Louise Bell is researching the impact that war wounds of all kinds had on people and society during World War I.  Caring for the wounded was a vital, complex process involving many people, institutions and activities, and it continued long after a wounded person was evacuated from the battlefield.  Digging In’s Ned Suesat-Williams spoke to her about her findings.

Louise is the First World War Diverse Histories researcher at the National Archives.  With its focus on those disabled by the war, her work is revealing how complex were the issues faced by those returning from the front line. She offers some tips for your own research in the National Archives.

 RAMC stretcher bearers, 20th November 1917 (© IWM Q3180).

RAMC stretcher bearers, 20th November 1917 (© IWM Q3180).

 NSW – So to begin with, can you tell us a little about the world that the wounded returned to, and the kinds of care that were on offer?

LB – Nearly 6 million British and German men were disabled by injury or disease in the period 1914-1918. With regards to Britain, around 41,000 men returned missing one or more limbs – the majority of these being leg cases. Hospitals were set up to try and aid with the increasing number of limbless men who were being sent back to Britain. These were mainly set up within various stately homes and country mansions, which were taken over for the duration of the conflict. But it was the opening of hospitals specifically to aid and care for those who needed new limbs.

Yet it was the establishment of The Princess Louise Scottish Hospital For Limbless Sailors And Soldiers at Erskine House, and the Queen Mary Convalescent Auxiliary Hospital at Roehampton, which had some of the greatest impacts, as well as being two of the most well known of the hospitals dedicated to such a task. Limbs were created and supplied to these men, and were expertly fitted at such institutions. People were keen to support these institutions – as highlighted by the fact that by June 1915, donations totalling £19,715 had been subscribed to the hospital fund for Roehampton. Naming beds after those who donated was another tool used in order to gain support for the hospital. Who could resist having their name attached to such a cause, if they could afford to give enough money?

Rehabilitation played a huge role in the work undertaken at the hospitals set up to deal with the men who were injured due to the war. Allowing these men the chance to have a new limb attached was all good and well, but without proper instruction in how to use, and adapt to having, such a limb, life for them could have proven to be even more difficult.

The rehabilitation process usually took two paths: that of sport and exercise, and that of teaching the men trades and work that they could undertake even with their artificial limbs. Still, rehabilitation did not just cover those who had lost an arm or a leg, but also those who had paralysis, complete or partial, of an arm, leg, foot, hand, and so on.

Leisure activities, such as football, played a huge role in allowing these men to feel as they did before they went off to war. It added a semblance of normality to their lives. Learning a trade, and being able to attend work bureaus set up by these institutions, also added a sense of ‘usefulness’ to their lives.

Many men also returned from the Front with a facial disfigurement. A few options were available to them, including: undergoing plastic surgery; wearing a mask; never going out in public; or wearing the scars with pride. For those who opted for plastic surgery, Harold Gillies and the hospital at Sidcup were where they wanted to end up.

Despite surgical advances, these facial disfigurements could remain profound. Even after undergoing what could be deemed successful reconstructive surgery, many men still continued to cover their faces. Within hospitals, mirrors were covered in order to stop them from seeing their reflections whilst they were undergoing the reconstruction process. Outside, benches were specially painted blue, in order to designate them for these men. However, the bright blue was also a marker to the public – to warn that the appearance of the men seated upon them could be distressful to some.

For men who returned from the Front suffering from blindness, once more, special hospitals and institutions were set up. The most well known of these was St Dunstan’s (now Blind Veterans UK) – originally set up as the Blinded Soldiers and Sailors Care Committee in January 1915. Again, rehabilitation was the primary focus of St Dunstan’s. Men were trained in trades, and leisure and sports activities were also encouraged. They were also taught to read braille.

Blind soldiers and sailors learning poultry farming at Fawkham (© IWM Q54571).

Blind soldiers and sailors learning poultry farming at Fawkham (© IWM Q54571).

NSW – Can you tell us more about how the wider war effort impacted on the lives of those traditionally not considered at risk?

LB – One did not have to be a soldier on the front line to sustain an injury relating to war or the war effort. Nurses who were serving near the Front were susceptible to suffer from injury, in the physical sense. But the constant shelling and barrage could also have an effect on their mental health. Likewise, working in such close proximity to these injured men and to the unpleasant conditions of the trenches meant that it was not uncommon for them to contract some form of disease or sickness.

Nurses who were serving back home in England were still known to leave service with some nervous ailment, after some of the horrible injuries they had witnessed and worked with. Those working at home for the war effort were also not safe.

