1st Australian Casualty Clearing Station
From Our Contribution
In October 1914, a new type of medical unit was added to the order of battle of the Australian Army’s casualty evacuation chain. Designated the casualty clearing hospital, it would later be called a Casualty Clearing Station. This unit was established as the most forward unit to provide emergency surgery, freeing the forward field ambulances from the necessity of holding wounded soldiers, a task which compromised their mobility and prevented them from moving with the brigades they supported.
The Casualty Clearing Station was to be the most forward unit where specialist surgeons, anaesthetists, nurses, radiologists and a dentist were to be found. The No.1 Australian Casualty Clearing Station (1ACCS) was raised in Hobart and consisted of 93 men including 7 doctors. After some seven weeks of training in camp, the new unit embarked for Egypt.
In February 1915 the unit was based at Port Said in a convent and at the Savoy Hotel. During the Turkish offensive against the Suez Canal, patients and nurses were evacuated to the Government Hospital in Cairo. The unit was then transferred to Cairo, before embarking with 1st Australian Stationary Hospital and 3rd Infantry Brigade to Lemnos.
1 ACCS was transferred from 'Line of Communication' troops to 'Divisional' troops. The landing party would consist of five officers; O.C. Lt. Col. Wilfred Giblin, Maj’s Richards (OIC Landing Party) and Corbin, and Capt’s O’Brien & Atkins - all of whom were medical professionals. They commanded 60 OR’s.
They landed on the beach at Anzac Cove in 3 tows between 10am and 12 noon on 25th April 1915. Giblin's personal diary suggests the equipment carried ashore by the Casualty Clearing Station was barely adequate to meet the situation before them. They found the number of casualties waiting to be treated so overwhelming that little more than first aid could be provided. Cases were evacuated to the waiting ships. The hectic pace of evacuations and treatments meant records were not fully maintained. It is estimated in the first day and night (between 11am and 3 am the next morning) more than 700 men were treated.
Operating under extreme pressure, with very limited equipment and an area of beach approx. 20 ft. by 20 ft., the unit was clearing casualties for two Divisions (approx.30,000 men), while being exposed to shrapnel from artillery fire. In the first three days it treated around 2,100 casualties, working 20 hour days. Yet despite these relentless hardships, the unit distinguished itself in the field. Within 12 weeks of the landing Private M.D. Cowtan was awarded the Distinguished Conduct Medal, and eleven members of the unit had been Mentioned in Dispatches.
The Casualty Clearing Hospital (Station) was reliant on the piquet boats to transfer casualties to the ships offshore but with the boats being used to land troops or stores the unit often relied on Naval officers who commandeered a large Lighter (which had an awning erected to assist the stretcher cases); a Horse Float (which also had an awning); and ships cutters (which were small and not ideally suited to stretcher cases).
On 7th August, after a large attack, 1,937 casualties were evacuated, 400 of which were stuck on the beach when no boats were available to transfer them and no available accommodation on any the Hospital Ships if they could be transferred. After an urgent message for more ships, three arrived from Lemnos.
By the middle of August No.1 ACCS was seriously undermanned. Reinforcements intended for unit were held-up in Cairo working at hospitals. By 14 August the number of NCO’s and men was down to 45. On top of this on 1 July 1 ACCS had been linked with 13th CCS (Walkers Beach) and 16th CCS (No2 Outpost) and OC 1 ACCS, Lt Col Giblin, who had returned to his duties, was Medical Control Officer, responsible for all evacuations to the Hospital Ships from Anzac Beach.
Throughout November freezing conditions and rough seas made treatment and evacuation of sick and wounded extremely difficult. Between 27 and 30 November conditions were so poor that no evacuations were possible. On 19 December 13 CCS transferred all casualties to 1 ACCS and evacuated at 11:10pm. 1 ACCS then evacuated in 2 groups, the first group evacuating at 2:00am on the 20th and the final party consisting of 1 Officer, 1 NCO and 6 men to depart with the final covering party of 68 men.
Between 25th April and 20th December 1915, a total of 37,100 men were evacuated through No.1 Australian Casualty Clearing Station on Anzac beach. This was an outstanding achievement for a new type of unit, made up of a good officer group and volunteers. The OR's, mostly from Tasmania and aged in their mid to late 20’s, comprised 19 semi-skilled workmen and labourers; 15 skilled tradesmen; six miners; six clerks; six farmers and graziers; one medical student; seven waiters or servants; and nine others.
The men of the 1st Australian Casualty Clearing Station were among the first to land and the last to leave. 
Nos. 1 and 2 A.C.C.S. arrived in France with the A.I.F. and were at once established behind the force in the British Second Army—almost literally “in the front line.” In this solidly efficient Army, under Surgeon-General (later Sir) Robert Porter they worked till the end of the war — always in close conjunction, at times in double harness.
