In the early 20th century, although women were advancing in the medical profession, they still had few opportunities in comparison to their male counterparts. In 1914, the Royal Free was the only London hospital to admit female students, while Oxford and Cambridge still refused them. For those lucky enough to obtain a medical degree, job prospects were heavily restricted. Women were often constrained to less specialised spheres such as asylums, dispensaries and general practice. Any that held higher positions, for example as surgeons, worked not in general hospitals but in private institutions for women and children that had been set up by wealthy benefactors.
The outbreak of war in August 1914 introduced new opportunities, and prominent suffragist and surgeon Elsie Inglis took full advantage of them. She established the all-female Scottish Women’s Hospitals for Foreign Service (SWH) to provide medical services on the war front, in partnership with the Scottish branch of the National Union of Women’s Suffrage Societies (NUWSS) and the American Red Cross. The SWH was run entirely on donations and staff received no wages, so extensive fundraising campaigns were carried out across America, Canada, India, Australia and New Zealand.
The organisation had two aims: 1) to support the war effort by providing medical services, and 2) to further the cause for women’s rights by showing they were capable of doing the same work as men during a time of national need. Although the British War Office initially refused the SWH’s offer of service, foreign allies in desperate need of assistance eagerly accepted it.
The Scottish Women’s Hospitals mobilised with astonishing speed. By the end of August, more than £5,000 had been raised. By November the first unit was established, staffed and equipped at Calais to support the Belgian Army, followed in December by a 200-bed auxiliary hospital in the ancient abbey of Royaumont. Eventually, 14 units were established across Europe – in France, Macedonia, Greece, Corsica, Romania, Russia and Serbia (where most SWH efforts were concentrated).
Over 1,000 women, from various backgrounds and nationalities, served with the SWH during the course of the war. They worked as doctors, nurses, administrators, mechanics, ambulance drivers and cooks (such as Ishobel Ross). For these women, the dangerous voyage through the Mediterranean to their posts was a great adventure, their first chance to see some of the world and have new and exciting experiences. In Serbia, especially, they were welcomed with open arms. Diaries and letters record the special relationships many women established with each other and with Serbians, telling stories of picnics, dances, sporting events and nights singing with their patients around campfires.
But for many this great adventure had a much darker side. Serbia had been hit hard by the war, with little Allied assistance and only 300 doctors to treat over half a million soldiers. Conditions were horrendous in badly organised, poorly equipped and unhygienic medical facilities that struggled to deal with both the severity of the wounds they were treating and the volume of patients.
The efforts of the SWH brought great relief. The women introduced safer and more hygienic practices, such as burning contaminated bedding and whitewashing medical buildings. They also operated an organised system, with each unit led by a Chief Medical Officer (CMO) and an administrator. Even so, the SWH units were under extreme pressure, treating not only soldiers in need of complex medical care – from amputation of limbs to treatment of burns – but also civilians. The women were exhausted, often working all day without a break and in bitterly cold conditions.
One of the greatest challenges they faced was in treating and prevent disease. In 1914-15, a typhus epidemic spread around the weakened army and civilian population, eventually killing 150,000. Nurse Louisa Jordan, who was caring for a sick colleague, wrote in her diary: ‘hardly a day passes but there is one or two funerals here.’ A few days later she died too, and so eventually did Madge Fraser, Augusta Minshull and Bessie Sutherland.
In September 1915, Serbia’s depleted forces were forced to draw back, prompting a mass exodus of Serbians into Albania. The Scottish Women’s Hospital staff split into two groups: one followed the retreat into the mountains and the others remained south to face the advancing armies.
Both options were dangerous. Those following the retreat had to deal with plummeting temperatures as they navigated mountain passes, often stumbling across dead bodies. Many thousands of soldiers, civilians and prisoners of war died along the way and Caroline Toughill of the SWH died when the ambulance she was driving crashed. The women who remained south were held captive by enemy forces and had to survive on very little food. They were eventually repatriated to Britain, and most of the women who had retreated into Albania were also allowed to return home. As soon as they were able, many women of the SWH returned to their posts to continue helping with the war effort, supporting Serbian units in their fight to regain their homeland in 1916-18.
Others, including Elsie Inglis and Evelina Haverfield, went to Russia and provided medical care mainly to the Serbian division of the Russian Army – prisoners of war who had volunteered to fight for the Allies. Again they took part in a chaotic retreat when the Romanian Army was routed in 1917.
The Scottish Women’s Hospitals played an extremely significant part in aiding the war effort while furthering the position of women in medicine. Female medics took on responsibilities and roles that they had never before held in hospitals in Britain, and thus were able to develop their skills in more complex procedures. Moreover, people began to notice and appreciate their talents. A Serbian official commented, ‘No wonder England is such a great country if the women are like that’, and The Daily Telegraph reported in 1916: ‘to the women doctors the war has brought triumph.’
To the people they helped, their efforts were not just glowing validations of their abilities but also profoundly heroic and selfless acts. Numerous commemorations have been made to the women of the SWH, including a fountain in the town of Mladenovac, at which the local community holds a remembrance ceremony each year. Across Europe, SWH staff laid down their safety and sometimes their lives so that others might survive and other women in the future might enjoy greater freedoms than they had.
Words by Gemma Close