Call of duty: the story of military nurses

From the Zululand War of 1879 to the long conflict in Afghanistan, the Australian War Memorial commemorates the history of service of military nurses. By Linda Belardi.

From the birth of Australian military nursing in 1879, nurses have formed an enduring and integral part of military history. Accompanying servicemen and women on every military and peacekeeping mission, they have cared for thousands of casualties and confronted volatile and dangerous conditions.

The first known Australian military nurse, Sister Mary Jane Armfield, was awarded the Royal Red Cross for her efforts in the Zulu War where she provided care to hundreds of sick and wounded men. Selected in England to join the troops, Armfield bequeathed her medal, as one of the first recipients, to the Australian War Memorial in memory of her childhood in Australia.

Historically nursing was one of the only ways that women could make a difference to the war effort and many put their hand up for duty as a way to contribute their skills or out of loyalty to the British Empire.

Just over 100 Australian nurses have died whilst serving in overseas conflict. The first nursing casualty, Fanny Hines, died of overwork during the Boer War in South Africa in 1900.

“We had 60 women serve during the Boer War. They worked in British hospitals in unsanitary conditions. The water was contaminated and disease rampant. Fanny contracted pneumonia whilst working with a group of patients in a tent hospital and she died alone,” says Robin Siers, the exhibition’s curator.

The greatest loss of life was in the Second World War, where 78 Australian nurses out of some 5000 serving died because of disease or accident but mostly at the hands of the enemy. Ships were also shelled and sunk and Japanese captors took 38 Australian nurses as prisoners of war in Papua New Guinea and Singapore. Among them were Sister Viviane Bullwinkle and Sister Betty Jeffrey whose stories of courage and tenacity are captured in secret diaries kept while in captivity.

Another former PoW, Lorna Johnston, recently made headlines around the globe when she became the first Australian nurse to receive a formal apology from the Japanese government for the suffering she endured. Johnston, now 96, has lived most of her life in New Zealand but returned to Japan in early December to accept the offer of an apology.

The exhibition displaying traditional uniforms, examples of equipment and private records including letters and diaries, takes a chronological but also a personal look at the history of military nursing.

Siers says she was keen to tell their history through the eyes and words of the nurses who experienced the often confronting sights of war. The exhibition has more than 21 personal stories captured through excerpts from diaries kept on the frontline and through personal belongings and artefacts. A desire to make a difference, a sense of adventure and good humour are common features throughout.

A personal favourite of Siers’s is the story of a Queensland nurse, Matron Grace Wilson, who was based at the third Australian general hospital on Lemnos during the Gallipoli campaign in 1915.

“She was much loved by her girls,” she tells Nursing Review. “While they weren’t directly positioned on the Gallipoli Peninsula, they certainly dealt with a huge influx of the wounded and sick. Wilson was described by one of her nurses as a ‘woman of understanding’. She herself had lost her brother Graeme in the Gallipoli campaign shortly before arriving in Lemnos. She soldiered on and that inspired her to care for as many wounded Australians as she could.”

In addition to long hours and poor equipment, the nurses battled harsh climate and weather conditions. Tents invariably blew down in bad weather and freezing temperatures in northern winters meant frostbite was common. With the outbreak of the Second World War, Wilson was appointed Matron-in-Chief of the Second Australian Imperial Force and served in the Middle East until she became ill and was forced to return home in 1941.

The changing face of military nursing
From the expansion of technology and the introduction of male nurses in the 1970s, wartime nursing has undergone a profound transformation. By the end of World War II nursing sisters were commissioned as officers and today are very much involved in the military establishment.

“In the First World War nurses wrote in their diaries about how hilarious it was when they were ordered to line up and march. They were very much nurses first and military personnel second but that has blended into the modern military being an intrinsic part of the military organisation today,” says Siers.

Modern military nurses have rank, they wear a military style uniform and are weapons trained and can protect themselves in combat zones if they need to. Currently, there are more than 600 nurses attached to Joint Health Command in the Australian Defence Force. Reserves with civilian jobs account for about half of that number, and male nurses now make up 40 per cent of personnel.

The changing of the guard
Military nursing services were opened up to men in the 1970s and in a move that reflected the changing status of women, female nursing officers were granted the same status and pay as their incoming male equivalents. Women could also continue to serve after they were married or had children.

Despite a century of developments, Siers says the human hands of nursing have remained unchanged. “It is still the human hand that holds the patient, whoever the casualty of war is. A commitment to patient care and providing care and comfort – those things haven’t changed.”

In many respects, military nursing is nursing in its purest form. Nurses deployed in temporary or mobile environments apply the core principles of nursing in the absence of expansive technology and hospital services.

In addition to working in makeshift environments, the nature and scope of practice of military nursing is very different from their civilian contemporaries. Military nurses often work in extended roles and encounter wounds from the battlefield unseen in a civilian hospital. But as a drawback, they lose continuity of care as patients are quickly moved on to other medical facilities or back home.

The tempo of their patient load also rises and falls according to activity on the front line. Military nurses often work 14-16 hour days in unfamiliar environments treating high numbers of patients.

“Sometimes they are waiting and waiting and other times they are frantic as huge numbers of trauma cases come in. Heavy workloads have certainly been the case from the earliest experience of nurses at war.”

In her diary, Squadron Leader Sharon Bown who served at Tarin Kowt, Afghanistan, in 2008 recorded a day in September when her team received the largest number of Australian casualties in one attack since the Vietnam War. Bown spoke of the high emotion of confronting an injured Australian digger and knowing his life hung in the balance.

Siers hopes this exhibition will immortalise the contribution of nurses in our military history. “Nurses have not often been at the forefront of military stories because they are seen as the support crew but they are always there and they have a very valid place in our military history.”

Nurses: from Zululand to Afghanistan runs from December 2, 2011 to October, 17, 2012 at the Australian War Memorial, Canberra before travelling around the nation, including regional areas.

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