‘Here we met our first Australian soldier who passed on. He was only with us five days and during that time we noticed some roses brought by a kindly clergyman from Queenstown. With one of those in his hand he remarked that similar ones grew at his home in St Mary’s near Parramatta. Under his pillow we found a little prayer book, which later I had the pleasure of returning to the donor, his special friend at home. Thirty-one graves mark our short stay of three months.’1
DURING THE ANGLO-BOER WAR, more than sixty nurses from the six independent Australian colonies went to South Africa to assist the sick and wounded in various hospitals, mostly under very harsh conditions. Prior to 1899, there were no military nursing divisions in any of these colonies. There were an urgent need during the war, however, for nurses to tend to casualties in the field. As a result, the governments of some of the colonies arranged for nursing contingents to go to South Africa; some were sent with privately raised funds, while others chose to go independently and at their own expense. In charge of the New South Wales (NSW) nursing contingent was Nellie Gould, a woman who had already made a substantial contribution to the development of the nursing profession in Australia. Welsh by birth, Nellie possessed vision and energy; she was an excellent nurse and an able administrator – a leader at a time when women had limited rights to positions of authority and influence.
Nellie Gould’s early life and education provided an excellent foundation for her future roles. Christened Julia Ellen Gould, she had been born on 29 March 1860 in Aberystwyth, Wales, to Sarah and Henry Gould – the latter a mining agent from Exeter. When Nellie was eighteen months old, her mother – Henry’s second wife – died in childbirth. Henry then moved with his family to Portugal. By now Nellie was four, and her father provided a secure family life as well as home tutoring until she was ten years old. On their return to London, she attended Midmay Park College from the age of fourteen. Two years later, she passed the senior local Cambridge examination and became a member of the teaching staff until 1879. She spent the next four years or so in Hamburg, Germany, where she worked as a governess. Fluent in Portuguese and English, she added German and French to her repertoire. Her itinerant lifestyle and broad education provided insights into the social and political life of Europe – insights which, together with her skills as an educator, she would use to good effect in training nurses and reforming the profession.
In 1884, Nellie and her stepsister, Emily, decided to visit relatives in Grafton, NSW, in Australia. The Prince Alfred Hospital had just been built, and Nellie decided to remain Down Under. In January the following year, she enrolled for a two-year training course at the hospital. Nursing was a sought-after career at the end of the nineteenth century, so much so, that 600 women applied for under thirty training positions at Sydney Hospital.
At the time, the low level of staffing meant a high workload for the nurses, who were also exposed to a variety of infectious diseases. Nellie excelled at her work, and in 1888 she was awarded the prestigious Women’s Industries Gold Medal in the category of sick nursing and ambulance work. That year, hers was one of only ten Gold Medals awarded at the Women’s Industrial Exhibition, which was part of the NSW centennial celebrations.
On completion of her training, she held a number of leadership positions, among them matron of St Kilda Private Hospital at Woolloomooloo, and third matron and superintendent of the training school at Sydney Hospital. Initially, Nellie had the added responsibility of administering the nurses’ training programme while the new Sydney Hospital was being built and the Nightingale Wing (the nurses’ home) was being restored. This somewhat chaotic period provided valuable insight and also experience for her later role of military nurse leader. It was at this time that she remarked, ‘No one who has experienced the satisfaction that arises from work of this nature … ever cares to go back to the dull routine of earning her living in any of the other spheres at present open to women.’2 In 1898, she joined the NSW Public Health Department, and from then until 1900 she was matron of the Hospital for the Insane at Rydalmere in Sydney.
Nellie was also a founding member of the Australasian Trained Nurses Association (ATNA), and from then until she retired twenty-two years later, in 1921, she was a council member. In keeping with her interest in developing nursing into a profession, she initiated the ATNA journal in 1903 and was a member of its editorial committee. Some years before, in February 1899, Colonel (later Surgeon-General) William Williams recruited her to help form the NSW Army Nursing Service Reserve (NSWANSR) to be attached to the NSW Army Medical Corps; twenty-six nurses were sworn in, and Nellie was appointed ‘lady superintendent’. This proved to be timely, as they were soon put to the test when war broke out between Britain and the Boer republics in South Africa in October 1899. Nellie was the ideal person to take charge of the NSW nursing contingent. Apart from her experience, she had impeccable manners and gentle humour; she would set and maintain standards that would leave a mark on future generations of Australian nurses, right up to the present day.
