A lot of people have visited the grave of Nellie Spindler who died in Belgium in 1917, but how many really understand what happened on the day she died? 

Nellie Spindler was born in Wakefield, Yorkshire, on the 10th August 1889. She was the eldest daughter of George and Elizabeth, had two younger sisters, Lillie and Mary, and a brother, Edward. Her father was in the police force1.  She was educated at Eastmoor Council School in Wakefield and then trained as a nurse in the Township Infirmary, Leeds, 1912-1915. She joined the Queen Alexandra’s Imperial Military Nursing Service (Reserve) in November 1915 and was posted the the military hospital in Lichfield1. In May 1917 she was posted to join the British Expeditionary Force in France with No. 42 Stationary Hospital1, then building up at Amiens.

She became a staff nurse in No.44 Casualty Clearing Station (CCS), at that time located in Brandhoek, a township near Poperinge, beside the road to Ypres. There were a number of Casualty Clearing Stations grouped together. There were strong objections to Brandhoek as a location for the Clearing Stations. It was too close to the front line and was surrounded by ammunition and supply depots. What happened on the 21st August 1917 was described by Kate Luard who was the sister in charge of 32 CCS, which was alongside 44 CCS at the time of the attack, and gives this account in 'Unknown Warriors'2.

I’m afraid you’ll be very disappointed, but we are to re-open on the same spot so Leave is off. The Australians are not to go back, but we are to carry on the abdominal work alone as we did before they came up. I imagine that this week’s Push has gone well and that we’ve shoved their line back a bit, or they wouldn’t start the Hospital there again. Westhoek Ridge is ours. I don’t know about St. Julien, but we’ve done well. The ground has been hard and Tanks have been able to get going, flattening out these Pill-boxes which held us up before.

I expected [for one rash day] to be telling you all about Tuesday at home tomorrow, but must write it now. The business began about 10 a.m. Two came pretty close after each other and both just cleared us and No. 44. The third crashed between Sister E’s ward in our lines and the Sisters’ Quarters of No. 44. Bits came over everywhere, pitching at one’s feet as we rushed to the scene of the action, and one just missed one of my Night Sisters getting into bed in our Compound. I knew by the crash where it must have gone and found Sister E. as white as paper but smiling happily and comforting the terrified patients. Bits tore through her Ward but hurt no one. Having to be thoroughly jovial to the patients on these occasions helps us considerably ourselves. 

Then I came on to the shell-hole and the wrecked tents in the Sister’s Quarters at 44. A group of stricken M.O.’s were standing about and in one tent the Sister was dying. The piece went through her from back to front near her heart. She was only conscious a few minutes and only lived 20 minutes. She was in bed asleep. The Sister who shared her tent had been sent down the day before because she couldn’t stand the noise and the day and night conditions. The Sister who should have been in the tent which was nearest was out for a walk or she would have been blown to bits; everything in her tent was; so it was in my empty Ward next to Sister E. It all made one feel sick.

The episode was also captured in the War Diary of Maud McCarthy, Matron-in-Chief BEF France3, who wrote these passages:


Staff Nurse N. Spindler, QAIMNSR: Received telegram from OC 44 Casualty Clearing Station that this lady had been killed that morning, when the Clearing Station had been shelled by the enemy. Repeated telegram to the Matron-in-Chief, War Office, and also informed the DGMS.


Staff Nurse Spindler, QAIMNSR: Received letter from the Sister-in-Charge, 44 CCS, Miss Wood, QAIMNS, giving details of Miss Spindler’s death when that Clearing Station was shelled on 21st instant; this Sister was in bed when she was hit and became unconscious almost immediately, dying about 15 minutes later. Owing to the continued shelling of the Station it had to be evacuated at once, and Miss Spindler’s body was taken to the Mortuary of No.10 CCS from where the funeral took place next day, with full military honours. The Army Commander, DMS of the Army and 4 other Generals attended and as many Sisters as could be spared were also present.


St. Omer: Went to 10 Stationary Hospital, St. Omer, where I saw the Sister-in-Charge of 32 Casualty Clearing Station, Miss Luard, and the remainder of her Staff who had been resting for two or three days at the Mess of 10 Stationary Hospital after the recent shelling of Clearing Stations when Miss Spindler was killed. They had all rested and everyone was willing and anxious to return to the work, and the DMS of the Army had informed them that the Quarters had been made Bomb-proof – and that it was perfectly safe for them to return. The Staffs of No.44 CCS and No.3 Australian CCS were still to remain in St. Omer, having been distributed amongst the various units for accommodation for the time being; arrangements were being made for those due for leave to have it and for the remainder to go to the Convalescent Homes for rest until their units were re-established.


