Sister Nellie Clark & Lady Paget’s Hospital
Nellie Clark was born in Cumberworth in 1888. The family lived in the Railway Gatehouse at Farlesthorpe for many years. Nellie’s father Thomas worked as a railway platelayer. Following her school years in Bilsby, Nellie trained as a Nurse, it was in this capacity that she joined the Serbian Relief Fund and traveled out to Serbia with Lady Paget’s unit in Oct 1914.
Serbian Relief Fund
The murder of Archduke Franz Ferdinand and his wife by a Bosnian Serb ultimately led to Austria Hungary declaring war on Serbia one month later, 28th July 1914, and the beginning of the Great War. Serbia faced a third war in two years, the young nation was impoverished and exhausted. Widespread appeals were launched by the handful of British nurses already in Serbia. They highlighted the plight of its people, particularly following the “Punitive Expeditions” of Austria Hungary, and the Serbian Relief Fund was formed at the end of September 1914.
One month later finances were in place to enable the first hospital unit to depart.
The story of Sister Nellie Clark
Sister Clark’s story has been uncovered through the diaries of other members of the unit who recorded their experiences during this time, documents and journals now housed within the archives at the Imperial War Museum. Trawling through this collection has revealed both the environment where Nellie Clark spent the last few weeks of her life and the story behind her death.
The members of the Third Reserve Hospital in Skoplje (Lady Paget’s Hospital) who recorded their experiences were:
Lady Leila Paget: General Superintendent
Louise Margaret Leila Wemyss Paget, wife of Sir Ralph Paget
(Diplomat) Lady Paget ran a military hospital in Belgrade during the Balkan Wars. Both she and her husband had close links to Serbia.Lady Paget’s report on the first few months of the hospital was published by the Serbian Relief Fund under the title “with our Serbian Allies”.
Professor Morrison FRCS: Surgeon in Chief
Major RAMC: Senior Surgeon to the Queen’s Hospital Birmingham. Professor of Forensic medicine in the University of Birmingham
Professor Morrison’s experiences were published in the Lancet, Nov. 1915, under the title “Major JTJ Morrison: Experiences in Serbia 1914-15”.
Mr Henry Fremlin Squire:Orderly
Medical Student Cambridge University. Harry kept a diary for his family of his time in Serbia at Lady Paget’s Hospital Skoplje
Miss Flora Scott: Nursing Sister
Trained nurse with papers. Miss Scott joined the hospital slightly later than the others. She included details of her experiences in Skoplje within letters to friends. They were recorded for the purpose of being included in the local paper for her supporters who had donated so enthusiastically to the fund.
The Journey to Skoplje
The first unit left Southampton on the SS Dongola on October 29th 1914. They carried an astonishing amount of supplies, 500 bales and cases, sufficient to fully equip a hospital with 300 beds. In addition a large quantity of groceries, drugs, surgical appliances and clothing for refugees were also transported. Upon arrival in Skoplje, on 17th November, Lady Paget reported that, despite double transhipment via Malta and Syracuse, they had arrived with all bales intact.
Professor Morrison recalled:
We sailed on Oct 29th, accommodation being provided on a British transport, thanks to the benevolence of the admiralty. Our P & O boat was one of ten troopships bound for Egypt and India, with an escort of British and French cruisers and destroyers as far as Gibraltar. We tran-shipped at Malta and at Syracuse without mishap, called as Piraeus, and on November 15th landed at Salonika. Our destination was Uskub, or, to give the town her revived ancient name, Skoplje.
The Embarkation: Southampton James McBey © IWM Art.IWM ART 1398)
Harry Squire’s diary and letters provide an insight into the voyage:
Thurs 29th Oct 1914 10.30pm ….at last we are actually off, this is a weird old ship.
Next Day (30th Oct): This evening fairly rough, first lesson in Serbian and heard that we are going 100 miles beyond Nish, nearer the fighting line.
Next Day (31stOct): We are not allowed to give particulars as to date place or anything. Inoculated today, no ordinary job, with a large harpoon in chest, feel very wobbly.
Next Day (1st Nov): Fearful rough night – motto: a rolling ship scatters much breakfast
Next Day (2nd Nov):- motto: it is better to have lunched and lost than never to have lunched at all.
Played hull board, sea quieter, slept on deck in deck chair, coolish but not stuffy.
Next Day (3rd Nov): – motto: A breakfast inside is worth two in the sea
4th Nov: Slept on deck again- lovely and warm. It’s nice to feel fit, concert this eve. Most of the party performed. Tommies thoroughly enjoyed it judging by their applause.
