Henley-in-Arden V.A.D. Hospital, Open-Air Ward

     During the present was open-air treatment has played a large part in the cure of wounded soldiers, and any medical man who has had charge of wounded knows what excellent results can be obtained by this method, especially in the more serious kinds of suppurating wounds and in cases of general infection. I submit this short account of an open-air ward because I think it may be of interest to your readers and also because it has one or two features which many specially commend it.

     The ward was built for use at the V.A. Hospital, Henley-in-Arden, of which hospital I am Commandant and Medical Officer, and is specially adapted for such hospitals, as it has the merit of being cheap and at the same time efficient. This particular ward has accommodation for eight beds, though I have had as many as nine beds in it at one time, but buildings can be constructed on these lines to take two or three beds, or twenty or thirty. The chief features which I claim for this particular form of building are as follows:

OPEN BOTH SIDES
It is open to the air on both sides, the ends only being closed in. Most open-air wards that I have seen are closed in on three sides. The protecting screens, at the back of the bed-heads, seen on the right-hand side of the view of the interior, are 4ft high, and afford ample protection from draught. The left-hand side is open down to the ground, except for an open balustrading. Thus there is a free current of air continually passing over the heads of the patients as they lie in bed, and yet they do not feel any draught.

ROOF
The deep sloping eaves are set at such an angle that the rain cannot drive in, even on the most windy and rainy days. During the past month of July, in which we have not had a single day without rain and have had some of the most severe thunderstorms I have ever seen, the interior of this ward has always remained dry and the patients have suffered no inconvenience from wind or rain.

CLOSING THE WARD
If it is desired to close in one side completely, this is done by means of screen fitting into grooves and which can be raised or lowered by a system of counter-weights as shown in the illustration. In this way either side of the ward, or both, can be entirely or partially shut in.

BUILDING AND MATERIAL
It is easily built, the materials being wood and asbestos sheeting, the latter being cheaper than wood, besides having the additional merit of being fireproof. The roof is of match-boarding, covered with rubberoid. The floor is constructed of boards, tongued and grooved, so that no draught can come through. The whole structure is raised some twelve inches from the ground on small brick pillars; this allows a free current of air under the building, and at the same time does not kill the grass, should it be found necessary to erect such a building on a lawn or in a field.

TIME REQUIRED FOR BUILDING
It is quickly and easily erected. This particular building was put up complete in four days – ten days from the date of the order being given.

MAIN BUILDING
It is easily connected with the main building of the hospital by a covered way, so that nurses and patients can pass to and fro in any weather.

FURTHER NOTES ADDED APRIL, 1916
Since this short description of an open-air ward was first published, I have had a large number of letters and enquiries for further particulars, not only from Commandants of V.A. Hospitals, but also from Members of the Medical Profession both at home and abroad.

COST
The question of cost was perhaps the one most often asked, and it is a little difficult to answer this question, as prices have risen so much since a year ago. The original estimate for this building was £53. The covered way into the Hospital main-building cost another £14. The movable screens, the spare screens, gas lighting and the spouting to carry off the rain water (not shown in the illustration) were all later additions, and cost about another £10, making a total of £77 for the building as it stands today, and I think another 15 to 20% should be added for present-day prices. Messrs. Osborne, Pemberton and White, Architects, 40 Bennetts Hill, Birmingham, who prepared the plans at my suggestion, have now made working plans and are prepared to give full details, by which these buildings can be erected by any local builder or carpenter.

HEATING
This is another point on which I have had many enquiries. I can only say that I have not found artificial heat required for the patients. With plenty of blankets the men tell me they do not feel cold even in severe frosts. On two occasions, when the thermometer registered 15 degrees of frost, I had two oil radiators placed in the ward at night. This is a simple and easy way of providing artificial heat if it is really required for a short time. But the need seldom occurs, and the artificial heat is required more for those in attendance than for the sick themselves.

WINTER MONTHS
Lastly, I have been able to test the efficiency of this form of open-air ward during the winter months and have found it entirely satisfactory, having had nearly all the beds occupied up to the present date. During the coldest part of the year the upper screens were raised over the bed-heads at night and spare screens, 4ft. high, were places along the open side, but on find days the upper screens were always down.

SNOW
Snow is always a difficult thing to deal with in open-air wards and during the latter part of the year a snow blind, a thick sheeting, was kept rolled up to the wall-plate on the open side; it was however seldom used, though on the occasion of the severe blizzard at the latter end of March it proved quite effective in keeping out the snow.