1. Arrival and Constitution
     No.22, General Hospital, which had started as a British Unit in June 1915, and of which Miss Suart, QAIMNS, was in charge, was taken over by the 1st Harvard Unit, which arrived in France on June 25th.
     No notification of their impending arrival at Boulogne was received, and arrangements had to be made for the complete staff to be accommodated at the Louvre Hotel for the night. I happened to be in Boulogne at the time and was able to receive them. They were taken to Etaples the next morning, by the Motor charabanc. The Matron, Miss Suart, and the Home Sister remained at the Hospital to welcome the Americans, and to assist them in getting their unit into order.
      This unit was staffed by Medical and Nursing personnel from the Harvard School of Medicine, U.S.A. It was attached to the British Expeditionary Force, and paid from Army Funds. The O.C. was Lt. Colonel Sir Allen Perry, RAMC. The Nursing Staff of 75 was constituted as follows:

     1 Matron (Miss M. Parsons)
     26 Sisters
     48 Staff Nurses

      These ladies were serving under six-monthly contracts, and in a few cases, under three-monthly contracts, so that constant reinforcements were necessary in order to keep the staff up to strength (73). The O.C., Registrar, and N.C.O.’s and men were supplied to the unit by the R.A.M.C.

2.  Reinforcements
During the whole period of its existence, the Unit received the following reinforcements;

7.9.15         1 Nurse from American Ambulance, Paris
9.12.15       36 Nurses from America
6.5.16         5 Nurse from American Ambulance, Paris
12.6.16       33 Nurses from America
8.9.16         15 Nurses from America
8.12.16       20 Nurses from America
13.3.17       17 Nurses from America
30.4.17        7 Trained nurses and 4 VAD from America
8.6.17         16 Trained nurses and 4 VAD from America
9.6.17         2 Nurses from Ambulance, Paris
16.6.17       1 Nurse from Ambulance, Paris
10.7.17       1 Nurse from Ambulance, Paris
22.9.17       9 Nurses from Ambulance, Paris
20.3.18       1 Trained nurse and 2 VAD from Paris
28.3.18       1 Trained nurse from Paris
11.5.18       1 Trained nurse from Paris
8.6.18         1 Trained nurse from Paris
25.8.18       1 Trained nurse from Paris
21.9.18       11 Trained nurses from America
22.10.18     1 VAD from America
26.10.18     8 Trained nurses and 1 VAD from America

3.  Establishment
     The establishment for this Unit (1040 beds) was 73 Nursing Staff. In August 1916, the strength of the Nursing staff stood at 79, and 10 members were temporarily detached for duty with the Chicago Unit, then very considerably under strength.
      In October 1916, Doctor White (Business Manager of the Harvard Unit in America) wrote a letter stating that the Nursing Staff would be reduced from 73 to 50 during the winter months. It was immediately pointed out that the Hospital could not be run with such a reduced staff and no further action was taken. In March 1917, a request was forwarded for an increase of staff from 74 to 90, to meet an increase in beds from 1040 to 2370 during the summer. This was authorised by War Office Letter 0153/2538 (A.M.D.1) dated 29.3.17. On 8.4.17., the Matron forwarded another application, requesting that 10 VAD members be sent out from America. The strength of the Unit was then only 78.
      The request for VAD members was approved and they arrived during the summer of 1917. In October 1918, when the work was very heavy, it was found difficult to carry on with the existing nursing establishment, as those members on the strength were not all employed on nursing duties, some of them being employed as Anaesthetists, X-Ray assistants etc. War Office authority was therefore obtained on 24.10.18, War Office Letter 121/Medical/3500 (A.M.D.1) to increase the Nursing Staff by a number corresponding to those Nurses then doing work which would otherwise be performed by Medical Officers.

