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Tuesday, 31 December 2013

Lieutenant Mary Lillian Cameron - A Nursing Sister's Story

Date of Birth: December 8, 1894

Place of Birth: Canso, NS

Mother's Name: Laura Condon

Father's Name: Frederick A. Cameron

Date of Enlistment: May 22, 1917 at Montreal, PQ

Regimental Number: n/a

Rank: Lieutenant (Nursing Sister)

Force: Canadian Army Medical Corps (CAMC)

Name of Unit: No. 4 General Hospital (University of Toronto Unit)

Location of service: Canada & England

Occupation at Enlistment: Nurse

Marital Status at Enlistment: Single

Next of Kin: Mr. Fred A. Cameron, Canso, NS (father)
Mary Lillian Cameron was the oldest of three children born to Fred and Laura Cameron of Canso, NS.  Her father operated a general store in the small fishing port, while her mother's parents owned a similar enterprise in Guysborough.  A person with a keen interest in travel and adventure, Mary's life choices took her to places far beyond the small community where she was born.

Nursing Sister Mary Lillian Cameron.
Mary's journey began with her decision to enroll in a Montreal nursing school during the early months of World War I.  Upon graduation, it is not surprising that Mary chose to serve with the Canadian Army Medical Corps (CAMC).  Montreal was one of several Eastern Canadian military ports where soldiers departed for and returned from Europe.  As the war progressed and casualties spiraled, there was an increasing demand for nursing services.  The pay - $ 4.00 a day - was attractive, as was the opportunity to serve one's country in its time of need.  There was also the possibility of overseas service, bringing with it the opportunity to experience distant parts of the world.

In December 1916 and January 1917, Mary worked with 8th Field Ambulance CAMC at Montreal, possibly as part of her nursing training.  The experience may have piqued her interest, as Mary enlisted for 'home service' with CAMC on May 21, 1917.  Her age at the time - 22 years, five months - suggests that she had only recently completed her training, as nursing schools of the day accepted only women 21 years or older.

Mary spent the next nine months working in a Montreal military hospital, one of the city's seven wartime facilities that contained a total of over 900 beds.  Canadian medical services provided accommodations and convalescent homes for officers and men 'invalided from overseas' due to illness or injury.  The size of the CAMC's Canadian operations at war's end indicates the scope of its activities.  As of November 11, 1918, its 59 hospitals were providing medical care for 9,784 patients.

As with many young nurses who enlisted with the CAMC, Mary no doubt hoped to serve abroad.  In total, over 2500 Canadian women served overseas during World War I, one thousand of whom saw duty near combat zones in France or Belgium.  The remaining Nursing Sisters were stationed at various facilities in England, providing medical care for soldiers 'invalided' from stationary and general hospitals located on the continent.

Mary's opportunity arose the following year when she officially attested for overseas service on March 2, 1918 and departed for England shortly afterward.  Prior to leaving, she assigned $ 25 of her monthly salary to her mother, Mrs. Fred A. Cameron, Canso, NS.  On March 25, Lieutenant Mary Lillian Cameron was 'taken on strength' by the CAMC Depot England, pending posting to a general or stationary hospital.  Two weeks later, Mary was assigned to the nursing staff of No. 4 General Hospital, Basingstoke, Kent, England.
No. 4 General Hospital was one of four similar units organized by Canadian universities offering medical studies programs at the time of the war's outbreak.  Sponsored by the University of Toronto, it was officially created on March 25, 1915 and embarked for England two months later.  Personnel remained in England until mid-October 1915, when the unit was selected to provide medical services to Allied soldiers fighting in the Eastern Mediterranean.

The unit stopped briefly at Alexandria, Egypt before establishing operations at Salonika, Thessaloniki, Greece on November 9, 1915.  Six months later, the hospital relocated to nearby Kalamaria, where it maintained a general hospital until its departure on August 17, 1917.
Park Prewett Hospital (date unknown).
Upon returning to England, the unit assumed responsibility for the operation of a recently established 1040-bed general hospital, located on the grounds of Park Prewett Asylum for the Insane at Basingstoke, Kent.  No. 4 General Hospital remained in this location for the duration of the war.  On April 10, 1918, its war diary recorded the arrival of "sixteen Nursing Sisters… from C. A. M. C. Depot".  Mary Lillian Cameron was one of the new additions to the hospital's staff, which consisted of 31 Officers, 88 Nursing Sisters and 191 'other ranks'.