Twenty years later, Nellie noted the significance of the NSWANSR:
In February 1899 Colonel Williams asked me to help form a Nursing Service in connection with his Army Medical Corps Service. In May of the same year, when the various branches were receiving the training necessary to make them militarily efficient, the little band of 26 Nurses were ‘sworn in’ – one Lady Superintendent, one Matron and twenty-four Sisters. Colonel Roth and Colonel Vandeleur Kelly succeeded in convincing us that only in the Army would you find a nursing field where everything ran on ‘greased wheels’ from the firing line, back through the various collection stations, stationary hospitals and base hospital. More greased still the Army Service Corps. Our place in this magic organisation was clearly defined and, twenty years later, the Australian Army Sister still reaps the benefit of those preliminary instructions for the nursing spirit of the New South Wales section (of which alone I can speak with authority) has always kept in time with the rest of the Corps and worked harmoniously with the medical officers, orderlies, and others.3
On the morning of 17 January 1900, Nellie prepared to depart for Africa. Marching through the streets of Sydney behind Lieutenant-Colonel Vandeleur Kelly and the NSW Army Medical Corps, Nellie led her thirteen immaculately turned-out nurses to the harbour, where they would board the troop ship, the Moravian. They had the distinction of being the first group of female military nurses sent to war by an Australian colony. Each civilian-trained NSWANSR nurse was provided with a uniform, paid a £2 allowance on joining, and £1 thereafter each year. Nellie had full confidence in the capabilities of her group, as they each had more than seven years’ nursing experience in Australia. Aged between twenty-five and forty-one, the women all came from middle- and upper-middle-class homes, and had all been educated at private schools.
The nurses’ uniforms were smart and practical, and Nellie’s report provides a detailed image of their design:
The question of Uniform (for the N.S.W. service) was settled by our Medical Officers, Colonel Williams and Lieut.-Colonel Vandeleur Kelly, who obtained a red cape from the War Office as a pattern, and also the regulation cap (muslin hemstitched square). The dress was of dark grey serge (made in Australia) with, in addition to the red cape, a three-quarter length cape of same and a bonnet for outdoor wear. The plain trimming was of brown as worn by the Army Medical Corps. Working uniform was of grey zephyr, washing capes (scarlet) and the muslin-square caps. These capes were made for us at the Army tailors. Before the matter was finally settled, I was called to go with the Colonel to see General French (Commander of the New South Wales Forces) and he approved of the arrangements to be made for the uniform.4
The Moravian docked at Cape Town on 19 February 1900. Nellie’s orders were to divide up her group of nurses and to send them off to places that turned out to be a great distance apart. They would not all be working with the NSW Army Medical Corps, as they had supposed. Six were dispatched south of Cape Town to the British General Hospital (BGH) at Wynberg; eight were shipped to East London, where four sisters under Bessie Pocock were assigned to the Base Hospital; and Nellie, together with her deputy, Julia Bligh Johnston, their close friend, Penelope Frater, and two other nurses were sent to the Stationary Hospital at Sterkstroom, about 250 kilometres north-west of East London.
This temporary hospital was near Stormberg Junction, close to a frontline in the north-eastern Cape. British troops had lost a major battle at Stormberg during the ‘Black Week’ of 10–16 December 1899. On 9 December, General Gatacre had advanced from Sterkstroom to attack the Boers at Stormberg; his 3 000 men in open railway trucks detrained at Molteno in the evening, but, as dawn broke on 10 December, he and his men were routed by the Boers. Twenty-six British soldiers were killed, sixty-eight were wounded and 600 were taken prisoner, while losses on the Boer side were very light. General Gatacre’s troops were still in the area when Nellie’s group arrived, though many of his soldiers were in the hospital as a result of wounds, accidents and illnesses associated with drinking contaminated water.
