Nursing Memorial Appeal

Women in the Voluntary Aid Detachment (VADs)

The early days and the Great War

by Sue Light

There had been concern ever since 1902 and the end of the war in South Africa, that in the event of another war the medical and nursing services wouldn't be able to cope sufficiently. There was always a fundamental problem that the peacetime needs of a standing army, in relation to medical care, were very small and specific, and to find thousands of trained and experienced personnel at very short notice, without the expense of maintaining them in peacetime, was a difficult problem to overcome. R. B. Haldane's new Territorial scheme of 1907 solved some of those problems, and opened up new possibilities of co-operation between voluntary agencies and the Army, and on the 16th August 1909 the War Office issued its 'Scheme for the Organisation of Voluntary Aid in England and Wales,' which set up  Voluntary Aid Detachments to fill certain gaps in the territorial medical services, with a similar scheme for Scotland following in December 1909. By early 1914, more than 1700 (1757) female detachments had been registered with the War Office.

They consisted of a Commandant, a Medical Officer, a Quartermaster, and twenty-two women, two of whom were to be trained nurses, although even finding one could be difficult in some rural areas, so this was reviewed and altered in 1910 to just one trained nurse.

Pre-war, the Detachments varied in how seriously they took their responsibilities. Some were ill-equipped, poorly managed and staffed, and put in only a minimum of effort to meet the standards required by the Territorial County Associations. Others were intent on being as prepared as possible for a role that they might never be called upon to fulfil. The detachments were intended for home service - just in the United Kingdom - to staff auxiliary hospitals and rest stations. They were to receive no payment or salary for these duties - 'voluntary' was the vital word.

Detachments had to meet at least once a month, with many meeting as often as weekly, and women had to work towards gaining certificates in Home Nursing and First Aid within twelve months of joining, and they learned to bandage, to do simple dressings, and the basics of invalid cookery and hygiene. In some areas it was arranged for them to go into local hospitals for a few hours each week to gain an insight into ward work, and due to the low number of men being recruited in certain places, women could also gain experience in outdoor activities, stretcher duties, the transport of sick and wounded and improvisation with whatever came to hand.

The women who joined Detachments were a mixture - a wide range of ages and with different sorts of life skills, but as a group they were very much defined by being middle or upper middle-class. And middle-class not by today's standards, whereby almost everyone calls themselves middle-class, but they were the daughters of local gentry, landowners, army officers, the clergy, and professional men, and also included a good sprinkling of women with an aristocratic background. The majority were young women who had never had any paid employment, and of those who eventually went on to wartime service more than three-quarters had either never worked outside the home, or had done work which qualified them for payment of a minor nature. Generally speaking, women of their class were not expected to work - they moved from their parents' home into marriage and running a home of their own, and if they remained single then they would in all likelihood eventually take responsibility for the care of their elderly parents. One VAD, the daughter of a Yorkshire lawyer, explained:

Irene Rathbone wrote an autobiographical novel about her life and war service called 'We that Were Young,' and in the introduction to this book, Elizabeth Delafield wrote in 1931:

Home life, particularly in rural areas, must have been stifling for intelligent young women, and the chance to get away, if only for a few hours a week, and make new friends and acquire new skills, would have been a real attraction. This 'breakaway' was often found acceptable by parents, as it was considered that the new knowledge would serve the women well in their future lives - to know the basics of home nursing, first aid and invalid cookery would always be useful for the well-rounded wife and mother.

For some women, the chance of a few days away at summer camp alongside members of the Territorial Force, was an occasion to remember for a lifetime - or it might have been, if something rather bigger hadn't come along. Those women probably never thought in 1909 that within a very short time they would be experiencing things that few women had ever experienced before, and not many ever would again. They were on the brink of something quite unique.

When war came, the Red Cross and Auxiliary hospitals, already prepared, sprung up rapidly in church halls, public buildings and private houses, accommodating anything from ten patients to more than a hundred. Many of the men were the less seriously wounded and convalescents transferred from larger military hospitals. The proportion of trained nurses in the units was small, and much of the basic work was the responsibility of the VADs - they cleaned, scrubbed and dusted, set trays, cooked breakfasts; they lit fires and boiled up coppers full of washing - these were things many of them had never even witnessed before, let alone taken part in. They also helped to dress, undress and wash the men - which was of course a step even further for young women who may never have been alone and unchaperoned with a member of the opposite sex before, other than their brothers. But it was their strong sense of patriotism and the need to help the war effort that gave them the maturity and common sense to succeed in these difficult areas.

