Over 6.2 million sick and injured troops during the First World War
were evacuated from the Western Front. Yet, despite almost every
aspect of the First World War having been examined by historians in
near forensic detail, very little has been unearthed concerning
casualty evacuation - and the start of the long road to recovery.
The provision of high-quality treatment and care is an important
attribute in the maintenance of morale and the will to fight.
Therefore, casualty evacuation deserves more attention, and this
book does just that. This book is about how mass casualties were
planned for, and then evacuated in an age before many modern
medicines, stabilisation techniques and helicopters. The main
purpose of this book is to examine the evacuation of casualties
from the first days of the Battle of the Somme in July 1916. The
aftermath of the opening day of this battle, on 1 July 1916,
resulted in the highest number of British casualties in any single
day. A situation that was to severely test the medical and
evacuation services, over a number of days. The book is based upon
primary research of the War Diaries of medical units, and in
particular those of the medical officers of the ambulance trains.
The author has analysed the activity of every hour of every
ambulance train in the period of June and July 1916 in order to
build a unique oversight of how the evacuation pipeline coped with
the crisis. This analysis is revealed after the reader experiences
how the army medical services capability and procedures evolved as
the war continued. The reader is taken on a journey from the 1840's
to 1914 as military medical science and the capability of the
railway in sustaining war, and in evacuation, developed
concurrently. Thereafter, attention shifts to the frantic efforts
in late 1914 to introduce a means to evacuate casualties by train.
As medics and logisticians become more organised processes are
introduced to manage casualty evacuation, trains are constructed
and shipped to France. Thereafter, the book explains the principles
of the medical evacuation pipeline from the point of injury, to the
Casualty Clearing Stations, ambulance trains and eventually, many
hours to the rear, the base hospitals. The emphasis then shifts to
the medical planning and organisation for the Battle of the Somme,
including learning from the experiences of the Battle of Loos in
September 1915. The focus then turns to the 1 July 1916 and the
initial battle, the surge of wounded and how the evacuation
pipeline coped with the unprecedented demand. The book reveals how
the mass of injured humanity from 1 July hit the limited number of
Casualty Clearing Stations and were packed into almost 50 trains on
long journey and uncomfortable journeys to places of safety and
eventual recovery. This book exposes the enormous logistical and
physical effort involved in mass casualty evacuation and shows that
despite the unprecedented number of casualties, every available
ambulance train was optimised to recover the wounded. It challenges
the theory that ambulance trains failed on the 1 July 1916, and
shows that, crucially, the medical planners for this battle failed
to anticipate what was, in fact, a predictable level of casualties.
What is unclear, though, is had they accurately predicted the
casualty rate whether it would have been possible to have evacuated
the injured any more expeditiously.
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