When the South African Expeditionary Force was organized on the termination of the campaign in German South-West Africa, Colonel P. G. Stock was appointed S.M.O., and in addition to the South African Medical Corps personnel who volunteered for regimental duties, arranged for the mobilization of one Field Ambulance and one General Hospital. The former, under the command of Lieutenant-Colonel G. H. Usmar, S.A.M.C., assembled at Potchefstroom with the 1st South African Infantry Brigade; while the General Hospital was formed at Wynberg, the personnel being largely composed of volunteers from the staffs of No. 1 General Hospital, Wynberg, and No. 2 General Hospital, Maitland, and included representatives from each of the four provinces of the Union. It subsequently provided the personnel for the Depot in England, and the South African Military Hospital at Richmond, which was afterwards built and organized.

No hospital equipment was available in South Africa, but the official Advisory Committee on Voluntary Aid, of which Sir Thomas Smartt was chairman, met the difficulty by voting £15,000 to purchase it on arrival in England, and a further £1,500 to augment the equipment taken by the Field Ambulance.

Both units accompanied the Infantry Brigade to England, the General Hospital embarking on H.M.T. Balmoral Castle at Cape Town on 25th September, and the Field Ambulance on H.M.T. Kenilworth Castle on October 10, 1915. On arrival there, they proceeded to the R.A.M.C. Depot at Twezeldown, near Aldershot. At the depot the training of the Field Ambulance proceeded under its own officers, and, with the rest of the Brigade, it was present at Bordon when her Majesty the Queen reviewed the troops on December 2, 1915. On 29th December the unit proceeded by route march to Farnham, there entraining for Devonport, where it embarked on H.M.T. Corsican for Egypt, Alexandria being reached on January 13, 1916.

In the meantime, the personnel of No. 1 General Hospital—which had been particularly fortunate in securing the services of some of the leading surgeons and physicians and most experienced nurses in South Africa—was temporarily detailed to strengthen the staffs of various Imperial hospitals in England. On 20th December, however, the unit was reassembled at Bournemouth, where it took over and staffed the Mont Dore Military Hospital, which, under an Imperial officer as commandant, had just been equipped for 520 patients.

In February 1916 the control of the “Grata Quies” Auxiliary Hospital was transferred to the Mont Dore, which became a “Central Hospital,” and on April 1, 1916, seventeen additional auxiliary hospitals, situated in the districts of Poole, Wimbourne, Swanage, Sherbourne, and Yeovil, were affiliated, increasing the number of beds controlled to over 1,200.

The first patients from overseas were admitted on 8th January, the majority being medical cases, and although a number of severe cases of “trench feet” from Gallipoli were taken in, few wounded were received up to the time the unit left on July 3, 1916, when it proceeded to Aldershot preparatory to joining the British Expeditionary Force in France.

When the decision to send South African troops to England became known, a number of prominent South Africans in London formed a committee under the chairmanship of Lord Gladstone—until recently the Governor-General—to start a fund for the establishment of a hospital and for the general comfort of the troops. On the arrival of the contingent in England this movement received renewed attention, a proposal then being under consideration to erect huts to accommodate some three hundred patients, as a South African wing to the Royal Victoria Hospital at Netley. On further investigation, however, it was found that the site, although in many respects an ideal one in the summer, would not have been suitable for South African troops during the winter, and further search had to be made. Many places and buildings were inspected, and finally a site in Richmond Park, for which his Majesty the King was graciously pleased to grant the necessary permission, was selected, and no more beautiful, convenient, and healthy spot could possibly have been obtained.

Much of the success of this hospital was due to the time and care spent over the plans, and Mr. Allison, the chief architect of the Office of Works, was always ready to adopt any recommendations made by Lieutenant-Colonel Stock and the expert sub-committee of officers of No. 1 General Hospital who were dealing with the project. The desire was to provide 500 beds, but for financial reasons it was decided to start with 300, on the basis of plans which provided for future necessary extensions.

The construction was begun early in March, and on June 16, 1916, the hospital was formally opened by its patroness, H.R.H. Princess Christian, being then taken over fully equipped as a gift from South Africans by the D.D.M.S., London District, on behalf of the Army Council.

