‘We are all on rations of corned beef, bread, tea, coffee, sugar, and jam. As the food question never troubles me, I don’t mind the monotony; but some of the sisters don’t fancy these things, and would be glad to be home again. Many women don’t understand roughing it, as one is bound to do on active service, and are a nuisance all round in consequence. Fine ladies – professional or otherwise – are out of place here – rain, hail, wind, thunder, storm, and stress – or sun, sand, and flies – it’s all one to the right sort – but you are not asked by the elements to take your choice.’1
VISITORS TO ST JOHN’S CHURCH in St Helens, Lancashire, in the north-west of England, are likely to pause and admire three stained-glass windows in the foyer of the church. The first window depicts a South African battlefield against the backdrop of Bloemfontein. The second shows a ward in The London Hospital, while the third is an image of a nurse in an army nursing uniform – not some anonymous nurse, but rather a well-loved local by the name of Clara Evans. A few months after the outbreak of the Second Anglo-Boer War, Clara set off for South Africa – though, tragically, she was never to return. Her nursing service is further commemorated in an engraving on the baptismal font: ‘To the glory of God and in memory of Clara Evans, presented by the Sunday School children 1900.’ The dedication is especially appropriate, as she had been a Sunday school teacher at the church.
Clara Evans was born in 1871 in the small village of St Helens, where she attended the local school. Like many other young people at the time, she was inspired by tales of Florence Nightingale during the Crimean War. She grew up in a corner shop on Crossley Road opposite St John’s church, where she was to teach Sunday school. The surrounding area had been home to the Ravenhead Coal Mine, and was well known for its glass industry. Fortunately, the shop survived encroaching development, and may still be seen today.
Clara entered The London Hospital as a non-paying probationer on 30 April 1896 at the age of twenty-six, and she could not have wished for an institution with a greater tradition. Founded in September 1740 as The London Infirmary, it was renamed The London Hospital in 1748, and today it is located in Whitechapel.2
Entries for Clara Evans in the ‘London Hospital Register of Pupil Probationers, 1895–1896’, gives her address and other details: ‘Woodlands. St. Helen’s, Lancashire, age 26. Entered London Hospital Preliminary Nurse Training School, Tredegar House, Bow on 14 March, 1896. Previous occupation: Home duties. Previous hospital training: None.’ Under ‘Remarks’ is written: ‘Intelligent, ready & quick at seeing things. Bright & cheerful with capabilities for making a smart nurse.’3
In another register in the same archives, an entry reads: ‘Date of appointment as Probationer: 30 April 1896; age 26. Previous occupation: lived at home.’ Remarks signed by Eva Luckes,4 who was matron at the time, read: ‘Clara Evans was a satisfactory probationer. The Sisters were always glad to have her in their wards as her work was always thorough, and capable, and she was always pleasant and adaptable. She was very punctual, kept rules carefully, and had the additional merit of getting on well with her fellow-workers.’5
During the latter part of the 1890s, the chairman of The London Hospital, Sidney Holland, together with Matron Eva Luckes, embarked on a scheme to improve conditions at the hospital. At the time of his appointment in 1896, Holland’s first impression of the hospital had been its dreary long passages, dark wards and poor furniture; the hospital was seriously underfunded and lacking in modern equipment. In the same way as Matron Luckes shared his sympathy for the poor, Holland shared her concern for the welfare of the nurses. In 1897 he produced a ‘charter’ for nurses, setting down working conditions. These included not more than ten hours a day in the wards, one day off a month and four weeks’ annual holiday. At the time, the nurses were working eighty-four hours a week, for fifty weeks a year. The hospital steadily increased the number of nurses, and, where in 1893 the nursing staff totalled 275, by 1900 it had increased to 441.6
Clara was appointed as a staff nurse on 13 June 1898, serving in Mellish Ward under Ethel Becher, who was later also selected to go to South Africa during the Anglo-Boer War. Sister Becher was a strict disciplinarian, the daughter of a colonel and granddaughter of an army general. She was ‘a smart sister, her nursing instincts beyond question’, but with her excitable temperament, outbreaks of temper and lack of self-control, she was apparently not an easy person to work with.7
Mellish was a men’s surgical ward, with a heavy intake of emergency cases. There were breweries in the neighbourhood, and draymen were often admitted following accidents because of drunkenness. Lighting in the ward was poor, as gas brackets with burners were not very effective, and so nurses often held up paraffin lamps during surgery. The usual anaesthetic was ether, though nurses often had to restrain patients who did not immediately drift off into unconsciousness. This kind of experience would stand Clara in good stead in a theatre of war such as the Anglo-Boer War in South Africa.