At the time of Mary's arrival, the facility was operating at approximately 70 % capacity.  Two factors combined to increase the workload as the events of 1918 unfolded.  As in previous years, fighting intensified with winter's end, as spring and summer weather made large-scale military action possible.  In addition, German forces launched a major assault on Allied positions in March 1918, part of a plan to achieve a final victory. 

As a result, casualties increased dramatically, resulting in a sharp rise in hospital admissions.  The hospital surpassed its capacity on April 23 when it accommodated 1046 patients, although numbers declined slightly the following week.  Throughout the month, staff ministered to a daily average of 798 patients, "principally surgical cases" from the battlefields of France.

Total patient numbers remained well above 900 throughout May 1918, reaching more than 1000 on several days late in the month.  The daily average of 953 patients indicates the increasing demands placed on staff as "convoys from France [arrived] daily - many severely wounded cases."  The situation was complicated by the fact that ten Nursing Sisters were "ill and off duty" at various times during the month, although the hospital's Matron, Annie Jane Hartley, commented: "General health of Nursing Staff is good."

As spring gave way to summer, admissions continued to rise as staff cared for a daily average of 997 patients in June.  The arrival of two small groups of 'ill' patients placed additional demands on a nursing staff struggling to tend to wounded soldiers.  On June 25, Matron Hartley reported: "60 men from [the] Forestry Corps near Reading [were] admitted to Hospital with severe attack[s] of Influenza.  Ward isolated."  Two days later, 18 Nursing Sisters from another facility were attached to the hospital "for quarters and rations… [and] isolated for Measels [sic] and Mumps contact cases, many have colds."  Throughout the month, the hospital received "some severely wounded, tuberculosis [and] Gassed Cases", indicating the breadth of medical care provided by hospital staff.

By July 1918, the number of 'evacuations' [patients being discharged to convalescent homes or other facilities] gradually surpassed admissions, resulting in a reduced daily average of 820 patients, "principally Gas cases, Kidney, Influenza and Surgical cases."  By this time, the German offensive had ground to a halt.  The following month, however, an Allied counter-offensive once more generated a rise in admissions, increasing the daily patient average to 1038 and producing a single-day record of 1290 occupied beds.  Matron Hartley also recorded the arrival of 21 gas cases and 127 femur cases in the last two weeks of August.

Amidst the frenetic pace of nursing care, a variety of events provided Mary and her colleagues with the occasional opportunity for recreation during the summer months.  Each week, staff organized 'cinema performances' and concerts featuring local musical groups and staged on hospital grounds.  Matron Hartley observed: "Bicycle Riding and Tennis are [the] principal recreations enjoyed [by nursing staff]".  Her monthly report also commented that 36 Nursing Sisters "spent a very enjoyable picnic on the River Thames" on the afternoon of August 9. 

Mary Lillian Cameron (left) and two colleagues, Basingstoke, England (date unknown).
Another welcome diversion was a steady stream of dignitaries who interacted with patients and staff.  On June 11, for instance, "The Duke and Duchess of Wellington entertained 60 patients at tea at [their] Ewhurst [estate].  A very enjoyable afternoon was spent."  Canadian Prime Minister, Sir Robert Borden, and his Minister of Militia, Sir Edward Kemp, visited all hospital wards on July 28. 

The following month brought more distinguished guests.  On August 2, CAMC Matron-in-Chief Margaret MacDonald visited the facility, while University of Toronto President Robert Falconer held an afternoon tea in the Nursing Sisters' quarters on August 8.  Four days later, Sir William Osler, renowned Canadian physician and co-founder of Johns Hopkins University, visited the hospital in the company of Lady Osler.  Perhaps the month's most impressive visitor - Prince Arthur, Duke of Connaught, seventh child and third son of Queen Victoria - toured the hospital on August 30.

By September 1918, the Allied offensive launched in early August pushed the hospital's resources to the limit as patient numbers surpassed 1200.  In response, authorities increased bed capacity to 1540, effective September 9.  The newly available space filled quickly as staff ministered to over 1500 sick and wounded by September 22 and the month's daily patient average rose to 1390.  Admissions were "principally Fractured Femur… and Surgical Cases", with medical staff performing 186 operations, twice as many as the previous month.