On the opening of the hospital, the S.A.M.C. Depot in England was transferred to Richmond, and a redistribution of the personnel of No. 1 General Hospital carried out, which enabled a South African Staff to be placed in charge of Richmond without interfering with the efficiency of the former unit. Major Thornton, the adjutant and registrar of No. 1 South African General Hospital, succeeded Lieutenant-Colonel Stock in command at Richmond, and Captain Basil Brooke was appointed adjutant and registrar of No. 1 General Hospital. Before, however, proceeding further with the history of the South African Hospital at Richmond, it will be convenient to follow the fortunes of the units which left England.

On January 13, 1916, No. 1 South African Field Ambulance arrived at Alexandria on H.M.T. Corsican, and marched the following day to Mex Camp, where the rest of the Brigade was encamped. Its history is included in that of the South African Infantry Brigade, with which it was associated from this date until the cessation of hostilities.

On the arrival of No. 1 South African General Hospital at Aldershot, the final touches were given to the unit, and about 400 shipping tons of stores and equipment drawn, which, by a special arrangement with the Army Council, had been paid for out of the £15,000 voted by Sir Thomas Smartt’s Committee in Cape Town.

On 12th July the unit entrained for Southampton, there to embark on H.M.T. Huntcraft. The ship berthed at Havre about 10.30 a.m. on the 13th, and as she was urgently required elsewhere, the unloading at once commenced; and on the following day the unit—together with its stores and equipment—left for Abbeville, which was reached on 15th July.

Here it was found that the hospital would be established next to No. 2 Stationary Hospital, an Imperial unit which had been there for some time. The necessity for not interfering with the ripening harvest considerably curtailed the choice of a site, the ground allotted being a ploughed field on the slope of the hills overlooking the valley of the Somme. Abbeville itself lay about a mile away in the valley, but the railway station and “triage” were on the far side of the town and must have been nearly three miles from the hospital.

Some hospital marquees had already been erected, but the layout of the hospital was greatly handicapped by the cramped area of ground then available. As the corn was reaped more ground became vacant, and, later on, by frequent striking and repitching of tents, the hospital gradually took a more symmetrical and workable shape.

When the unit arrived in France the First Battle of the Somme had begun, and hospital accommodation was urgently required for the large number of casualties. So, in the absence of any kind of building, a store tent was converted into an operating tent; an improvised sterilizing shelter erected; and within forty-eight hours of arrival patients were admitted and every available surgeon hard at work.

In those early days the wide surgical experience and considered judgment of Lieutenant-Colonel Ritchie Thomson proved invaluable. He had accepted the post of chief surgeon when the hospital was mobilized in South Africa, and many a sorely wounded man owes his life and limb to his skill and judgment.

The initial difficulties were many: buildings and engineering services were almost impossible to obtain, and it was not until the end of November that the operating block—the first building to be erected—was completed. All, however, were willing workers, and it was not long before additional tentage was pitched and Major Merritt had organized the kitchens, stores, and a hundred and one odd things appertaining to the Quartermaster’s Department, all of which mean so much to the efficiency and comfort of any hospital.

Until early in August the hospital was without its own nursing Sisters—these services being performed by members of the Q.A.I.M.N.S., the Canadian Military Nursing Service, and English V.A.D.’s, who did all that hard work and devotion to duty could do to make up for the shortage in number. On 5th August, however, Matron Creagh and twenty-one members of the S.A.M.N.S. arrived from England, and the greatest difficulties in this respect were over. The nurses’ camp had to be pitched in the wooded ground of a château some little distance off; but when the storm clouds rolled up the valley, and the winter rains set in, they had perforce to be billeted in the town until the huts which were contemplated for them were completed.

Situated as it was at the advanced base in a convenient position for their reception, the hospital, during the autumn of 1916, received a large number of wounded direct from the Somme battlefield. Amongst the earliest admissions in July 1916 were South Africans wounded at Delville Wood, and towards the end of July General Lukin was one of the first officer patients.

