What happened to the 8 million people who were disabled during WW1?

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Jugon’s case was an example of the more severe injuries sustained during the war, and he had spent over four years recovering and receiving treatment at Val-de-Grâce. Mobilised in August 1914, he was wounded on 16 September that year at Ville-sur-Tourbe, where a shrapnel blast blew away half of his face and throat. The treatment received under Hippolyte Morestin at Val-de-Grâce reconstructed his face, enabling him to go on to live a full civilian life. (Morestin’s skills in reconstructive surgery inspired the New Zealand-born surgeon Harold Gillies, who in 1917 set up a unit at the Queen’s Hospital, Sidcup, where he further pioneered techniques in plastic surgery.) After the war Jugon co-founded the Union of the Facially Wounded in 1921 to support ex-servicemen who had been through the same experience.

The presence of ‘men with broken faces’ at Versailles was a staged denunciation of Germany, demanding that it took responsibility for the conflict

The presence of the gueules cassées, who had been summoned by French prime minister Georges Clemenceau, was a staged denunciation of Germany. Their presence demanded that the country take responsibility for the conflict, and required the treaty’s signatories to come face to face with these severely disfigured veterans. But such men, who had fought and sacrificed their health in the conflict, did not represent a merely political issue. Indeed, the medical, social and professional futures of disabled veterans was already being addressed by international communities.

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Allies look for answers

Two years before the events at Versailles, while the fighting was still raging, a groundbreaking meeting took place in Paris – the first inter-allied conference examining professional re-education and other issues affecting servicemen disabled during the conflict. It was promoted by the Belgian government in exile and co-organised by a Franco-Belgian committee established in early 1916. The idea behind the first conference was to exchange ideas and best practices for dealing with a growing problem in wartime societies: the sheer number of servicemen disabled in the fighting. Political and medical authorities in each country aspired to make such men fit again, so that they might return to productive work – efforts motivated by both social and economic concerns.

That first conference drew representatives of national governments and offices, medical and voluntary aid authorities, and leaders of disabled veterans’ associations from the allied and associated forces. It began on 8 May 1917 at the Grand Palais, an exhibition hall built for the Universal Exposition in 1900, and was formally opened by Raymond Poincaré, president of the French Republic.

During the conference, which continued until 12 May, representatives from France, Great Britain, Belgium, Russia, Portugal, Italy and Serbia discussed issues covering six areas: physical re-education or treatment; professional re-education or training; employment and job placement for disabled men; economic and social interests of the disabled; the blind, deaf and those seriously disabled by injuries to the nervous system; and documentation and propaganda.

There were also opportunities for delegates to visit hospitals and schools of re-education in Paris and the neighbourhood. They toured the military hospital in the Grand Palais itself, another at Saint-Maurice in the south-east of the capital, the city’s hostel for the blind, and the Belgian school at Port-Villez, 40 miles to the west. This latter institution, which opened in 1915 “to give a thorough physical, technical, intellectual and moral re-education to the severely wounded”, was particularly highly praised for its treatment of high numbers of inpatients (around 1,300) and its wide range of rehabilitative therapies and workshops.

In addition to exchanging ideas, the delegates passed a series of resolutions. One key outcome was the creation of a Permanent Inter-Allied Committee for the Study of Issues Concerning the War Disabled (CIP), based in Paris and composed mostly of medical experts, to maintain the connections established before and during the event between inter-allied institutions and individuals interested in the aftercare of the war disabled.

Disabled veterans did not want to be mere objects of study but co-protagonists in the making and implementation of policies

Notably, disabled veterans requested to be actively involved in the works of the CIP: they wanted to have a say in the planning of healthcare and social systems. They did not want to be mere objects of study but, rather, co-protagonists in the making and implementation of policies.

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Alongside the conference, importantly, a public exhibition was mounted to inform the wider public about advances in medicine and technology; it featured displays of a range of prosthetic devices, along with details of professional training available for the disabled. British delegate Sir Arthur Griffith-Boscawen, then serving as parliamentary secretary to the Ministry of Pensions, reported that he was “struck very much with the great interest which the subject evoked”. The high attendance reflected the widespread recognition by the French public that the question of the re-education of disabled veterans was “a most urgent and important social problem”.