During wartime, the VAD organisation was administered by the Joint War Committee of the British Red Cross Society and St. John of Jerusalem and run from Devonshire House in Piccadilly, loaned for the War by the Duke and Duchess of Devonshire. Its palatial rooms became a myriad of offices that dealt with recruiting, training, and managing the staff of hundreds of VAD and auxiliary hospitals at home, and sending staff to hospitals overseas. Many new recruits to the service would have trodden the corridors there, to be interviewed, measured and kitted out ready to be added to the ever-growing ranks, the ranks which doubled during the course of the war. To try and quote statistics and numbers is very hard, as every source seems to suggest a different figure. There were about 50,000 women involved in the movement immediately before the war, some in a very minor role - we know that about 10,000 served in hospitals under the direction of the War Office and 8,000 VADs served overseas. It is thought that in total somewhere between 70,000 and 100,000 women served as VADs at some time during the war, although some for very short periods.

If the war had been a short one, and a small one, perhaps the military nursing services would have managed without additional help. But by early 1915 it was already evident that there were not enough trained nurses to keep the British military hospitals staffed, and the War Office agreed that VADs could be employed in the large military hospitals at home to augment the trained staff, and by early summer of that year, 1915, in overseas hospitals as well. It was not a universally popular move, with much wariness and mistrust on behalf of some of the trained staff, but the meeting and the mixing of the two groups was inevitable.

Many trained nurses didn't want to work alongside the amateur nurse in wartime - there was a feeling among them that patriotism was no substitute for professionalism, and this made life difficult for the VAD, although on the other hand, there were VADs who were in no way suited to nursing, and some who wanted the status and glory of war service, but simply had no aptitude for practical work.

For employment in military hospitals as nursing VADs, i.e. hospitals under the direction of the War Office, women had usually worked for at least six months initially in a hospital under the control of the Joint War Committee. In those hospitals they did not get paid, although if living away from home would get board and lodging provided. On transfer to hospitals under War Office control, they were initially paid £20 a year, with allowances for uniform, board and lodging, laundry, fuel and light and further amounts if serving overseas, which in total added up to at least £115 a year in payment or kind. However, the vast majority of women who served during the Great War were not working in these military hospitals; they were in smaller VAD and auxiliary units, and therefore the whole of their service was unpaid. It's also true that the majority did not work throughout the war, with some leaving after a just a few weeks or months, but it's still hard to imagine many young women today working for nothing at all - to work for nothing, for up to four or five years was indeed a gift to the nation.

VADs sometimes considered that they were treated as little more than domestic staff, and given very little responsibility, but nursing had always been an onerous and difficult life. In the normal way, when a girl entered nurse training as a probationer she was well aware of what lay ahead, particularly in the early days.

But most VADs had never intended to become nurses before the war, and some were not prepared for the repetitive, mundane work, the discipline and petty rules which abounded in hospital. Neither were they, for the most part, women who were used to taking orders from others - some found it difficult for the 'mistress and servant' role to be reversed and occasionally saw their treatment as bullying, although they were being treated no differently from the average student nurse of the time.

In 1916, some humorous rules for VADs appeared in the hospital magazine of No.1 Eastern General Hospital, Cambridge, the first of which rather aptly read:

There were a number of complaints about the meanness of allowances - not being able to claim any travelling expenses when attending an initial interview or when going home on leave. In a complaint to Devonshire House one woman wrote:

Another, although she liked her work, could stay no longer at Queen Mary's Hospital in Whalley, Lancashire, as she felt the men were, in her words, 'far too free-making' and she was the subject of 'constant unwelcome attention'. It’s surprising that more women didn't feel the same, and most coped admirably with this new and unusual situation.

In all areas, the women were expected to see things and do things that they had never been expected to confront before. Things which few people would ever be expected to confront even once in their lifetime, let alone on a daily basis. In the beginning they cleaned and scrubbed, set trays and boiled eggs, and later moved on to help the trained nurses with dressings and treatments - viewing every bodily cavity never designed to be viewed from the outside. They learned to smile and accept mutilated faces without flinching or turning away; they learned to breathe through their mouths during the dressing round, to prevent the stench of gangrenous limbs overwhelming them. And often they did all this for no monetary reward. Their reward was knowing they were serving their country, as their brothers, their fathers and their friends were serving theirs. It was both their wish and their duty.