Patient numbers remained at or above 1500 throughout October, reaching a peak of 1573 as staff performed a record 249 surgeries.  Nursing staff was increased to 118 to accommodate the increased workload.  Throughout the autumn months, in recognition of the demands placed upon its staff, authorities granted short leaves to small numbers of Nursing Sisters.  Having worked steadily at the Basingstoke facility for six months, Mary received 14 days' service leave on October 28.  Given her interest in travel, she quite likely took the opportunity to tour the attractions of London, only 60 kilometres away, before returning to work on November 10.

No. 4 General Hospital operated at capacity throughout November 1918, accommodating a total of 1593 patients at month's end.  Staff paused briefly on November 11, when a "great deal of excitement [was] shown on [the] report that [an] Armistice was signed".  There was little time for celebration, however, as casualties continued to arrive from the continent and medical staff performed 136 surgeries.  Fortunately, there were several diversions amidst the month's busy schedule.  On November 19, distinguished British surgeon, Sir Arthur William Mayo Robson, visited the facility.  That same day, perhaps in conjunction with his visit, the 'Hospital Orchestra and Concert Party' staged a 'Minstrel & Vaudeville Show' for the entertainment of staff and patients.

Patient numbers briefly exceeded 1600 in early December before declining to 1425 by month's end.  Several lectures on English points of interest - the Thames and Oxford - and contemporary events - the Russian Revolution - offered staff a welcome break from patient care.  Matron Hartley described December 25 as "the happiest day of the year spent in Hospital.  Wards and Dining Halls decorated and splendid dinner and supper served to all.  All expressed their happiness" that hostilities had finally ceased.

While fighting had ceased almost two months previously, admissions continued to outnumber 'evacuations' as hospital staff welcomed in the New Year 1919.  On January 16, 235 new admissions briefly pushed patient numbers above 1700.  The hospital operated above capacity for the remainder of the month as staff daily tended to more than 1600 patients.  The departure of 33 Nursing Sisters for Canada at month's end suggests that CAMC operations in England were beginning to 'wind down', but much work remained before they ceased completely.

No. 4 General Hospital operated at capacity throughout February as Matron Hartley reporting 35 cases of illness - mainly influenza - among nursing staff.   These numbers declined slightly the following month, when 28 Nursing Sisters were unavailable for work.  Mary's health appears to have been unaffected, as her name is not amongst the monthly lists of nurses absent due to illness.  By April, patient numbers began a steady decline, reaching 1219 by mid-month and dropping to 864 at month's end.  The cases of illness amongst nursing staff also decreased to 14, suggesting that the influenza epidemic was also waning.

May's patient numbers clearly indicated that the hospital was fast approaching the end of its mission.  On May 15, only 649 patients remained in the facility, a statistic that declined to 255 as of May 31.  The war diary recorded one marriage in addition to numerous leaves to France by personnel wishing to visit deceased relatives' graves before returning to Canada.  Mary was fortunate enough to receive a brief 'service leave' from May 27 to June 3.  By the time she returned to Basingstoke, staff had received notice that all patients were to be discharged to other facilities by June 6.

The deadline was subsequently postponed until June 7, when the hospital's war diary officially recorded: "Hospital closed for the reception of patients.  All wards cleaned out and all equipment turned in."  The final 32 patients were 'evacuated' by day's end as staff commenced the remaining tasks required for the facility's closure.  Two days later, word arrived that No. 4 General Hospital was "to proceed to Canada as a unit and not to leave Basingstoke" until their departure.  On June 10, the war diary provided an update: "Wards nearly all closed.  Ordnance to take every thing over and sell it at an auction sale."  The following day, medical staff was granted leave as auxiliary personnel completed the tasks required to close the facility.

A sale of hospital contents took place during a two-day, on-site auction held on June 26 and 27.  The following day, 92 Officers and Nursing Sisters were designated to proceed to Canada "with the Unit" on board the SS Olympic.  The remaining 70 Nursing Sisters - including Mary - were scheduled to leave England on July 5.  After the first group's departure, Mary was briefly transferred to No. 15 Canadian General Hospital on June 30.  One week later - July 7, 1919 - she boarded RMS Carmania at Liverpool for the journey home, arriving at Halifax eight days later.

