CHAPTER 1 CASUALTY SERVICES

General

Although, for some curious departmental reasons in Whitehall, the Ambulance Service and First Aid Posts came under the Ministry of Health, while the Stretcher Bearers were under the control of the Ministry of Home Security, we found it necessary to group all these sections as part of one compre-hensive Casualty Service operating throughout under the Medical Officer of Health. When recruitment for the Casualty Services was commenced, early contact was made with the South West Essex Division of the British Medical Associa¬tion and with the local divisions of the St. John Ambulance Association and the British Red Cross Society with regard to the Medical and First Aid personnel respectively.

The consultation with the St. John Ambulance Brigade in March 1938 was probably the first Civil Defence contact made in Walthamstow between the Council and an outside body, and it is appropriate to record here the invaluable and unfailing help then and since received from every Officer, N.C.O. and Member of the St. John Organisation in Walthamstow. The following pages indicate in some detail the development of the three sub-divisions of the Civil Defence Casualty Services.

(a) Ambulance Service

The Ambulances of the Local Authority, Fire Bri¬gade and St. John Ambulance Brigade available at the time of the Munich Crisis in September 1938, totalled six only, for no vehicles had yet been provided for Civil Defence Services. In order to supplement this obviously inadequate provision, approximately 120 commercial vehicles were earmarked by the Council's Chief Transport Officer and " TOR" Stretcher Frames were put in hand, each to take four wood and wire-netting stretchers. At the outbreak of war, in September 1939, the whole-time vehicles available were supplemented by the purchase of vehicles and those selected for use as ambulances were fitted with the "TOR" frame already referred to.

Eleven motor coaches were requisitioned and converted to ambulances to take eight stretchers, and drivers were enrolled and allocated to vehicles according to their ability to drive coaches, converter ambulances or sitting-case cars. Earlier in the war, while still awaiting provision of official vehicles and without official authority, eleven trailers, each taking six Home Office pattern stretchers, were purchased. These were towed by the sitting-case cars and materially increased the stretcher carrying capacity of the emergency ambulance service. These trailers later became redundant with the provision of converted ambulances and when then adapted for use as Light Rescue Trailers. In addition to the dispersal of ambulance vehicle to the ten District centres, a central reserve was held at another site in the Borough, but this reserve was abolished following the first reduction in ambulance vehicles and ambulance personnel.

At December 1939, the Emergency Ambulance Service vehicles between them represented a total stretcher-carrying capacity of 250. Like other Services, the Ambulance Services were extended to their full capacity during the blitz of 1940/41 and during the later raids but, although the vehicles left much to be desired, the personnel never hesitated at the call of duty. The personnel also manned the Municipal Ambulance Service from the middle of 1941 (when the Fire Brigade was removed from the Local Authority control), until January 1945 when further cuts in the Services made it impossible for Civil Defence to continue to accept full responsibility for Municipal Ambulances although assistance was still rendered in emergency from time to time.

In addition to their ordinary C.D. duties and the manning of Municipal Ambulances, the Ambulance Service had to act as general utility carriers until half-way through the War. No cars were provided for Headquarter use and it was necessary to use Ambulance cars whenever a "taxi service" was re¬quired for C.D. purposes.

(b) Stretcher Party Service

Stretcher Bearers (later renamed Light Rescue men) were recruited, as their title indicates, primarily for the purpose of rendering First Aid at the Incident and conveying injured persons on stretchers, either direct to First Aid Posts, or to the Ambulances which would attend at the Incidents. We were much concerned at one time regarding the possibilities of roads becoming impassable to traffic owing to heavy bombing and provision was made for the equipping of the Cleansing Department's Street Orderly barrows with brackets which would permit of them being used to carry stretchers.

Some 54 of these were distributed over the Town at the different First Aid Posts and District Centres and, had the anticipated bombing of roads taken place, it would have been possible for one man or, if available, two men, quite easily to transport stretchers on these barrows. Fitted with pneumatic tyres, the barrows would have ensured as easy a passage as possible in difficult circumstances but, fortunately, they were never needed as any road which became blocked was quite easily by-passed by using other roads.

The equipment of the Stretcher Bearers in the early days was rather primitive and we had to make quite a number of wooden-framed stretchers to meet our possible requirements long before we were able to get official stretchers for the purpose. From the beginning it was felt desirable that stretcher bearers should be men although, in one or two Districts, emergency squads of women were trained for the purpose so that the official stretcher bearer establishment could be supplemented if necessary.

When reservation from Military Service and other forms of National Service was first introduced by the Ministry of Labour, it was recognised that Stretcher Bearers played a most important part in the handling of casualties, and they, together with the Rescue men, were scheduled for reservation at the age of 30 before such reservation applied to any other sections of the A.R.P. Services.

In 1942, when extensive reductions were made in the Civil Defence Service whole-time establishment, the Government decided that Stretcher Bearers should be reclassified as Light Rescue men and, at the same time, reduced the number of men in both the Heavy and Light Rescue Services. In order to cover the deficiency thus created, the Heavy Rescue Service were given more intensive First Aid training than they had previously had and arrangements were also made for the Light Rescue men to be given recue training so that they might be used for Rescue work as well as for Stretcher Bearer functions.

With the approval of the Controller it was arranged locally that the Heavy Rescue Service should remain under the Rescue Officer and the Light Rescue Service (as the ex-Stretcher Party Service) should remain under the Medical Officer of Health, the respective Heads of Services being responsible for the training of both sections of the Service in their own technical functions. The combination of functions for both sections did, in fact, increase the flexibility of the Service, theLight Rescue Service proving itself very adaptable to the new conditions and playing its part in the rescue of 219 trapped persons referred to in the chapter on Heavy Rescue Service.