The most severely wounded journeyed by specially-fitted hospital barges, which, from the casualty clearing stations around Corbie, floated down the Somme to Abbeville, where the patients were disembarked and taken by motor ambulances to the hospital. The use of barges was restricted to those cases who were unable to stand the strain of a journey by train. Usually they travelled in pairs, but on more than one occasion during the autumn of 1916 patients from six barges were admitted during the twenty-four hours. Towards the end of 1916 the barges ceased running, as the winter rains had rendered the passage down the Somme too dangerous, and they were not again employed, as the advance in the spring of 1917 carried the fighting away from the river.

Fortunately, during the first few weeks after the arrival of the unit in France, the weather was fine, but even then difficulties were experienced in regard to the main road leading to the hospital. For part of the way this was formed by “sleepers,” but as the supply of them gave out beech planking had to be substituted. This quickly “warped,” and becoming displaced with the constant traffic, was always a source of trouble, as the underlying chalk during the dry weather quickly powdered to a fine dust, and later, when the rains set in, turned into a particularly greasy form of mud.

As soon as materials and labour became available, the “sleeper track” was continued, and a large “triage” constructed on which the ambulance wagons could turn; but it was not until many months later that it became possible to build a macadamized road connecting the hospital with the Route d’Amiens. The old entrance was then utilized as an exit for empty wagons, and the original signboard of the hospital, on which Major Merritt had painted the Springbok badge, was removed to the new entrance.

Progress was gradually made in the erection of temporary buildings, and by the end of 1916 there was accommodation in huts for 120 patients. It was obvious, however, that for that winter at least the majority of beds would be under canvas, and a particularly successful form of sliding door with windows at the top was designed; and with the funds available a local contractor was engaged, who quickly fitted them at each end of the tented wards. At the same time the Royal Engineers undertook the installation of stoves and wood flooring, and with doors closed and the sides of the tents fastened down the tented wards were really most comfortable. “Duck” boarding also gradually became more plentiful.

During the period July 23, 1916, to December 31, 1916, the total admissions were 6,436, of whom 3,032 were “battle casualties” and 3,404 “sick.” During the same period 5,719 were “discharged hospital.” Of these 673 were returned to duty; 548 transferred to convalescent depôts; 3,306 evacuated to the United Kingdom; and 1,192 transferred to hospitals at other bases in France. Five hundred and eighty-eight major operations were performed; and there were in all, for the same period, 236 deaths, or—calculated on the number of admissions—a percentage of 3.68. This comparatively high mortality is explained by the fact that practically every case admitted to this hospital was seriously wounded—the barges, from which the large majority of cases were received, only carrying those cases which were unfit to travel by other means of transport. The mortality was further increased owing to the fact that this hospital was the nearest General Hospital to the Somme front, and many moribund patients were taken off ambulance trains on account of their being too ill to travel to more distant bases. By the end of the year, in addition to the operation block, hutted accommodation for 120 patients was erected, and in the early part of 1917 hutted quarters for the nursing staff and rooms for officers’, sergeants’, and men’s messes were added, as well as buildings for part of the quartermaster’s stores.

Early in the year instructions were received from General Headquarters that the hospital was to be enlarged from 520 beds to a normal capacity of 1,120 beds, with a “crisis expansion” to 1,500 beds. The hospital remained on this basis, and during the latter part of 1917, and not infrequently during 1916, as many as 1,600 to 1,700 patients were accommodated at one time.

The total admissions for the year 1917 were 19,109, of which 7,613 were battle casualties and 11,496 were sick. During the same period there were 18,277 discharges. Of this number 2,638 were returned to duty, 4,253 were transferred to convalescent depôts, 8,749 were evacuated to the United Kingdom, and 2,637 were transferred to hospitals at other bases in France. One thousand two hundred and ten major operations were performed during the year 1917. For the same period, including eleven cases brought in for burial, there were 181 deaths in the hospital. Of these 128 were due to wounds—a percentage of 1.68; and 53 were due to sickness—a percentage of .46. The death rate from all causes for this year worked out at .94 per cent.

Promises of hutted accommodation, both for patients and personnel, were current for at least twelve months. Nothing, however, happened in this direction, except that an administration block and a new kitchen for the hospital were built; and in October 1917, with keen remembrances of the previous winter, it was decided to erect such huts as was possible with labour supplied by the staff of the hospital. A start was made, with the idea of housing the men of the company who were over forty years of age, and a hut was built, using discarded telegraph poles as the principals, covered with corrugated iron and lined with wood—the lining being bought from funds provided by the South African Hospital and Comforts Fund at a cost of, approximately, £120.