4.  Promotions
     In August 1917, a request was forwarded to the War Office for the promotion of 22 Staff Nurses to the rank of Sister, as only 4 of the original Sisters remained, and all reinforcements joined as Staff Nurses. These promotions were approved by the War Office Letter 24/America/29 (A.M.D.1) dated 19.9.17. Approval was also given on 10.9.17 for the appointment of Miss A. B. Stevens as Assistant Matron.
      On 26.9.18., a further application was forwarded for the promotion of 11 Staff Nurses to the rank of Sister, there being at that time only 15 Sisters on the Staff, and establishment being 26 Sisters. These promotions were approved by War Office Letter 24/America/29 (A.M.D.1) of 11.12.18.

5.  Pay and Allowances
     Members of the Harvard Unit were paid from Army Funds at Q.A.I.M.N.S.R. rates, with the exception that they did not receive Active Service outfit and Camp Kit allowances. On arrival in England in June 1915, the 75 original members were provided with Active Service Outfits, Camp Kits and a grant for uniform. In October 1917, when the staff had been increased to 90, a request was made for a corresponding increase for Camp kits, but the War Office directed that beds and mattresses should be indented for, as required, to meet the increase in staff.
      Uniform allowance (£9) was not paid to individual nurses, as many of them were serving on short contracts, but the whole sum was administered by a Committee, of which Dr. White (the Business Manager) was a member.
      War Office Letter 0153/2381 (F.2) of 22.11.17, ruled that members of the Harvard Unit were eligible to receive the additional £20 per annum on signing a contract to serve for the present emergency, and the greater number of Nurses took advantage of this ruling.
     On leaving the service, members of the Harvard Unit were entitled to a gratuity at Q.A.I.M.N.S.R. rates.

6.  Sickness
     Members of the Unit when sick were admitted to Sisters’ Hospitals in the usual way, and, when necessary, evacuated to the United Kingdom. Many of them enjoyed a rest at one or other of the Convalescent Homes in France.
     On 16.2.17., Miss C. Sinclair was admitted to the Villa Tino suffering from cerebro-spinal meningitis, and unfortunately died on 22.2.17. This was the only casualty the Unit suffered.

7.  Change of Matron
     In July 1916, a letter was received from Dr. White, through the War Office, stating that the Matron, Miss M. Parsons, was desirous of resigning, and suggesting that Mrs Hagar, then in England, should be sent out to replace her. This was agreed to, and on 8.8.16., Mrs Hagar arrived and was temporarily attached to No.18, General Hospital, in order that she might become acquainted with a Matron’s duties in a Military Hospital. Miss Parsons handed over to Matron Hagar on 16.8.16., and left for England. She has since returned to France for service with the American Red Cross.

8.  Surgical Teams
     During the heavy work in the beginning of 1918, surgical teams were sent up from the Harvard Unit to work in the front area. S/Nurse Stone was appointed Anaesthetist to No.8, Team, and Sister Haley as Theatre Sister, whilst S/Nurse Thompson was Anaesthetist, and S/Nurse Christie Theatre Sister to No.9, Team. Later S/Nurse Christie was replaced by S/Nurse Angus. Other Sisters who worked in the front area during the autumn of 1917 and in 1918 were Sisters Enebuske (anaesthetist), Hinckley, Aschah, Bentley, Durling, Brown, Norton, Thompson, Springer, and Davidson, whilst Sisters Porter and Hinchliffe both worked in CCS’s as anaesthetists.

9.  Anaesthetists
     In November 1917, when the training of Sisters in the administration of anaesthetics was decided upon and courses were started, No.22, General Hospital was chosen as one of the training centres. The Unit was already experienced in this branch of work, which is often undertaken by Nurses in America, after special training, and several trained anaesthetists were included in the original Nursing Staff. Sister H. Enebuske, a trained anaesthetist, was appointed to assist Colonel Cabot in the training of the Sisters. The first 4 members of the Unit to undergo training were Sisters A. E. Clinch, and M. A. Dunn, and S/Nurses G. Lawrence and M. Daniels. Of these, only Sister Dunn and S/Nurse Lawrence completed their two months at the Base satisfactorily. They were then posted to No.5, C.C.S. for the final month of training, but Staff Nurse Lawrence was not ultimately considered suitable for the work. In July Sister Dunn acted as Anaesthetist to a surgical team at No.6, C.C.S. during the very heavy work. In the second course which started in May 1918, Sisters M. A. Ball, A. T. Porter, and S/Nurse E. Hinchliffe were trained and after taking the course at the Base and in a C.C.S. were all certified as competent.