The principal medical officer with Gatacre’s column was Colonel J. Dallas Edge, who had the field hospital and bearers of the Cape Medical Staff Corps at his disposal at Sterkstroom. When British intelligence reported the presence of a large Boer force in the area, trenches were dug around the hospital and a shell-proof underground operating theatre was constructed. By the middle of January 1900, the field hospital had a considerable number of patients with gastrointestinal disease, including some with typhoid, in addition to patients with war wounds. The local school was converted into a typhoid hospital, and with the arrival of the NSW Army Medical Corps and Nellie’s nurses, a stationary hospital and half a field hospital were established for Gatacre’s troops. The hospital accommodated 107 patients, and it remained active for the next three months, until April, by which time the threat of Boer attacks had considerably diminished.
Named after the strong-flowing Hex River, Sterkstroom lies in a valley, with the Stormberg and Bamboesberg forming an amphitheatre. Nearby is a wide expanse of rolling grassland, with rocky koppies on all sides, where the wind blows fiercely, and lightning and severe thunderstorms frighten strangers. Nights are bitterly cold, mornings are frosty, and summer days are unbearably hot. It was in this inhospitable place, at the stationary hospital, that Nellie and the other sisters prepared to nurse Gatacre’s sick and wounded soldiers. It was the beginning of a period in which Nellie and her team set about transforming decrepit buildings into hospitals, and raising the level of patient care; supplies were often limited, and food and water were in short supply. The team was fully committed to its task, however, and the women tirelessly scrubbed and cleaned sick tents, frequently using their own clothing as covering for the patients. At one point, Nellie was in charge of the entire Orange River district, which stretched far beyond Sterkstroom.
About their time at Sterkstroom, Nellie noted, ‘they were mostly Irish troops and bonny lovable personalities they were too. Here we met our first Australian soldier who passed on. He was only with us five days and during that time we noticed some roses brought by a kindly clergyman from Queenstown. With one of those in his hand he remarked that similar ones grew at his home in St Mary’s near Parramatta. Under his pillow we found a little prayer book which later I had the pleasure of returning to the donor, his particular friend at home. Thirty-one graves mark our short stay of three months.’5 The soldier Nellie refers to here was most likely Edwin Horace Ransley, who died of typhoid fever on 27 April 1900.
In the meantime, British forces had been advancing northwards after the Boer surrender at Paardeberg on 27 February, occupying Bloemfontein and Kroonstad on 13 March and 12 May respectively. Nellie and her group were now ordered to No. 3 BGH in Kroonstad, and thus began their long train journey north, passing through Bloemfontein, which was still recovering from the devastation of a typhoid epidemic. Early in the campaign, after the Battle of Magersfontein on 11 December 1899, there was a long period during which troops were stationed at Modder River and, later, at Paardeberg. A situation where vast numbers of troops were massed together, all using a contaminated water supply, created ideal conditions for a massive outbreak of typhoid fever. The British Army was, therefore, already stricken with typhoid when Lord Roberts’s troops marched on to Kimberley and Bloemfontein. On reaching Bloemfontein, the army became immobilised by the illness, and within a month, more than 4 000 troops had succumbed to the disease.
No. 3 BGH had been moved from Rondebosch to Kroonstad, where it arrived on 25 May, accompanied by Surgeon-General C.W. Wilson and the Scottish National Red Cross Hospital. The hospital was positioned on the outskirts of Kroonstad, to the north of the railway station, and by mid-June it accommodated fifty officers and 720 men. Lord Roberts’s force had only recently passed through the town, and many of the patients were wounded, while the number of typhoid victims had increased during the army’s long halt there. To cope with their needs, hospital facilities were also established in hotels and churches. Nellie and the NSW Army Medical Corps nurses were moved to the Dutch Reformed church building, which had been taken over from the 18th Brigade Field Hospital that had left for the front. No. 3 BGH admitted about 140 patients on 28 and 29 May. It remained in Kroonstad until 31 May 1902, serving the central region of the Orange River Colony. Sadly, both the commanding officer, Colonel Oswald Wood, and his wife, who was nursing superintendent, died of typhoid that year.
