By the end of the war, there were more than 40 camps for white people, with more than 116,000 inmates. More than 27,000 people died in these camps. There were at least another 60 camps for black people, with almost as many inmates, of whom 14,000 died. In both camps, the vast majority of deaths were amongst the children.
Lucy Watchorn, a Queen’s Nurse who spent a year in South Africa nursing in the Boer camps, wrote an article for the Queen’s Nurses’ magazine about her experiences. She describes the camps as ‘quite unorganised as far as the nursing was concerned’ when the British nurses first arrived, which meant that ‘the sisters started with a free hand’. Very soon, it appears from her account, the nurses had instigated the kind of order and routine that their own training had taught them was essential to good nursing care:
‘A year in a country like S. Africa, everything quite fresh – the whole country and life there making new impressions and giving new thoughts daily – charms and fascinates in a way which can never be forgotten and leaves in one’s mind a seemingly endless train of thought.
The glorious sun soaks through you, and the pure, fresh air makes you feel you have never really breathed before. The sunsets, the thunderstorms and the nights of South Africa are living things in one’s memory. In the Autumn of 1902 English trained nurses were sent out by the British Government to nurse the Boer women and children of the Concentration Camps in Orange River Colony. Thirty sisters left England for this duty and upon arrival were drafted off in twos and threes to the various Concentration Camps in the Colony…
The week we landed the mortality in the camps varied from eight to twenty-seven deaths a day. One must, however, take into consideration that the infant mortality among the Boers is always very high and also that had they themselves been a little less calvanistic and a little more energetic they would most certainly not have lost so many of their dear ones. We divided the camp roughly into camp and hospital. The camp consisted of long rows of single bell tents in an irregular square. Each tent was the property of one family. Everything except cooking was done in this tent, the space not being so limited when one understands that the whole undressing that a Boer considers necessary is accomplished when he has taken off his shoes. The cooking is done in little mud ovens built outside, which were on the same principle as our old country ‘stick’ ovens, where sticks are placed in the oven, lit, allowed to burn, then raked out and the bread put in. The rest of the food, meat, potatoes, onions and vegetables, were all cooked together in one utensil over an open fire…
The Camp Sister trained twelve Boer girls to take temperatures, make poultices, give fomentations, sponge and do slight dressings. Each girl had two ‘lines’ [of tents] which must be visited every morning before nine, every tent entered, and the temperature of any suspicious case taken. The sister had a small bell tent in which solutions, simple remedies and dressings were kept, and here she met her nurses and took their reports, visiting any serious case herself and reporting to the doctor. If the temperature of the patient was found to be 102 he was promptly removed to hospital.
The sister then went to the dressing tent where surgical dressings were done and medicines given out. After this she went with her nurses to show them any fresh treatment, or to dress any case confined to bed in the tents. Then to the soup kitchen, where soup was made daily and served to all the children of the camp, and beef tea and benger prepared for the camp invalids.
The nurses meanwhile helped in the tents, nursing under the sisters’ directions, helping with the children and cooking for those too ill to look after their own duties, and being generally useful…
The hospital consisted of marquees which could have the sides removed partly or as a whole. This let us have plenty of fresh air. Throughout the whole war the sun and healing air were the sisters’ best allies. When we found it impossible to get the blankets washed we put them out in the sun, which baked them through and through. The mattresses also we had to disinfect in this manner. At the end of the campaign these small camp hospitals were as well equipped and managed as a cottage hospital at home.
The Boer nurses in the hospital – trained by the sister – had each charge of a marquee. It took the sister an hour to go round to each case under her care, this, of course, was without doing anything for the patient. However, we found the Boer girls most trustworthy and most anxious to make good nurses. We had a great variety of diseases, measles in a most virulent form ending in chancre mores being our most trying sickness. We had enteric [fever], dysentery, pneumonia, cancer, phthisis [TB], diphtheria, gangrene, burns – many of the most serious caused by lightning, etc, etc.
Our water supply was limited, but we were always able to get enough for hospital purposes. All excreta was carried right away from the hospital, boiled in huge boilers and afterwards buried. At first one great grief was that we could get no fresh milk; this was afterwards remedied. Goats’ dung was the chief remedy used by the Boers; this was applied irrespective of the cause or nature of the wound; proving ineffectual, the patient was considered doomed by fate for an early grave and no further effort was made to avert this destiny.
Sandstorms were a great trial to us. They rose in a few minutes without any warning, tore wildly along in thick clouds of dust, wrenched the tents from their fastenings, and often carried them off bodily. Upon the first sign of these storms, we had to rush out, tighten all the ropes and close the marquees as quickly as possible, but in spite of all precautions, beds and patients were thick with dust, and all one’s morning work had to be done over again. Other storms we had of hail. Hailstones the size of pigeon’s eggs and larger, fell with a hard rattle on the ground sometimes when falling on the tents ripping through the canvas. The farmers told us the hailstones, on account of their hardness, the rapidity and force with which they descended, were a considerable danger to cattle.
