THE R.A.M.C. AT ARNHEM
COLONEL G. M. WARRACK, D.S.O., O.B.E. A.D.M.S.
1st Airborne Division

The medical services of the 1st Airborne Division which took -part in the battle at Arnhem in September 1944 consisted of three field ambulances, the 16 Parachute Field Ambulance, the 133 Parachute Field Ambulance and the 181 Air Landing Field Ambulance. In addition there were regimental medical officers and about a dozen R.A.M.C. orderlies with each fighting unit. The Polish Parachute Brigade and its field ambulance were also under command.
To understand the situation the general plan of battle must be considered briefly. The division was to drop in three lifts on three consecutive days.

Phase 1. - The landing on the first day was to consist of the 1 Parachute Brigade, the 1 Air Landing Brigade and part of divisional troops including the 16 Parachute Field Ambulance, and 181 Air Landing Ambulance. The task of this force was in the first place to capture the main road bridge over the Rhine, and in the second place for the air-landing element to secure the dropping zones for the second lift on the following day. 

Phase 2. - The 4 Parachute Brigade and the remainder of the divisional troops (including 133 Parachute Field Ambulance) were to land on the second day and move forward into the town with the covering party who had been protecting the dropping zones and con¬solidate a bridgehead there.

Phase 3. - This was to consist of the Polish Parachute Brigade. They were to drop on the third day south of the Rhine and take over an area to the east of Arnhem.

Original medical plan. - Dropping zones and landing zones were to be cleared of casualties by units. A temporary dressing station was to be established in the neighbourhood of the landing zones and dropping zones by 181 Airlanding Ambulance. The 16 Parachute Field Ambulance was to go into Arnhem with the 1 Parachute Brigade and set up in St. Elizabeth Hospital. After the arrival of the second lift 181 Airlanding Field Ambulance was to move into the town with 133 Parachute Field Ambulance; each unit was to set up in its own brigade area. Regimental medical officers and their staffs were to remain with their battalions all through the battle and to evacuate casualties to the nearest dressing station. So much for the original plan and the medical arrangements.

Diary of the battle. ~ What actually happened is well known. The first lift landed safely with very few casualties. The 1 Brigade formed up quickly and moved off towards the town with the 16 Parachute Field Ambulance in attendance. Part of the brigade reached the bridge and stayed on the north end of it for four days in the face of overwhelming odds; finally they were all killed, wounded, captured or dispersed. The 16 Field Ambulance got to St. Elizabeth's Hospital at 22.00 hours on the first day and found casualties already awaiting them on the steps of the hospital. They took over part of this hospital and the surgeons were operating within ten hours of landing. 181 Airlanding Field Ambulance established its dressing station in the area of the dropping zones and admitted over 150 wounded within twenty-four hours. The second lift was six hours late and the Germans contested their drop strongly. More casualties were admitted to the 181 Field Ambulance, bringing their total up to 250. On the evening of the second day the remainder of the division moved in towards Arnhem, and by nightfall they were concentrated at Oosterbeek and it was here that they were contained by a large enemy force complete with tanks and self-propelled guns. The 4 Parachute Brigade as already mentioned had a very rough passage on its drop and a hard time trying to rejoin the rest of the division. By the evening of the third day the battle was in two clear parts, (a) the 1 Parachute Brigade were at the bridge fighting stubbornly (its Field Ambulance (16 Parachute) had been captured by the Germans on the second day and moved out of the hospital, and the two surgical teams were allowed to stay and deal with over 100 wounded) and (b) the airlanding Brigade and 4 Parachute Brigade were in the divisional perimeter at Oosterbeek with the 181 Airlanding Field Ambulance and five officers and thirty other ranks of 133 Parachute Field Ambulance in support.

Conditions in the perimeter. - The Divisional area was about half a mile across and about one mile in length stretching north from the river. In this area there was a medical area occupied by 181 Field Ambulance, the remnant of 133 Field Parachute Ambulance (now reduced to 5 officers and 5 other ranks, the remainder had been captured by the Germans during an attack) and 4 regimental aid posts. The original dressing station started off in a large hotel with a surgical annexe in a near-by emergency hospital of 30 beds. It gradually spread, as wounded poured in, to over 10 buildings. They were consistently hit by shell and mortar fire and one was burnt to the ground, two were rendered uninhabitable. Often one or more buildings were captured by the Germans, but they saw how acute the medical emergency was and allowed the staff to remain. I cannot speak too highly of the extreme bravery and self-control shown by the wounded under these most appalling conditions; even when mortaring was at its height. when glass and plaster were falling in profusion and when bombshell fragments were whistling through the windows, there was never a murmur or sign of hysteria from the wounded. It is one of the most shattering experiences to see men who have been wounded in battle being killed and rewounded in bed where they should be safe. It is felt, however, that the damage caused to the hospital buildings was not wilful as the whole area was extremely small and the medical buildings were on the edge of the perimeter.