  1. The National Archives WO 399/ 7850
  2. Luanda, K., Stevens, J., & Stevens, C. (2014). Unknown warriors: the letters of Kate Luard, RRC and Bar, nursing sister in France 1914-1918. Stroud, Gloucestershire : The History Press
  3. The National Archives WO 95/ 3988-91



In St Michael’s churchyard, Dumfries, where the poet Robert Burns is buried, another monument marks the burial place of over 420 people, who died from Asiatic Cholera, between September and November 1832. Cholera originated in India and first entered Britain in October 1831. Further epidemics occurred in 1848 and 1854. By the 1840s, although the cause of Cholera was unknown, there was enough knowledge to link infectious diseases to the sanitary conditions of towns and a centralised General Board of Health was set up to initiate public health reforms.

In 1848, Dumfries was again in the grips of a cholera epidemic and Dr John Sutherland of the General Board of Health arrived on the 6th December, to ascertain the extent of the problem. As he found no system of treatment or prevention, he organised the town into districts, drafted in extra medical staff to conduct house to house visits, set up a house of refuge for the ill, and ensured that only safe supplies of water were taken from the river. This time 269 people died but the epidemic was contained. Although Sutherland (1850) does not mention in his report how people were treated, nurses were probably involved in caring for the sick.

Later in the century, Dr Sutherland was to become much more involved in nursing. In 1855 he was sent to the Crimea as the head of the Sanitary Commission to investigate the health of the army and the causes of the high mortality rate amongst the troops. Here he met Florence Nightingale. Following the war, he became one of her trusted advisors, working with her closely on the health of the army, sanitary reform in India, the design of hospitals, nursing, and the reform of workhouses (Bostridge, 2010). This collaboration lasted until 1888 and because of his devoted service to the cause he was referred to, by one author, as the ‘doctor who slaved for Miss Nightingale’ (Cope, 1955, 27).


Bostridge, M (2010) Florence Nightingale: the Woman and Her Legend. London: Penguin

Cope, Z. (1955) Florence Nightingale and the Doctors. London: Museum Press

Sutherland, J. (1850) Appendix A, in General Board of Health. Report on Epidemic Cholera of 1848 and 1849, London: HMSO.


Today, it is difficult to imagine that this ‘Bar-Grill-Pub’ on Broad Street, Birmingham, today the hub of the city’s nightlife, was once described as ‘one of the very best sites that could possibly be selected within the Borough of Birmingham for the purpose of a Children’s Hospital’ (Reinarz, 2009, 79). Partially obstructed by the twenty-first-century smokers’ shelter this solidly constructed building served, first as the Lying-in-Hospital (maternity) until 1860 and then as the Children’s Hospital from 1870 until 1916. The hospital was founded in 1862 but moved from the centre of the town to gain more beds and a healthier aspect.

The Children’s Hospital was at the forefront of introducing nurse training to Birmingham. In 1865, a subcommittee of the Lady Visitors recommended that the hospital should offer to take in paying pupils for up to six months to train as nurses. This plan was abandoned as there was no space to house the pupils. However, in 1869 the Birmingham and Midland Counties Training Institution for Nurses was established in the town. It had three aims: to train nurses for hospital work, for private families and for the sick poor free of charge. The probationers, were given a certificate after a one year of period of practical training. The institution wanted to regulate the conditions under which the probationers worked and to ensure that they received an organised experience as a learner. In 1869, the hospital and the institution agreed that the probationers would gain experience in male, female, medical and surgical wards, and attendance at operations. Night duty was only to be undertaken to nurse individual cases. Initially the hospital was very satisfied as the Training Institution was able to improve the quality of nursing as compared to pre-training times. However, during the 1870s there was conflict as the probationers were being used to undertake domestic tasks such as cleaning and were not following the training plan. Thus the issue of control over the probationers became a problem. Once the hospital realised that it could increase its own income, either by taking in paying probationers or by using probationers instead of trained staff to reduce costs, it decided to introduce its own scheme in 1881 (Wildman, 2003, 57). It stayed on this site until it moved to a purpose built hospital just round the corner in 1916 and it is now hard to believe that this ‘night-spot’ was once at the cutting edge of nurse education!


Reinarz, J. (2009) Health care in Birmingham: the Birmingham teaching hospitals, 1779-1939, Woodbridge, Boydell.

Wildman, S. (2003) The development of nurse training in the Birmingham Teaching Hospitals 1869-1957, International History of Nursing Journal, 7, 3, 56-65

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