The Cameron family home, Canso, NS.
On July 15, 1919, Lieutenant Mary Lillian Cameron was officially discharged from the Canadian Army Medical Corps, her proposed residence listed as the family home in Canso, NS.  Mary received the British War Medal in recognition of her service with the CAMC in England.  She was also awarded a War Service gratuity of $ 366.00 upon discharge.
Following her military service, Mary continued to work in health services, finding employment in New York City and Montreal as a public health nurse.  On June 7, 1927, she married Colin Andrew Chisholm, a native of Port Hood, NS and son of her parents' long-time acquaintances, Dr. and Mrs. Duncan M. Chisholm.  A World War I veteran who had served with the 7th Siege Battery, Canadian Field Artillery before joining the Royal Flying Corps, Colin graduated from Queen's University in 1924 with a degree in mining engineering after returning to Canada.

After their marriage, the couple briefly resided in Montreal and a small community near Ottawa before relocating to Kirkland Lake, Ontario, where Colin took a position as Assistant Manager with Macassa Mines, a gold-mining operation.  Here, Mary devoted her time to raising a family as the couple's first child - a daughter, Laura - was born on May 28, 1928.  Four more daughters - Dorothy Lee, Jean Marguerite, Carole Ann and Nancy Jane - followed as Mary balanced the tasks of motherhood and family with an active social life that included concerts, theatrical productions and bridge games.  The family remained in Kirkland Lake until 1951, when parents and children relocated to Stirling, Cape Breton, where Colin managed a base metal operation owned by Mindamar Mines.

In 1956, the Chisholm family temporarily returned to Montreal as Colin assumed a Manager's position with a base metals mining company at Beardmore, Ontario.  Shortly after returning to the city where her nursing career began, Mary suffered a sudden, severe brain hemorrhage, passing away unexpectedly on August 26, 1956.  She was laid to rest in Cote Des Neiges Cemetery, Montreal.  Following her death, Colin returned to Montreal, where he remained until his death on September 4, 1977.  He was buried beside his beloved wife, Mary.

Canadian Army Medical Corps Overseas Hospitals.  Canadian Great War Project.  Available online. 

Service Record of Nursing Sister Mary Lillian Cameron.  Library & Archives Canada, Ottawa: RG 150, Accession 1992-92/166, Box 1411-8.  Available online.

War Diary of No. 4 General Hospital, CAMC.  Library & Archives Canada, Ottawa: RG9, Militia & Defence, Series III-D-3, Volume 5035, Reel T-10925, File: 854.  Available online.

A special thanks to Mary's daughters, Carole (Chisholm) Henschel and Nancy (Chisholm) Rogers, and Carole's husband Lyman, who provided information about Mary's life in addition to the family pictures displayed in this post.  This story would not have been possible without their invaluable assistance.

Tuesday, 17 December 2013

Canada's Nursing Sisters and World War I

While the vast majority of Canadians in military service during World War I were male, a small group of females made a significant contribution belied by their numbers.  During the conflict, over 3000 women served as nurses with the Canadian and British Army Medical Corps.  Their official title - 'nursing sister' - reflected the profession's traditional connection with religious orders, though none belonged to such organizations.  This cadre of women played a vital role in the war's events, simultaneously transforming their profession in ways that none could have imagined.

The integration of nursing into the armed forces traces its origins to the Crimean War (1854-56), when Florence Nightingale's efforts convinced military authorities of the need for its inclusion in an organized medical corps.  Before the war's end, the British government established a nursing service that operated under a separate administrative structure within its military.

Canadian women first provided such services in 1870, when four volunteer civilian nurses accompanied Canadian troops to Red River, where they tended to soldiers who were injured or became ill during the first Metis uprising.  Fifteen years later, a larger contingent travelled to Saskatchewan with Canadian troops in response to the Northwest Rebellion.  In this instance, the federal government requested the creation of a formal 'medical and surgical department' to accompany the expedition.  Seven nursing sisters and one matron spent four weeks tending to sick and wounded soldiers in field hospitals established at Moose Jaw and Saskatoon.