Moreover, in addition to their casualty and rescue functions, the Light Rescue Service at various times provided valuable assistance with furniture removal and by aiding the Debris Clearance Organisation in the removal of debris from the scene of incidents after casualties had been disposed of and the incidents officially closed.

(c) First Aid Posts

The first official report compiled for the Council was dated March 1938. This report suggested the provision of ten First Aid Posts and Decontamination Centres in order to ensure that such a centre would be available to every person in the Borough within a distance of approximately half-a-mile. It will be remembered that at that time the greatest importance was being paid to the possible use of gas, and the need for speedy decontamination was held to be of primary importance. It was obvious that the premises already under the control of the Local Authority and most readily meeting the requirements of First Aid Posts, were the schools and, accordingly, eight Elementary Schools, one Secondary School and one Hospital were suggested as possible buildings.

The suggestion in regard to the eight Elementary Schools was approved but it was found that the other two Posts had to be located at alternative sites. Provisional plans were to be prepared for the adaptation of premises and enquiries were to be made from local chemists as to the stocks of suitable drugs, dressings and instruments which they held and which could be supplied on immediate notice. When the Munich Crisis arose in September 1938, the position was as detailed above and, in view of the fact that no equipment had been provided from central sources, the Controller authorised the despatch, on September 14th, of the pre-arranged order to local chemists. Supplies to the amount of £1,500 became available in a short time and were distributed to the previously selected First Aid Posts to which all available personnel had been allocated beforehand.

In consequence, all ten Posts were ready for immediate action in September 1938, each with one or more Medical Officers, a Dental Officer in most cases, a Pharmacist and Lay Superintendent in all cases and a Trained Nurse in some cases. Over 800 other personnel - trained and untrained - were also available. The cleansing facilities available were the ordinary facilities in the buildings. From our experience in September 1938, it was soon obvious that the adaptation of schools as First Aid Posts at an estimated cost of £3,000 each would only result in poor First Aid Posts and would interfere with school accommodation. The problems of proper black-out, splinter-proofing, and gas-proofing were considered incapable of satisfactory solution and, accordingly, on the night of Munich the Controller and the Hon. A.R.P. Officer obtained the approval of the Emergency Committee to order ten sets each of three Nissen huts, 16 feet wide by 48 feet long, so as to provide ten "ad hoc" First Aid Posts. The centre hut was to be divided longitudinally for male and female cleansing services, the huts on either side to be used for male and female first aid services respectively. The huts were to be provided with air-locks, and a connecting corridor at one end.

Emergency lighting and sanitation, together with reserve water supplies, were later incorporated. Suitable sites were found near the eight Elementary Schools already referred to, each of which was allocated to serve as a Multi-Service Depot, accommodating the District Warden, Report Centre Staff, Heavy Rescue and Stretcher Parties (later Light Rescue), and Ambulance Services. At the two remaining Districts, one of the three Nissen Huts was made available to house the District Centre and the services enumerated above, except that there were no Heavy Rescue Services at these two Centres.

In this way we had the First Aid Post and the other Services housed in close proximity in each of the ten Districts. All the First Aid Posts were completed and ready for action at the outbreak of war in September 1939, except one Post (H. District) which required modification of lay-out and this was ready soon after the outbreak of war. No difficulty was experienced in obtaining from among local Medical Practitioners a Medical Officer for each First-Aid Post, assisted at many Posts by a second (and even a third), Medical Officer. The Medical Officers-in-charge of Posts were relieved of the routine administration of the Posts by District First Aid Superintendents.

All the First Aid Superintendents (except one who was a Trained Nurse) were Lay Superintendents and members of the St. John Ambulance Brigade. They had been nominated to take charge of First Aid Posts since Munich or earlier and it would have been unfair to supersede them by Trained Nurses as and when these became available. The number of Trained Nurses available varied from time to time, and at the outbreak of war amounted to 29; nine for whole-time and twenty for part-time duties.

Until late in the War (January 1945), there was no reduction in the number of First Aid Posts, which incidentally appeared to be the only " ad hoc " Posts available in the Greater London area judging by the requests from London Region for inspection by visitors from abroad between Munich and the outbreak of war. In addition to the official ten First Aid Posts provided by London Region, arrangements were made with the Council's Electricity Undertaking - whereby the Undertaking's First Aid Post at Exeter Road could, if need arose, be made available to deal with civilian air raid casualties in that neighbourhood as our A.R.P. " C" District area, (with Markhouse Road as its main road), was the most heavily populated part of the Borough and the number of persons residing therein was approximately double that of any other A.R.P. District.

In exchange for the facilities offered by the Undertaking, arrangements were made for the First Aid personnel of the Undertaking to be attached to "C" First Aid Post, to be supervised by the District First Aid Superintendent of "C" District and for a fail-amount of inter-changeability between the personnel of the official Post and the unofficial Post with good results on both sides. Fortunately, the number of casualties which had to be handled oa no occasion required the opening of. the Exeter Road Post for the purpose of dealing with air-raid problems.

In appendix E will be found a list of Doctors concerned in the Emergency Medical Service at First Aid Posts and Headquarters. Others assisted from time to time but the list comprises those who were able to assist regularly to the end of Civil Defence.

Part I - General

Part IIa - The Services

Part IIb - The Services

Part III - The Story of the Raids

Part IV - Flying Bombs & Rockets

Part V - To the Unknown Citizen