Involving the public

The importance of involving and informing the wider public was again evident during the second annual conference, held in London’s Methodist Central Hall, Westminster, in 1918. A public exhibition was open daily from 20 to 25 May: displays included objects produced by disabled soldiers from different countries and institutions, along with other forms of war-related material culture. A correspondent for the London-based periodical The Hospital commended them thus: “A lectern – and also a tray with carved border completed during the week – was made by Private G Pell, who is blinded, and had had no experience of carpentry till he went to St Dunstan’s. A meat-safe with zinc panels was made by Lance-Corporal Hopper, who is not only blind but has lost the first finger of the right hand, and thumb and first finger of left hand.”

In October 1919 – four months after that fateful day at Versailles – the third of the now annual series of conferences was held in central Rome in the Palazzo delle Esposizioni, an exhibition area in Via Nazionale. Delegates came from nations around the world, including Canada, France, the UK, Japan and the US.

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In Rome, the veterans themselves made important points about the international nature of the problems with which they were confronted. Among their number was Aurelio Nicolodi, a native of Trento, who was blinded by a shell-burst while fighting for the Italians at the second battle of the Isonzo in July 1915. At the end of 1916, Nicolodi entered a rehabilitation centre for blinded servicemen in Florence; a year later he became the director of that same institution. In Rome, he presented a paper on the vocational training of the blinded for agricultural work. But for Nicolodi, this was just the beginning: he would go on to play a major role in the creation of Italy’s blind union, which mobilised both war-blinded and blind civilians under the slogan: “The solution of blindness’s problems concerns exclusively blind people.”

As the Rome conference proved, international collaboration and circulation of information about medical techniques, rehabilitation methods, aftercare and pension systems evident were considered vital in handling the transnational problem of severely wounded servicemen. Medicine and science had become increasingly internationalised since the 19th century, largely because of growing opportunities for scientists to exchange ideas and disseminate research outputs through conferences and publications.

Dramatic improvements in sanitation and hygiene, and advances in medicine and technology, allowed a high proportion of soldiers to survive their wounds and in many cases return to battle. The First World War triggered a rationalisation of medical procedures and practices, such as the reduction of evacuation times and the organisation of casualty clearing stations. In truth, efforts to improve the physiological reconstruction of the human body and the re-employment of the war disabled were prompted by the economic and military need to preserve as much manpower as possible.

The conflict had interrupted prewar channels of scientific communication, sidelining Germany and restricting its traditional academic dominance. An inter-allied cooperation network was established in part to supersede German knowledge and expertise in orthopaedics, prosthetics and the “recycling of the disabled” for efficient military and industrial use. After the war, though, the situation changed once again.

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The punitive terms of the Treaty of Versailles, which essentially apportioned all blame for the conflict on Germany, exposed the vengeful mood of the Allied leadership. Yet the Treaty also advanced the case for internationalism, including as it did the Covenant of the League of Nations and the creation of the International Labour Organisation (ILO). Germany did not become a member of the League of Nations till 1926, but the ILO decided in its first annual meeting in October–November 1919 to admit Germany and Austria as member states.

Cooperating after conflict

Disabled veterans, too, looked for new ways of cooperating – and their international approach encompassed former enemy nations. When Dante Dall’Ara, first president of Italy’s National Association for the War Disabled (ANMIG), addressed the delegates in the plenary at the conference in Rome on 13 October 1919, he criticised the decisions taken in Versailles. He also decried the fact that veterans from former enemy countries had been excluded from participating in the conference.

Dall’Ara observed that the ideals for which the war had been fought were inspired by human and social solidarity. His words were echoed by Henri Le Clercq, president of the Belgium’s National Federation for Disabled Veterans (FNI), who also demanded that the war disabled be allowed to contribute to the work of the CIP in collaboration with doctors and officeholders. He suggested, too, that the CIP should be explicitly associated with the League of Nations so that its recommendations would be taken more seriously by governments.