After 1885, nursing sisters were part of every Canadian military force sent abroad for service.  When Canadian authorities organized a contingent for service in the South African War (1899-1902), four nursing sisters accompanied the initial 1000 volunteers.  The women were awarded the rank, pay and allowances of an army lieutenant and wore army uniforms throughout their service.  At the same time, in June 1899, the Canadian government authorized the formation of the Canadian Army Medical Department (later re-named 'Corps'), with a mandate to provide a complete range of medical services to men in uniform.

Canadian Nursing Sister Minnie Affleck and wounded soldiers, South African War (1899 - 1902)

As Canada sent an additional 6000 volunteers to South Africa over the next three years, the director of the country's armed forces suggested the creation of an official nursing corps within the existing Medical Department.  In response, the federal government authorized the formation of the Canadian Army Nursing Service in 1901.  Four additional nursing sisters joined the South African contingent, treating diseases common in tropical climates and infections caused by unsanitary conditions in addition to combat wounds.

In the years following the South African War, the Canadian military implemented additional changes to its medical services.  In 1904, the fledgling nursing contingent was incorporated into the 'Reserves', a section of the Canadian Armed Forces consisting of 'semi-permanent' members who supplemented regular troops in time of need.  A total of 25 women were selected as the nursing contingent's initial members.

Four years later, the Canadian government authorized the formation of the Canadian Army Nursing Corps (CANC)*.  Its first matron, Georgina Fane Pope, established procedures for recruitment and operation in addition to managing nursing services at several military hospitals across the country.  Under Pope's leadership, navy blue dresses, white aprons and vales - attire that earned nursing sisters the nickname 'Bluebirds' - replaced the drab army khaki worn in South Africa.

As the above developments suggest, Canada was able to respond to the military's nursing requirements at war's outbreak, although its resources were limited.  The nursing corps consisted of five 'Permanent Force' nurses and approximately 60 reservists.  As events progressed, it was quickly apparent that this small group was ill prepared for the demands placed upon it.

Prior to World War I, nursing was undergoing considerable change, with the opening of nursing schools across the country and establishment of professional associations.  While the occupation represented only 2 % of the entire female work force, there were signs of significant growth.  In fact, by 1921, the number of nurses in Canada quadrupled.  The war played a significant role in this process, accelerating the pace of change and laying the basis for the emergence of a modern nursing profession.

Georgina Fane Pope, CANC's first Matron-in-Chief
In April 1914, Margaret C. Macdonald, a native of Bailey's Brook, Pictou County, was appointed CANC's second Matron-in-Chief.  A veteran of both the Spanish-American and Boer Wars and a member of the organization since 1906, Matron Macdonald had studied the organization of Britain's military nursing corps, adopting it as the model on which to built a Canadian equivalent. 

Despite Macdonald's wealth of experience and valiant efforts, the CANC was poorly prepared for the demands placed on its services at war's outbreak.  The organization hastily assembled a contingent of military nursing sisters for overseas service while launching a nation-wide appeal for additional recruits.  A total of 105 nursing sisters sailed for England with the First Canadian Contingent in September 1914.  By war's end, more than 3000 Canadian women served with the Canadian or British nursing corps.

Matron Macdonald dramatically revised the nursing selection process, which she considered an obstacle to the corps' growth.  She advocated the establishment of military nursing courses in Canadian hospitals and insisted that recruits work in soldiers' training camps and military hospitals prior to service.  Macdonald believed that significant differences existed between civilian and military nursing practice, a judgment soon verified by the CANC's experiences in Europe.

The majority of nursing recruits were born in Canada or the British Isles and raised in urban settings, where there was greater access to nursing schools.  For the most part, the women came from middle-class families whose fathers were 'professionals' by the day's standards - physicians, clergymen, accountants or businessmen.  They possessed a better level of education than average women of the time - most attended high school and some studied at university.  Some recruits previously worked as teachers, clerks or governesses before enrolling in nursing schools, which accepted only applicants 21 years or older.  The initial 1914 CANC recruits' average age was 24.

Priority was naturally given to women with civilian nursing experience, although their wartime duties proved to be dramatically different from such practice.  Candidates had to be single, in good health, and graduates of a recognized nursing school.  Upon selection, the women underwent four to six weeks' training in a military hospital - usually at Halifax, NS - where they received an introduction to the 'basics' of military nursing care.