If, after six months' work in a home hospital, a woman's work and conduct were deemed suitable, she could apply for overseas service, although she normally had no choice over where she was to go. Despite the popular image of VADs as being very young, for overseas service they had to be between twenty-three and forty-two years of age, and there were many mature and married women among them. A few served in BRCS and St. John's hospitals overseas, but the majority in British military hospitals in France, Malta, Serbia, Salonika, Egypt, and on board hospital ships. They signed a contract with the War Office for six months at a time, and each was supplied with a 'Camp Kit' which included items such as a flat iron, an oil stove, a canvas wash-stand and a waterproof bucket. Before embarking they were given a message from their Commandant-in-Chief, which, echoing the similar soldiers' message, ended:

Duty, God and the King - those three things so important then, which supplied the only reason most women needed for undertaking wartime service in such faraway places.

Although there were complaints of being under-employed in some home hospitals, that was something rarely levelled at military hospitals overseas. Due to the lack of trained nurses who became increasingly thinly spread over more and more hospitals, the proportion of VADs grew larger, and the work assigned to them more responsible.

Of all the accounts written by women serving as nurses during the Great War, most were written by VADs, and in one, Olive Dent describes her arrival at No.9 General Hospital on the race-course at Rouen in 1916:

Luckily she does go on to add that within a month this sister was a good friend, and there had developed a mutual liking and respect. But pre-war training wasn't forgotten, and lucky the women who joined pre-war and had the advantage of learning in a controlled environment, rather than being thrust headlong into the whirlpool of hospital life with little experience. The instruction in improvisation proved useful, although the situations in which it was needed could not always have been anticipated. Olive Dent again:

Vera Brittain, while working at No.24 General Hospital in Etaples, wrote with emotion of her experiences nursing the sick and dying of the war. She wrote in late 1917:

Vera Brittain was one of the most well-known nurses of the Great War, and gave up her life as a student at Oxford University to become a VAD. She has become an iconic figure, and sometimes seen as almost the sole representative of Great War nurses, but in fact she was just one of thousands - thousands of well-bred, educated young women, to whom mustard gas and gangrene should never have entered their lives at all.

On a lighter note, here’s an extract from a diary written by a trained nurse, by a woman called Edith Appleton, born in Deal in 1871, the daughter of a Trinity Pilot, and who trained as a nurse at St. Bartholomew's Hospital. In her diary she gives a wonderful description of the VADs she worked with in France - perceptive and humorous, hopefully never unkind:

There was a popular image of the VAD during the war that represented her as an 'Angel' - postcards sent from the war zone showed her as a painfully pretty young woman, either gazing up into the eyes of a man in uniform, or else the man in uniform gazing up at her while she mopped his fevered brow. This image of course had its origins in fact, but VADs, despite their patriotism and devotion to duty, were of differing personalities, and had very different levels of tolerance to the conditions they found themselves in on war service - in fact they were a group of 'normal' women.

The Army considered itself 'in loco parentis' of women serving overseas - they felt they had a responsibility not only to the women they employed, but almost more importantly, to their parents or guardians. Considering there was no nurse working in military hospitals abroad under the age of 23, or should not have been, and many were well over thirty, the amount of care that was taken to ensure that the most rigorous moral standards were upheld was fairly extraordinary by our standards today.

Many VADs came from backgrounds which encouraged a confident and outgoing nature, and they were not necessarily cowed into submissiveness by the army machine, and some of them got into all sorts of trouble. Enid Bagnold, later famous for writing the book 'National Velvet', worked as a VAD at the Herbert Hospital, near her home in Woolwich. While there she wrote a wonderfully perceptive account of the hospital  (A Diary Without Dates; Enid Bagnold; William Heinemann, 1918), but it was so critical of the nursing hierarchy and the hospital administration that she was dismissed. In her autobiography  (Enid Bagnold's Autobiography; Enid Bagnold; William Heinemann, 1969), she describes the morning of publication of the book, and then being ordered to leave the hospital within half an hour of reporting for duty. She is so vicious in her criticism of the trained nurse, and yet it's a book so elegantly written that it's a sparkling account of a large hospital during the war.

