In 1909 it was decided to form Voluntary Aid Detachments (VADs) to provide medical assistance in time of war. By the summer of 1914 there were over 2,500 Voluntary Aid Detachments in Britain. Of the 74,000 VADs in 1914, two-thirds were women and girls.
Katharine Furse took two VADs to France soon after the outbreak of the First World War. After establishing a hospital at Boulogne, Furse returned to London where she became Commander-in-Chief of the organisation. During the next four years 38,000 VADs worked as assistant nurses, ambulance drivers and cooks. VAD hospitals were also opened in most large towns in Britain.
Furse sent all VAD recruits a letter that stated: "You are being sent to work for the Red Cross. You have to perform a task which will need your courage, your energy, your patience, your humility, your determination to overcome all difficulties. Remember that the honour of the V.A.D. organisation depends on your individual conduct. It will be your duty not only to set an example of discipline and perfect steadiness of character, but also to maintain the most courteous relations with those whom you are helping in this great struggle. Be invariably courteous, unselfish and kind."
Furse went on to point out: "Remember that whatever duty you undertake, you must carry it out faithfully, loyally, and to the best of your ability. Rules and regulations are necessary in whatever formation you join. Comply with them without grumble or criticism and try to believe that there is reason at the back of them, though at the time you may not understand the necessity." Enid Bagnold, worked as a VAD nurse at the Royal Herbert Hospital, Woolwich, did not keep to this rule. Her account of this experience, Diary Without Dates (1917) was so critical of hospital administration that the military authorities arranged for her dismissal. H. G. Wells described it as one of the most human books written about the war.
Government poster (1914)
At first the military authorities were unwilling to accept VADs on the front-line. However, this restriction was removed in 1915 and women volunteers over the age of twenty-three and with more than three months experience, were allowed to go to the Western Front, Mesopotamia and Gallipoli. Later VADs were sent to the Eastern Front.
Vera Brittain was one of those sent to France. She wrote about her experiences as am a Sister VAD in her autobiography, Testament of Youth (1933). "Quite apart from the nursing, I have stoked the fire all night, done two or three rounds of bed pans, and kept the kettles going and prepared feeds on exceedingly black Beatrice oil stoves and refilled them from the steam kettles utterly wallowing in paraffin all the time. I feel as if I had been dragged through the gutter. Possibly acute surgical is the heaviest type of work there is, I think, more wearing than anything else on earth. You are kept on the go the whole time but in the end there seems to be nothing definite to show for it - except that one or two are still alive that might otherwise have been dead... Gazing half hypnotized at the disheveled beds, the stretchers on the floor, the scattered boots and piles of muddy clothing, the brown blankets turned back from smashed limbs bound to splints by filthy bloodstained bandages. Beneath each stinking wad of sodden wool and gauze an obscene horror waited for me and all the equipment that I had for attacking it in this ex-medical ward was one pair of forceps standing in a potted meat glass half full of methylated spirit."
The standard of treatment on the Eastern Front tended to be poor. Florence Farmborough went to work in Podgaytsy Hospital in Russia. "I was surprised and not a little perturbed when I saw that tiny bags, containing pure salt, are sometimes deposited into the open wound and bandaged tightly into place. It is probably a new method; I wonder if it has been tried out on the Allied Front. These bags of salt - small though they are - must inflict excruciating pain; no wonder the soldiers kick and yell; the salt must burn fiercely into the lacerated flesh. It is certainly a purifier, but surely a very harsh one! At an operation, performed by the lady-doctor, at which I was called upon to help, the man had a large open wound in his left thigh. All went well until two tiny bags of salt was placed within it, and then the uproar began. I thought the man's cries would lift the roof off; even the lady doctor looked discomforted. 'Silly fellow,' she ejaculated. 'It's only a momentary pain. Foolish fellow! He doesn't know what is good for him.'".
Wounded soldiers in hospital in Antwerp (1918)
Mary Borden was an American who worked in an Allied hospital in Dunkirk. She later wrote about it in her autiobiography, The Forbidden Zone (1929): "It was my business to sort out the wounded as they were brought in from the ambulances and to keep them from dying before they got to the operating rooms: it was my business to sort out the nearly dying from the dying. I was there to sort them out and tell how fast life was ebbing in them. Life was leaking away from all of them; but with some there was no hurry, with others it was a case of minutes. It was my business to create a counter-wave of life, to create the flow against the ebb. If a man were slipping quickly, being sucked down rapidly, I sent runners to the operating rooms. There were six operating rooms on either side of my hut. Medical students in white coats hurried back and forth along the covered corridors between us. It was my business to know which of the wounded could wait and which could not. I had to decide for myself. There was no one to tell me. If I made any mistakes, some would die on their stretchers on the floor under my eyes who need not have died. I didn't worry. I didn't think. I was too busy, too absorbed in what I was doing. I had to judge from what was written on their tickets and from the way they looked and they way they felt to my hand. My hand could tell of itself one kind of cold from another. My hands could instantly tell the difference between the cold of the harsh bitter night and the stealthy cold of death."
