ARRIVAL AND ESTABLISHMENT 
     No.1 South African General Hospital arrived in France in July 1916, and was established at Abbeville in a site next to No.2 Stationary Hospital, in an open camp. On 17.7.16., the Hospital began admitting, and an urgent request was sent to D.G.M.S. for the Nursing Staff which was to be composed of members of the S.A.M.N.S. Meanwhile the Matron of 2 Stationary Hospital, supplied a temporary day and night staff. On 4.8.16., the Matron Mrs. E. R. Creagh, and 21 Nurses of the S.A.M.N.S. arrived from England. On 5.8.16., 8 more Nurses arrived, and on 8.8.16., 11 more. This completed a total Nursing Staff of 1 Matron and 40 Nurses, including 1 Probationer, Miss D. M. Thomson, who was not fully trained. The O.C. of the Unit was Lieut. Colonel P. G. Stock, S.A.M.C., and the Matron (Mrs. Creagh) was also Matron-in-Chief of the S.A.M.N.S.

ACCOMMODATION
     The Nursing Staff were accommodated in a house a short distance from the camp, as no quarters had yet been built for them. Later accommodation was arranged for them under canvas in their own compound. During December, in consequence of an order that no members of the Nursing Staff were to be accommodated under canvas during the winter, the Nursing Staff had to be temporarily billeted in different parts of Abbeville. This arrangement was most unsatisfactory. Hutted quarters were being built in the Hospital, and these, when finished, provided ample accommodation for any increase in staff.

EXPANSION OF UNIT AND INCREASE OF STAFF
     During the heavy work of the Autumn of 1916, it was found impossible to cope with the work with the South African Staff alone, so a certain number of Reserves were lent temporarily. Six members of the A.A.N.S. who had just arrived from the United Kingdom also did temporary duty there to relieve the pressure. In October 1916, 5 British V.A.D.’s were posted for temporary duty to the South African General Hospital. In December 1916, the O.C. applied for an increase of staff to meet the increase of beds from 520 to 620 and also to cover wastage. A demand for 4 sisters and 8 Staff-Nurses was put forward to meet these deficiencies. In February 1917, a further urgent request for reinforcements was sent as a super-crisis expansion to 934 beds had been opened up. The numbers asked for were 7 Sister and 15 Staff-Nurses, in order to release the 10 British Members (5 V.A.D.'s and 5 Reserves) who were still lent to the Unit, and whose services could ill be spared.
In April 1917, no reinforcements having arrived, further British V.A.D.’s were lent, making a total of 21 attached. On 21st July, 1917, the long expected reinforcements arrived – 5 Sisters S.A.M.N.S. and 18 Probationers S.A.M.N.S. (who had been called for by Colonel Stock, and approved by War Office Letter 121/Overseas/3770 (A.M.D. 1) of 7.6.17.) Between September and December 1917, 10 more reinforcements arrived, replacing casualties. On 20.12.17., Miss D. H. Markus who had previously served as a British VAD., reported for duty as a S.A.M.N.S. Probationer.

     In December, 1917, the staff consisted of 1 Matron, 23 Sisters, 26 Staff-Nurses, 19 Probationers, all S.A.M.N.S., 12 members S.A.M.N.S. attached Q.A.I.M.N.S.R. (lent temporarily), the remainder having been withdrawn, as they were urgently needed in Imperial Units. The number of beds had by then been increased to 1112, and this left a shortage on Establishment of 4 Nursing Sisters and 19 Probationers. The O.C. South African General Hospital, requested however that Staff-Nurses should be sent in place of Sisters, as at present there were no vacancies for charge duties, and if any arose, he would prefer to promote some of his Senior Staff-Nurses who had been with the Unit since the beginning. In answer to this request for reinforcements, the War Office stated that a party of Nurses from South Africa were expected in April. On 23.4.18., S/Nurse Moffatt and a party of 15 S.A.M.N.S. Probationers arrived. Owing to the military situation, they were posted temporarily to Units in the Boulogne area, and did not join the South African General Hospital until 9.7.18. During July and August the work was of a very heavy nature, as large numbers of fractured femur cases were received and retained for treatment. One reinforcement arrived on 22.8.18. and 6 on 3.10.18. In November 1918, a further demand for reinforcements was made by the O.C. who stated that the work was very heavy. The Nursing strength of the Unit at that time was 51 Trained and 29 Probationers, the establishment being 52 Trained and 36 Probationers. It was not considered necessary to forward this demand, as the Armistice had been signed and the pressure of work could not be a lasting one.