5th Nov: Sports in the afternoon for the Tommies – 4 events:
- Slinging the monkey – competitor slung up by his feet with a piece of chalk in his hand. He then walks back on his hands and makes a mark as far back as he can.
- Potato Race
- Are you there? – Competitors are blindfolded in pairs on the deck and hit each other. Best of 3 shots
Pillow fighting on a wet scaffold pole hung over a large sail bath.This was most amusing as of course the vanquished had his ardour cooled well!
6th Nov: Malta in sight.
Awfully pretty cliff coast line. The water is clear as crystal and the blue is simply heavenly. Last night a gorgeous sunset, the whole sky was aflame. Followed by a moonrise such as I have never seen.
We waited outside the harbour for an hour. Then we got inside the Valetta harbour which is a fine place. Here we were quickly surrounded by a fleet of picturesque boats with high prows and sterns, containing every type of barterage from braces to pomegranates.
Some small boys were awfully clever at diving for pennies. About 3 we disembarked and waited at the landing stage for the baggage. The goats were a feature of the place, great herds going round the streets, and if anyone wants some milk, the goatherd catches a goat and milks it into a glass which is drunk on the spot. Our Boat for Salonica has left without us.
7th Nov: Malta
It’s awfully hot here and the blue of the water is gorgeous. The houses are all a yellow white with flat roofs and balconies…. We are having a holiday here, and no ordinary time but I want to get to work.
I believe there is a chance of sailing tonight Lady Paget has been moving heaven and earth to get a boat. We should have got a gunboat only the ladies couldn’t be exposed to possible fighting. The latest rumour is that we embark on a boat to Syracuse and get a boat hence to Salonica but plans are unsettled at present.
9th Nov: We are off to Syracuse on board a pokey little steamer, hope to arrive around 10am. Arrived at 1pm, we took some time to see the sights.
13th Nov: Greece in sight, very rough and large showers. Most people bad with mal-de mer. Supposed to reach Picaeus at midnight. We are going to land tomorrow morning, we are waiting outside the harbour at present next to a Greek battleship……we are up early tomorrow to get as long as possible at Athens.
14th Nov: Sightseeing in Athens sailed at two…..lovely sunset glow on the Greek hills, turning them an unbelievable pink, all the peaks lighting up and mingling with the pink of the clouds.
15th Nov: Hope to disembark at Salonica tonight as everyone is sick of this pokey little boat. Arrive about 6 but cannot land due to various ceremonies to be performed by the port authorities. Fed in resignation but cheered to find that the combined pressure of the Serbian and British Consuls stirred up the sleepy port and we got on shore into a decent hotel.
16th Nov: Saw Salonica, got lost in Turkish bazaars and alleys.
17th Nov: Early start, before dawn, changed trains onto a special express sent down by the Serbian Government, Serbs are perfectly delightful people! Absolute children!
Passed through some lovely country: about 20 miles along a river running through a gorge: high hills each side. Crossed two bridges which had been blown up by the Bulgars in the late war and were being rebuilt. Arrived Uskub about 5.30. Seems quite a big town much bigger than I suspected. We had a huge reception by all the big wigs, including the head of the Greek Church here, who only comes to the station to meet royalty.
The installation of a hospital
Lady Paget’s report provides extensive detail of the preparations to open a British Hospital. There were 3 hospitals in existence, under the Serbian authority, which were available for the British units to take over. Madame Popovitch was already operating the first reserve hospital. The second was situated in 3 tobacco warehouses, which the unit declined as an unsuitable building for a surgical hospital, it was taken over by a British Red Cross Hospital some days later.
Lady Paget chose to occupy a series of buildings which had previously been a school / gymnasium. Outbuildings served as lavatories and kitchens. Structurally the buildings were sound and dry, interior walls were distempered and rooms had cement floors. This site was currently being operated as a 330 bed hospital but the wards were very dirty and a thorough cleaning of the premises was required before the installation of the British run hospital, the 3rd Reserve Hospital could be undertaken. All but 20 of the patients were transferred elsewhere and from 19th to 23rd November the preparations were made to transform the hospital.
Sister Clark and the other staff spent the next five days ensuring that the walls, floors and bedsteads were scrubbed with turpentine. Each bed was made to meet hospital regulations and the wards were equipped with all of the stores from home. Some equipment had to be manufactured on site, limb baths were made from old petrol tins and old packing cases became cupboards.