Some women went to the Western Front as letter writers for soldiers who were either too ill or too illiterate to write their own letters. May Bradford, the wife of John Rose Bradford, Physician to the British Expeditionary Force, later recalled how she educated men on the treatment of women: "To one man I said, 'Shall I begin the letter with my dear wife?' He quietly answered: 'That sounds fine, but she'll be wondering I never said that before.' ... One day a youth was brought in with both eyes shot away. After all his messages to his wife and children had been written down, he put up his hand to try and find mine. 'Sister', he said, 'is it a fine day, and are the birds singing?' I pictured it all to him. 'Well,' he answered, 'I have much to live for still.'
May Bradford, hospital letter-writer in France.
Primary Sources
(1) Letter from Katharine Furse, B.R.C.S., the Commandant-in-Chief, Women's Voluntary Aid Detachment, to serving VAD nurses (1914)
This paper is to be considered by each V.A.D. member as confidential and to be kept in her Pocket Book.
You are being sent to work for the Red Cross. You have to perform a task which will need your courage, your energy, your patience, your humility, your determination to overcome all difficulties.
Remember that the honour of the V.A.D. organisation depends on your individual conduct. It will be your duty not only to set an example of discipline and perfect steadiness of character, but also to maintain the most courteous relations with those whom you are helping in this great struggle.
Be invariably courteous, unselfish and kind. Remember that whatever duty you undertake, you must carry it out faithfully, loyally, and to the best of your ability.
Rules and regulations are necessary in whatever formation you join. Comply with them without grumble or criticism and try to believe that there is reason at the back of them, though at the time you may not understand the necessity.
Sacrifices may be asked of you. Give generously and wholeheartedly, grudging nothing, but remembering that you are giving because your Country needs your help. If you see others in better circumstances than yourself, be patient and think of the men who are fighting amid discomfort and who are often in great pain.
Those of you who are paid can give to the Red Cross Society which is your Mother and which needs more and more money to carry on its great work. their Mother Society and thus to the Sick and Wounded.
Let our mottos be 'Willing to do anything' and 'The People give gladly'. If we live up to these, the V.A.D. members will come out of this world war triumphant.
(2) Catherine Cathcart-Smith was 24 when she joined the VADs in 1914. She was interviewed about the war in 1993 when she was 104 years old.
I wanted to do my bit for the war so I volunteered to drive an ambulance. We had to meet the troop trains at the big London railway stations - Waterloo and Victoria. The trains had hundreds of wounded soldiers packed on them. Their wounds were were frightful. Young men with no arms or legs. Many had been gassed. Others blinded. I had two nurses with me, we made a good team. One day I saw this young man on a stretcher. It was my brother, so I said to the soldiers who were carrying him: "Put him in my ambulance, I am his sister." When he died the next day I was with him, holding his hand.
The Pole sisters (Gladys, Hilda, Lily and Muriel) all joined the Voluntary Aid Detachment in Chislehurst.
In 1915, with Dick away I became more and more impatient with Oxford and my own non-involvement. Girls I knew had gone to do 'war work'; one or two were even in munitions factories. And at least I had passed first aid and home nursing examinations and what was more Sister Morag Macmillan had chosen me as the one to whom she could teach massage, feeling the hands of half a dozen girls and rejecting them before taking me on. Whether she knew I had some capacity as a healer which might be brought out is something else again; had she sensed that she would wisely have said nothing about it.
I nagged and nagged and finally went off to be a VAD nurse at St. Thomas's along with May Douie, an Oxford friend whom I did not know very well. I had no idea what a hospital was really like; I doubt if I had ever been inside one. Our friends and relations would never find themselves in a hospital; they went to nursing homes, especially the Acland at Oxford, though there might well be arrangements there for almost free treatment in certain cases. Some nursing homes or small, special hospitals were quite well endowed. So St. Thomas's was something of a shock; the size, the long, clattering corridors and staircases and the huge, undivided wards. Everything was, no doubt, sanitary, but there were no frills.
Of course I made awful mistakes. I had never done real manual household work; I had never used mops and polishes and disinfectants. I was very willing but clumsy. I was told to make tea but hadn't realised that tea must be made with boiling water. All that had been left to the servants.
Once when lifting a heavy patient my collar stud flew out and my stiff collar opened. Oh, dear! At that time we all wore stiff white cuffs, collar and belt into which we stuck our scissors, so much needed for bandages, dressings and sewing. One's blue skirt was ankle length with a long white apron over it. I ought to have had a proper uniform coat to go out in, but my mother had economised on that, thinking my own old one would do as well, but again I got an official scolding.
I am a Sister VAD, and orderly all in one. Quite apart from the nursing, I have stoked the fire all night, done two or three rounds of bed pans, and kept the kettles going and prepared feeds on exceedingly black Beatrice oil stoves and refilled them from the steam kettles utterly wallowing in paraffin all the time. I feel as if I had been dragged through the gutter. Possibly acute surgical is the heaviest type of work there is, I think, more wearing than anything else on earth. You are kept on the go the whole time but in the end there seems to be nothing definite to show for it - except that one or two are still alive that might otherwise have been dead.