The Boers were very kind to us – ‘the good and lovely English sisters who so far have come to nurse our loved ones’ – and the Boer girls we found most anxious to improve themselves…
The girls are fond of sewing and make their own clothes. They were delighted to learn new stitches from us. They have their own little daintinesses, always wear huge caps to protect their faces, and big pinafores of Kate Greenaway cut, their hands always covered, if only with mittens made of roughest leather. They marry young and age rapidly, lose their neat figures, and are old women at thirty. The young boys are most attractive, with their strong brown limbs, round smiling faces, blue eyes and lint white locks. They are clever fingered and quick witted. Out of old milk tins, under their nimble fingers, grow candlesticks and cups and vases, out of wooden boxes, chairs and stools, out of bones, brooches and pen holders, out of coins, rings – and out of clay, quaintly modelled figures, sometimes as elaborate as an ox-wagon with a span of oxen. When taught games of draughts and marbles, their eager brains soon grasped the play, and one diplomatically disappeared after the first shrill shriek of delight proclaimed ‘sister’ was beaten…
We have left all this behind, and the whole often seems as if it had never been. The Boers are back to their farms and are slowly gathering up the threads of life where they had dropped them three years before. One wonders sometimes, knowing that in the great scheme of the Universe we can never trace the end of an action, how far the double influence of our lives on theirs and theirs on ours will extend.’
Another nurse, Miss Cross, working in one of the largest concentration camps in South Africa, also wrote proudly of the impact of the English nurses, and in particular the ‘splendid management of the Sister-Matron, who reduced chaos and confusion to order and regularity’, so that the camp at Potchefstroom in the Transvaal ‘headed the list in the General Inspector’s reports’. The scale of the operation of the larger camps is evident from the reports from Potchefstroom, which had between 8,000 and 9,000 inmates, and included general hospitals and a maternity hospital. It was divided into five camps, each with three sections, and each with a camp nurse reporting to the h
ead nurse. It had a swimming bath ‘where two or three dozen can comfortably bathe together in constantly running water’, baking ovens, a soup kitchen, and two stores ‘for those who wish to buy without going to town.’ It even had schools, with sixteen teachers.
Florence’s service in South Africa lasted from April to September 1900; and coincidentally, her brother Offley was in the country at the same time. He had been suffering from tuberculosis, and, following treatment in Switzerland, was recommended the climate of South Africa in preference to a return to Russia or India, where he had previously served. Florence’s nursing service was not in the concentration camps, but as a Sister at the Imperial Yeomanry Hospital, Deelfontein; Mabel Rogers was a Sister at the same hospital.
Deelfontein was a village in the Northern Cape, 29 miles south of De Aar, one of the centres of the hostilities, and nearly 4,500 feet above sea level. The planned military field hospital was funded by subscriptions raised from the British public, with fundraising efforts for the ‘Imperial Yeomanry Hospital Fund’ led by Lady Georgiana Curzon. She wrote letters to newspapers early in 1900 asking for donations, saying:
‘I am very anxious to bring before the notice of the British Public that £50 will equip a bed in the Yeomanry field hospital. May I suggest that subscriptions should be raised in big towns or groups of villages to equip beds, and that these beds should be called after the town or village that equips them?’
At this time, the plan was for a hospital of 100 beds, with five doctors, eight nurses and ‘the usual complement of ambulance men and supernumeraries’.
By the end of January 1900, £11,000 of the £30,000 target had been raised, and many doctors and nurses were volunteering to go to the new hospital. Beds were to be named South Suffolk, Kerrison, Woolverstone, Ipswich and Bury St Edmonds, after some of the early donors; and Queen Victoria herself donated £100 for two beds. Princess Christian presented silver badges and personally-signed certificates to forty nurses who had been selected for service at the hospital; and the first contingent of staff sailed for South Africa – a journey of around 17 days – in the SS Norman on the 10th February. Others, including many of the nurses, sailed on the Guelph. The Senior Army Surgeon in charge of the new hospital was Colonel Sloggart, and the Senior Medical Officer was Mr Alfred Fripp, who had been Surgeon in Ordinary to the Prince of Wales, and assistant surgeon at Guy’s Hospital in London. Miss Mary Fisher was appointed Lady Superintendent of the Imperial Yeomanry Hospital – she had been a ward sister at Guy’s Hospital, and had experience of running a cottage hospital at Watford as well as a convalescent home at Saltburn-on-Sea. With this preparation, she and her two medical colleagues formed the management committee of the hospital.
By the end of March, the base hospital at Deelfontein was open and the field hospitals were being prepared. The hospital, set on the veldt between the hills and the railway line, was huge. Its tents and prefab huts extended for nearly half a mile, with roads and named streets (with lamp-posts) running through it. One newspaper described approvingly the concerted effort to set up of the hospital, saying:
‘The whole of the staff, medical officers included, have worked with an amount of energy which would have gladdened the heart of those at home, who may be inclined to think that a medical man is never in his element unless he is clothed in the regulation frock coat and top hat.’