Oil lamps provided the lighting throughout the buildings with the exception of the operating theatre which had electric light. Mains water was available in the kitchen and the central building. The water and electricity supply proved to be unreliable but such problems had been anticipated and the unit had arrived with a 200 gallon water tank and a large oil pressure lamp. Portable boilers were used to obtain hot water.
In under a week Nellie and her colleagues had the hospital ready to admit patients. Some conditions remained far from satisfactory but these were beyond their control. The Iron bedsteads were low and the mattresses simply bags of straw. The worse problem was sanitation, the hospital drainage was ineffective and this would prove to be an insurmountable problem for many months despite several appeals to the Serbian authorities.
Harry’s Diary provides a more emotional record
It is very cold here but we feel it more because we have just come from the Mediterranean, two days ago we dried ourselves in the sun and now there is snow on the hills.
18th Nov: Slept long and hard, rough cold as not much bedding. It snowed a bit today but nothing much. The hills surrounding the town are covered thinly.
19th Nov: Begin work in earnest today. Bales are coming in on Ox wagons, two or three in each. All morning working hard on tea and dry bread for breakfast as stores haven’t arrived yet.
20th Nov: Same as yesterday only more so. Had an awful time.
21st Nov: Still unpacking bales and stores. I have never seen anything like the amount of blankets, pillows, sheets and especially shirts. We have been piling up the stuff into one room right up to the ceiling. We have got, among other things, 5 tonnes or rice.
Weather remains very fine though cold and bracing. It’s like an English December, though this eve it is sleeting fast.
The wounded are expected on Monday, so we shall have a hard day tomorrow, I expect.
Mon 22nd Nov: Wounded expected all day, also preparing the wards.
Major Morrison provides an insight into his views on the many frustrating delays the unit would encounter in Serbia. Below he is referring initially to the delayed arrival of the wounded here:
The delay was advantageous to us and the cause well understood. But no such simple and valid explanation can apply to the thousand and one instances of delay we were to encounter in other directions. Day after day we were held up by unfulfilled promises and a policy of drift affecting matters of capital importance, to say nothing of the small vexations in regards to odds and ends of work to be done or material to be supplied. The characteristic mental attitude of the native official in Macedonia is the product of centuries of Ottoman influence, and he himself belongs as yet to the East rather than the West.
That attitude finds expression in three words which were constantly and unforgettably dinned into our ears-
Polaka go slowly
Lady Paget was generally more supportive of the Serbian Authorities but her concerns surrounding the drainage prompted the following statement:
It was found at once that the drainage of the hospital was in a hopeless condition. Repeated requests were made by us to the Serbian Authorities to have it put in order. But it was not until representations were made to the Ministry at Nish that we could not carry on the hospital under these conditions, owing to the number of cases of illness among the staff[eventually followed by the death of Miss Clarke] that anything was done to remedy this. Even then the work was only partially completed by the time we left the hospital.
The Wounded Arrive
Major Morrison’s description of the poor state of the wounded men leaves no doubt as to the horrors these men had endured:
The first batch of wounded numbered 180. Their plight was deplorable, and one’s mind and emotions were painfully stirred, while the eye, the ear and the nostril were offended. Wearing their peasants’ garb (for there was a shortage of uniforms as of all else), muddy and bloodstained, with shirts and bodies long unwashed and swarming with lice; a large proportion with septic compound fractures and suppurating wounds, many with gangrenous limbs, and all half famished and chilled in spite of fever – this groaning throng of mutilated men had surely sounded the depths of human wretchedness.
Lady Paget was similarly shocked and proud in equal measure, shocked at the appalling state of the wounded and proud of the work her unit had undertaken on that first day:
180 patients arrived from the Serbian authorities, most were stretcher cases. The condition of the men were dirty exhausted and neglected, their wounds had not been dressed for weeks and many had not had their clothes off in months. Limbs were tensely swollen with pus and the smell overpowering when the dressings were removed. Nearly all of the men had frost bitten feet and many had gangrene.
Every patient was undressed and washed on the stretcher, wounds were dressed. Following a haircut they were then admitted to the wards in clean pyjamas.
She would later say that: “the greatest praise is due to the nurses and orderlies for the expeditious way they carried out the work”
Wounded arrived at 7am pandemonium reigned until 11. Men arriving with all sorts of complications. All very tired and filthy. One man had his chest gashed, and a broken ankle. It took about 45mins to get his boot off as his foot had swollen and he had two layers of socks under his boots which were absolutely caked with dirt and seemed as if they had grown on him. Even after the boot had been cut up it wouldn’t come off.