Stimulated by the success of the first, the building of the second hut was then taken in hand; and eventually, with the assistance of the engineer services, comfortable quarters for all the personnel were erected. In January 1918 six hospital “Adrian” huts were erected, but were not completed until the end of March, chiefly owing to the lack of labour and uncertainty as to whether the hospital would have to be evacuated. Three double “Nissen” hospital huts were subsequently added—the last not being quite finished when the armistice was signed. The erection of a further eight, which would have completed the building programme of the hospital, was cancelled.

For the first few months all traffic to the hospital had to pass through a neighbouring hospital—No. 2 Stationary, R.A.M.C.—this being not only inconvenient, but leading to congestion. Later, a metalled road was made through the South African Hospital leading to the Amiens road and looping within the hospital. This meant that traffic was easily managed, and made the handling of convoys infinitely easier. In the summer of 1918 a tarred surface was put on to this road, which proved a great help in keeping down the dust.

The necessity for a special railway siding for the three large hospitals in this area to avoid the long, rough, and frequently interrupted journeys by ambulance from and to the main station was also met.

A church was erected within the precincts of the hospital, the cost of which was defrayed partly by subscriptions received from the patients and personnel, and partly by a donation of £75 from the South African Hospital and Comforts Fund, London. It was dedicated in the name of St. Winifred to the memory of the late staff nurse—Miss Winifred Munro, South African Military Nursing Service—and as a tribute to her devotion to duty.

In December 1917 the hospital was specially selected for the reception and treatment of cases of fracture of the femur. Beds for the accommodation of 200 such cases were provided—50 being reserved for officers, and 150 for other ranks. The special bed and technique devised at the hospital were afterwards adopted as the standard for the British Army.

During the German offensive of 1918 the hospital passed through what was its period of most intense activity. The medical staff was depleted to replace casualties in the South African Field Ambulance and other units in the forward areas, while reinforcements from the male personnel were sent to the Field Ambulance. Practically all the female nursing staffs from this district were withdrawn, on account of the enemy advance and the frequent bombing at night by hostile aeroplanes of the back areas. Thus the number of medical officers in charge of wards was reduced to 8 instead of the normal 22; the male personnel fell to 188—the normal establishment being 212; while the female nursing staff, with a normal establishment of 88, was reduced to 8.

With this depleted staff it would have appeared almost impossible to look after a normal number of patients, but many more than normal had to be dealt with during the last week of March, 1,820 being admitted and 2,365 discharged.

Many of these received at the hospital their first medical attention since leaving the battlefield, and a very large number had to be operated upon immediately.

This involved teams working in the operating theatre day and night, but all members of the unit rose to the occasion and worked with a splendid will and cheerfulness under these trying conditions.

The huts recently erected for accommodating the personnel had to be evacuated by them to make room for patients, of whom as many as ninety slightly wounded were packed into one hut on stretchers. The men were crowded into the remaining three huts, and the overflow slept on the football field.

Nor did the work end here, for, owing to the threat of hostile air attacks, it became urgently necessary to dig protective trenches for patients, sisters, officers, and other ranks, and also to erect sandbagged revetments around the wards which contained the helpless patients. Outside assistance at this time was unprocurable, as all labour was fully employed in the digging of a defensive system at Flixecourt to protect the town of Abbeville, and the task therefore fell on all ranks of the personnel. Soon after this air alarms became an almost nightly occurrence, and even when raids did not actually take place, sleep was broken. But the nursing staff and all inmates of the hospital passed through this prolonged period of physical and mental strain without failing to respond adequately to the demands made on them. Though no definite attack was made by hostile aircraft on the hospital, bombs on several occasions fell uncomfortably near, one actually falling inside the grounds. This fortunately buried itself before exploding, and, beyond tearing the roof of a tent used as a carpenter’s shop, did no damage.

The approach of the enemy and the frequency Of bombing raids made the retention of cases of fracture of the femur in this hospital inadvisable, and on that account as many as possible were evacuated to the United Kingdom, together with the greater portion of the special equipment used for these cases.