Evacuation of casualties from regimental aid posts to dressing stations was a hazardous business, and was done by jeep and by hand carriage. We used to teach soldiers to drive jeeps slowly when carrying wounded to avoid undue shock but in the circumstances it was considered safer to arrive with a shocked patient from fast driving than not to arrive at all, which was the other alternative. By the fifth day it was no longer possible to carry out any proper surgery. The rooms where the surgeons were working in the annexe had been wrecked and the cellars were completely inadequate for surgery. By the seventh day of the battle it became extremely perilous to admit any more to the already overcrowded dressing station buildings, and it was decided that the wounded must take their chance in the more dispersed regimental aid posts. Finally on the Sunday, a week after we landed, the A.D.M.S. visited the G.O.G. as usual at his headquarters and explained how very bad the medical situation was. It was agreed that he should approach the Germans who by now were occupying the dressing station and ask that they should evacuate our seriously wounded to their own safe hospitals. The G.O.C. was emphatic that this must not seem a sign that the division was weakening, but merely that the battlefield should be cleared to enable the fight to continue. The A.D.M.S. collected an interpreter, a fellow from the Dutch Resistance who had dropped with the Division and made his way back to the dressing station. They were taken to the German Divisional Headquarters where they met the opposing General and stated their case. General Blaskowitz agreed to (a) evacuate all our wounded and (b) to stop firing on the dressing station area and on the regimental aid posts. Finally the A.D.M.S. was given a bottle of brandy by the German H.Q. staff and went back into the perimeter. (The Germans rightly called it 'The Cauldron.')

Case of interest. - One of the wounded evacuated by the Germans was the commander of the 4 Parachute Brigade. He had been wounded in the belly by a fragment of mortar bomb. He was admitted to the St. Elizabeth Hospital where the parachute surgeons were still working. They opened him up and found he had fourteen holes in his small intestine. These were sewn up, the wound was closed and a drain left in situ. He was given transfusions and put back to bed: careful instructions were given to the nursing orderlies of the R.A.M.C, who were to tend him. Ten days later a member of the Dutch Underground visited the hospital, then completely taken over by the Boche, and asked the British surgeon if he had any cases fit to travel and live underground. The brigadier was selected as being the most important soldier there (he was always referred to as 'Corporal' in the Hospital). He was not very keen to get up at first but made a big effort. He was dressed in civilian clothes and a bloody bandage was wound round his head, he walked out of the hospital on the arm of his Dutch friend who drove him away under the eyes of the Germans to a safe place. He got back into our own lines over four months later after a long and perilous journey. This I think is a great tribute to his personal courage, to the efforts of the surgeon who operated, to the staff who nursed him and to members of the Underground Movement who sheltered him.

Withdrawal. -On the following day G.O.G. informed the A.D.M.S. that the division was pulling out that night on orders from Montgomery. It was explained that we had over 2,000 wounded, and that it would be better for the medical services to stay behind to look after them. The A.D.M.S. was to procrastinate as much as possible in the hope that the relieving force of the and Army would be up before the wounded and staff were moved back into the heart of the Reich. The first stage was a move of wounded and staff to a bare barracks at Apeldoorn. There 1,400 wounded were admitted and many more to the neighbouring hospitals. They were surrounded by barbed wire and guarded by elderly members of the Wehrmacht known as 'Bismarck Youth.' (There were over 4,000 German wounded in the area, mostly from the Arnhem battle.) In these barracks we established the 'First Airborne Divisional Military Hospital in occupied Europe.' The staff consisted of 24 officers and about 200, orderlies of the divisional medical service. The accommodation stores came from Dutch sources, as did food and large supplies of medical stores. The Germans gave what help they could with the limited stores they had available. Their chief doctor viewed with joy the proposition that the British would fly in medical supplies for our wounded if it were allowed. When he put this plan to Field Marshal Model it was turned down. We sat there waiting as the weeks slipped by and the hoped-for attack did not come through. Gradually and under protest our wounded were moved to Germany, at first in cattle trucks with straw, little food and no sanitary arrangements and the wounded were wired in. After this strong protests were made to the commandant and he was threatened with an official protest to the Protecting Power. At the time no one was quite sure who the Protecting Power was or how to make contact with it. The threat sufficed, however, and next time 500 wounded were moved to Germany in a fully equipped hospital- train. During our stay at Apeldoorn we were visited by the Director of Medical Services of the German Armies on the Western Front. He seemed pleased with what he saw. Finally, after a number of medical officers and others had escaped, the hospital was closed and the staff dispersed to German hospitals m Holland and Germany.

CONCLUSION

This has been a very short and sketchy account of the doings of the R.A.M.G. at Arnhem. There is no doubt, however, that many gallant soldiers of our division owe their lives and their limbs to the care of these doctors and orderlies who carried on their work under such extreme difficulties. Last, but by no means least, we shall never forget the help we received from the brave Dutch.