CLOSING OF UNIT
     In March 1919, instructions were received that in accordance with South African Demobilization Instructions the South African General Hospital would be gradually reduced, 10 other ranks proceeding each week, and the accommodation to be reduced by 50 beds weekly. Instructions were asked for regarding the Nursing Staff, and orders were received that they were to be transferred to the United Kingdom, as accommodation became available. Sister M. A. Gilson and S/Nurse Delaporte had already proceeded on 23.3.19. to Richmond for transport duty to South Africa, and Sister M. Tilney on 17.3.19. for duty. The remaining Sister proceeded as follows:

8 to South African Hospital, Richmond Park on 28.3.19.
10 to South African Hospital, Richmond Park on 1.4.19.
10 to Hospitality S. A. Comforts Fund on 8.4.19.
10 to South African Hospital Richmond Park on 9.4.19.
11 to Prince of Wales Hospital on 23.4.19.
10 to Endell Street Hospital on 24.4.19.

Matron Creagh, R.R.C. to 40, Bedford Place W. on 25.4.19.

     All members were seen by me before their departure, and were thanked for the work they had done in France.

PAY AND ALLOWANCES
     A.C.I. 1586 of 1917 laid down that pay, allowances and gratuities on termination of services of trained members of the S.A.M.N.S. should be as laid down for Q.A.I.M.N.S.R. Untrained members were entitled to the same rates of pay and allowances as V.A.D. Members. Whilst serving in France these ladies received their pay and allowances through the Command Paymaster, Base, and in the same way as British Nurses.
Some correspondence took place on demobilization with regard to the procedure to be adopted for the completion and forwarding of Army Form W. 3165 (gratuity form) Army Form Z.22 (disability form) and other demobilization papers. O.C., South African General Hospital, received instructions direct from the South African Authorities, to forward all papers direct to the War Office, in accordance with South African Demobilization Regulations, and not through this Office, as in the case of all other Nurses.
     As instructions had been received that all demobilization papers were to be forwarded through this Office, the question was referred to the War Office, through the D.G.M.S., and a ruling was obtained that South African Demobilization Regulations should be complied with.

PROMOTION
     In July, 1917, the O.C. forwarded to South African Staff Officer, London, recommendations for the promotion of the following seven Staff-Nurses to the rank of Sister:-

S/Nurses A. B. Conyngham, M. A. Fynn, M. A. Gilson, D.N.K. van Niekerk, I. F. Waters, M. Nothard, and H. L. Bester.

     These recommendations were returned with a request that they should be dealt with in France. Reports were called for on the ladies concerned, and having been found suitable, they were promoted to A/Sister’s rank, to date from 19.3.17.

CONTRACTS
     No information was received in this Office with regard to agreements signed by members of the S.A.M.N.S., until July 1917, when War Office Letter 121/Overseas/4411 (F.2) dated 4.7.17. was received, notifying that members of the S.A.M.N.S. were entitled to the extra £20 provided they signed A.F. W.3538. It was not until April 1918, that it was discovered that the original members of the Unit had signed no agreement before embarking for France, but as soon as this was known, all members were asked to sign agreements and these were forwarded to the War Office. One member, N/Sister A. M. Newth, having objected to signing an agreement, the matter was referred to the War Office, and a ruling received that members of the S.A.M.N.S. were not required to sign agreements unless they wished to draw the additional £20. Resignations of the S.A.M.N.S. were carried out in precisely the same way as for Q.A.I.M.N.S.R., the member submitting her application, stating reasons, and only leaving this Command on receipt of War Office Authority.

UNIFORM
     The uniform of the S.A.M.N.S. is both pretty and practical. The indoor uniform consists of tussore coloured washing material, with blue cape for Sisters, and tussore cape edged with blue for Staff-Nurses, white linen collar and cuffs and apron, and Army cap. The outdoor uniform consists of a navy blue long coat and blue hat for winter, or white hats with blue band for summer, with springbok badges. In February 1918, Mrs. Creagh informed us that at her request an additional off duty uniform had been authorised by Defence Headquarters, Pretoria. This off-duty uniform consisted of a brown coat and skirt, tussore silk blouse and blue silk tie. The 25 members of the S.A.M.N.S. attached to Q.A.I.M.N.S.R. who arrived in December 1916, for duty in British Units were specially authorised to continue to wear the S.A.M.N.S. uniform.

