by Alan Palmer
Throughout that third week in October Florence Nightingale and her friends were engaged in a frantic search for capable nurses. Some episodes stand out from the records of the time: a blank response from Elizabeth Fry’s successor; the despatch of five nuns from Bermondsey, who had to wait in Paris for the rest of the party; delicate negotiations over safeguards for the spiritual welfare of the St John’s House, Westminster, sisterhood; and the telegram to Plymouth that brought the five Seddonites up on the mail train to Paddington. And at Sidney Herbert’s private house in Belgravia there were long interviews with the Sarah Gamps of London as the Dean of Westminster’s sister, Mary Stanley, looked for professional nurses of skill, sobriety and probity: ‘I wish people who may hereafter complain of the women selected could have seen the set we had to choose from,’ she wrote. Yet by Saturday, 21 October, fourteen nurses from the capital’s hospitals were ready to join the twenty-four nuns and sisters who had said they would travel to Constantinople. Among the Nightingale Papers in the British Library is preserved a signed document in which the lay nurses acknowledge an advance of three pounds ‘received from the hands of Miss Nightingale’ on 21 October. Only two signatures are written with the easy confidence of someone accustomed to hold a pen.[300]
Sidney Herbert also persuaded his colleagues to accept the appointment of a three-man ‘Commission of Enquiry into the State of the Hospitals and the Condition of the Sick and Wounded’. Yet most of the cabinet continued to deplore what Clarendon called ‘the infinite mischief’ done by The Times correspondent in ‘his descriptions of wounds & sufferings & hospital deficiencies’.[301] Sir James Graham did indeed show concern over hospital ships: ‘Distressing accounts, probably exaggerated, of the sufferings of the sick and wounded after the battle of Alma, on their passage to Constantinople, have produced a painful impression in England,’ he wrote to Vice-Admiral Dundas on the day of Balaclava, and he ordered him ‘to have one or two of the large steam-transports fitted’ for the carriage of the sick and wounded ‘without delay’; but so tardy was the elderly Rear-Admiral responsible for Black Sea transports, Edward Boxer, that little improvement had been made by the end of the year.[302] Constantly the service ministers in Aberdeen’s cabinet were puzzled by these complaints of hospital inadequacies. The Director-General of the Army Medical Department in London, Dr Andrew Smith, could point to long lists of medicines and supplies sent out to Scutari since the spring; and he received letters from Dr John Hall, the inspector general in the field, and from the principal army dispenser at Scutari maintaining that ‘the hospital establishment has now been put on a very creditable footing’ and that there was enough ‘lint, linen, bandages, dressings and necessary medicines’ for ‘any emergency’.[303]
John Delane, having seen the hospitals in the third week of September, had no time for such complacency. He did, however, discover why supplies known to have left England were not available in Turkey when he was there. ‘The absence of medical supplies and comforts which was deplorable when I left is at last explained,’ he wrote to his friend Monckton Milnes, the Peelite MP, on the day that the Nightingale nurses set out from England. ‘They had all been sent to Varna, while the sick and wounded were sent to Constantinople.’[304] Earlier campaigns — notably Moore’s expedition to Corunna in the winter of 1808-9 and the landing on Walcheren a few months later —were marred by similar administrative incompetence; but in the Napoleonic Wars newspaper editors remained at their desks and pioneer special correspondents had not developed the investigative sixth sense of a Russell or a Chenery.
Not that there was, in 1854-5, any common approach by the British press to the fatuities of a muddled campaign or the chaos in Constantinople. A newspaper war within a war rumbled on throughout that winter and into the following summer.[305] Professional jealousy of Delane, the influence and facilities which he secured for his correspondents, their speed in getting the news through to London, and the mounting fame of Howard Russell distorted editorial comment on events around the Black Sea in contrast to reports from the Baltic, over which there was a shared feeling of hopes dashed to disappointment. No editor questioned the heroism of the Queen’s soldiers and sailors in the Crimea or the Baltic, but treatment of Britain’s allies and of the supporting ancillary services away from the war zone varied from paper to paper.