No.1 Australian Casualty Clearing Station opened at Estaires in the 2nd Army in May 1916, with a Nursing Staff of 7, drawn from the staff of No.1 Australian General Hospital. On 27 Apr 1916 it was set up in the Sacred Heart College for Boys in Estaires, which was not convenient and was very hard to keep clean as well as being overcrowded.
In May 1917, the C.C.S. moved to Bailleul, where it had a busy time during the battle for Messines ridge, and in July it moved again to Outtersteene, a site called "Tasmania" near Hazebrouck. Here the work was very heavy during the mustard gas attacks in the Armentieres sector. On the afternoon of Sept.26th, the vicinity of the C.C.S. was shelled, and one fell at the back of the Officers’ ward, but fortunately did not explode. The patients were evacuated and the Sisters sent to No.2 C.C.S. for the afternoon, but returned later. After this, a concrete dug-out was built in the Sisters’ compound.
On 26 March, a new site at Ana Jana Siding near Hazebrouck was inspected, and site (Hendeghem) allocated. In less than a fortnight, a further move back to Blendecques was necessary as the Germans advanced.
On March 18th 1918, the C.C.S. came under shell fire during the German advance, but the work (which was tremendously heavy) continued through the first days of the retreat, until March 28th, when a removal was ordered owing to an expected enemy attack. The huts and tents were taken down by degrees and re-erected on a site at Hondeghem, further back, the removal being carried out in an orderly way in spite of the shelling. For several days the work was carried out at Hondeghem under great difficulties owing to rain, mud and other conditions, until on April 12th orders were again received to evacuate, as another enemy attack was expected. The Nursing Staff were transported in motor buses to No.10 Stationary Hospital (where they came in for an air-raid that night) and remained there until April 17th, when No.1 Australian C.C.S. opened up at Blendeques, a few miles out of St. Omer. The Sisters were billeted in houses, but they wrote regretfully that they had lost many of their mess comforts during the hasty removal from Hondeghem.
On 17 Apr 1918 Nursing staff rejoined the unit at Blendeques, proceeding by motor ambulance. Most of the equipment was saved in the hasty move from Hondeghem but many comforts belonging to the Sisters’ mess were unavoidably left behind. On 26 Apr 1918 they again received patients.
The Sisters billeted in houses, but they wrote regretfully that they had lost many of their mess comforts during the hasty removal from Hondeghem.
It was a dirty dusty camp consisting of several very long tents and a couple of huts for Theatre and Xray. The officers had ‘bell’ tents in the grounds but the sisters were billeted 4 in a room using camp furniture. There was no bath in the house, and we washed in our basins behind a screen carrying the hot water in jugs from the wards (about 5 minutes walk) and their pumping cold water from the bottom of the garden another few minutes walk. Invariable ‘Fritz ‘came over on his nightly visit while we were in the middle of our ablutions… No bombs ever fell very close to the hospital, but the bursting was sufficient to shake the house and terrify some of the patients besides causing extreme pain to those with shattered limbs done up on splints. One night a dump which was quite close was hit and all night the ammunition was going off. No civilians slept in the village, one saw continuous streams of women and children and a few men – mostly old – making their way to the woods about 9 o ‘clock each evening. They felt safer there and it was warm summer weather. Early in the morning we would hear them returning. In the house I was in there lived four generations of women, the Great-Grandmother must have been a tremendous age and she was quite foolish and unable to accompany the others into the wood so they locked her in a basement room – her cries were uncanny during raids and one of us would go down and talk to her through the door – she did not know what we said but she showed her appreciation by laughing a laugh almost as, weird as her cry…
…All our patients were ‘Tommies’ and a few Hun prisoners. The Tommies were wonderful. Never a grumble and hardly a cry of pain. They would see a friend and ask how the fight went when he left it, where he was hit etc. and would then compose himself to sleep or his cigarette – his greatest of all comforts. After that he took little interest in what happened in the line and seldom mentioned his Home people but always asked if he had got a ‘Blighty’. Food and drink of all description, pyjamas, comforts were all plentifully supplied and a most satisfying sight was to see the convoy lined up on stretchers ready for the train all comfortable with a cake of chocolate in their pocket and perhaps an orange.
Advancing with the Fifth Army
From 4 September 1918; orders to close down Hondeghem from midnight 12 September and move to St Venant.
[I don’t] remember when we got a meal or where we went to bed but within a couple of days we had a good hospital going and all cases sorted out and in their proper (wards and equipment all drawn, but the rain persisted and the wind increased as it only can in Flanders. There were no paths and the duck boards were late in arriving our transport consisted of only a few lorries. There was no water supply water having to be pumped from a waterhole which had pretty green stuff growing on top and then boiled and strained several times before drinking – we had fortunately plenty of soda water for the patients. The first thing to do for ourselves after arranging ourselves as comfortably as possible in our… Huts — 6 sisters to a hut – was to look for someone to wash for us. This was a difficult job and when we eventually had our laundry returned to us, it was quite impossible to wear and was much dirtier than when we sent it. We remained in this camp only ten days.
