Australian Army Nurses in the Vietnam War (1967-1971)

"Don’t forget your cotton underwear girls":

Abstract

War and nursing are unequivocally linked and the impact that this type of nursing has had upon the nursing profession in indisputable. However, a review of the Australian scholarly nursing and military history literature revealed that the contribution and experiences of Australian nurses in the Vietnam War has not been widely published. In an attempt to redress this gap in history, this study explored the phenomenon of nursing within the bounds of the Vietnam War in order to explore the nature of the nursing work in the Vietnam War, and to increase awareness of the contribution made by the nurses to both the war and the nursing profession. Using oral history interviews, this study investigated the nature of nursing work as experienced by seventeen Australian Army nurses who served in Vietnam between 1967 and 1971. It was found that the vast majority of the nursing sisters sent to Vietnam knew very little about the type of work or the environment into which they were entering and were, therefore, clinically unprepared. It appeared that, by virtue of their being a nurse, it was an expectation that the nurses would adapt to the nature of their work in the war zone. Even more interesting was the effect of femininity on their roles as nurses within the confines of war.

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While nursing within the confines of a war environment is not new, the role of Australian nurses in the Vietnam War has not been prolifically reported in the research literature. For centuries, women have cared for sick and battle-injured soldiers around the world, and the experiences of Australian Army nurses involved in some of these conflicts have been published to some degree (White 1952; Jeffrey 1954; Goodman 1985, 1988; Simmonds 1985; Kenny 1986; McBryde 1986; Barker 1989; Robinson 1989; Bassett 1992). Each of these works discussed aspects of Australian Army nursing history, commencing with Australian nursing involvement in the Boer War, followed by accounts from the Great War and World War II, the post-war years and the more recent involvement of Australian Army nurses in the Gulf War. Most of these accounts were written from personal experience as anecdotal reports. However, there seemed to be little learned discourse in the Australian literature from the Vietnam War era, serving to highlight that the Australian nurses who served in the Vietnam War have, until recently, been excluded from both the Australian cultural and public image of the Vietnam Veteran and the history of military nursing. Much of the focus on military nursing in general in the international nursing literature is on aspects of the American military nursing experience in the Vietnam War. When one thinks of nursing in the Vietnam War, most Australians would be more familiar with accounts in the American literature and popular media, such as in the television series China Beach which appeared on Australian television in the late 1980s. The literature on this topic appears to be written in three interrelated genre’s: general and professional literature (Odom 1982; Kalisch & Scobey 1983; Bigler 1985; Freedman & Rhoads 1987; Schwartz 1987; Klubes 1993; Gianas 1994), personal anecdotal literature (Walsh 1982; Van Devanter 1983; Walker 1985; Marshall 1987; Palmer 1987; Hampton 1992; Smith 1992; Otto 1995), and research studies (McVicker 1985; Paul 1985; Norman 1990; Furey 1991; Scannell-Desch 1996), each of which obviously targets different audiences.

In 1997, a study examining the experiences of Australian Army nurses who had served in Vietnam during the war years was commenced (Biedermann 2001). The purpose of the study was to uncover the experiences of Australian Army nurses who served in the war years to gain an understanding of their experiences as the history of the involvement of Australian nurses in the Vietnam War that, up until then, had been relatively conspicuous by its absence. Ethical clearance was sought and gained from the university ethics committee, the Australian Defence Medical Ethics Committee and the Army Personnel Research Committee. Over a two-year period, in-depth oral history interviews were conducted with eighteen female Vietnam veterans who resided all over Australia and who had consented to take part in this study to describe their experiences of being an Australian Army nurse in the Australian military hospital in Vietnam during the years of the Vietnam War. The main finding of this study was that, by virtue of their being a nurse, it was expected that they would simply adapt in their new environment, despite being critically unprepared for their tour of duty in a war zone. One nurse recounted that the only thing she and her colleagues were told about Vietnam was, "Don’t forget your cotton underwear girls". The majority of these forty-three nurses had no extensive high dependency nursing experience, or indeed to a greater extent, any experience in wartime nursing. One of the interesting themes that stemmed from this study surrounded the meaning of gender and the way in which it shaped the experience of nursing in this particular war. The purpose of this paper is to explore the gender issues that arose in the nurses’ narratives whilst serving in Vietnam, and since. In accordance with the wishes of the participants, all participants were allocated pseudonyms, and these are also throughout this paper.