The church could accommodate about ninety patients inside the building, and about 100 in tents pitched outside in the churchyard. With its wooden floor, the church functioned well as a hospital, and the adjacent tented area eventually accommodated 200 patients. ‘Here we nursed in connection with No. 3 British General Hospital in a large Dutch Church, and we were quartered in an old corn store where at night rats scampered over us,’ Nellie later recalled. ‘We boarded with a family who were none too loyal but they did their best for our creature comforts. One tin of condensed milk had to do nine of us for one month, but who cared?’6 With large numbers of sick and wounded left stranded in the town, even the Kroonstad Hotel and the Grand Hotel were temporarily converted into hospitals.
Nursing typhoid patients was a very unpleasant task, as Gertrude Fletcher, an Australian nurse who had arrived with the British Army Nursing Service Reserve, recorded:
Lately I have taken to cleaning the mouths of the worst typhoids. By the time I have finished doing twenty or thirty tremulous pairs of lips, the same number of quivering tongues, with the teeth, gums, and palates accompanying them, I am nearly as tremulous as any of them. It is the most trying piece of work I have ever undertaken. When one begins, their mouths are stiff and caked with sores so that they cannot articulate or taste at all (many times) till they are cleaned.7
In August 1900, the chief medical officer at No. 3 BGH decided on new postings. Two Australian nurses were to remain in Kroonstad to look after a small exclusive hospital for British officers; of the original nine, Bessie Pocock and three others had already been posted to No. 17 Stationary Hospital at Middelburg in the Transvaal. However, Nellie suggested that the remaining five nurses stay together, and in August they were posted as a group to No. 6 BGH in Johannesburg. Nellie recalled:
Three months later, we were transferred to No. 6 British General Hospital in Johannesburg. Our reception here was curious. On handing in my papers to the Principal Medical Officer he groaned, ‘My God, Australian Sisters, what shall we do?’ On my asking the reasons, he said they did require help but he understood we could not work with the Royal Army Medical Corps (RAMC) Sisters. Upon my assuring him that we not only could but would with pleasure, he sent for the Superintendent, Sister Oram, who was to my mind then, exceptional, and she has never come off that pedestal.8
Their cool reception in the city was unexpected, as Nellie and her team had nursed troops from many British and colonial regiments, as well as Boers who had been captured during the preceding six months. The reaction was especially ironic since Nellie had been born in Wales and spent more than twenty years in Britain and Europe before immigrating to Australia, yet she was still regarded as a colonial.
No. 6 BGH had been brought up a month earlier from Naauwpoort in the Cape Colony, where the full unit was no longer required, and was established at the popular Wanderers Club, which had extensive grounds and buildings. ‘The hospital … took up its quarters in the beautiful grounds of the Wanderers Club, with its protecting fringe of well-grown eucalyptus and other Australian trees,’ described Australian medical professor, Archibald Watson. ‘The Wanderers Ground is situated at the back of Johannesburg Park Railway Station, a two-chain road intervening. The Principal Medical Officer had a railway siding constructed directly to the hospital, thereby obviating the necessity of ambulances.’9
The hospital started off with forty marquees, and gradually expanded until, at one stage, it could accommodate over 1 000 patients. Lieutenant-Colonel Somerville-Large was in charge, assisted by four RAMC officers, fourteen civil surgeons, eight Army Nursing Service nurses, 250 orderlies, and the five Australian sisters, led by Nellie. They had an operating theatre and a fully equipped X-ray room in the surgical section. Working conditions for the medical staff in the tent wards were tough, however. Nellie’s team shared duties with thirty RAMC nurses, and together they looked after 1 200 beds, which meant fourteen-hour shifts for a period of eighteen months.