Poor fellows, some of them have had an awful time. One man was shot through the abdomen, piercing the gall bladder. In this condition he had lain for a day and a half on the battlefield, he was then roughly bandaged and endured two and a half days in a bullock cart…………..followed by a day and a half in the train. He was operated on this evening, he is expected to pull through all right. It was an awfully fascinating operation.
The hardships these men go through are simply appalling, and if only the English people would realise what this little country is doing to help us they wouldn’t say it was a country of villainous ruffians. It has done far more in proportion than any other nation now fighting. After all its resources have been drained by the last two wars it is absolutely penniless and yet it still holds out nobly. Practically all its ammunition is gone, the men are half starved but their courage is indomitable and they go on fighting even more fiercely than before.
They are awfully grateful to us for all we do for them and though one gets awfully weary at times there is no time to stop and think about it as there is such a lot to do. We are of course hopelessly understaffed having 4 doctors to 300 men, most of them have at least one mashed up limb, besides the septic condition of the wounds and the presence of gangrene, which makes a lot more work in the dressing.Of course this morning’s work was merely to get them washed and put to bed, most were in a fearful state, some hadn’t taken off their clothes for 4 months.
Major Morrison and Lady Paget’s reports do not adequately convey how this hopeless situation affected those at the heart of it. This was not just a situation to be endured on the first day but was the same on all subsequent days.
Harry’s Diary reveals the relentless nature of the situation for Nellie and her colleagues:
Wed 25th Nov: Just got the first batch of wounded settled when we received news that 40 more are arriving this morning. Worse pandemonium as half the staff have to look after their wards, around 5pm hear over 40 more arriving. I will draw a veil over proceedings, however the main hall was absolutely covered with stretchers containing the wounded in a groaning mass of pus and smell.
Thurs 26th Nov: Dressing all day. Saw amputation of both legs of one poor fellow who had gangrene after frostbite. We are doing about 14 hours a day now and jolly hard work it is.
Fri 27th Nov: Dressing all day. The man with two stumps has a wife and 5 children to support. He is almost raving and will probably die soon owing to the fact that he has made up his mind to.
Sat 28th Nov: Did odd jobs and dressed in the morning then had a nasty shock! The matron called me and said that owing to the sister to whom I was orderly being on night duty, I was supposed to take charge of a ward of 10 beds and prepare it for wounded who were arriving soon! In fact I became a sister. After some rushing around, I got the place ready only to find the wounded did not arrive. It seems the stock thing out here to give one shocks by misinforming or else by dumping down patients without warning. The man with the stumps died this morning.
Sun 29th Nov: My patients have arrived and I am writing in my ward. There are six of them. One man has lost an eye and has several wounds in the scalp. He is continually surrounded by relatives who give him fearful messes to eat and generally get in the way.
I have an Austrian prisoner to help me, an awfully nice chap who speaks German and Serbian, at least one can guess German better than Serbian.
Lady Paget’s report shows her understanding of the hopeless situation they were in:
In nearly all cases wounds were in a very septic condition and the work of constantly changing the dressings taxed the staff to its utmost. Large numbers of patients continued to be admitted daily, all in the same condition. Some of the first admissions were found to be suffering from Typhoid and Dysentry and subsequently isolated.
Skoplje is a very fascinating town, 500 years ago it was the capital of Serbia and is full of wonderful old places and buildings such as Turkish baths and old mosques. There is nothing approaching English anywhere about, even the mountain sides are not like ours being covered in vines. The weather is warm in the day but bitterly cold at night. Fresh snow falls overnight yet mountain violets and crocuses are to be found and orange, lemon and almond blossom are on the trees, looking very beautiful below the snow.
There are people here of nearly every Eastern race, especially lots of Turks. Their part is very funny to see. They sit in their bazaars making rugs or hammering those beautiful brass trays and ornaments. All the time you are out you are reminded of Bible pictures. One of the funniest things is to see great big men riding such little donkeys and the women walk behind carrying loads or children. Never do you see a woman riding. Mules, bullocks and Oxen do the heavy work. It is very picturesque but everything goes slowly here, no one hurries.
Managed to get off for a stroll the other day, we discovered a topping shop where we got some awfully good preserved fruits, much better than those in England, more juicy and flavoured. Lovely great apricots, we are enjoying our 2nd kilo. There are lots of things which one can’t get here though, butter 3/6 lb and biscuits are double the English price as there is a heavy duty.