Before this discussion begins, it is probably appropriate that some dialogue of gender and war is presented. Without wanting to enter in to an in-depth feminist or political discourse on the ‘rights’ and ‘wrongs’ of women in combat, either in the present day or in the past, it is somewhat a topic that still contributes to lengthy debate over dining room tables and military boardrooms internationally. Masculine identity, whether it is presented as inherent or constructed, is considered fundamental to war-making. Traditionally, men are seen to be natural aggressors and innately attuned to the warrior/hunter instinct, while the perception that a woman is perfunctorily violent or is capable and willing to utilise violent tendencies is dismissed as absurd (De Pauw 1998). Instead, accepted war mythology either assigns to women a supportive role of a whore or wife, or depicts them as a symbol of what men are fighting to protect (Elshtain 1987; Summers 1994). Despite the twentieth century chronicling that women have only ever played a supportive and distant role in war, historical evidence indicates that women have always actively participated in the military in some capacity, as snipers, partisans, political officers, combat pilots, tank-crew members, machine gunners, snipers, de-mining experts, gladiators, warriors, as well as prostitutes, nurses, wives, and other administrative roles (Cottam 1998; De Pauw 1998). Yet contemporary popular culture views the images of women’s involvement in war in conflicting light. Modern women warriors are either ‘dis-gendered’, like Hollywood’s GI Jane who ‘trades in’ her feminine hair style, physique, and boyfriend and adopts masculine language and physique in order to enter the all-male bastion of the United States Navy SEALS, or are presented as an offence to natural order, like the female Viet Cong sniper in the motion picture, Full Metal Jacket. But what about those women, in particular the nurses, who participate in war but assume nurturing roles? The history of the role of women as nurses in war is long and complex, and has never been completely presented. Several authors, including De Pauw (1998), and Roberts and Group (1995), have provided a broad-brush examination of this role from pre-mid 19^th century to contemporary involvement. What these sources have failed to identify was issues of femininity from the perspective of the nurses involved. This paper presents that perspective.

The value of femininity in the war-zone of Vietnam, and its perceived effect on healing, was an interesting phenomenon that regularly arose in the nurses’ accounts of nursing work in the Vietnam War. From the narratives created during the interviews, it appears that many of the nurses subconsciously participated in sustaining a feminine mystique – a link to their woman-ness regardless of the overtly masculine environment of the Vietnam War. They did this in a number of ways: wearing their traditional uniforms instead of the disgendering jungle greens and boots; maintaining their appearance by wearing make-up and perfume to work, and styling their hair; adhering firmly to their multiple roles as nurse and surrogate mother, wife and sister to the sick and wounded patients; and their beliefs that they were there to be a nurse, not a combatant or participant in the war itself. This manifested itself in several ways and this paper will illuminate some of these while providing examples from the narratives.