Not long after the last consignment was despatched the Allied offensive began, and the heavy influx of fractured femur cases—amounting to more than 150 in the hospital at one time—made it necessary to use improvised apparatus for dealing with a number increased to this extent, in spite of the fact that as many of these cases as possible were at once evacuated to the United Kingdom.

During the months of June and July 1918 the admissions of sick to the hospital were large, owing to an epidemic of influenza. Since then admissions steadily increased, both of sick and wounded, due to the offensive which began in the latter part of July and which continued up to the signing of the armistice.

During September the admissions reached the figure of 3,276, while in October they numbered 3,214, and the discharges 3,318. For the period of January 1 to November 30, 1918, the total admissions were 20,089. Of these 8,716 were battle casualties, and 11,373 were sick; discharges for the same period amounted to 19,921. Of these, 4,196 were returned to duty; 4,229 were transferred to convalescent depôts; 9,028 were evacuated to the United Kingdom; and 2,468 were transferred to other hospitals in France.

All the tented wards were equipped with sliding doors, the first of which were provided out of South African funds. These were made by a French contractor to our design, and the type was afterwards adopted for all hospitals in this area. The engineer services eventually supplied the remainder of the wards with similar doors.

A considerable amount of extra equipment was also provided out of South African funds, notably, an extra operating table, portable ray apparatus for use in the fractured femur wards, additional surgical instruments, and the apparatus necessary for Ionic medication.

The appearance of the hospital grounds improved from year to year, grass lawns and flower-beds being laid out, and vegetable gardening being carried on each year on a progressively larger scale.

From the early days of the unit in France a field adjoining the hospital was available for purposes of recreation, the rent being paid from hospital funds. During all seasons of the year it was made full use of by the unit for football, hockey, cricket, and other games. Badminton and tennis courts were constructed in the officers’ and sisters’ quarters, and a tennis court was made on ground adjoining the recreation field for the use of other ranks of the unit.

In June 1917 a surgical team for duty at a casualty clearing station was provided by the unit, and performed continuous duty in the forward areas until December of that year. Since then a surgical team performed duty in the front areas on eight occasions. In addition, nursing sisters from time to time were detailed for duty on ambulance trains and for nursing duties and as anæsthetists at casualty clearing stations.

On July 10, 1917, the hospital was honoured by a visit from her Majesty the Queen and his Royal Highness the Prince of Wales. Her Majesty inspected three of the wards in the Hospital and the operating theatre block, and before leaving was graciously pleased to express her entire satisfaction with the work of the Hospital.

To return to the South African Military Hospital at Richmond. In September 1916 the Army Council, on its own account, proposed to add to the accommodation; the Committee, however, considered that, in view of the fact that the provision of 500 beds had been originally contemplated, the additional accommodation proposed should be undertaken by the Committee. This necessitated a further appeal for funds; but, to avoid delay, Mr. Otto Beit generously gave a very substantial contribution. Eventually the total donations received from the issue of the second appeal assured the extension being carried through. The work was pressed forward, and the extension was opened for patients in February 1917. It was, however, hardly in use when a demand was made for further beds. This was met by the Committee converting into wards the quarters originally built for orderlies, and by renting a neighbouring house as an annex, so that in April 1917 the total accommodation for patients had increased to 620 beds.

Early in 1918 the War Office, seeing that the Richmond Military Hospital was almost entirely filled with South African patients, proposed to the Committee that the South African and the Richmond hospitals should be amalgamated, the combined hospitals to be known as the South African Military Hospital. The Committee readily agreed, and the two hospitals were completely amalgamated on July 1, 1918.

The enlarged hospital provided 1,098 beds; but even this was not sufficient, and 250 emergency beds were added by billeting patients in the neighbourhood. In addition, four auxiliary hospitals were attached, bringing the total number of beds to 1,321, or, including billets, 1,571.

The Park section of the combined hospitals stood on an enclosed site of about twelve acres, the actual area of the building being about two and one-third acres. The construction throughout was of timber with felt and weather-board linings on the outside, and asbestos board-sheeting on the inside of the walls and ceilings of all wards and principal rooms. A special feature of this section was the bath ward, with six fire-clay continuous baths for the treatment of patients suffering from severe wounds.