Tues 8th Dec: Went to the Turkish market, awfully picturesque with the various nations costumes intermingling. The black and white costumes of the Albanian peasants contrasting vividly with the bright harem skirts of the Turkish women. There were some pretty embroidered scarves and waistcoats there.
Wed 9th Dec: by arrangement we only get 10hrs a day as we all have to have 2 hours off in the afternoon. Went for a stroll in the old Turkish slums with mud hovels and in a most dilapidated state. We were threatened by a large pack of howling dogs but some men came up and beat them off.
Thurs 10th Dec: Climbed the hill behind the town today for an hour and got about a third of the way up beyond the snow line. In the town there was a thick mist but soon after getting well out we got above the mist. I had a magnificent panorama of the whole place. Uskub or Skoplje is in a valley about 10 miles wide surrounded by snow hills. We had a view of billows of mist right from our feet to the other side of the valley, dotted here and there with minarets of the Mohammedan mosques which were lit up by the sun. The sun was setting and all the snow was turned a pinkish hue and so were the minarets.
It is the custom in Serbia and I suppose it is universal in the Greek church, that when a man is dying his hands are crossed and a taper put in them and lighted, this must be alight at death. It is of course jolly difficult to time them accurately especially as the other patients have to be looked after. One man was dying hard so he was given a taper and then left for e few moments. On the sisters return she found that the man, instead of dying, had calmly lit a cigarette at his taper and was puffing away quite happily. Unfortunately the story did not end properly, for he died the same night.
Besides the patients we have several other people wandering about the ward. There is an awfully nice Russian priest who is quite useful at holding legs and fetching and carrying bowls etc. He turned up this morning and stank the place out with incense, a little goes a long way in a stuffy ward. There is a small boy about 14 who runs about in pyjamas and slippers. He seems to belong to nobody but is awfully useful. He winds up bandages and fetches hot fomentations. There are also two Austrian prisoners, one of which talks English a little, and a Serbian lady who speaks French, so between them we get on well in languages.
Harry’s Diary……..The Loss of Sister Clark
Fri Dec 18th:
Evening concert in aid of Serbian Red Cross Fund. Attended by the British consuls and one of the big generals who is chief of the army.
Mon Dec 20th: Usual work
Tues Dec 21st: Went to a weird little café where there was a lovely orchestra of Bohemians who played most beautifully. On our way back we found unusual activity at the hospital and there were 50 wounded coming in for the night staff to deal with. So we went and offered our services.
Wed Dec 22nd: Usual work
Thurs Dec 23rd: One of the sisters is ill with Uskub fever, a speciality of this place.
Friday Dec 25th: The first thing we hear is that the sister has died during the night. I am awfully sorry for Lady Paget and those that knew her well. It has of course stopped all Xmas festivities, though we have a dinner in the evening.
Nellie lost her life on Christmas Day 1914, she had succumbed to the fever and septic throat which had plagued the staff since their arrival.
Sister Clark had been nursing at Lady Paget’s Hospital in Skoplje for a little over a month.
Harry’s Diary……….The Funeral of Sister Clark
Saturday Dec 26th: The funeral is to be today. It is to be semi-military.
At 1.30 we had a short selection of the English service read by the British Consul in the hospital, then we formed up a procession, Rex being one of the bearers, and went to the Greek Church.
It is marvellous what respect everyone showed, even the smallest kids crossed themselves as we passed.
The Greek service was really……….. I don’t know what to call it quite.
There were 8 priests, in the most gorgeous robes I have ever seen, who stood round the coffin and chanted most beautifully. The church was dimly lighted, and the incense made it dimmer, and through the mist, the gilded pictures and decorations dimly showed.It was most impressive.
Then outside the church a Serbian high official gave a funeral oration and then we went to the cemetery where the British Consul read the church burial Service. We were accompanied throughout by a Serbian Military Band who played weird minor marches.
On Jan 4th 1916 The Hull Daily Mail printed a message from the Serbian Relief Fund:
Miss Clark….. was buried at Skoplje with full military honours. The funeral was attended by the entire population of the city and her loss is most keenly felt.
Lady Ralph Paget wrote:
She was the best nurse we had and was so very sweet and gentle that she was loved by everyone who had the honour of knowing her. As for the wounded men she nursed they simply adored her, and it was touching to see their grief when they heard of her death.