Most nurses indicated that, while the tropical environment was not entirely conducive for their traditional nursing uniforms, they preferred to wear their grey dresses, stockings and veils, believing that it was important for ‘the boys’, that is the patients, to see them as a woman/nurse when they entered the hospital. Kim remembered that she preferred to wear her ward dress uniform because "it was what the boys liked us in". Nola indicated that she believed that "the boys appreciated us wearing them and I do think the boys liked us in our dresses and veils. They respected us in them". Interestingly, several noted the excruciatingly heavy time commitment of maintaining this uniform. The veils were made of cotton and needed to be heavily starched before wearing. The nurses weren’t provided with this starch and it was a frequent item requested to families back home to be sent over. One nurse noted that despite the heavy starching, once the veil was donned, the "humidity instantly reduced it to a dull limp piece of material within minutes". Additionally, the dresses needed to be hand-washed as the washing machines shrunk and faded the grey fabric. The stockings worn by the nurses couldn’t be purchased in Vietnam, and like the starch, were items frequently requested to families back in Australia to be sent in packages to the nurses in Vietnam. Several other nurses indicated that they liked to wear make-up and perfume to work, again in an attempt to emphasise their femininity amongst the masculinity of war. For instance, Emma intimated:

I always made sure to wear perfume and make-up … for the boys. Because you were the first person that they saw in resus, and they often said, "Geez, you smell nice Sis".

There were differences in the attitudes to socialising and the social life in the hospital over the five years. In the narratives from the nurses who served in Vietnam in the early years, the social aspects of their time in Vietnam were frequently described in a positive light. Most indicated that they had a wonderful social life in Vietnam. One commented: "Oh the Mess was everything. There was always lots of parties and I accepted every invitation and had a wonderful time". According to Barr (2001), himself an anaethetist in Vietnam at the time when the first four Australian nurses arrived in Vung Tau in May 1967, the arrival of these women in Vietnam caused a significant amount of excitement amongst the Australian men in the area. The nurses were the guests of honour at many parties and one nurse recalled to me, "I don’t recall ever having to buy myself a drink in Vietnam". However, it was profound that very few of the narratives from the cohort of nurse veterans from 1970 and 1971 actually discussed social aspects of Vietnam. It is also interesting that many of the nurses who indicated that they did not enjoy the social aspects of Vietnam served in the last half of the involvement of the nurses. This could have occurred for a number of reasons; namely changes in battles, and their effect on staff; the declining image of the war and events in Australia; individual personalities. The implied notion that sexual harassment was rampant within the officers’ messes in Vung Tau and elsewhere appeared to be a major cause of disinterest in mess life, although not all nurse veterans defined it as ‘sexual harassment’. It has been suggested that up until the late-1980s, sexual harassment incidents were considered by most women to be the way women are viewed by men, and rarely questioned as inappropriate (Wood 1994). Yet this way of thinking was contradicted in some accounts. Several nurses indicated that they avoided attending the Mess primarily because some male officers acted inappropriately or offensively when they were inebriated, or they expected more from the nurses than they were willing to provide. Emma perceived that the inappropriate treatment of the nurses in Vietnam was out of control, which at times made her life unbearable:

It was typical … well the sexual harassment that they talk about now was just so mild [compared] to the harassment that happened in the 60’s and 70’s. People just wouldn’t believe it, and … who was shacking up with whom. So you had all that to cope with as well as trying to look after your patients and to survive.

Rather than bolster the activity, those nurses affronted by the men’s behaviour remained in the sitting room of their quarters of an evening talking, writing letters, setting their hair or preparing their uniforms for the following day, in an attempt to avoid the behaviour. Their reticence to participate in the social environment in Vietnam effectively denied some nurses the opportunity to relax and unwind in a safe social atmosphere.

Several nurses described episodes of being flown up to Nui Dat to "improve the morale of the troops". Astonishingly, none of them indicated that they were insulted to take part in these events, as they considered it was helpful for the soldiers.

I remember one time we went right up to the front line because the commander felt that it would be nice for the troops if we went up there to talk to the troops. They were lonely and all they wanted to do was talk.

Hence the nursing sisters were flown up for the entertainment of some lonely men in combat. By permitting this activity, the commanders were obviously prepared to risk the nurses’ lives by flying them in helicopters over known enemy territory into the Australian task force base at Nui Dat, which had been attacked at various times during the previous years, in order to relieve the boredom of some ‘lonely’ soldiers. These same women were not allowed to go into the township of Vung Tau unless an armed escort accompanied them, or permitted to establish personal relationships with subordinate ranks in the hospital, although three nurses indicated in our interviews that they did form relationships with men of subordinate ranks. Perhaps this further magnifies the total inequality and inconsistencies present in the Australian military in the 1960s and 1970s, and reinforced the notion that women are for the sexual gratification of men, and that nursing was simply an extension of womanhood.