Capable and adaptable as she was, Clara was also a stickler for rules, and did well in her examinations, obtaining a First Grade for her sick-room cookery. Sister Becher was therefore eager that Clara be selected to go to South Africa. Unsurprisingly, Clara was among those chosen, and was enrolled into the Princess Christian’s Army Nursing Service Reserve on 18 December 1899, just two months after the outbreak of the war.
In the ‘London Hospital Register of Sisters and Nurses, 1880– 1903’, the entry for Clara Evans reads: ‘Date of appointment as Staff nurse (alternate), Mellish Ward: 13 June 1898; age on appointment: 28.’ Matron Luckes signed the ‘Remarks’, which read:
Further experience of Clara Evans in the capacity of staff nurse fully confirmed the excellent record of her character and capabilities contained in the Probationers register. When the Sister under whom she served (Miss Becher) was selected for Army Nursing in South Africa, she was particularly anxious that Clara Evans should be one of the half-dozen Sisters who were to be specially chosen by the Princess of Wales. Clara Evans was herself most keen to go, and went off greatly rejoicing in the distinction conferred upon her. Clara Evans left to take up Army Nursing in South Africa and sailed in the Dunottar Castle on Christmas Day 1899.8
After the Crimean War and various military campaigns in Africa, the provision of health care for soldiers was more formally structured. Shortly before the Anglo-Boer War, the Army Nursing Service was established in Britain to provide trained and competent nurses to serve at home and overseas. By the time war was declared, in October 1899, the Army Nursing Service had one lady superintendent, nineteen superintendent sisters and sixty-eight sisters. Initially there was no mechanism for the deployment of reserve nurses, but with the formation of the Princess Christian’s Army Nursing Service Reserve, more than 1 400 trained nurses from the United Kingdom could eventually be sent to South Africa.
Although very keen to serve in South Africa, Clara had little idea of what to expect before leaving for the African continent. Had she had the wisdom of hindsight, one wonders whether she would have been so eager, especially in light of a report by Nurse Kinealy at the end of the war:
These nursing sisters objected very much to life in South Africa, chiefly because it was not what they were used to. They resented the idea of houses built bungalow fashion, with no upstairs. And they naturally disliked Kaffir servants, whose language they could not understand. Not a few objected, like the Tommies did, to ‘beastly tinned food’, and the primitive way in which most food was served. And they forgot there was inclement weather at home, and were aggrieved by the heat, by the cold, by the dust, by the flies, by the hot winds, and by everything Colonial.
Typically, however, on returning to England, the nurses
seemed to forget the objections in time, and to remember the freedom of life out there, the irresponsibility of the people, the apparent absence of supervision by Mrs. Grundy, as well as sports and pastimes, travel and sea voyage, and the novelty of the whole experience, which was very great to girls, many of them from remote country towns and Scotch villages, girls who may never have gone farther from home than to their schools and their training hospitals.9
Clara experienced all this and more, except that she never returned home to England. Despite the fact that she herself did not leave any written accounts of her experiences during the war, and despite limited information about nurses in the Boer War, it is nevertheless possible to paint a fairly complete picture of her time in South Africa.
When the nurses from The London Hospital sailed from Southampton in December 1899, Clara’s name was listed among the nursing sisters on board. The others were Mrs Kelso-Hamilton, Miss F. Bell, Miss A. Davidson, Miss E. McCarthy, Miss L. Tippetts, Miss N. Strangman, Miss M. Greenham, Miss C.S. McGowan and Miss E. Becker [Becher].10 The famous Field-Marshal Lord Roberts was also on board; he was on his way to take over command from General Buller. British troops had already suffered three humiliating setbacks that December: at Stormberg on the south-eastern front; Magersfontein on the western front; and Colenso on the eastern front.
The Dunottar Castle docked at Cape Town on 11 January 1900. Clara did not have far to travel as she was posted to No. 1 General Hospital in Wynberg. This was a large, hutted, base hospital at the Wynberg barracks that accommodated 1 000 beds; No. 2, consisting of marquees and tents, was also at Wynberg. Just a few months earlier, on 29 November 1899, Wynberg Military Camp had been declared a military hospital to receive wounded and sick soldiers from the front. The garrison officers’ mess was used as an officers’ hospital, and the wood-and-iron troop quarters were converted into wards. Because the barrack accommodation was inadequate, a field hospital consisting of tents was also erected at the camp. The barracks had been named No. 1 General Hospital, and the tents No. 2 General Hospital. Seven sisters were on day duty and two were on night duty in a hospital spread over an area 400 metres in diameter. Lord Roberts inspected the hospitals at the camp on 13 January, only two days after the Dunottar Castle’s arrival in Cape Town.