In France, discipline was very tight, with nurses not being allowed any social interaction with men except that approved and chaperoned by their Matron or other senior nurse. But there were many occasions where women were disciplined after attending dances in Officers' messes or seen walking with soldiers on the beach or in the woods. The usual punishment for these offences was to be given the choice of either resigning, or transferring back to a home hospital in disgrace. So if you did want to sin, better to choose your time and place carefully. In January 1917 Rachel Crowdy, Principal Commandant of VADs in France, was at dinner in a hotel in Rouen when she saw two VADs in the same hotel dining-room - Maud McCarthy, the Matron-in-Chief in France relates in her war diary:

The result of this excursion was that Mrs Lloyd was advised to tender her resignation. And note that while it was fine for Miss Crowdy to dine out with two officers, Mrs. Lloyd was committing a mortal sin worthy of dismissal, while in another time and place she was quite likely more than the social equal of Rachel Crowdy.

It mustn't be forgotten that VADs’ contribution went far beyond nursing. The formation of the General Service section in 1917 saw hundreds of women taking over the jobs previously done by men in military hospitals, in order to release them for military service, and they worked as dispensers, clerks, cooks and servants and storewomen. And never to forget the VAD ambulance drivers, possibly doing the most arduous and potentially dangerous of all VAD work. Of fifteen Military Medals awarded to VADs during the war for bravery, four were to drivers, all for one incident in France in July 1918 - the citation reads:

And there were many VADs and helpers who never entered a hospital or nursed a soldier - those women who staffed War Hospital Supply Depots, rolling bandages, padding splints and preparing many different types of dressing to be sent to Red Cross Hospitals everywhere.

It can't be denied that there were difficulties surrounding VADs during the war. From the early days there was friction between them and the trained nursing staff; there was ongoing criticism from the nursing press who always saw them as a threat; they themselves sometimes found their surroundings uncongenial, unwelcoming and occasionally frightening.

And Lord Northcliffe wrote during a visit to France:

But these women were versatile and willing, self-sacrificing, and with a deep sense of patriotism and a range of skills and life experience not usually seen in military hospitals, and with stamina that surprised everybody, even themselves. They found comradeship, independence, and a freedom that they had never grown up to expect but which changed their lives forever. Perhaps it could be argued that without them the war could not have been won; by 1916 the military nursing services would have been unable to cope, and by 1917 may well have collapsed completely. Without these extra nurses, the medical services, already terribly understaffed, could not have continued to give the care that enabled wounded and sick soldiers to return to the ranks. For the want of a nail, the Kingdom might well have been lost.

As they waited, and prepared to go overseas, most VADs would have read, and been inspired by those words of their Commandant-in-Chief, urging them to do their duty loyally. On the back of that message was a prayer, written for them by Rachel Crowdy, the Principal Commandant in France. It read:

Written by Sue Light.  She was founder of the Scarlet Finders website and, through her painstaking research into nursing in the First World War, became a leading authority, with particular regard to nursing within the military.  Her expertise was very highly regarded, and her assistance with research into the names now etched onto our memorial was invaluable.

Roll of Honour

Previously, there had been no single, comprehensive list of World War nurses who gave their lives for their country. This Roll of Honour is therefore unique, as is the Memorial at the National Arboretum. It has been compiled by Sonja Curtis, Secretary to the Appeal, from many sources, which have then been cross-checked wherever possible.

In some cases, however, the source documents themselves may have contained errors or omissions in the spelling of names, ages, dates or other details. It is also possible that we may have missed someone. So if you have any information to add or amend in this respect, please email us: nursingmemorialappeal@drewrys.com, and we will update the Roll of Honour accordingly.

The Nursing Memorial Appeal is grateful to the organisations and individuals who helped with the preparation, supply and compilation of source documents, including:

Philip Nixon, National Memorial Arboretum
Martin Edwards Roll of Honour website
Red Cross Listings
Sue Light for researching and cross-checking data
Viv Bennett - the Guildford VAD Memorial
Vic Raffles - local history researcher, Liverpool

Sponsoring a nurse in the Roll of Honour costs £100, and your donation will go into the fund for Extreme Nursing Today, supporting contemporary students who wish to specialise in humanitarian and conflict nursing. Your name is registered and published in the Sponsor column below. We also send you a commemorative certificate. Click here to download and print your application form.

On smaller mobile devices, please scroll the table in both directions to view all information