As nurses, some male veterans believed that they were in their own unique category that was asexual or gender neutral, in that the soldiers classified them as neither female nor male, just a nurse. One nurse veteran reported:

They didn’t think of you as a girl in many ways. One fellow said to me, "I haven’t seen a girl for three months". And I thought, "what am I? A side of mutton?" We weren’t counted as girls as such.

Additionally, the nurses did not always go in uniform to Nui Dat or the messes, but the authoritarian system often encouraged the women to dress in civilian attire, particularly in that the fashions called for mini-skirts and mini-dresses. Several nurses commented that they remembered wearing mini skirts in Vietnam when they were off duty. One nursing sister remembered attending a dust-off that arrived in the middle of a mess function in a tiny mini skirt. Some time during the resuscitation, a medic covered her with a patient gown as her dress was so short that she was showing her underwear. Another nurse veteran recalled incredulously that the nurses were told that they had to wear long sleeved shirts after dusk in order to avoid being bitten by mosquitos, although they were permitted to wear their mini-skirts.

Sally cited an example that was contradictory to some statements that refuted that the nurses were not sexual beings for the soldiers. She recalled that on her return flight to Australia, she was the only female, and the recipient of everyone’s attention. She goes on:

Someone must have said, "who’s the girl?" and before you knew it, someone up the back was ‘sick’ [indicates quotation marks] and they said, "could you come up?" I thought that I didn’t know what I could do but anyway, I went up and he said, "I’ve got malaria". It was all a bit of a joke, so everyone could check me out.

Perhaps this insight identified by Sally may be attributed to the fact that the soldiers going home were obviously excited and animated, and while in this elevated mood, much of their normal ingrained inhibitions and respect towards a female officer were lost. The most interesting aspect of that discourse is that while they tolerated being sexual objects and nurturing caregivers for the ‘real’ soldiers, they did not permit the officers in their Mess to indulge in the same sexual objectification. Ideally, this sexual stereotype implies that the nurse is an extension of being everything for the soldiers; their nurse, their girlfriend, their mother, their sister, and their lover (Roberts & Group 1995). In an interview with a medic who had spent some time working in the 8^th Field Ambulance in 1967, Charles disclosed:

I admired their compassion and courage in coming to a place many others avoided. I think, by virtue of their femininity, the women were able to give the wounded diggers a magical something we male medics could not. However nurturing we might have wanted to be, the macho male image stood firmly in the way. If it was difficult for we males, as soldiers, to offer that level of comforting, I think it was even more difficult for the wounded warrior to accept it. We cared from them in a physical sense, met their immediate needs and encouraged them in a blokey way. The women were able to do something more. I’m not talking anything sexual here, though I don’t doubt there were more than a few fantasies. Rather there was a softness we could not provide, a feminine side to nurturing that males often have difficulty communicating without themselves appearing effeminate (Martin, C. 2000, pers. comm., 6 May).

So from Charles’ perspective as a male caregiver in Vietnam, the role that the nurses took was not overtly sexual. They provided the womanly touch that seemed almost out of place in such as environment. However, some nurse veterans admitted that it was a boost for their own ego to be so few females amongst so many males: "we could have had two heads and the boys would have loved us". She further went on to say that getting a date for a night ‘out’ was always easy, as it was a matter of calling one of her male friends and saying, "come and pick me up, I need to get out". She jokingly noted that it was pretty rare to get a knock back.