The Grove Road extension was a brick building, and consisted for the most part of modern infirmary wards supplemented by additional wards in old buildings.

The equipment of the Park section was entirely provided by the Committee, while that of the Grove Road section was found by the Board of Guardians and the War Office, and was only where necessary supplemented by the Committee.

Towards the end of 1916 the Committee offered the privilege of naming a bed in the hospital to any persons or institutions making a gift of £25, and of naming a ward for a donation of £600. The appeal resulted in 99 beds and 8 wards being thus named, approximately 265 of the beds being the gifts of schools in South Africa, the organization for these being initiated and carried out by Mr. Maskew Miller of Cape Town.

The principal corridors and rooms in the hospital were named after well-known streets or places in South Africa, all the principal towns in the Union being represented. The result of this, and of placing the tablets over the beds, was that familiar names greeted the South African visitor—a happy idea on the part of the Committee, and one which was much appreciated by the sick and wounded of the contingent.

The Committee expended approximately £45,000 on building the hospital and its extensions, and £19,000 on equipment. The former figure, however, includes a sum of approximately £2,000 expended in erecting a concert hall and certain workshops, while the latter figure includes considerable sums spent on replacements. That the money was well spent is shown by the fact that the hospital was always regarded as one of the model war hospitals in the United Kingdom.

The medical staff consisted of thirteen officers of the South African Medical Corps, and eleven civilian practitioners, who for various causes were not eligible for commissions in the S.A.M.C.

Various changes naturally occurred in the staff owing to interchanges being effected from time to time with the units in France. When Lieutenant-Colonel Thornton took over the command he was succeeded as registrar by Captain Coghlan, S.A.M.C., who in turn was succeeded by Major J. C. A. Rigby, S.A.M.C. The first quartermaster was Major G. Merritt, S.A.M.C., who left, however, with No. 1 South African General Hospital when that unit proceeded to France, his duties being taken over by Captain Lunney, S.A.M.C. In the autumn of 1917 Captain Lunney relieved Major Merritt in France, and Major Merritt then returned to Richmond, where shortly after he was promoted to the rank of Lieutenant-Colonel.

The nursing staff under the matron—Miss Jackson, R.R.C., Q.A.I.M.N.S.—consisted of 2 assistant matrons, 23 nursing sisters, 55 staff nurses, and 88 probationers, the larger proportion of whom were South Africans. The trained members of the staff mostly belonged to the Q.A.I.M.N.S. (Res.), or to the S.A.M.N.S. The subordinate personnel consisted, with a few exceptions, of N.C.O.’s and men who, having been invalided owing to wounds or sickness in the field, did duty at the hospital while regaining health and strength.

The hospital also served as the depot for the S.A.M.C. subordinate personnel; and 18 drafts, comprising 423 men, were sent to France as reinforcements for the First South African General Hospital and the First South African Field Ambulance.

The number of patients admitted up to October 31, 1918, was 274 officers and 9,412 other ranks—a total of 9,686. This does not include any patients admitted to the Richmond Military Hospital prior to the date of amalgamation. Of the 9,686 patients, 2,628 belonged to Imperial units, but included a good many South Africans, and 7,058 were members of the South African Contingent; 8,260 patients were discharged, including 6,230 members of the Contingent.

The total number of operations performed under a general anæsthetic was 2,125, and the number of medical boards held was 1,559.

Most of the swabs and bandages used in the hospital were manufactured in the South African workrooms, organized by a group of ladies attached to the South African Comforts Committee. The ladies responsible for these workrooms made most of the curtains and other similar articles required to equip the hospital, and undertook most of the mending. Under Mrs. Friedlander they rendered most valuable assistance to the hospital since its foundation, and their help was much appreciated by all concerned.