10.  Surgical dressings laundry
      In January 1918, a scheme was started in the Etaples area, for establishing a laundry for Surgical Dressings, which a view to seeing what could be done with large quantities of soiled dressings, which up to then had been thrown away. Miss Hinckley, one of the Harvard Nurses, who had been trained in this sort of work, took over the management. In 10 days it was calculated that £120 had been saved to the public by the cleansing of materials for surgical dressings, gauze, etc., which could be utilised again as such. Three empty huts were given up to Miss Hinckley, who had 4 French women, 3 men and a number of convalescents to help her. This temporary laundry continued working for about 3 months. After a time, Miss Hinckley’s services being no longer available, the supervision was undertaken very satisfactorily by Sister J. M. E. Livingstone, Q.A.I.M.N.S.R. The laundry had to be closed on April 1st, as the buildings it was occupying were required, and there was also great difficulty in obtaining the necessary labour.
     As soon as the possibilities of the scheme were seen, a proposal was put forward by Captain Child, S.S.O. Etaples, who had been the main mover in the whole undertaking, for a surgical dressing laundry to be erected on a larger scale. The proposed building would cost about £2000 and would be able to deal with six times the amount of dressings dealt with by the temporary laundry. This scheme, however, never materialised, and the Armistice having been signed the necessity for it no longer existed.

11.  Ambulance Trains
      In September 1918, 3 members of the Harvard Unit were chosen to staff a British Ambulance Train, in order that they might have the experience of this branch of work. They remained on the train 3 months, Miss Bentley being in charge, but in December they were transferred back to 22, General Hospital, as the Unit was shortly to be demobilized.

12.  Closing of Unit
      On 29.12.18, a notification was received from D.M.S. L. of C. that No.22, General Hospital was to be cleared of patients, and the staff would return to England on 8.1.19. Lieut. Colonel White, the Manager of the Harvard Unit, came to France to arrange for the closing of the Unit, and the transfer of personnel to America. On 7.1.19 the whole of the Nursing Staff (the Matron, 85 Sisters, and 10 V.A.D.’s) arrived in Boulogne. They were entertained at lunch at the Hotel du Nord, and I saw them off by the afternoon boat. Before leaving, each member was seen by the Command Paymaster and received all pay and allowances due to her. Miss A. M. Alexander, who was sick in Hospital at the time, was evacuated to the United Kingdom by Ambulance Transport on 10.4.19, where leave to a Convalescent Home was to be arranged for her before her return to America.

12.  Honours
      The work accomplished by the Nursing Staff of the 1st Harvard Unit was officially recognised by the award of Honours to certain members, and by the Mention in Despatches of the Commander-in-Chief, of others who had specially distinguished themselves. The number of Awards and Mentions are as follows:

     R.R.C. 1st Class             5
     R.R.C. 2nd Class            9
     Mentions in Despatches   9

   Matrons M. Parsons and K. Hagar both received the R.R.C. 1st Class for their services in France.


E. M. McCarthy
Matron-in-Chief
British Troops in France and Flanders
24th June 1919




1.  Arrival and Constitution
     On the 15th June, 1915, the Chicago Medical Unit arrived in France and took over No.23, General Hospital at Camiers.
      Miss Bills, QAIMNS, who had started the Hospital with a British staff remained temporarily, to assist Miss Patton in taking over.
      The arrival of this, the first American Unit in France, was made the occasion of a dinner of welcome, to which I invited all the Matrons of the area, and also representatives of the Indian and Overseas Nursing Services.
      The Nursing Staff consisted of 75 members:

     1 Matron (Miss I. M. Patton)
     26 Sisters
     48 Staff Nurses

      These ladies were all serving under a six months agreement, and at the end of that time, 35 signified their willingness to renew for a further six months, the remainder either returning to America, or taking up other engagements. The O.C., Registrar, N.C.O.’s and men were supplied to this unit by the RAMC.