Every leading London journal sent at least one correspondent to Balaclava. The ablest of them were Nicholas Woods of the Tory Morning Herald, who seems to have kept a cabin aboard what was virtually the headquarters ship, HMS Caradoc, and Joseph Archer Crowe of The Illustrated London News, who, being an excellent artist, also supplied his journal with drawings that could be speedily turned into wood-engravings. Crowe attached himself to Sir George de Lacy Evans’s 2nd Division, just as the correspondent of the Morning Chronicle attached himself to the cavalry division, an interesting association for a reporter representing a newspaper with radical traditions. Both Woods and Crowe distinguished themselves as journalists in later years, Crowe also earning a knighthood for his perceptive analyses of German society while serving as British Consul General. But all that lay in the future. In 1854 even Crowe was liable to suffer humiliation at the hands of his editor. Having spent Balaclava Day under fire on the right flank of the army while Russell observed the battle in Olympian detachment from the Sapoune Heights, it was no doubt galling for Crowe that on 18 November The Illustrated London News — without acknowledgement — lifted Russell’s account of the charge of the Light Brigade word for word from Tuesday’s Times and printed it on thejournal’s second page, while relegating to a separate supplement Crowe’s painstakingly judicious report of the same action (‘I am not aware whether any discretion was left to Lord Lucan to obey or disobey...I know not whether the causes of the disaster of the day will ever be explained’, etc., etc.).[306] The truth was that in 1854 no other correspondent — except perhaps Chenery at Constantinople — came anywhere near to possessing Russell’s gifts of descriptive imagery or his Irish turn of phrase.
The motives of The Times, both in reporting the miseries of Scutari and in opening a ‘Fund for the Sick and Wounded’, were questioned by other dailies, notably the Daily News and the Morning Post. At the same time an official ‘Patriotic Fund’ for widows and orphans was set up under the presidency of Prince Albert and established so speedily that it seemed to be competing with the charity sponsored by Delane and the initial generosity of Peel. The Illustrated London News singled out for attack Delane’s fund and scoffed at a newspaper, ‘cursed with too much zeal and too little discretion’, for ‘lustily calling...for the subscriptions of the wealthy and tender-hearted to alleviate the misery said to be suffered in the General Hospital at Scutari by our wounded soldiers’. It condemned ‘these rumours’ as ‘either grossly exaggerated or totally destitute of foundation’, and hoped ‘for the sake of truth, the interest of the public service, and the national character that such reports should not be circulated by British newspapers’. The journal’s editorial insisted that ‘British benevolence...will have ample and noble work before it’ in supporting the Patriotic Fund, made ‘under the sanction of the Queen in Council’; and it hoped that Delane’s appeal ‘will fall dead with the contradiction of the false statements on the truth of which alone it would have been justifiable...to respond to it’.[307]
Despite this robust salvo in the newspaper war, The Illustrated London News, like every other daily and weekly, supported the principal immediate beneficiaries from The Times Fund, the Nightingale nurses, if now and again a little oddly. Thus the issue on sale when the nurses left London Bridge station welcomed reports that ‘Mrs Nightingale’ (sic) was taking ‘Sisters of Charity and Mercy’ to Scutari, the editor assuring his readers that once they were there the English ladies would be able to ‘compete with the French...in the generous rivalry of good works’; and a fortnight later a half-page engraving depicted ‘Boulogne fishwomen carrying the luggage of the nurses for the East’ from ship to train above a report of the ‘demons
trations of sympathy and respect’ which accompanied the ‘self-devoted band’ down to the Mediterranean.[308] This slightly puzzled and slightly patronizing tone in the London press foreshadowed many of the social difficulties ahead of the Nightingale mission. What even its leader did riot apprehend, however, was the depth of professional resentment she would meet on the Bosphorus and outside Sebastopol.
