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Durante la Grande Guerra uno dei problemi principali fu la diffusione delle malattie. La vita in trincea fu talmente difficile e precaria che era praticamente impossibile, per un soldato al fronte, trascorrere questo lungo periodo senza problemi fisici. Il freddo, l’assenza di ripari, la completa mancanza di igiene personale per diverse settimane, il cibo mal conservato e consumato in mezzo alla sporcizia assoluta e la mancanza di latrine erano solo alcune delle cause che contribuirono alla diffusione di germi, batteri e virus.
Tra le malattie più diffuse negli anni della guerra ci furono il tifo, il colera e la dissenteria. Molti inoltre si ammalarono per patologie legate alle vie respiratorie (basti immaginare un soldato zuppo d’acqua sul Carso sferzato dal gelido vento di bora o un alpino a 2000 metri di altitudine), alla promiscuità nei periodi di riposo sulle retrovie ed alle infezioni che si espandevano per una ferita, anche banale. È stato calcolato come tra gli italiani almeno 100 mila uomini morirono per malattia. Nel 1918 inoltre, come se non bastasse, giunse in Europa la terribile epidemia dell’influenza “Spagnola” che decimò l’intera popolazione (anche quella civile).
Non meno importanti poi furono le malattie psichiche dovute ai lunghi periodi passati sul fronte. Un incubo per molti soldati, giovani e non, costantemente minacciati dalla morte. Chiunque fosse schierato in prima linea era consapevole che, in qualsiasi momento, sarebbe potuto morire: i bombardamenti dell’artiglieria nemica furono incessanti ed i cecchini non mancavano mai di vigilare e di sparare sugli obiettivi. Anche solo un gesto imprudente, come alzarsi dalla trincea, poteva costare la vita ad un soldato.
La vista costante di cadaveri non aiutava certo a migliorare la situazione resa ancora più tragica dal duro atteggiamento tenuto dagli ufficiali. Ogni battaglia, come si legge in molti diari dei protagonisti, era attesa con un silenzio irreale. Privati della possibilità di ribellarsi, i soldati uscivano dalle trincee rassegnati e alle volte in lacrime sapendo che, chiunque avesse esitato sarebbe stato punito.
Fu in questi anni che nacque l’espressione “Scemo di guerra” per indicare tutti quegli uomini che, durante o dopo la Grande Guerra, furono colpiti da patologia mentale. Essendo una materia ancora oscura, tra i medici si diffuse la pratica dell’elettroshock come tentativo di cura, provocando ulteriori dolori e complicanze a coloro che ritornarono dal fronte.
Shellshock was the blanket term applied by contemporaries to those soldiers who broke down under the strain of war.
The pace and intensity of industrialized warfare had profound effects on the human mind and body that were not related to wounds or physical injury. Poorly understood at the time and for many years afterwards, the crying, fear, paralysis, or insanity of soldiers exposed to the stress and horror of the trenches was often held by medical professionals to be the result of physical damage to the brain by the shock of exploding shells. Military authorities often saw its symptoms as expressions of cowardice or lack of moral character. Its true cause, prolonged exposure to the stress of combat, would not be fully understood or effectively treated during the war.
Doctors diagnosed almost 10,000 Canadians with shellshock during the war. Medical treatment ranged from the gentle to the cruel. Freudian techniques of talk and physical therapy helped many victims, while more extreme methods involved electric shock therapy. During the latter, patients were electrocuted in the hope of stimulating paralyzed nerves, vocal chords, or limbs. Shock therapy was more effective than Freudian techniques in returning soldiers to the front, with about two-thirds of all patients returned to the front. It is unknown how many relapsed when they re-entered combat.
Doctors knew very little of what we now term Post Traumatic Stress Disorder, and there were few treatment programs after the war for returned veterans who suffered from the mental trauma caused by war.
The wounded passed through a series of medical units in their treatment process.
Front line medical officers treated many casualties but, often overwhelmed by sheer numbers, they quickly transported many of the wounded to field ambulances, located as close as safety allowed to the front lines. The ambulances took the wounded to dressing stations and, later, to casualty clearing stations. Surgery could be performed at any of the medical units, depending on the patient’s need for immediate or deferred care.
Often the doctors and medical orderlies were forced to practice a system of triage, a selection process to determine which patients would be operated on immediately, which could wait a few hours, and which were untreatable and, therefore, would be left to die. It was a harsh but necessary system, especially when medical units were overrun with hundreds of wounded, many in the final stages of life unless care could be given immediately.
Following an initial recovery from surgery, patients could proceed to stationary and general hospitals in France and England for long-term care. By 1918, the Canadian Army Medical Corps operated 16 general hospitals, ten stationary hospitals, and four casualty clearing stations.