SICKNESS
     There were two deaths among members of the S.A.M.N.S. while serving in France.
Miss O. Hockey, S.A.M.N.S. attached Q.A.I.M.N.S.R., who was serving at No.2 General Hospital, Havre, died of cerebro-spinal meningitis on 14.8.17.
Miss E. A. Baker, S.A.M.N.S. No.1 South African General Hospital, died on 6.11.18. of influenza. This was during the bad influenza epidemic of the autumn of 1918.
     During the bombardment of 44, and 47, C.C.S. in August 1917, when a member of the Q.A.I.M.N.S.R. was killed, several members of the Nursing Staff were evacuated to the Base suffering from Shell Shock, amongst them being N/Sisters E. Burgess and D. van Niekerk, S.A.M.N.S. who were temporarily attached to 47 C.C.S. at the time. They returned to duty after a short rest at a Convalescent Home.

LEAVE
     Members of the S.A.M.N.S. were granted 14 days leave every six months in the same way as other Nursing Services. In addition they spent periods of rest and sick leave at Convalescent Homes in France and could also spend their leave at these Homes, or at the Paris Club, if they wished.
I     n January, 1917, Matron Creagh, R.R.C. spent 14 days’ leave at the Villa Roquebrune, Mentone, this being the first year the Villa was open to Military Nursing Sisters. During the season 1917 – 1918, 16 members of the S.A.M.N.S. spent periods of leave at Cannes Convalescent Home, and during the season 1918 – 1919, 10 went to Cannes, and 3 to Casa del Mare, Mentone.

SURGICAL TEAMS
     S/Nurse E.M.R. Currie, S.A.M.N.S., was nominated as Team Sister to the surgical team from the South African General Hospital, for work in front areas, and worked on the French front with the 9th Corps during the battle of Champagne in May and June 1918. On her return, after a strenuous time, she proceeded on leave and was replaced on the team by S/Nurse F. Brookshaw. Other members of the South African Hospital were attached to surgical teams for short periods and did excellent work.

ANAESTHETISTS
     When the first course of instruction in the training of Nursing Sisters as Anaesthetists was begun in January 1918, No.1 South African General Hospital was selected as one of the approved training centres. Two S.A.M.N.S. Sisters – N/Sisters H. L. Beaters and A. M. Newth – received training in the first course, being posted to 2, Stationary Hospital for instruction. They proceeded on 18.3.18. to 48, C.C.S. for their final month, but were obliged to return shortly afterwards owing to the Retreat. They resumed their interrupted training on 20.4.18. at 2, Stationary Hospital and were certified competent on 19.5.18. Sister M. E. Johnson, S.A.M.N.S. attached Q.A.I.M.N.S.R., commenced the first course at 2 Stationary Hospital, but was not considered suitable for the work and was not recommended for further instruction.
In the second course, which began on May 21st, 1918, N/Sister H. A. Kingdon, S.A.M.N.S., received instruction at No.1 South African General Hospital, and 2, Australian C.C.S., and was certified as competent to administer Anaesthetics at the completion of her three months training.

FRACTURED FEMUR WARDS
     In January, 1918, the South African General Hospital was selected as the Unit to receive all cases of fractured femur coming to the Abbeville area, and wards were set apart and specially equipped for this purpose. An increase of 4 Staff-Nurses was asked for to carry on this special branch but it was pointed out that as no increase in establishment could be sanctioned, a rearrangement of the staff should be effected to meet requirements. In June 1918, S/Nurse I. Lyons, Q.A.I.M.N.S.R. was posted to the South African General Hospital for duty as masseuse in these wards. In September, 1918, a trained masseuse of the A.P.M.M.C. was posted to the Unit, and remained until demobilization. The work done in this fractured femur department was of a very heavy nature, as many as 50 or 60 patients sometimes being on the “D.I.” and “S.I.” Lists.

DISPENSER
     In October 1917, Miss K. Osborne Day, Probationer, applied for permission to be employed as Dispenser at the South African General Hospital, where she was already serving. The O.C. recommended her application, and it was approved by the D.G.M.S. She accordingly assumed the duties of a dispenser on 25.10.17., her pay and allowances remaining those of an ordinary S.A.M.N.S. Probationer.