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The CIP continued its work for a few more years. The last inter-allied conference on this topic was held in Ljubljana, Zagreb and Belgrade in Yugoslavia (officially the Kingdom of Serbs, Croats and Slovenes) in 1922. By that time, though, disagreements had arisen among CIP members about the relationship of the committee with the League of Nations and about its enlargement to include defeated countries. Its effectiveness was declining, and it ceased to operate in 1924.

Meanwhile, building on the network of contacts developed during the inter-allied conferences, veterans formed a transnational organisation, the Inter-allied Veterans’ Federation (FIDAC) in 1920. It was intended exclusively for groups from allied countries, but some national associations started promoting alternative views on that issue, proposing a broader membership.

Photographs, sketches and descriptions of prosthetics enabled readers to understand and take advantage of advances in technology

The ILO – whose remit was, and still is, the promotion of social justice through the improvement and regulation of working conditions and the protection of workers’ interests – also took a great interest in the question of disabled veterans after they made an explicit request for its intervention. In January 1921, the ILO’s Geneva-based permanent secretariat – the International Labour Office – launched a Disablement Service charged with the collection and survey of data relating to disabled veterans. Led by Adrien Tixier – a French former soldier disabled by injuries sustained during the conflict – the Disablement Service liaised and cooperated with a variety of veterans’ associations from countries including Great Britain, France, Italy, Germany, Austria, and the United States. The overall purpose of this small section was to place “at the disposal of men disabled by industrial accidents the new ideas and experiments evolved as a result of the peculiar position of disabled soldiers and sailors”.

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The service convened two meetings in Geneva in 1922 and 1923 at which experts exchanged information about prosthetics and job placements for disabled veterans, comparing social policies in different countries to identify the most effective. The first meeting, in March 1922, was devoted to medical treatment and the supply of artificial limbs, and led to a report “of an entirely practical character on methods of fitting disabled men for employment”. Using photographs, sketches and descriptions, the report enabled a large circle of readers to understand and take advantage of advances in technology. It was authored by Florent Martin, who was attached to the limb-fitting branch of the Belgian Army Medical Corps and had participated in the works of the prosthesis committees of the inter-allied conferences.

The second meeting, in July 1923, studied different methods of finding employment for disabled veterans adopted in the various countries. The resulting report concluded that it was the duty of the state to assume responsibility for the welfare of those who had been disabled by the conflict, and that “in order to ensure definitely and finally the permanent employment of disabled men, it is absolutely necessary to have recourse to the legal obligation of employment”. These were merely recommendations, of course, but they had an impact: the following year, the French government passed a law introducing the mandatory employment of disabled veterans.

Workers unite

Veterans played an active role in promoting these events and in the international circulation of information. Backed by the ILO, veterans’ associations held the first meeting of what would become the International Conference of the Associations of War Disabled and Veterans (CIAMAC) in Geneva in September 1925, gathering together former servicemen from both sides of the conflict. The event was attended by groups from Italy, Yugoslavia, Austria, Germany, France, Poland, Romania and Czechoslovakia. Their primary goal was the establishment of a lasting peace in collaboration with the League of Nations and the ILO.

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One of the main supporters of this initiative was René Cassin (1887–1976), jurist and co-founder of the Union Fédéral. Mobilised in August 1914, Cassin was wounded during a night raid on the Chavoncourt barracks near Saint-Mihiel, south of Verdun, on 12 October that year. He taught at universities in Lille and Paris, and served as a member of the French delegation to the League of Nations on behalf of French veterans. In tandem with Tixier, he indefatigably promoted the internationalisation of the movement of disabled veterans to promote peace and discuss matters of common interest. Later in life, Cassin took up important public roles. He received the Nobel Peace Prize in 1968 for his work in drafting the Universal Declaration of Human Rights, adopted by the UN General Assembly on 10 December 1948.

The various initiatives, and examples of the work of men such as Cassin, show how the eight million people disabled during the First World War played a key role in fostering international interactions and promoting the welfare of the severely injured after the end of the conflict.

Martina Salvante is honorary research fellow at the University of Warwick. She was co-editor of Landscapes of the First World War (Palgrave Macmillan, 2018)

This article was taken from issue 17 of BBC World Histories magazine