Some narratives described a reciprocation of admiration from the nurses to their patients. Many described the wounded patients as "brave boys" who never cried out or made a fuss, despite their pain, injuries or emotional situation. One nurse veteran remembered that the casualties would only start a commotion if their mate or buddy was not receiving treatment at the same time. It was evident during the analysis of their interviews that the nurse veterans held the Australian troops in high regard. What is even more interesting was that the narratives never described the soldiers as being anything but compliant and brave; they weren’t troublemakers, non-compliant, or difficult patients. Many nurses indicated that they became close and protective of their patients during their often brief stay in hospital. One nurse recounted that they hated the fortnightly medivac flights back to Australia, because it meant that some of their patients would be leaving. She recalled, "I remember we went to the airport once to say goodbye to the boys, and we were all crying and blubbering like fools. After that, Matron never allowed us to go to the airport ever again! I think she was embarrassed by our behaviour. But we were sad for them, going back to who knows what". Some nurses also reported that they would use touch, primarily as a means of indicating their understanding for the boys and their situation. One recalled:

You became instantly very close to these guys … not in a familiar way … more of a caring female way, because they were so young to be so wounded … and so traumatised. When someone is so badly wounded that even if you just held their hand while you were doing things … it wasn’t in an overly familiar way, it was just a way that you could help a little bit. … You’d go and sit with them, hold their hand…mightn’t say anything, just sit there, because it must have been frightening for them, lying there.

Another nurse recounted an episode of sitting with a soldier who had received such significant burns that he was categorised an ‘expectant’, in that he was expected to die and little more could be done for him apart from some basic palliative care. She couldn’t bear the thought of leaving him alone, as he was still somewhat conscious and aware of his surroundings. She went on to describe how, even though when she first went to hold his hand, the skin slipped off in her hand, she just held it in place and sat with him, singing, talking and preying with him, until he finally passed away. When she recalled that time in her tour, she could remember feeling guilty for feeling so repulsed by his injuries, but as she didn’t want him to die alone, she refused to leave his side. "His mother couldn’t be there, and he kept asking for his mum. So I became his surrogate mum for those few hours that he was alive".

Although this paper is brief, it has highlighted the role that the nurses played in caring for the sick and wounded Australian soldiers in a horrific and dirty war. These women, in their crisp uniforms and veils, cloaked in makeup and perfume, stood in to became surrogate mothers, wives and girlfriends to these men. This categorisation of the nurse in war is not a phenomenon new to Vietnam. Holmes (1995) describes the ambiguities surrounding the roles of nurses in the Great War. The nurses readily became the mothers or the sisters or the lovers, in which the traditional roles of women in society were not reflected in the army hospital wards. Most of the nurse veterans who served in Vietnam noted that they joined the Army specifically to go to Vietnam. They were volunteers to participate in what was a ‘dirty war’ at the time, and follow in the steps of their predecessors who, as part of the Australian Army Nursing Service, defied traditional roles by participating in the ‘work of men’. Women have almost certainly been a part of warfare since war began, often as murdered civilian women, and probably more often as nurses, care-givers, raped civilians and prostitutes. Women have sent off their beloved men and boys to battle and received their bodies back for burial, or been told that their man’s body was unrecoverable and they would never even have a grave to tend. Women have attended to the maimed, and buried them, or given them back their health and their lives. Women’s bodies have been used, willingly or not, to satisfy the sexual needs of men, and to reproduce the next generation of warriors. Women have even occasionally served as combatants when the need for our strength and courage was seen as great enough to outweigh the domestic consequences of a woman hardened not only to death, but also to killing. This is not new. What is new, and arguably not yet achieved, is the willingness to espouse the roles of women in war into history and lore. The women who served as Australian Army nurses entered the war with an expectation so formidable as to contribute to the momentum propelling their involvement in the war; by virtue of their being a nurse, they would adapt to the nature of the nursing work required of them. The contribution of these women undoubtedly affected many soldiers in ways more profound than those of us who were not there could ever imagine. However, their contribution should never be disregarded or forgotten.

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