Major Margaret C. Macdonald, CANC's Second Matron-in-Chief
Candidates subsequently completed a written and oral examination before becoming full-fledged members of the CANC.  While possessing the rank of Lieutenant, their authority as officers was limited to their hospital duties.  Unlike male medical officers, they could not make military decisions outside of a medical facility.  Despite their official rank, the women were commonly described as 'Nursing Sisters' throughout their service.  CANC nurses were the only Canadian women to hold a military rank and work under direct army control during the war.

There was considerable response to the CANC's recruiting efforts, as civilian salaries were low and job prospects in Canada poor at that time.  Enlistment promised regular employment at a respectable wage and appealed to young women's sense of patriotism and desire for 'adventure'.  While initial recruitment focused on members of the 'reserve' who already had experience working in military hospitals, increasing demand expanded the appeal to single women outside the military. 

As demand for nursing services increased, the CANC streamlined the recruitment process by waiving the initial examinations and six week's training.  As a result, 'military nursing' training was often limited to experiences on board ship during the short trans-Atlantic voyage, usually followed by a brief period of training in England.

During the course of the war, Canadian nursing sisters served in over thirty medical facilities in England, France and the Eastern Mediterranean (Gallipoli, Turkey, Alexandria, Egypt, and Salonika, Greece) as well as on board hospital ships.  The Canadian Army Medical Corps provided services at four levels, two of which actively involved nursing sisters.  The stages of care closest to the front line - field ambulance and casualty clearing stations - were staffed by male medical personnel and focused on 'first aid' treatment.  Nursing sisters occasionally worked at a clearing station in the company of a physician, but were never permanently assigned to this location.

Patients requiring further care or long-term treatment were evacuated to stationary hospitals relatively close to the front, mainly at locations in France along or close to the English Channel.   At each facility, a matron managed a staff of 16 nursing sisters who tended to patients in a facility designed to accommodate 250 patients, although actual admissions were often higher.

Canadian Nursing Sisters in working uniform, England.
Soldiers with serious injuries or requiring a lengthy convalescence were evacuated to general hospitals in England, facilities that held 500 or more beds and whose nursing staffs consisted of a matron and 72 nursing sisters.  It was common practice to rotate nursing staff between stationary and general hospitals, making service at several locations over the war's duration commonplace.  In some instances, a unit's nursing staff was dispersed to various locations in response to an urgent need.

Nursing sisters followed the same procedures as civilian hospitals in treating such conventional ailments as influenza, tuberculosis and dysentery.  In many ways, daily routines were also similar as staff disinfected wounds, changed dressings, served food, and tended to patients' hygiene and bodily functions.

Differences, however, greatly outweighed similarities to civilian practice.  Injuries never seen at home presented the greatest challenge as patients recovered from wounds caused by artillery shells, shrapnel and poison gas in addition to bullets.  Most nurses had neither training nor experience in providing such care.  Perhaps most challenging were the effects of prolonged exposure to combat on mental health.  "Shell shocked" soldiers suffered from insomnia, night terrors, incontinence and other symptoms caused modern warfare's impact on the human psyche.

Conditions at stationary hospitals presented another obstacle.  Unhygienic environments, limited quantities of potable water for basic hygiene and human consumption, and insufficient equipment were commonplace.  Personnel serving at the front also suffered the effects of unsanitary accommodations - trenches and occasionally hospitals were over-run with mites, fleas and rats.  Infectious diseases were responsible for almost 70 % of hospital admissions at a time when there were no antibiotics to combat infections or such conditions as meningitis.

Perhaps the most difficult aspect of military nursing near the front was the volume and pace of work.  During an offensive, dressing stations were crammed with wounded soldiers.  When finally evacuated to a stationary hospital, patients were often spread across the grounds outside the facility due to lack of beds.  Nursing sisters roamed from stretcher to stretcher, working long shifts caring for bleeding wounds and broken bones until 'normal' accommodations were available.

Canadian Nursing Sisters 'under canvas - No. 2 Canadian General Hospital, Le Treport, France.
Nursing sisters were also affected by the high mortality rate among patients, as compared to civilian experience.  Witnessing the tragic deaths of so many young men produced considerable stress, compounded by the fact that these young women worked far from family and friends.  Nursing sisters commonly suffered from exhaustion and mental fatigue, problems that often necessitated a leave from service.