LABORATORY
     From July 22nd, 1917, until the closing of the Unit, Miss D. M. Thomson, Probationer, S.A.M.N.S., acted as bacteriological assistant and gave valuable help in the many important researches which were carried out in this laboratory under the direction of Colonel Cummins, Adviser in Pathology. It was in this laboratory, that the late Major Graeme Gibson, R.A.M.C., carried out his valuable research work in connection with the influenza germ.

AMBULANCE TRAIN
     In March 1918, 3 members of the S.A.M.N.S. were selected for duty on No.38 Ambulance Train, in order that they might have experience of this kind of work. They were N/Sisters E. S. Wessels, i/c, and S/Nurses C. A. Nothard and E. Ramage. On 27.7.18, the two S/Nurses were exchanged for S/Nurses C. O’Brien and P. M. Kenyon. In the beginning of September, the need for Nurses at the South African General Hospital became so pressing that the S.A.M.N.S. staff were relieved from train duty, and returned to their Unit at the Matron’s request.

TEMPORARY DISPERSAL OF THE UNIT DURING THE RETREAT
     During the last few days of March, the Military situation was considered sufficiently critical for the Nursing staff to be removed from the Abbeville Area, and in the three large Hospitals there, it was reduced to the strength required for Casualty Clearing Station work. From March 29th to April 3rd, groups of 10 and 20 Nurses, with a Sister in charge of each party, were sent away daily by different trains, from the South African General Hospital, for temporary duty in the Boulogne and Rouen areas. On April 4th, there was a total of 9 trained Nurses, and 1 Probationer on duty at the Hospital only.
     As the Military Situation improved, and large convoys of serious cases were admitted to the Hospital, some of the Nursing Staff were able to return almost immediately – though on account of the bad air raids, they were not all returned until August, when the Probationers rejoined their unit.

GIFTS
     In December 1917, a request was received from the War Office for a list of members of the S.A.M.N.S. serving in France, to be sent direct to Lady Gladstone, at the South African Comforts Fund. The list of 92 names, including S.A.M.N.S. attached Q.A.I.M.N.S.R. was sent as requested, and we were then informed that each S.A.M.N.S. Nurse was receiving 10/- as a Christmas gift from the people of South Africa. This sum was paid to each member by arrangement with the Command Paymaster.

S.A.M.N.S. ATTACHED Q.A.I.M.N.S.R.
     In December, 1916, a contingent of 25 S.A.M.N.S. Nurses were sent to France to be attached to the Q.A.I.M.N.S. Reserve for service in British Units. They received the pay and allowances of the Reserve and were under its regulations, but they were permitted to continue wearing the uniform of the S.A.M.N.S.

COMMEMORATION SERVICE
     On 17.2.18., a Commemoration Service was held in Delville Wood in memory of the members of the South African Contingent who had fallen there. Permission was obtained for Matron Creagh and some members of her staff to attend, and also Miss Schreiner, V.A.D. (then on duty at Etaples), daughter of the High Commissioner for South Africa.

HONOURS
     The valuable and devoted services, rendered by members of the South African Military Nursing Service, were recognised in the New Year and Birthday Honours’ lists of ’17, ’18, and ’19, by Sir Douglas Haig in his Despatches. The number of awards and mentions are as follows:-

1 R.R.C. (awarded to Matron Creagh in January 1917)
8 A.R.R.C.
16 Mentions in Despatches.

In June 1918, Matron Creagh received the O.B.E.

     The work of the South African General Hospital has been much appreciated, and the most cordial relations have always existed between the Nursing Staff and that of the other Nursing Services. Mrs. Creagh, R.R.C. has rendered me most valuable assistance on many occasions, notably, by lending some of her staff to meet the sudden calls from Army Areas, until reliefs could be brought up from the Base, by offering to accommodate any surplus staff at the time of the influx of the Territorial Hospitals in 1917, when almost at the same moment Units were being handed over to Americans and to Australians, and by her active co-operation in March 1918, when it was necessary to send away from Abbeville, at very short notice, practically the complete staff of the Unit.



E. M. McCarthy
Matron-in-Chief, British Troops in France and Flanders
A.P.O. 3
23rd June, 1919.