasted a sleepless 17 days and nights. Helmer was killed on May 2, and McCrae buried him.

The next day, McCrae wrote In Flanders Fields.  He crumpled it up, and tossed it aside.  One of his fellow soldiers retrieved it, and his friends urged him to have it published.  London's Spectator rejected it.  It was published in Punch, in December of 1915, with a change in the first line, from "poppies grow", to "poppies blow".  One hundred years later, In Flanders Fields is recited at the eleventh hour, on the eleventh day, of the eleventh month, at every Remembrance Day ceremony, in every town and city across the land.

In late 1917, while stationed at Boulogne, France, McCrae was promoted to acting Colonel, and came down with pneumonia the same day.  He then developed Meningitis, and died on January 28th, 1918. Nurses placed poppies on his grave.



Photographs Copyright of: Ruth Adams, Widow's Endorphins Photographic Images Incorporated

Poppies, the colour of life-giving blood, are a symbol of remembrance of the war dead.  The blue Cornflowers on the French water pitcher, are a symbol of those wounded in war.  The blue flowers recall the wounded soldiers who recovered in France's Les Invalides Hospital, by making blue coloured cloth.  Fields or bouquets of poppies, cornflowers and white daisies are iconic images in France.

Image of two laughing Canadian Army Medical Corps nurses, and the lone nurse in front of a tent, all courtesy of Canadian War Museum archives.
Image of the sinking of the Llandovery Castle, courtesy of McMaster University Libraries, digital archives.
Image of the bronze book shaped plaque of the poem, at the John McCrae memorial in Guelph, Ontario, courtesy of Wikimedia Commons.




    

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