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But Florence Nightingale’s first enemy was not bureaucracy and red tape. It was filth. ‘The strongest will be wanted at the wash-tub,’ she had told an enthusiastic nurse as the new arrivals waited to be carried in caiques from the mail-steamer to the landing pier. The sprawling yellow walls of the Selimiye Kislasi barracks still survive, on their eminence across the waters from the Topkapi Palace; and, with an avenue of cypresses behind them in an old cemetery, the barracks make an impressive skyline along the Asiatic shore of the Bosphorus. But in 1854 there was nothing attractive about this former headquarters of the Sultan’s artillery corps. In 1854 the Nightingale nurses found the Selimiye Kislasi in an even worse condition than the gloomiest newspaper reports had suggested. It was not until September that the buildings began to be used as a hospital and some parts of the barracks were still serving as a transit depot when the nurses arrived. Walking patients or orderlies were faced with an uphill climb from a ramshackle landing stage before they reached the three-storeyed rectangular block, where lines of verminous beds stretched down four miles of corridors which the Hospital Commissioners later described as ‘a sea of sewage’. There was a shortage of doctors, a shortage of drugs, a shortage of lamps and candles, a shortage of basic domestic furniture. Sister Sarah Anne, one of the more restrained chroniclers of those early weeks on the Bosphorus, was told on arrival that ‘there was not a table in the Hospital, even for operations’.[309] Rain penetrated the roof and on bad days caused the latrines to overflow and flood the wards; and sometimes when a gale swept down the Bosphorus rickety windows would blow in on the sick and wounded as they struggled to survive. Surgeons carried out amputations without anaesthetic within sight and sound of those next awaiting attention, making the filthy corridors as hideous as the cockpits below gundecks aboard Nelson’s warships in action half a century before. One of Florence Nightingale’s first purchases was ‘a Screen for the amputations’ in the hopes of beginning to lift morale among those ‘poor fellows’ awaiting ‘the knife’. ‘You Gentlemen in England, who sit at Home in all the well-earned satisfaction of your successful cases, can have little idea from reading the newspapers of the Horror and Misery (in a Military Hospital) of operating upon these dying, exhausted men,’ she wrote to a Harley Street friend after her first ten days in Scutari; ‘A London Hospital is a Garden of Flowers to it,’ she added.[310]
Florence Nightingale at once drew on The Times Fund for basic necessities. ‘I recollect one of the first things she asked me to supply was 200 hard scrubbers and sacking, for washing the floors, for which no means existed at that time,’ recalled John Cameron MacDonald, the newspaper’s Manager, who was sent out to Constantinople as the Fund’s first almoner and travelled in the same ship as the nurses.[311] From her own purse she found cash to augment the limited food resources of the hospital in these early days. Help would come from the ambassador, Sidney Herbert had assured her, on the Foreign Secretary’s prompting. Stratford de Redcliffe did, indeed, send his First Secretary to Scutari on the day the nurses arrived, with an enthusiastically phrased letter of welcome from his wife. Lady Stratford would not herself come to the hospital as the stench made her feel unwell, but she ensured that her husband supplied ‘articles of comfort’ for the sick and wounded which the medical authorities did not at that time possess. But the Stratfords’ ideas of what was needed by a military hospital were so unimaginative that relations soon became strained between the strong-willed ambassador and the strong-willed Superintendent.[312]
Sister Sarah Anne recalls that on the day she arrived at Scutari, ‘Miss N. sat down with us, and told us the last news from the Crimea, the wonderful charge at Balaclava’. It was the first any of the nurses had heard of the battle, which had taken place ten days before, and in their innocence they did not realize that a ‘wonderful charge’ would be followed by a stream of casualties to a hospital not yet ready to receive them. Next day what Sarah Anne called ‘the wreck of the Six Hundred’ were ‘landed and carried up to the Hospital’.[313] This influx of casualties, followed four days later — and at half an hour’s notice — by more than 300 wounded from Inkerman, brought the total number of patients in the Selimiye Kislasi to 2,225, with another 650 men housed in the General Hospital, a purpose-built Turkish institution where accommodation was less cramped than up the hill. Had the Nightingale Mission left England a month earlier, it is possible that at least the sanitary conditions in the hospital might have been improved before the wounded hundreds began to arrive from the Crimea. As it was, roofed and tiled wash-houses, clean kitchens and effective latrines had to wait until the spring. The Superintendent’s energy was absorbed in a constant battle to secure for her patients the basic medicines, drugs, ward fittings, and clean clothing and, by the end of the year, she had achieved wonders, at the cost of her own health and that of many of her assistants. Even so the mortality rate rose rather than diminished in the critical weeks which followed the nurses’ arrival. In the last month of 1854 two thousand British soldiers died in the Scutari hospitals.[314]
