On the Western Front, medicine became an integral feature of military planning, with both sides developing refined systems for evacuating and treating their wounded.
Mechanisation meant casualties could be extensive and complicated by head wounds, shrapnel and the risk of infection.
The greatest number came from artillery fire, small arms and poison gas.
Over the three years that Australians served on the Western Front, more than 181,000 men were injured, of whom at least 46,000 died.
Recovering and treating the wounded required an efficient system of doctors, nurses, stretcher bearers, ambulance drivers, orderlies and clerks.
This network was spread across various stages: aid posts and field ambulances, dressing stations, casualty clearing stations and base hospitals, including one in underground caves near Arras.
Stretcher bearers collected the injured from the field and took them to a regimental aid post (RAP). From there, a motor ambulance transferred them to a casualty clearing station (CCS) and, if necessary, a hospital train took them on to a base hospital that could accommodate up to 1000 patients.
These staff worked alongside welfare workers, including military padres and the Red Cross Society.
The most common injuries recorded were leg wounds which often required amputation, while most men shot in the torso never made it to a hospital. Arm injuries were usually caused by high-explosive artillery shells.
In addition, medical staff treated a large number of soldiers for poor health. Standing in muddy trenches for long periods caused soldiers to contract ‘trench foot’, an infection that caused the flesh to decay and die.
Not surprisingly, nurses dressed in white, dispensing care and compassion, were often seen as angels of mercy by soldiers who were wounded, dirty and traumatised.
Australia had more than 3,000 civilian nurses enlisted in the Australian Army Nursing Service (1903) which was part of the Australian Army Medical Corps.
Many nurses were decorated for their dedication, with eight receiving the Military Medal for bravery and 25 killed in action.
Some of the most dangerous medical jobs were those of stretcher-bearers and field ambulance workers who often had to undertake long journeys on foot through mud and gunfire.
As the first responders, they often heard young soldiers crying out for their families, especially mothers.
Doctors routinely risked their lives to save those of others. Australia despatched more than 600 Australian doctors to the Western Front, some of whom were killed while treating the wounded ‘in the open’.
The injuries did not end when the Armistice was declared on 11 November 1918. Service men and women returning home suffered from physical disabilities, severe respiratory illnesses, eye problems, trench fever (influenza, typhus, dysentery and skin diseases from lice) and shellshock.
Facilities to deal with mental illness were limited and, by 1938, 77,000 incapacitated ex-soldiers and 180,000 dependants were receiving pensions.
The Repatriation Department (established 1917) provided pensions, employment bureaus, rehabilitation services, job training, medical and hospital care, hostels and artificial limbs.
- Joan Beaumont. Broken Nation: Australians in the Great War. Sydney: Allen & Unwin, 2013.
- Robert Likeman. Australian Doctors on the Western Front: France and Belgium, 1916-1918. Sydney: Rosenberg, 2014.