The picture came back to me of myself standing alone in a newly created circle of hell during the 'emergency' of March 22nd 1918, gazing half hypnotized at the disheveled beds, the stretchers on the floor, the scattered boots and piles of muddy clothing, the brown blankets turned back from smashed limbs bound to splints by filthy bloodstained bandages. Beneath each stinking wad of sodden wool and gauze an obscene horror waited for me and all the equipment that I had for attacking it in this ex-medical ward was one pair of forceps standing in a potted meat glass half full of methylated spirit.
The cold is terrific; the windows of the ward are all covered with icicles. I'm going about in a jersey and long coat. By the middle of December out kettles, hot water bottles and sponges were all frozen hard when we came off duty if we had not carefully emptied and squeezed them the night before. Getting up to go on duty in the icy darkness was a shuddering misery almost as exacting as an illness.
Our vests, if we hung them over a chair, went stiff and we could keep them soft only if we slept in them. All the taps froze; water for the patients had to be cut down to a minimum and any spilt in the passages turned in a few seconds to ice.
(5) Lesley Smith worked as a VAD at the Royal Sussex Hospital in Brighton during the early stages of the First World War. Later she was posted to a field hospital on the Western Front.
Day after day we cut down stinking bandages and exposed wounds that destroyed the whole original plan of the body. One man had both buttocks blown off, one arm had been amputated at the elbow, and he had a host of smaller wounds from flying metal. Another lay propped on sphagnum moss to absorb the discharge from two large holes in each thigh.
(6) In May 1917 Florence Farmborough, a Red Cross nurse, saw British VAD nurses working in Podgaytsy Hospital in Russia.
I was surprised and not a little perturbed when I saw that tiny bags, containing pure salt, are sometimes deposited into the open wound and bandaged tightly into place. It is probably a new method; I wonder if it has been tried out on the Allied Front.
These bags of salt - small though they are - must inflict excruciating pain; no wonder the soldiers kick and yell; the salt must burn fiercely into the lacerated flesh. It is certainly a purifier, but surely a very harsh one!
At an operation, performed by the lady-doctor, at which I was called upon to help, the man had a large open wound in his left thigh. All went well until two tiny bags of salt was placed within it, and then the uproar began. I thought the man's cries would lift the roof off; even the lady doctor looked discomforted. "Silly fellow," she ejaculated. "It's only a momentary pain. Foolish fellow! He doesn't know what is good for him."
(7) On the outbreak of the was Enid Bagnold joined the Voluntary Aid Detachments (VADs) and worked as a nurse at the Royal Herbert Hospital, Woolwich. Her account of this experience, A Diary Without Dates in 1917 was so critical of hospital administration that the military authorities arranged for her dismissal.
It was the first time I had a man sing at his dressing. I was standing at the sterilizer when Rees's song began to mount over the screen that hid him from me.
It was like this: "Ah... ee... oo, Sister!" and again: "Sister... oo... ee... ah!" Then a little scream and his song again.
I heard the Sister's voice: "Now then, Rees, I don't call that much of a song. " She called me to make her bed, and I saw his left ear was full of tears.
Oh visitors, who come into the ward in the calm of the long afternoon, when the beds are neat and clean and the flowers out on the tables and the VAD's sit sewing at splints and sandbags, when the men look like men again and smoke and talk and read... if you could see what lies beneath the dressings!
It was my business to sort out the wounded as they were brought in from the ambulances and to keep them from dying before they got to the operating rooms: it was my business to sort out the nearly dying from the dying. I was there to sort them out and tell how fast life was ebbing in them. Life was leaking away from all of them; but with some there was no hurry, with others it was a case of minutes. It was my business to create a counter-wave of life, to create the flow against the ebb.
If a man were slipping quickly, being sucked down rapidly, I sent runners to the operating rooms. There were six operating rooms on either side of my hut. Medical students in white coats hurried back and forth along the covered corridors between us. It was my business to know which of the wounded could wait and which could not. I had to decide for myself. There was no one to tell me. If I made any mistakes, some would die on their stretchers on the floor under my eyes who need not have died. I didn't worry. I didn't think. I was too busy, too absorbed in what I was doing. I had to judge from what was written on their tickets and from the way they looked and they way they felt to my hand. My hand could tell of itself one kind of cold from another. My hands could instantly tell the difference between the cold of the harsh bitter night and the stealthy cold of death.
(9) Poem sent out by Katharine Furse to all VAD nurses (1914)
And only the Master shall praise us, and only the Master shall blame.
And no one shall work for money, and no one shall work for fame,
But each for the joy of working, and each in his separate star,
Shall draw the thing as he sees it for the God of things as they are.
(10) May Bradford later wrote about her experiences as an official letter writer on the Western Front.
One day a youth was brought in with both eyes shot away. After all his messages to his wife and children had been written down, he put up his hand to try and find mine. "Sister", he said, "is it a fine day, and are the birds singing?" I pictured it all to him. "Well," he answered, "I have much to live for still."