Watson recorded the fairly low mortality rate: ‘The total number of cases treated since the inception of No. 6 Hospital up to January 1901, was 13 000, and the percentage of deaths 2.15. The enteric cases numbered some 2 500, with a percentage of deaths 7.86.’ Patients were well cared for and well treated, had access to a large reading and writing room, and were encouraged to participate in fund-raising evenings, cricket matches and cycling events. ‘From all over the world have they come, these battered warriors – together they have fought, and now together they suffer – South Africans, Canadians, New Zealanders, Australians, wounded Boers, and the British foot soldier, than whom there lives no braver man.’10
By the end of September 1901, when there was no longer a need for a general hospital in the city, No. 6 was closed down and the Wanderers Club re-opened to the public. And so, for the next five months, until February 1902, Nellie and Julia Johnston worked at No. 25 British Stationary Hospital, which was also in Johannesburg: ‘We stayed 18 months here [in Johannesburg] and never once felt we were not wanted, for there were only 35 Sisters for the 1 200; 14 hours duty was the minimum,’ Nellie recorded.11
From what Sister Janey Lempriere of NSW wrote about a nursing sister’s typical day, it is clear that they were not in South Africa for a holiday:
The sister has to go around with the surgeon, take his orders, pass the dressings – the orderlies fetch & carry & clean up after dressings. It is puzzling to define the work the sister does. She has all anxiety and worry. Before 1 o’clock she leaves for lunch, writing down any instructions for the orderly or relieving sister, & then after lunch we rest till 4.45 till we have aft. tea & then go back to superintend again from 5 till 7.45 when we are bound to return for dinner at 8. The night sisters go on duty at nine, leaving at 8 in the morning. The hours are not long, but you get tired all the same from running about.12
As the war ground slowly towards its end in 1902, Nellie’s final posting was further north, at No. 31 British Stationary Hospital in Ermelo in the Eastern Transvaal. By now, British campaigns to capture roving Boers were well under way, and Lord Kitchener had established a vast network of blockhouses to counter Boer movements. For three decades, Ermelo had been a stopover point for wagons travelling between Lydenburg and Natal. The town had grown rapidly until the Anglo-Boer War, when it was almost completely destroyed by the British; only one home survived the senseless destruction. Whereas Dr R.K. Eberhardt of the Russian Red Cross Ambulance had, on visiting Ermelo in June 1900, found an ‘attractive little town’, Nellie and her band of sisters encountered a devastated place.13
The British camp was strategically positioned on Tafelkop, providing troops with an excellent view of the town and surrounding area. ‘When No. 6 closed down, we went to Ermelo in the Eastern Transvaal to No. 35 [actually 31] Stationary, on a bare hillside at the end of sixty miles of Blockhouses [the Standerton–Ermelo blockhouse line],’ Nellie recalled. ‘We were nursing the sick from 2 000 troops about there. Mostly typhoid and yellow jaundice. Here we saw the start of seven columns which took part in the last drive of the war and here we saw the Boers come in to surrender arms. No bitterness on either side.’14 She and Julia Johnston later opened a private hospital in Newtown, Sydney, which they named Ermelo – in memory, no doubt, of their wartime experiences on the ‘bare hillside’ in the South African veld.
Soon after Nellie’s arrival in Ermelo, a peace treaty was signed at Vereeniging, about 230 kilometres away, on 31 May 1902. Nellie and the NSW Army Medical Corps nurses had been in South Africa for almost the entire duration of the war – close on two and a half years (most Australian soldiers, on the other hand, served only one-year terms, though many did re-enlist). Yet even once the war had ended, the nurses were not sent home. There was still a lot of work to do in South Africa, including caring for Boer people who had been interned in concentration camps, as well as nursing the wounded and sick of both sides who were too ill to be discharged. Nellie and five of her colleagues attended a farewell dinner for the British Stationary Hospital on 1 July, but it was not until the end of the month that the war was finally over for them, and all fourteen NSW Army Medical Corps nurses boarded the troop ship Montrose for Australia. On 2 August 1902, they sailed through Sydney Heads; after well over two years of hardship in the war hospitals of South Africa, they were home.
The Anglo-Boer War had a powerful impact on the lives of these Australian nurses, with some of them succumbing to the effects of the diseases that plagued their soldier patients. Bessie Pocock contracted typhoid and was sent to England in May 1902, where she remained a while before sailing back to Australia. And sadly, on 7 August 1900, one of the nurses from Victoria, Fanny Hines, died of pneumonia at the Memorial Hospital in Bulawayo, where she was buried in the local cemetery. She had been treating up to twenty-six patients at any one time on her own, with no one to relieve her, and no time for proper meals. A few nurses remained in South Africa, among them Elizabeth Orr from Tasmania; she nursed privately in Johannesburg and Pretoria for a while after the war, and from 1908 was matron at a mine hospital in Krugersdorp, where she worked for several years.