From the very first the Committee spared neither trouble nor money to provide for the comfort and welfare of the patients. At first the work of visitation and entertainment was organized under Lady (Lionel) Phillips, but later it was taken over by the Red Cross sub-committee of the Fund. For those sufficiently convalescent to enjoy them, every possible variety of amusement was provided. On four or five nights a week some form of entertainment was given in the large concert hall, while every week theatres or places of interest were visited, a special feature being the river trips arranged by the “African World” War Comforts Service, who also very generously provided gifts of fruit and other comforts. Further, in order that nothing should be left undone, Lady Phillips founded a riverside club in close proximity to the hospital, for the benefit of those patients sufficiently convalescent to enjoy the delights of its garden and picturesque river views.

Arrangements for bedside occupational work were, in the early days of the hospital, made by lady visitors. Material for fancy work and needlework was generously provided, and the making of regimental crests and other work of a like nature helped patients to pass in bed many a weary hour when they were still too weak to be doing the more serious vocational work.

Shortly after the hospital was opened the problem of dealing with the permanently disabled men of the Contingent had to be faced. After negotiations with the War Office, it was arranged that a Vocational Training School should be established in connection with the hospital. A commencement was made in November 1916, and the school was finally opened in February 1917. The scheme involved awakening the men while still in bed to interest in their future, so that when well enough they might go to the classrooms and undertake extensive courses of training. The South African Military Hospital was the first primary hospital in the United Kingdom in which permanently disabled men, while being restored to the best possible physical condition, were trained, with due regard to their disabilities, for a civil career to enable them on discharge from the army to become self-supporting members of the community. There was what was perhaps a natural reluctance on the part of the Home Government in giving sanction to this new venture, which was for many months looked upon as being at the best an interesting experiment. The New Zealand authorities, however, quickly saw the advantages of the methods, and in August 1917 a similar scheme for their hospitals was adopted.

The desirability of training permanently disabled soldiers while still undergoing hospital treatment was finally endorsed at the Inter-Allied Conference on Disablement Problems, held in London in May 1918, and committees were subsequently formed in each Command to organize similar work throughout the hospitals of the United Kingdom.

The South African Vocational Training Scheme was carried on side by side with the work of the hospital, and was successful both in improving the mental attitude—especially of limbless men—and in training many disabled men of the Contingent who would otherwise have been unproductive to the community.

The cost of the erection of the workshops—amounting to £2,335—was borne by the South African Hospital and Comforts Fund and the Governor-General’s Fund.

Much of the equipment was either given or lent, but about £1,200 had to be expended to obtain such tools and appliances as could not otherwise be obtained. The latter expenditure was defrayed by the Governor-General’s Fund. The scheme also necessitated the hiring of four houses in the vicinity of the hospital for housing students who had been discharged from hospital; the cost of the equipment of these, amounting approximately to £1,400, was also met by the two funds.

These hostels were managed by a small committee appointed by the General Committee. The expenditure on rents, rates, and taxes for the hostels was shared by the local fund and the Governor-General’s Fund, but all other expenditure was met by the sub-committee which received through the High Commissioner the sum of £1 per week for each inmate. This sum represented a ration allowance of 1s. 9d. per head per diem received from Defence Votes, the balance being made up by the Governor-General’s Fund. The Union Government also made itself responsible for the pay and allowances of the inmates, and entirely relieved the Imperial Government of all financial responsibility for the period during which the men were undergoing training after discharge from hospital. The number of crippled men who attended classes since their commencement was 393. Of these 167 remained on October 31, 1918, and 226 had left. Of those remaining, 112 were out-students—that is, men discharged from hospital—and 55 were patients still in hospital. The number of out-students dealt with was 215, of whom 103 have left.

The school was at first under the direction of Mr. Charles Bray, but on his resignation owing to ill-health, Staff-Sergeant Newell, B.Sc., of the S.A.M.C., and in civil life on the staff of the Natal Education Department, was appointed as educational organizer. He was subsequently granted honorary commissioned rank in the Union Defence Force. The propaganda work in the wards and the ward teaching were in the hands of Miss Edith Hill, also of the Natal Education Department.

The hostels for housing out-students were managed by a matron—Mrs. Lennox, of Lovedale—and a staff of ladies, whose efforts were attended with every success.

But the success of the school, in spite of many initial difficulties, was due to the keenness of the men themselves and to the excellent co-operative work of the whole staff of the hospital, with the result that in a number of cases of limbless men the earning capacity was undoubtedly increased as a result of the training they received at Richmond.