More than 3,000 nurses served in the Canadian Army Medical Corps (CAMC), including 2,504 overseas. Nicknamed “bluebirds” because of their blue uniforms and white veils, Canada’s Nursing Sisters saved lives by assisting with medical operations and by caring for convalescing soldiers.
Canadian military nurses were trained nurses before the war. This professionalization ensured the exclusion of semi-trained women who, in the past, had sometimes filled the ranks of nurses in other armies. Canada’s nurses were all women between the ages of 21 and 38. The eventual average age was 24, and almost all were single. Many of the nurses had brothers or fathers serving in the Canadian Expeditionary Force. All were volunteers and there was never a shortage of candidates. In January 1915, for instance, there were 2,000 applicants for 75 positions.
Nurses had served in the CAMC since the 1885 Northwest Rebellion and compiled a distinguished record during the South African War (1899-1902). The Canadian Army Nursing Corps was established in 1908, but had only five permanent members by the start of the First World War. In August 1914, the Matron-in-Chief, Major Margaret Macdonald, an experienced nurse who had served in South Africa, received permission to enlist 100 nurses. Almost all were drawn from hospitals, universities, and medical professions from across Canada and the United States.
Nurses did not work in the front line trenches, although they were often close to the front. As patients arrived by truck or rail, the nurses were among the first to meet wounded soldiers, cleaning wounds and offering comfort. They assisted in surgery and often had primary responsibility for cleaning post-surgical wounds and watching for secondary infections. Nurses cared for wounds daily, bandaging and re-bandaging injuries and ensuring that oxygen entered wounds to destroy the anaerobic infections that could result in a patient’s painful death. They served in several theatres of war outside the Western Front, including Gallipoli, Egypt, and Salonika.
Of the 2,504 Canadian nurses who served overseas, 53 were killed from enemy fire, disease, or drowning during the war. On two occasions in 1918, Canadian hospitals in Europe were hit by enemy bombers and several nurses were killed in the line of duty. On 27 June 1918, a German U-Boat torpedoed and sank the Canadian hospital ship, the Llandovery Castle. All 14 nurses on board were killed.
Nurses returned from overseas with refined medical skills that infused their profession with new medical techniques and a heightened sense of legitimacy. They had won the affection of thousands of Canadian soldiers who often referred to them as “Sisters of Mercy” or “Angels of Mercy.” A memorial to the war’s nursing sisters was erected in Ottawa in 1926 in the Parliament of Canada’s Hall of Honour.
Front line medical officers treated many casualties but, often overwhelmed by sheer numbers, they quickly transported many of the wounded to field ambulances, located as close as safety allowed to the front lines. The ambulances took the wounded to dressing stations and, later, to casualty clearing stations. Surgery could be performed at any of the medical units, depending on the patient’s need for immediate or deferred care.
Often the doctors and medical orderlies were forced to practice a system of triage, a selection process to determine which patients would be operated on immediately, which could wait a few hours, and which were untreatable and, therefore, would be left to die. It was a harsh but necessary system, especially when medical units were overrun with hundreds of wounded, many in the final stages of life unless care could be given immediately.
Following an initial recovery from surgery, patients could proceed to stationary and general hospitals in France and England for long-term care. By 1918, the Canadian Army Medical Corps operated 16 general hospitals, ten stationary hospitals, and four casualty clearing stations.
In 1915, the Germans were attacking Russia in the east. On the Western Front, they were mostly on the defensive, though they continued to mount local attacks if conditions were favourable. To probe Allied defences, cover the movement of troops to the Eastern Front, and test their new weapon, chlorine gas, the Germans prepared for a limited offensive in Belgium in spring 1915 against the Ypres salient, a bulge in the Allied lines. The last major Belgian town in Allied hands, Ypres provided a defensive position from which to protect French ports on the English Channel. It had to be held.
On 22 April, two Canadian brigades were in the front lines, with a third in reserve near Ypres. At 5 p.m., the Germans released gas against the French 45th (Algerian) Division to the Canadians’ left. An enormous green-yellow gas cloud, several kilometres long, drifted towards the French lines. When it rolled over their positions, French troops either suffocated or fled, their eyes and throats burning from the chlorine.
Most of the gas missed the Canadians, but the French retreat had exposed the Canadian’s left flank and threatened the destruction of the whole Allied position in the salient. General Alderson’s units shifted positions to cover the gap, but the German gas attack had torn a huge hole, several kilometres wide, in the Allied line.
From 22 April to 25 April, the Canadians fought tenaciously to defend this exposed position. Outnumbered, outgunned, and outflanked, on the 24th they faced a second, this time direct, chlorine gas attack. The Canadians counterattacked to stall the German advance, and then slowly gave ground, buying precious time for British troops to be rushed forward.
A New Reputation but High Casualties
The Canadian Division’s trial-by-fire at Ypres earned the Canadians a reputation as tough and dependable troops, but they had paid a high price: some 6,000 casualties over the four-day battle.
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