Florence Nightingale - Crimean War

Crimean War

Florence Nightingale's most famous contribution came during the Crimean War, which became her central focus when reports got back to Britain about the horrific conditions for the wounded. On 21 October 1854, she and the staff of 38 women volunteer nurses that she trained, including her aunt Mai Smith, were sent (under the authorisation of Sidney Herbert) to the Ottoman Empire. They were deployed about 295 nautical miles (546 km; 339 mi) across the Black Sea from Balaklava in the Crimea, where the main British camp was based.

Nightingale arrived early in November 1854 at Selimiye Barracks in Scutari (modern-day Üsküdar in Istanbul). Her team found that poor care for wounded soldiers was being delivered by overworked medical staff in the face of official indifference. Medicines were in short supply, hygiene was being neglected, and mass infections were common, many of them fatal. There was no equipment to process food for the patients.

After Nightingale sent a plea to The Times for a government solution to the poor condition of the facilities, the British Government commissioned Isambard Kingdom Brunel to design a prefabricated hospital which could be built in England and shipped to the Dardanelles. The result was Renkioi Hospital, a civilian facility which under the management of Dr. Edmund Alexander Parkes had a death rate less than 1/10th that of Scutari.

The first edition of the Dictionary of National Biography (1911) asserted that Nightingale reduced the death rate from 42% to 2% either by making improvements in hygiene herself or by calling for the Sanitary Commission. However, death rates actually began to rise to the highest of all hospitals in the region. During her first winter at Scutari, 4,077 soldiers died there. Ten times more soldiers died from illnesses such as typhus, typhoid, cholera and dysentery than from battle wounds. With overcrowding, defective sewers and lack of ventilation, the Sanitary Commission had to be sent out by the British government to Scutari in March 1855, almost six months after Florence Nightingale had arrived. The commission flushed out the sewers and improved ventilation. Death rates were sharply reduced, but she did not recognise hygiene as the predominant cause of death at the time and never claimed credit for helping to reduce the death rate. In 2001 and 2008 the BBC released documentaries which were highly critical of Nightingale's performance in the Crimean war, as were several follow on articles published in The Guardian and the Sunday Times. Nightingale scholar Lynn McDonald has dismissed these criticism as "often preposterous", arguing they are not supported by the primary sources.

Nightingale still believed that the death rates were due to poor nutrition, lack of supplies and overworking of the soldiers. After she returned to Britain and began collecting evidence before the Royal Commission on the Health of the Army, she came to believe that most of the soldiers at the hospital were killed by poor living conditions. This experience influenced her later career, when she advocated sanitary living conditions as of great importance. Consequently, she reduced peacetime deaths in the army and turned attention to the sanitary design of hospitals.