The Casualty Clearing Station

Last week in our series on Private Wilfred Pegrum, an ancestor of our own builder James Pegrum, we introduced you to the Royal Army Medical Corps and the Chain of Evacuation for the casualties of war. In it, we focused on the Field Ambulance stage of the Chain, in which Wilfred would have found himself following his wounding in the final days of the Battle of Passchendaele.

Following his time at the Field Ambulance, he would have been transferred to the Casualty Clearing Station (CCS). CCSs were situated several miles behind the front line usually near railway lines and waterways so that the wounded could be evacuated easily to base hospitals. While they were often located in permanent buildings, such as schools, covenants or factories, they would often have to move, following the ebb and flow of the front line. Facilities included medical and surgical wards, operating theatres, dispensary, medical stores, kitchens, sanitation, incineration plant, mortuary, ablution and sleeping quarters for the nurses, officers and soldiers of the unit. Normally, a CCS could cater for 200 or more wounded and sick at any one time, however, as the war drew on they would be forced to accommodate up to 1,000. From the CCS men were transported en masse in ambulance trains, road convoys or by canal barges to the large base hospitals near the French coast or to a hospital ship heading for England.

There were two categories of hospital in the chain of evacuation, Stationary Hospitals and General Hospitals. Stationary Hospitals were designed to hold up to 400 casualties and sometimes specialised in certain treatments, for example for gas victims, neurasthenia cases and epidemics. They normally occupied civilian hospitals in large cities and towns, but were equipped for field work if necessary.

General Hospitals were usually located near railway lines to facilitate movement of casualties from the CCS's on to the coastal ports. Former bastions of leisure, such as hotels and casinos were often requisitioned for the purpose, but other hospitals were no more that hastily constructed collections of huts or tents. They could at peak times accommodate up to 1,200 casualties. Some general hospitals were Voluntary Hospitals supplied by voluntary organisations, notably the Red Cross.

Our model is based on this photo of the 2nd Australian Casualty Clearing Station at Steenwerke, November 1917. Imperial War Museum copyright image E(AUS)4293.

If it was unlikely that a soldier could ever be returned to active service they would often be sent home on hospital ships, which were usually requisitioned and converted passenger liners. Due the seriousness of the injuries sustained by the ships’ patients, many died on the voyage home, while the risk of U-boats and sea mines was also a serious danger.

We know not what sort of hospital Wilfred would have been transferred to, or indeed if he ever made that far. We do know however, that he would not be a passenger aboard a hospital ship.

Throughout this project, James has asked his two sons to think about what might have happened to their ancestor, following his wounding at Passchendaele. They continue the story:

Jon (age 12)

In the CCS a row of beds are laid out for the injured to lie on while nurses attend to the wounded soldiers, trying to save as many as possible, including Wilfred.  Sadly, not everyone survives. 

Toby (age 9)

"Can you hear me!" The nurse screamed, but it was too late, every knew that he had died from his wound.  The bloody raged sheets had been burned and now it was time to bury his rotten body...

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