Women working in munitions factories were often dubbed ‘canaries’ after the chemicals used in production started to turn their skin yellow. Working with munitions was a highly dangerous job in general, with the potential for explosions to occur. One of the worst medical disasters which occurred in the period of the war was the Spanish flu. This affected everyone from troops to those back home, killing millions. Unlike most influenza, it did not have such a devastating effect on the very young and the elderly. Instead, it had the worst impact on those in the middle age range – previously young, healthy adults.

Nurses and soldiers survey damage sustained during the bombardment of a hospital, 2nd June 1918 (© IWM Q11541).

Nurses and soldiers survey damage sustained during the bombardment of a hospital, 2nd June 1918 (© IWM Q11541).

NSW – We have become increasingly aware of less visible injuries such as post-traumatic stress in recent years. Is there much in the way of a recognition of these issues in the records of the time?

LB – Our records series of PIN 26 and MH 106 both contain records relating to injury such as neurasthenia and shell shock.

PIN 26 contains a representative selection of case files of the Ministry of Pensions concerning was disability pension awards. The cases selected cover all types of disability pensions awarded after the First World War, and include files for serving men and officers, army, navy and air force, widows and dependants and nurses. This series can be searched using terms such as ‘neurasthenia’ and ‘shell shock’ to find results; the same goes for any injury that one might be interested in researching.

MH 106 contains First World War representative medical records of servicemen. The records include admission and discharge registers from hospitals and casualty clearing stations, field ambulances, an ambulance train and a hospital ship. There are also medical sheets, selected to illustrate the diversity of diseases contracted, injuries received and treatments prescribed and medical cards relating to individuals in selected regiments.

We have a wonderful record regarding the Khaki Handicrafts Club in Bradford (RAIL 491/854), which was set up to give men suffering from shell shock a calm place to go and undertake activities such as basket weaving and embroidery. The thought that has gone into this room is great to read – the walls are painted in cheerful colours and the room is airy and full of light. The atmosphere seems to be one where men can enjoy the tasks they are undertaking; feel useful, and most importantly, feel safe whilst they are participating in these crafts.

Our records also contain the service record (WO 339/35077) and court martial proceedings (WO 71/1027) for Eric Poole. In 1916, he was arrested and tried for deserting when on active service, after having wandered away from his platoon. According to the medical history sheet compiled for Poole’s general court martial in November 1916, he suffered from ‘shell shock’ after being hit by clods of earth distributed by an enemy shell during fighting on the Somme on 7 July 1916. Later, Poole stated that he often felt confused and this was why he wandered away from his platoon.

Even with an officer of the Royal Army Medical Corps speaking on his behalf and stating that his nerves were clearly shot, Poole was found guilty of desertion and sentenced to death by firing squad. What makes this sentencing all the more surprising is that Poole was an officer.

Staff and wounded in a hospital ward in France, 7th July 1917 (© IWM Q2505).

Staff and wounded in a hospital ward in France, 7th July 1917 (© IWM Q2505).

NSW – Looking at the archival material, do you think that the experiences of people injured during the wider First World War changed how disability was seen by the public, and if so, in what ways?

LB – In terms of disability being recognised more and discussed more, then, yes, I think that WW1 made disability a much more prominent issue in society. That they are starting to have more of an understanding of mental health and the link to trauma and warfare becomes more evident.

However, a lot of the cases come under ‘neurasthenia’, which seems to be a term used as catch all for incidents and ailments that can’t quite be put under any other existing category. And there was reluctance within the military to allow shell shock to be seen as a result of war unless it was physically caused by the impact of a shell and not just from the wearing down that occurred from the constant fear and noise associated with barrage.

There was much more emphasis on rehabilitating these men and allowing them to return to work, than there would have been previously – but again, this could have more to do with needing them to be able to contribute to society and, more importantly, the economy.

The story of one ex-serviceman, Thomas Kelly, a private in the Gordon Highlanders, and a man who returned from the First World War in receipt of a 100% disability pension after having both of his legs amputated above the knee, is shown through records held in LAB 2/1195/TDS2884/1919.

He wrote in a letter: ‘But now when I am a maimed and not fit for manual labour, this country has no further use for us.’ These may be the words of one disgruntled ex-serviceman who returned from the war with a disability, but his situation was not an unfamiliar one. Kelly’s letter allows us to springboard into the wider story of returning to employment, which again allows us to return to the ideas of workshops and employment bureaus set up in order to aid disabled men.

Convalescing soldiers in Edinburgh with teacher Miss Heddewick, showing the toys they have made (© IWM Q108094).

Convalescing soldiers in Edinburgh with teacher Miss Heddewick, showing the toys they have made (© IWM Q108094).

You can find out more by reading Louise’s blog post about Thomas Kelly.

In the Digging In mobile app you can hear oral histories on tending to the wounded in WWI.  The app is available to download for FREE for both Android and iOS.