2.  Reinforcements
      To replace these casualties, a draft of 33 Nurses arrived from America on 26.2.16 and joined No.23, General Hospital. In June 1916, 17 more Nurses left on termination of contract and in August, 27 more (including the Matron) were due to proceed, this leaving only 17 remaining. Meanwhile 10 members of the Harvard Unit and 21 members of the Australian Army Nursing Service were temporarily attached to 23, General Hospital, to keep the staff up to strength (75). The remaining American Nurses stated that they were willing to extend their services, if required, or to join the British Nursing Service, 10 of them being of British nationality. This information was forwarded to the War Office, and a reply was received, stating that the appointment of these ladies to the Q.A.I.M.N.S. Reserve, could only be sanctioned when an official report had been received as to their suitability.

3.  Transfers to Q.A.I.M.N.S.R.
     I then visited the Unit, and interviewed those ladies wishing to transfer, and it was found that only 4 – Sisters M. Brown, B. Murdoch, M. Brooks and H. Moore were suitable, the remainder not being willing to conform to all Regulations and to sign a year’s agreement. These 4 were accepted later for the Q.A.I.M.N.S. Reserve, after their reports had been forwarded to the War Office and approved.

4.  Closing of Unit
     On 28.8.16., the Unit broke up, the majority of the Nursing Staff returning to America. Two members obtained permission to proceed to Nice, and 2 to Juilly to take up appointments in American Hospitals. The Matron, Miss I. M. Patton, returned to England, where she joined the Canadian Nursing Service, subsequently returning to serve in France. A staff of British Nurses was instructed to join No.23, General Hospital, with Miss H. M. Drage, R.R.C., QAIMNS, as A/Matron, to replace the American staff.

5.  Pay and Allowances
     War Office letter 0153/2/43 (F2) dated 1.7.15., stated that minimum rates of pay and allowances laid down for members of the QAIMNSR should be paid to the Nursing Staff of the Chicago Unit, with the exception of outfit and camp kit allowances. Active Service outfit, camp kits and uniform grant were provided for the Nurses on their arrival in London in June 1915.
      The second draft of Nurses, who arrived in February 1916, received no grant for uniform, and this fact gave rise to considerable correspondence. War Office letter 0153/2303 (F2) dated 22.6.16., laid down that 12 months after the arrival of the of the first Nurses (i.e.15.6.16), the annual uniform allowance (£9) could be issued to the Nurses then serving, but that this allowance would be administered in a lump sum by a Committee, and not issued to individuals. A Committee consisting of the C.O., the Officer i/c Surgical Division, and the Matron was accordingly appointed to settle all claims regarding uniform. Another point which was raised was that of the right to return passages to America. The original agreement stated that passages both ways would be paid, but several members applied to defer their return passage as they wished to accept employment in Paris. War Office Letter 0153/2306 dated 19.3.16 ruled that they would retain their right to a return passage, provided they exercised it within 6 months of termination of Contract.
      All members of the staff were entitled to a gratuity at Q.A.I.M.N.S.R. rates.

6.  Death of Miss Hamilton
     On 21.10.15., Miss Margaret Hamilton, one of the original members of the Unit, was taken suddenly ill with cerebro-spinal meningitis. She was admitted to the Sick Sisters’ Hospital, Etaples, and unfortunately died next day.

7.  Honours
     The good work rendered by the Nursing Staff of the Chicago Medical Unit during their year’s service in France was much appreciated, and was officially recognised by the award of the R.R.C. to Miss Patton, the Matron, in the Birthday Honours of June 1916.
     Sister M. R. Adams was mentioned in the Commander-in-Chief’s Despatches of January 1916, and Sister M. Brooks in the Despatches of June 1916.


E. M. McCarthy
Matron-in-Chief
British Troops in France and Flanders
23rd June 1919