It is likely that the new arrivals would have been delighted with No. 1 – just a month before, a nurse had enthused: ‘Such a lovely place it is, with that wondrous Table Mountain at the back, and Simon’s Bay in the distance in front. A pine wood surrounds us – and it is summer! The Camp is now one huge hospital all up the hill and in the wood.’11
Conditions at the Wynberg hospitals were described as follows in a 1901 Royal Commission report:
At first in some of these there were bugs but they were never numerous. It is undoubted that at times there was great pressure on these hospitals, first when the wounded and sick came down in large numbers from Lord Methuen’s Army and secondly, when the epidemic of enteric fever took place at Bloemfontein and very large numbers of men were sent down from the Orange River Colony to the base. At these times the staff of medical officers, nurses and orderlies was very hard worked, and the hospitals were undermanned. The same causes rendered their equipment inadequate, or barely sufficient for the number of patients. But there was not at any time a shortage of food or proper medical attendance. All the chaplains who ministered in the hospital speak in the highest terms of it as do the nursing sisters who had been there, and passed on to other hospitals.12
While living conditions were relatively comfortable, working conditions were far from easy, and somewhat chaotic, as a volunteer nurse at No. 1 General Hospital suggested:
This is the principal Camp Hospital, holds over 1,000 patients, nurses, medical staff, &c. We are very comfortable, and the army people have a house furnished (£18 per month) for the nurses. Each four nurses are entitled to a servant. We have a regular ‘Topsy’, and I am appointed housekeeper for the time being. We are allowed servants’ wages, coal, and £1 per week each, for food extra, but the price of food is awful, and it will take us all our time to manage it from above amount. The patients are six in a tent, and so many tents for each nurse. We have the officers’ quarters. Patients are coming down every day from the front. There is no system whatever as to work. You can do as you like.13
In the meantime, Lord Roberts’s forces had begun to turn the tide, relieving Kimberley on 15 February and forcing General Piet Cronjé to surrender with some 4 000 at Paardeberg two weeks later. However, there was a long period when the British troops remained stationary at Modder River and later at Paardeberg; vast numbers were massed in one place, using a contaminated water supply, creating ideal condi tions for a massive outbreak of typhoid fever. The British Army was already stricken with the disease when it marched to Kimberley and later to Bloemfontein. They occupied Bloemfontein on 13 March with no resistance from the Boers, but the troops had no sooner entered Bloemfontein than thousands were paralysed by typhoid. Within a month, 4 000 to 6 000 troops had succumbed to the disease. The field hospitals that had moved with the army were only supplied with ground sheets and blankets, and the few stationary hospitals only had stretchers. Every available space in the town was converted for use as typhoid hospitals, including the Raadzaal, churches and school buildings.14
One of the consequences of the typhoid outbreak was the transfer of a large number of nurses from elsewhere to Bloemfontein to combat the crisis. Both Clara and Sister Becher were keen to be transferred, and in May both women and a few other nurses left Wynberg for No. 8 General Hospital in Bloemfontein.
‘The greatest misfortune of the [British] campaign, one which it was obviously impolitic to insist upon at the time, began with the occupation of Bloemfontein,’ was the verdict of Arthur Conan Doyle, who had been a hospital volunteer. The misfortune had, allegedly, begun with
the great outbreak of enteric among the troops. For more than two months the hospitals were choked with sick. One general hospital with five hundred beds held seventeen hundred sick, nearly all enterics. A half field hospital with fifty beds held three hundred and seventy cases. The total number of cases could not have been less than six or seven thousand – and this not of an evanescent and easily treated complaint, but of the most persistent and debilitating of continued fevers, one too which requires the most assiduous attention and careful nursing. How great was the strain only those who had to meet it can tell. The exertions of the military hospitals and of those others which were fitted out by private benevolence sufficed, after a long struggle, to meet the crisis. At Bloemfontein alone, as many as fifty men died in one day, and more than 1 000 new graves in the cemetery testify to the severity of the epidemic. No men in the campaign served their country more truly than the officers and men of the medical service, nor can any one who went through the epidemic forget the bravery and unselfishness of those admirable nursing sisters who set the men around them a higher standard of devotion to duty.15
At No. 8 General Hospital, between 1 300 and 1 400 enteric cases were accommodated in tents about a mile from the town. No. 8 was badly overcrowded and soldiers lay on the ground, making it very hard – if not impossible – for the doctors and nurses to treat them properly. Some patients were in a filthy state and too ill to get up. Convalescent soldiers were immediately sent to the base, cleared out to make room for others. One especially difficult problem was the lack of fresh milk. None of the hospitals had a sufficient supply of it, and some none at all, though milk was always available for porridge and tea at the officers’ club and at hotels in the town.