No doubt the hidebound regulations which required doctors’ signatures for anything requisitioned for hospital use delayed effective improvements; and it is clear that, even before the nurses left England, the medical authorities at Scutari were finding it difficult to induce the civilian Purveyor (a muddle-headed Peninsular War veteran named Ward) to keep his stocks up. But there was never any prospect of the senior doctors and the Superintendent of Female Nurses working together to cut through the red-tape of officialdom. Biographers of Florence Nightingale rightly emphasize the hostility she encountered from Dr Duncan Menzies, the senior medical officer at Scutari, and Dr John Hall, Chief of Medical Staff of the British Expeditionary Army in the Crimea. On the clay after the nurses reached the Bosphorus, Menzies wrote to the Duke of Newcastle in London giving his ‘settled opinion that the admission of women, whether wives or not, was an unwise indulgence, unfavourable to medical discipline and the recovery of the patients’; and it was Hall who told London that nothing was lacking in the base hospitals, now ‘on a very creditable footing. Hall or Menzies seem momentarily to have even convinced Chener’ that ‘the present state...is by no means unsatisfactory’,[315] for they were desperate to keep out the nurses. Both doctors would have resented the interference of any woman in the running of the army’s medical service. Florence Nightingale, however, was especially unacceptable to them; for she had behind her the Press and in particular The Times, the newspaper which had shaken their world with its reports from Scutari. Close contact with ‘MacDonald enabled Florence Nightingale to use Delane’s Fund to advantage, so that, as the 1855 Select Committee of Parliament reported, ‘the first real improvements in the...Hospitals...are to be attributed to private suggestions, private exertions, and private benevolence’.[316] This was sour reading for the misogynists who remained Miss Nightingale’s immediate superiors.
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There was no comparable outcry in the French press. If there was corruption in the commissariat, it was no more marked in the Army of the East than in garrisons at home or in North Africa. The ambulance service and the work of the Sisters of Charity were known to be efficient and well-organized. Closer acquaintance with the French medical service made Florence Nightingale more critical than the praise lavished on it by Russell, Chenery and Delane might suggest: female nurses were not allowed in the Crimea but were expected to remain in the ring of base hospitals around Constantinople; and to the English Superintendent they seemed more like ‘comforters’ (consolatrices) than ward sisters.[317] But, while the war made no great change in the French system of nursing, it ha
d considerable effect on hospital administration in Russia, where developments seem at times to have run almost parallel to what was happening in Britain.
During the Russian campaign against Turkey in 1828-9 the Tsar’s army had suffered heavy casualties from epidemics, the mortality rate soaring because of poor nursing. This experience led Nicholas I to encourage the development of military hospitals, and he visited them from time to time on surprise tours of inspection. The Tsar retained, under his wife’s patronage, a charitable body of women hospital helpers established by his mother, Dowager Empress Marie Feodorovna, during the Napoleonic Wars and known as the ‘Compassionate Widows’. Nicholas I also took a particular interest in the Military-Medical Academy, established by his father as early as 1798, in the Viborg district of St Petersburg. By the 1840s the Academy possessed a first-rate professor of hospital surgery, Nicholas Pirogov, who spent nine months with the army in the Caucasus in 1848-9 pioneering improved medical services in the field and using ether as an anaesthetic for the first time in a military campaign.
Nevertheless the allied landings in the Crimea, unexpected so late in the year, took the Russian military-medical authorities by surprise and exposed weaknesses in their system. Ghastly tales reached St Petersburg after the battle of the Alma. Pirogov, who thought poorly of the professional value of the Empress’s ‘Compassionate Widows’, at once sought support from the vigorous and intelligent Grand Duchess Elena Pavlovna, in whose palace had taken place the famous ‘sick man on our hands’ conversation. The Grand Duchess showed interest; her concern for Russia’s sick and wounded was deep and genuine, but there was, too, a personal reason why she was especially pleased to become founder-patron of the Orthodox Sisters of Charity. She was a Wurttemberger princess, like the late Empress Marie Feodorovna who was both her mother-in-law and her great-aunt; but the Empress had treated her so badly as a young bride that the Grand Duchess had no fond memories of her. It gave Elena Pavlovna particular satisfaction that her nursing Order would undertake duties for which the ladies of the ‘Compassionate Widows’ were unsuited. The Grand Duchess called on Russian women to serve, for one year in the first instance, as military hospital nurses in the ‘Order of the Exaltation of the Cross’. They would wear a habit to emphasize their religious calling and receive no pay, their reward being the spiritual fulfilment of a vocation for patriotic self-sacrifice; but the Grand Duchess undertook to maintain the Sisters out of her private funds.[318]