The hospital soon had 800 beds, and plenty of work to fill them. It became a pioneering centre for the use of x-rays in diagnosis, under the leadership of the Surgeon-Radiographer, Major John Hall-Edwards – who later lost an arm to x-ray damage. Hall-Edwards wrote an article for the British Medical Journal, describing life at the Imperial Yeomanry Hospital at the time that Florence was serving there:
‘Shortly before the close of 1900 our accommodation was considerably reduced by sending up country a number of marquees which had been placed at our disposal by the Government. Even now, however, we have a larger number of beds than it was the original intention of the Committee to supply, and were it not that a large number of our patients are convalescents, it would be impossible for our small staff to keep pace with the work.
For about two months prior to the invasion of Cape Colony our hospital contained so few acute cases, that to all intents and purposes it was little more than a rest camp for convalescents. Since January 1st however our work has gradually increased, until at the present time we have as much work as we have ever had with the same number of beds. At the present time our staff consists only of six medical officers, and our commandant (Colonel Sloggett). We have in hospital 587 patients, 170 of which are acute cases, including 48 cases of enteric fever. On the surgical side our work has of late much increased, and twice during the last fortnight we have, for the first time in the hospital, received wounded men straight from the field.
For the last three weeks intelligence wires and scouts have regularly arrived, telling us of the presence of Boers in our immediate neighbourhood. Last week a scout was fired at from a kopje only two miles distant from the camp, and one night a Kaffir kraal less than a mile away was visited by six Boers, who questioned the natives about the hospital. They were anxious to know how many rifles we had in stores, the number of our horses, and the strength of the guard at the railway station. On hearing of this our store of rifles and ammunition was despatched to De Aar, and orders were issued prohibiting any of the staff from riding more than a mile from the hospital…’
A telegram from Colonel Sloggart, the Chief Army Surgeon and ‘commandant’, summarised their work more tersely in early April:
‘Deelfontein treated seven officers, 402 men … 69 men yeomanry. Present patients 275 … expecting 100 fresh cases Bloemfontein today. Securing all possible Yeomanry patients. Everything running satisfactorily … base camp furnished hospital hut and bedding for sickness amongst arrivals.’
One of the nurses working with Florence and Mabel at the hospital also wrote about her experiences at the Imperial Yeomanry. Her letter, published in a Scottish newspaper, reminded people back home that, just as in the concentration camps, infectious diseases were as big a problem for medical staff as war injuries:
‘Not many bad surgical cases, but so much typhoid for which of course we have special tents. We have had only 14 deaths in the 7 weeks and they were all from enteric [fever], and as we have over 500 patients, that is a very low death rate!’
An article in the British Medical Journal, written by Dr H. D. Rolleston, a consulting physician to the hospital, reported that nearly 15% of the medical and nursing personnel of the hospital also went down with enteric fever: nursing in South Africa during the War was not just demanding and stressful, it was also dangerous.
A picture of the Imperial Yeomanry Hospital shows one of the long metal huts with its windows standing wide open, and four Sisters in the doorway. They wear ankle-length white aprons over their dark dresses with red crosses on the sleeves, and long white veil headdresses. Another picture shows the tent housing the ‘Devil’s Fountain’: the camp newspaper, edited by Newland Pedley, Fellow of the Royal College of Surgeons, and formerly Senior Surgeon to the Dental School at Guy’s Hospital.
Florence’s time at the Imperial Yeomanry Hospital saw it set up and its services getting into full swing during the peak of the war. A letter from one of its patients describes the regime and treatment in September 1900, just before Florence left to return to England:
‘After leaving Kroonstad hospital the major sent me over the Y. Detail camp, where I stayed a few days expecting to be sent up to Pretoria to join the fighting line again. However for some reason or another they packed some dozen or so down here to Deelfontein, much to our delight. This camp and hospital, you must understand, is organised especially for the Yeomanry, and splendidly it has been carried out, everything is tip top, the grub particularly. My diet sheet for today consists of: Breakfast: porridge, coffee, bread, butter and jam. Lunch: Mellin’s food or Benger’s food, and 4oz of port wine. Dinner: chicken (tinned), potatoes, ric
e pudding, bread &c. At 4: extras, beef tea, milk pudding. Tea: tea, toast, butter and jam. Supper: soup mince, arrowroot and milk pudding. Besides which we have a big jug of fresh milk, a can of condensed milk, a tin of cocoa and another of Benger’s food …
Lady Chesham comes round every other day with tobacco, cigarettes, cigars (all good quality), daily papers, note paper &c. For recreation there is a well-stocked library, cricket, football, concerts. Every evening church service. You would scarcely believe the amount of flesh I have put on within the last days.’
In spite of vthe enormous contribution that nurses were making to the nursing of wounded and sick people both in the camps and in the hospitals, they did not always escape criticism, as the Nursing Notes of 1904 recognised with its reference to the few ‘undesirables’. A snippet published in the October 1902 edition, from a letter sent by a nurse Superintendent in South Africa, gave some hint of the problem. She commented that ‘the nurses are crowding in and no rooms are to be had’, then asked in exasperation,
‘Why do such helpless sort of creatures come and start growling about the country at once? Oh me, I fear some of them will be very disappointed. Impress on them at home – that good all round nurses are required here, and women with some grit besides their training, and that this is a new country.’
The Nightingale Shore Murder Page 11