It was in such conditions that Clara and her fellow nurses worked long hours, under-staffed and often under-equipped, and in severe climatic conditions. The Nursing Record & Hospital World reported the following on 19 May:
In a letter received from Bloemfontein, we learn that there are at least 2,000 men suffering from ‘enteric’ in the town, and every available space is taken up for the sick. The Sisters’ work is no sinecure, when one learns that many of these poor fellows are, in addition, suffering with pneumonia or rheumatism, as well as abscesses. Indeed, those of us comfortably working at home, have little conception of the terrible hardships our brave soldiers have been compelled to endure, and the after-wreck of health and strength is yet to come. The Sisters are on duty long hours, from 8.30 am. often to 9.45 pm., and then they tell us, ‘our help seems a drop in the ocean of suffering’. Poor fellows, many need a special nurse all to themselves, but such attention it is impossible to give, though we do our best.16
Rudyard Kipling, who was working in Bloemfontein at the time as war correspondent for The Friend, gained the impression that dysentery and enteric patients were less welcome in the military hospitals than those who were wounded. There was little enthusiasm for nursing enteric cases, which were long and troublesome. As Kipling remarked, ‘There was not much heroism about enterics.’17
In May 1900, while Clara was still at No. 8, one of the nurses recorded the appalling conditions:
Our work is all so different to what we thought and hoped, and many of us will not be sorry when we turn our faces towards dear old England. The ‘live stock’ in these parts is beyond description – and flies are not the worst specimens. Water has been so short for washing purposes that many of our patients are covered with pediculi [lice], far worse than in a receiving room at the East end [of London], and the nurses do not escape their attentions – and then the sand, we shan’t be accused of want of grit when we return. Nursing in military hospitals is very disheartening in many ways. We can’t do for our poor fellows all we wish, and my experience of many orderlies is best left unwritten, there is a screw loose somewhere in the system. The truth is nursing does not rank. Many military doctors don’t grasp that it exists. There will be a fine battle royal before military medicine realises the evolution of the art. Meanwhile we muddle on.18
The nurses had no option but to ‘muddle on’, and one wrote somewhat stoically:
We are all on rations of corned beef, bread, tea, coffee, sugar, and jam. As the food question never troubles me, I don’t mind the monotony; but some of the sisters don’t fancy these things, and would be glad to be home again. Many women don’t understand roughing it, as one is bound to do on active service, and are a nuisance all round in consequence. Fine ladies – professional or otherwise – are out of place here – rain, hail, wind, thunder, storm, and stress – or sun, sand, and flies – it’s all one to the right sort – but you are not asked by the elements to take your choice.19
Nor did typhoid ask who it might strike next, and it was not long before several nursing sisters were debilitated by the disease, Clara among them. She had no sooner arrived at No. 8 General Hospital than she also became seriously ill. She and the other afflicted nurses were cared for in the Bishop’s Lodge, which had been taken over that very month as a separate hospital for typhoid patients, and fitted out with sixteen beds. It was a simple but attractive red-brick building, with sandstone window sills and lintels, and a stoep garlanded with passion-flower vines.20 However, behind this picturesque façade lay a scene of utter human misery.
Having witnessed the suffering of so many typhoid patients during her short stay, Clara herself now endured the agony of the deadly disease; the first symptoms were malaise and headaches, followed by nose bleeds and abdominal aches. She was hospitalised, and then experienced high fever, delirium, diarrhoea and dehydration; in the final stages of the disease, she suffered intestinal haemorrhage and perforation. Clara died on 31 May 1900 and was buried in Bloemfontein, thousands of kilometres from her beloved England. At a time when white crosses sprang up in the cemetery like weeds, Clara’s death was just one among hundreds that month. The General Record Office in Bloemfontein blandly states that she ‘died of disease’ in Bloemfontein on 31 May 1900.21
Matron Luckes recorded:
We had happy letters from Clara Evans in South Africa until May 1900, when C. Evans with her favourite Sister, Miss Becher, and some others, were transferred, in accordance with their own earnest desire, from Wynberg to Bloemfontein. Shortly after that we received a cable, telling of her serious illness, followed by another some days later to the effect that Clara Evans had died of Dysentery at Bloemfontein on May 31st 1900. Her many hospital friends shared the deep sorrow of her own relations for the loss of her useful, valuable life.22
Back home, in St Helens and at The London Hospital, the towns-folk and her fellow nurses had taken note of the tragedy. The extent to which Clara was honoured after her death is true testimony to the love and esteem people felt for her. In June 1900, the council of St Helens decided to include her name on a memorial tablet they had commissioned for the Town Hall. She is thought to be the first woman whose name appeared on a war memorial in Britain.
