It would be inconceivable to imagine hospitals without nurses, and yet there were none in the early moments of the conflict. While some men compete in ingenuity in an effort to annihilate their adversaries, others make every effort to save lives. In 1914, the Belgian medical service finds itself unprepared for this war. Also, the German advance will cause the Army Health Service to abandon a large part of its equipment.
Medicine will be one of the fields in which major innovations will be seen. The main curse during this war will be the infection of wounds. Many people succumb to illnesses caused by their poorly treated wounds, and this situation is aggravated when the few people available to help physicians end up countering the sterilisation efforts of the latter.
The training and development of hospital personnel then becomes the priority, and it is thanks to the experience and foresight of a few Belgian physicians – amongst others – that medical practices will become more efficient.
While at the very beginning of the 20th century, this role was still assigned to the willingness of hospital nuns, it very quickly passed into the hands of professional nurses who will occupy a central place in this conflict by restoring the strength of the soldiers in order to allow them to return to the front. Despite their essential role, few traces have been kept of them.
The war will profoundly change this profession's image, but can it be hoped that because of their essential role, nurses will improve the condition of women in the early part of the 20th century?
While some men compete in ingenuity in an effort to annihilate their adversaries, others make every effort to save lives.
From amateurism to the professional nurse
Medicine had seen considerable progress in the second half of the 19th century. Running water, electricity, more demanding hygiene standards, and industry all responded to the needs of modern hospitals. However, while physicians are rigorous and working in a modern setting, the same cannot be said for the hospital personnel made available to them. The amateurism of the auxiliary personnel contrasts with the progress of medicine.
Until the start of the 20th century, the women serving as nurses were very often hospital nuns. Thereafter, this function increasingly falls into lay hands, while attention is still paid to soothing Catholic opinions, and the decision is made to offer training provided by physicians. It will not be until 1907 that the first real nursing school is created under the impetus of Dr. Antoine Depage.
Pushing at all costs for much more advanced professionalism, Dr. Depage looks to England, a country very well known for the quality of the training provided to its nurses, to find the future director of his school. He selects Edith Cavell, who in 1907 is appointed as the head of the Berkendael Medical Institute in Ixelles. She is quite familiar with Belgian society and the French language after having worked for six years as a governess in Belgium, and having worked for several years as a nurse at the Royal London Hospital, which makes her an ideal candidate for directing the nursing school created by Antoine Depage somewhat later that year. She encounters countless difficulties with regard to recruiting and promoting the nursing profession, but with the First World War, this function receives its due recognition.
In 1914, a totally unprepared Belgium is thrust into the war. The lack of means is glaring. As such, of the 245 physicians called for by the law of 25 May 1914 for the Army Health Service, only 166 and 12 reserve physicians are available at the time of the mobilisation. This situation will be even more critical with the realisation that the Army Health Service includes not a single nurse. Only the hospital nuns, the number of which had been calculated for peacetime, were available, while the staff of certain hospitals did not include any such nuns…
In addition to the fact that their numbers were insufficient, the inadequacy of their habits will also be harmful to these devoted sisters. Their large flowing sleeves do not lend themselves to the sterile treatments provided to the wounded. The contrast will be all the more glaring with regard to the English nurses, whose uniforms are impeccable and functional.
The conflict bogs down, with the number of deaths steadily rising. Up to the battle of the Yser, the Belgian army loses up to one third of its strength. The growing number of wounded and the quality of care having to be increased, a preference gradually grows for trained nurses, and many young Belgian girls are then sent to England for training.
While the events quickly exceed the abilities of the hospital nuns, the same cannot be said of the English nurses who are present from the start of the conflict.
There are a few testimonials from nurses during the First World War. However, the few rare traces that have reached us stress, amongst other things, the efficiency of the British medical corps that had come to help. As such, a hospital nun in Ypres, present during the events, does not hesitate to comment on this in her precious journal:
" We received our first wounded on 22 October, 300 English soldiers. Until 6 November, we sometimes had up to 500, with 8 English ambulances succeeding one another until 8 November; from 12 to 15 December, it was the turn of the French, who were then replaced once again by the English. Each ambulance stayed for 24 hours. I must comment on the devotion of the English doctors and nurses who, filled with attentiveness for their wounded, devoted themselves day and night without rest to bandaging wounds, deciding only to take a little rest when the last had received the necessary care. I saw some of them stay at the operating table for 16 consecutive hours, with only a quick bite to eat from their hands from time to time. "
The first moments of the conflict bring only chaos and grief for the medical services. This pathetic scene is only accentuated by the lack of personnel and of means. For better or worse, efforts are made to save those who can still be saved, ambulances (aid stations close to the front) are hastily created, with improvised hospitals in schools, convents…
Faced with such a scene, this same nun describes the intensity of the conflict:
" The bombardment resumes furiously in the afternoon, another eight of our sisters leave Ypres, some for Boesinghe (city located north of Ypres), and the others for Westvleteren (village located near the city of Vleteren) or Poperingen. All of these separations are very painful for us. Not only the canons, but also the Taubes (German military aircraft) drop their incendiary bombs on all sides, creating new devastation: streams of flames climb into the streets and destroy everything, unaware of the misery and ruins that hatred causes them to heap up. "
At the heart of the conflict, these men and women risk their lives every day in order to save the wounded. No location can provide safety. In Ypres, where the battle is raging, the number of corpses grows steadily. Death therefore becomes the day-to-day affair of this hospital personnel:
" Five deaths are regretted: the good and saintly vicar Leys ; the model servant Céline Pladys and three little old ladies. The bodies were taken to the laundry, and then we looked after the wounded. Mother superior was unconscious. She had been thrown some distance, and was almost buried by rubble. Only her feet were visible, and we had quite some trouble getting her out from under there. She had two broken ribs. Sister Livine, though injured herself, wanted to treat her but, soon weakened by her blood loss, which was considerable, she collapsed. An hour later, new explosions in the laundry where the cadavers were located, and which were thrown several metres away. The body of Céline Pladys couldn't be found though we continued looking for three days. It was only found 5 months later, devoured by rats. "
While the events quickly exceed the abilities of the hospital nuns, the same cannot be said of the English nurses who are present from the start of the conflict.Thanks to their experience during the Crimean War, they demonstrated rigorous organisation. Their professionalism is particularly appreciated by Antoine Depage, who goes so far as to dismiss Belgian nurses whom he considers to be incompetent.
Some tension is also noted between Belgian and English nurses during the war. The former find the English to be too strict and uncomforting with the wounded, while the latter find the Belgians to be quickly exhausted. The iron discipline applied by the English nurses will result in considerable problems for the Belgian nurses. Many cannot tolerate the infernal working pace imposed upon them as well as the lack of human contact with the wounded, which included a ban on speaking with them, in addition to the penalties in case of violations of the regulations. Though the system implemented by the English nurses is extremely rigid, the other nurses are forced to admit their admiration, with the mortality rate having fallen sharply.
It is in the agony of war that Belgian nurses will acquire the professionalism of their English counterparts.
Not yet emancipation
It is in the agony of war that Belgian nurses will acquire the professionalism of their English counterparts. The lay nurse discredited at the start of the century was, by the end of the war, a heroine, an image that would be further strengthened by that of the Queen Nurse, Elisabeth, queen of the Belgians, who regularly comes to assist wounded soldiers.
However, though women play an essential role in terms of healthcare, this will unfortunately not lead to their emancipation. As a nurse has to be obedient and devoted to her physician, her function will not change the pre-established order.