One of the more contentious policy issues during the Anglo-Boer War campaign had been the appropriateness of employing female nurses, as opposed to male orderlies, in a war. However, the critics were to a large extent silenced by the resilience and effectiveness of the Boer War nurses. Indeed, their efficiency paved the way for nurses who offered their services in World War I.
Nellie Gould and her team had returned to a newly federated Commonwealth of Australia. She now had first-hand experience in war nursing, and was able to give due consideration to the suitability of military policies as they related to nursing. When requested on her return to develop the Australian Army Nursing Service (AANS), she drew on her wartime experience and organised six military districts, one for each state. She also further organised the NSWANSR and was appointed principal matron of the 2nd Military District. Julia Johnston was its ‘lady superintendent’.
As already mentioned, together with Sister Johnston, who had shared such difficult times with her during the Boer war, Nellie opened the Ermelo Private Hospital in Newtown, Sydney, and for the next ten years she dedicated her energy and initiative to the welfare of nurses and the enhancement of the status of the profession. When the Ermelo Private Hospital was sold in 1912, Nellie and Julia joined the Public Health Department.
When World War I broke out in 1914, Nellie was eager to offer her services, and on 27 September 1914 she enlisted in the Australian Imperial Force. She was appointed matron of No. 2 Australian General Hospital (AGH) and, together with six other nurses, left Australia a month later, disembarking at Alexandria, Egypt, on 4 December. The hospital unit arrived some time afterwards, and she assumed duty on 21 January 1915. The staff were established at Mena Hospital, which had formerly been a large tourist hotel; it was situated near the pyramids. A few months later, casualties from the Battle of Gallipoli necessitated the preparation of a second hospital at Ghezireh Palace on the Nile River. The two hospitals had a combined total of 1 500 beds.
Mena Hospital was closed as an acute hospital on 12 June 1915 because of the area’s high climatic temperatures (though it was later re-opened as a convalescent hospital). No. 2 AGH was then relocated to the Ghezireh Palace Hotel, which was inconveniently located on a small island. The next year, in April, No. 2 AGH was transferred to France and established at Wimereux. Nellie and her colleagues arrived there on 30 June 1916, on the eve of the advance on the Somme. By 1917, the strain of war was beginning to take its toll on Nellie’s health; she was now fifty-seven years old. She still had work to do, however, and accepted the position of matron at No. 1 Australian Auxiliary Hospital, a convalescent hospital of 500 beds at Harefield, England, where Australian casualties of the Somme were sent before being shipped home. Nellie’s final wartime duty was at Cobham Hall, an officers’ hospital where she served for a year before returning to Australia in January 1919.
After all her years of service, Nellie’s AANS uniform was weighed down with medals, which included the Queen’s South Africa Medal and the King’s South Africa Medal; even more significantly, she had been honoured in 1916 with the Royal Red Cross (1st Class), a medal that was awarded to members of the nursing services, irrespective of rank, who were commended for special devotion and competency.
Nellie Gould was discharged from the Australian Imperial Force on 3 March 1919; her health no longer permitted her to continue with her nursing duties. By this time she was sixty years old, and she retired to her home in Miranda, NSW, which she named Ghezireh, after her posting in Egypt.
At Ghezireh, she lived for the next twenty years with her close friend and Anglo-Boer War colleague, Julia Johnston, whom she outlived by a year. Nellie died in hospital at Neutral Bay on 19 April 1941, aged eighty-one – ironically, at a time when the world was again at war. She was not given a military funeral, as some may have expected, but was privately cremated. Her ashes are interred with those of Julia Johnston and her other close colleague, Penelope Frater, at Woronora Cemetery in Sydney, not far from her home in Miranda.
A plaque at The Rocks in Sydney commemorates the stalwart wartime service of Australian nurses such as Nellie Gould. Nellie’s greatest achievement was her ability to transfer the skills and experience of the civilian-trained nurse into the military nursing domain. This led to the emergence of a number of excellent nurses, all leaders in their field, with unique administrative and management skills. For it was in the spheres of the Anglo-Boer War and World War I that the ordinary Australian nurse evolved into an efficient and professional army nurse.