The British Interned in Switzerland

by Henry Philip Picot

The "Médecin d'Armée" was thus suddenly faced with the problem of the internment and treatment of a number of Ps. of W. largely in excess of those originally in view, and the whole of his programme had to be re-cast to meet the needs of a body of Interned, not less than the strength of an Army Corps. The serious nature of the demands made on the medical organization of the country may be realized from the fact that every one of the 30,000 men about to reach Switzerland was suffering from one or other form of disability, requiring medical attention at the hands of a Sanitary Service manned and equipped for the ordinary requirements of the small Swiss Army.

To meet the additional requirements of the medical personnel, medical officers in civil employ, liable for further service, were mobilized, and many civilian doctors, not so liable, were called upon for a term of duty.

As regards the housing of those prisoners whose treatment was not of a pressing nature, and who formed the majority of the Interned, accommodation was found in the hotels and châlets with which Switzerland is so richly endowed. In this respect no difficulty was experienced; but for those requiring that care and treatment which could only be given in a hospital, the solution was not so easy, as the necessary accommodation for the large numbers of sick, with which the country was being flooded, was lacking.

It is true that many of the private clinics which form so marked a feature of the modern life of Switzerland had been vacated by their foreign clients on the outbreak of war; but, as an off-set to this relief, the mobilization of the Swiss Army threw a strain on the Sanitary Service and the available accommodation which, perhaps, more than counter-balanced the relief afforded by the withdrawal of the foreign element. The "Médecin d'Armée" did not, at the outset, therefore, find much relief from the release of the private clinics, and a good deal of improvization had to take place before the difficulty was satisfactorily overcome.

Military and civil hospitals, already in being in the different regions, were set apart or partially utilized for the Interned, whilst other suitable buildings were commandeered, and were installed as hospitals or convalescent homes.

As to the treatment in the camps, the methods adopted were of a varying nature. At Château d'Oex, the men were, in the first instance, distributed amongst the hotels and châlets, without much regard to the nature of their physical condition, but as soon as the doctors could get to work, the worst cases were weeded out and sent to the local hospital, the "Soldanelle." Less serious cases, and those awaiting their time and turn for surgical treatment, were dealt with in their own establishments. The "Soldanelle" contained about eighty beds, and had in pre-war days been equipped solely for the use of visitors requiring rest cures, or electric or light treatments. The equipment included electric and X-ray installations, but was deficient on the surgical side. This defect was made good by the "B.L.R.C.O." at Berne, who presented the hospital with the complete equipment for an operating theatre.

A question in connection with this operating theatre was raised at the time by the "Médecin d'Armée," which is of some interest as illustrating the point of view of the Swiss Medical Staff in respect to the surgical treatment of serious cases. When I first suggested to Colonel Hauser the desirability of bringing this hospital up to date by the addition of an operating theatre, he threw cold water on the scheme, on the ground that Château d'Oex had never been intended as an operating centre, and its equipment as such might and would, probably, lead to the performance of operations by local surgeons, when such operations had best be left to the specialist. There was no gainsaying this argument, and for a time the matter was left in abeyance; but when an immediate operation had to be conducted at Château d'Oex, in a hastily improvised room, as the only means of saving the life of an officer suffering from acute appendicitis, the need for a suitable operating theatre again came prominently to notice, and Colonel Hauser gave his consent for its installation.

In the course of the first twelve months some 400 minor operations were carried out in this theatre by Dr. Brüstlein, who fully justified his reputation as a rising young surgeon. Occasionally operations of a serious character were also performed there, with the assistance of specialists who were called in for the occasion, Dr. Arndt, of Berne, amongst others. The hospital thus served an excellent purpose in relieving the specialized institutions of minor cases, for which the accommodation would have proved insufficient.

The nursing personnel consisted of orderlies, both Swiss and British. The latter were untrained, but acquired in the course of time a certain skill and readiness in their duties. As regards women nurses, the doctors at Château d'Oex were firmly opposed to their employment, as being contrary to the usual custom of Swiss military hospitals, and it was only at my repeated instance, after considerable opposition, that an offer to supply Swiss nursing sisters at the expense of the "B.L.R.C.O." was accepted.

Another difficulty, and one for which no immediate remedy could be found, was experienced in the lack of properly qualified masseurs. In this respect the Sanitary Service was faced with a very real difficulty. Most of the trained masseurs of the Swedish type had left the country on the outbreak of war, and the number available from all sources for the use of the Interned was totally inadequate. Training schools were at once opened, but it was not until the end of 1916 that the deficiency was made good.