St Venant Asylum from 18 September to 24 October 1918.
Orders came for another move this time further south to St. [Omer] The scene for the CCS was one old Lunatic Assylum which had been badly shelled. Some parts of it were burnt to the ground but all was more or less damaged. In the main surgical ward which was upstairs we could look through a shell hole in the floor and see what was going on in the ward below. There was not a pane of glass in the whole place the windows were fixed up with oil skin and blankets put up to keep in the light at night. The amount of cleaning done to this place was tremendous but the work here was extremely heavy we being a forward CCS and no other near … eventually we quietened down a little and No 2 ACCS got in front of us. There I was put on a team and sent to them for a few weeks. The work there was almost entirely oh French civilians ranging in age from 3 months to that indescribable old age of the French peasant.
Fretin - Receiving patients, 30 October 1918; moving out, 14 November 1918. “the nursing sisters are billeted in a chateau in Fretin. Their quarters are very comfortable”
Then the 1st ACCS moved again after the fall of Lille to a dreary bleak spot called Fretin just beyond Lille. Here we were billeted in an old Chateau about 20 minutes walk from the camp. Here I returned to my own CCS No 2 having closed down ready for another move. My team went on night duty and filthy weather prevailed cold winds and rain for it was now late in October. We were cold and miserable long before we reached our ward for the nights work. It was during this night duty that the late Sister Moorehouse took ill but would not give in until she could not move, and it was too late to save her precious life.
Tournai Hospital Militaire 15 November—26 December 1918
Hal Convent School, Sacre Coeur de Saint Marie 2 January 1919—12 March 1919
For a list of some of those who served with this unit: https://rslvirtualwarmemorial.org.au/explore/units/108/people
- Jesse Thomas Manser 10 Aug 1917 - 24 Aug 1918
Soldier Patients by date admitted
25 April to 20th December 1915
- John Charles Hutchinson 26 Apr 1915
- Alfred Cecil Clarence Curtis 11 Jul 1915
- Thomas Hetherington 18 Jul 1915
- Albert Stephenson Jackson 7 Aug 1915
- Arthur Charles Cam 8 Aug 1915
- John Donald Stalker 8 Aug 1915
- Stanley Joseph Callow Champion 9 Aug 1915
- John Grant Watt MM & Bar 17 Aug 1915
- John Charles Hutchinson 19 Aug 1915
- George Sidney Cook 28 Aug 1915
- Cyril Foxwell 2 Sep 1915
- John Alexander Spilsbury 5 Sep 1915
- Henry John Robert Saint 7 - 17 Sep 1915
- Arthur George Kettley 11 Sep 1915
- John Harold Coffen 13 Sep 1915
- Hugh Henry Smith 13 Sep 1915
- Fritz Robert Jaentsch 14 Sep 1915
- Frederick Fancote 22 - 26 Sep 1915
- Cecil Arthur Hill MM 6 - 9 Oct 1915
- James Thomson MM 20 - 24 Feb 1916
- Edward Patrick Thomas O'Brien 23 May 1916
- William Carroll 31 May 1916
- Frank Moore 4 - 6 Jul 1916
- Victor Emanuel Durling 11 Jul 1916
- Albert George Bullock 19 Jul 1916
- William Heath 20 Jul 1916
- Patrick Wilford Kelly 20 Jul 1916
- John Paterson Henderson 14 - 16 Aug 1916
- Terry de Bohun Helm 21 - 23 Oct 1916
- Gordon Weston Johanson 17 & 18 Feb 1917
- William Wright Casterton MM 8 Jun 1917
- William Moffat McLachlan MM 8 Jun 1917
- Archibald Shepherd 9 Jun 1917
- Robert Melville Salter 21 Dec 1917 - 11 Jan 1918
- John Henry Ward 23 - 24 Dec 1917
- Australian War Memorial. The Official War Diary of No. l Casualty Clearing Station. Ref. AWM 4(26/62]
- Butler, A. G. The official history of the Australian Army Medical Services in the War of 1914-1918 – Vol II, p382
- E. M. McCarthy – Matron-in-Chief, British Troops in France and Flanders, 22.7.19
- E. M. McCarthy – Matron-in-Chief, British Troops in France and Flanders, 22.7.19
- Diary, April 1918 (Appendix) – E. M. McCarthy – Matron-in-Chief
- WORK AT THE AUSTRALIAN CASUALTY CLEARING STATIONS ON THE WESTERN FRONT – E. M. McCarthy – Matron-in-Chief
- Sister Leila Brown, AWM nurses’ narratives – Sister Brown was attached to No. 1 ACCS from June 1918
- Sister Leila Brown, AWM nurses’ narratives
- Sister Leila Brown, AWM nurses’ narratives|
- War diary, 1 November 1918
- Sister Leila Brown, AWM nurses’ narratives