Nursing sisters worked and lived under the conditions of war.  Rationing and shortages reduced the availability of such basic goods as sugar, butter, coffee and chocolate.  While personnel in England and parts of France were billeted in houses - and occasionally in villas or castles - nurses close to the front were usually accommodated in canvas tents or wooden huts. 

Working in a war zone also placed nursing sisters 'in the line of fire'.  Stationary hospitals sometimes found themselves within range of enemy artillery, particularly during enemy offensives.  The most significant incident occurred near Etaples and Doullens, France in May 1918, when enemy aircraft dropped bombs on five Canadian stationary hospitals, killing six nursing sisters. 

The greatest loss of life among nursing sisters occurred on June 27, 1918, when a German U-boat spotted the British hospital ship Llandovery Castle off the coast of Ireland as it was returning to Liverpool, England after transporting wounded soldiers to Halifax, NS .  The German submarine torpedoed the ship, surfaced and fired its machine gun at survivors huddled in lifeboats.  Of the 258 Canadian crew and medical staff on board, only 24 survived.  Fourteen nursing sisters were amongst the dead, by far the largest number killed in a single incident during the war.

An additional twenty-two nursing sisters died of sickness or disease during the war years.  The total number of casualties remains a matter of considerable debate.  In the years immediately following the war, military authorities reported a total of 47 deaths amongst nursing personnel.  Since that time, this statistic has been frequently revised, recent sources claiming that the total may be as high as 76.

Funeral procession of Gladys Maude Mary Wake, one of six Nursing Sisters killed at Etaples, France - May 1918
In the midst of such challenges, nursing sisters formed a bond of solidarity, friendship and loyalty.  Their rank permitted them to fraternize with military officers, providing another level of support.  Perhaps most rewarding was the high regard in which their patients held them.  Soldiers frequently referred to the young women who tended to their needs during the most difficult of circumstances as 'angels of mercy'.

Nursing sisters stationed in England were able to enjoy a variety of diversions when not working.  Dancing, dining and sports were common, with tennis a particularly popular activity.  Nurses also adopted the British tradition of  'afternoon tea' as a welcome break from the daily demands of hospital work.  Others took the opportunity to travel to various parts of Europe during leaves.  Such activities no doubt helped the women cope with the stresses of wartime nursing.

By war's end, a total of 3,141 Canadian women enlisted with the CANC, 2,504 serving overseas.  Their performance in dangerous circumstances did not go unnoticed.  Nursing sisters received a total of nine Military Medals for 'gallantry under fire', the majority of which were awarded for actions during the May 1918 Etaples bombings. 

Nursing sisters' contributions during the war demonstrated their critical role in delivering military medical care.  Their work also had a dramatic impact on public attitudes at home, earning their occupation recognition as a legitimate profession.  While many nursing sisters married and raised families after returning home, some remained single and continued to work in health care.  Whatever their post-war paths, nursing sisters's significant contribution to Canada's war effort is widely acknowledged today by historians and citizens alike.

*: Various sources refer to the 1904 organization as the Canadian Army Nursing Service (CANS), although most use the term 'Corps'.  For the purpose of this overview, the latter term and acronym CANC are employed from that year forward.


Allard, Genevieve.  The Call of Duty: Canada's Nursing Sisters.  Library & Archives Canada, Ottawa.  Available online.

"Angels of Mercy" - Canada's Nursing Sisters in World War I and II.  McMaster University.  Available online.

Canada and the First World War: Nurses.  Canadian War Museum.  Available online.

Canada's Nursing Sisters. Veterans' Affairs Canada.  Available online.

Canadian Nursing Sisters.  Canadian Great War Project.  Available online.

For further information on Canada's nursing sisters, visit the following websites:

Canadian Nursing Sisters Index.  Canadian Great War Project.  An alphabetical index of nursing sisters who served with the Canadian Army Medical Corps during World War I.

Finding the Forty-Seven: Canadian Nurses of the First World War.  Author Debbie Marshall's blog endeavours to present the stories of nursing sisters who lost their lives while serving overseas.

National Film Board of Canada: Images of a Forgotten War - Hospital Bombed by German Planes.  This six-minute film records the funeral procession, ceremony and burial following the May 19, 1918 bombing of two stationary hospitals at Etaples, France.  Six Nursing Sisters were amongst the personnel killed in the attack.