A fortnight after Clara’s death, a report on this unique tribute appeared in The Nursing Record & Hospital World:
Several more Nursing Sisters have died from enteric fever in South Africa, and we are glad to observe that the loss of their valuable lives is meeting with expressions of public regret. At the monthly meeting of the St. Helens County-Borough Council, Alderman J. Forster, at the outset, asked leave to refer to a resolution passed by the Council two or three months ago, to the effect that all local Volunteers who had gone out for service at the Cape should have their names inscribed in tablet form, and placed in position in the Town Hall. He suggested that that resolution be improved by the addition of the name of the late Miss Clara Evans, of the Army Nursing staff, who had died at Bloemfontein. Miss Evans was formerly a resident of St. Helens, and she was selected by the Princess of Wales to go on the nursing staff to South Africa. The intention of the Council was to indicate that the Volunteers who had gone out were brave and loyal Englishmen, desirous of serving their country, and he thought the Council would agree that the word ‘men’ might also include women, because Miss Evans and other nurses had gone out to the war with an equally good spirit, and Miss Evans’s name might be put on the tablet. They all regretted the loss the town suffered by her death, and he felt that the Council would be pleased to show their sympathy for the family. The Council unanimously agreed to adopt the suggestion.23
The congregation of St John’s Church in St Helens also decided to honour Clara, and they did so by erecting a memorial in the form of three stained-glass windows in the church’s foyer. These windows were installed soon after Clara’s death, by late 1901, as suggested by The Nursing Record & Hospital World, which described the windows as follows: ‘One represents a South African battlefield, with Bloemfontein in the distance; another, Miss Evans in Army nursing costume; and the third is a picture of a ward in the London Hospital.’24 At The London Hospital, Clara’s former colleagues honoured her memory by hanging a clock in Mellish Ward, which bears the inscription: ‘In Affectionate Remembrance of Clara Evans (Nurse Mellish from 1898 to 1899). From her Fellow Nurses. She Died Whilst Serving Our Sick Soldiers at Bloemfontein, May 31st 1900.’
In 1901, in her annual letter to The London Hospital nurses, Matron Luckes wrote: ‘Our thoughts were very full of South Africa and of the many dear to us who are serving out there.’ She then quoted from a speech by the hospital chairman, Mr Holland: ‘The Princess of Wales sent out early in the year six of our Nurses to the War, and one of them, Nurse Evans, I deeply regret to say, died there – gave up her life to those she went to nurse. Ladies and Gentlemen, there is no Victoria Cross to Nurses; not even a mention in dispatches to lessen slightly the grief of those left behind, but I should like Nurse Evans’ relations to know that at the first great meeting after her death of people interested in this Hospital, at the first great gathering of Nurses and Students, her name was mentioned with honour, and I should like them to know that at this great meeting we all for a few moments kept absolute silence out of respect for her memory.’ Matron Luckes also mentioned that she wished Miss Evans’ relations could have been present at the moving event.25
And so, sadly, Clara did not live to see the end of the Anglo-Boer War – a peace treaty was signed on 31 May 1902, the second anniversary of her death, to the day. While attempts at peace had been made in March 1901, these failed, mainly because Boer leaders wished to maintain their independence. A year later, in April 1902, the Boer governments again met at Klerksdorp, though by now their situation had deteriorated considerably, and they agreed to negotiate with Lord Kitchener. A conference of sixty Boer representatives was convened at Vereeniging, where further proposals were discussed with the British authorities. Then, just before midnight on 31 May, the two parties signed the Peace Treaty of Vereeniging at Melrose House in Pretoria. With a majority vote of fifty-four to six, the Boer representatives gave up their independence in exchange for the repatriation of Boer prisoners of war, the protection of the Dutch language in the courts, the maintenance of their property rights, economic relief for war victims, and a promise of eventual self-government.
Clara Evans and other nurses from abroad had been participants in a bloody, momentous event in the birth of modern South Africa. Following the devastation that ripped through the country during the war, it took many years to rebuild not only the land, but also relations between its peoples. The British yoke was finally cast off a decade later with the founding of the Union of South Africa, and then, after another fifty years, with the country still under white rule, the Republic of South Africa was born. For the majority of its citizens, however, it would still be a long walk to freedom and full independence.