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Scores of thousands of persons in Canada benefit year in and year out from the institutions that serve under the White Cross, the emblem of the Venerable Order of the Hospital of St. John of Jerusalem. To most people this is better known as the St. John Ambulance.

The men and women in uniform, with the eight-pointed cross on the shoulder, who are seen on duty at parades, games, and public gatherings, are part of a tradition of service freely given for some nine hundred years. They are volunteers trained and equipped to provide first aid to anyone who is injured or becomes ill. They do this humanitarian work without any other reward than the satisfaction of helping people.

These peaceful services have developed over the centuries from a warlike start in the eastern Mediterranean. Knights of the Order fought in the Holy Land in behalf of freedom and Christianity, and for four hundred years they dominated the Mediterranean from bases on Cyprus, Rhodes and Malta.

The history of the Order from its beginning in the Holy Land down to its participation in Canada’s Centenary of Confederation is told in The White Cross in Canada (Harvest House, Montreal, 1967). This history, well illustrated, was written by Colonel G. W. L. Nicholson, who gave distinguished service to Canada in many and varied ways. He was a high school principal in Saskatchewan before the second world war. It was at Saskatoon Normal School that he qualified for his first St. John Ambulance Association certificate in first aid.

During the war Colonel Nicholson served with the Prince Albert Volunteers, and from 1943 with the Historical Section, General Staff. At the time of his retirement from the Army, in 1961, he was Director of the Historical Section. Colonel Nicholson is the author of a number of works on military history, including The Canadians in Italy 1943-1945; Canadian Expeditionary Force 1914-1919; and The Fighting Newfoundlanders. Much of the information in this Monthly Letter is taken from The White Cross in Canada.

Knights of the Cross

The devotion to good works shown by the men and women of St. John on the ski slopes, in crowds, in disaster, and in everyday life cannot be fully appreciated without looking back over a history as colourful and exciting as that of any organization in the world. The red thread of courage and the white thread of service are woven into the story continuously.

At various stages in their existence members of the Order called themselves Knights Hospitallers, Knights of the Holy Sepulchre, and Knights of Malta. They had their origin in Palestine in the middle of the eleventh century, their purpose being to succor and protect pilgrims visiting the holy sepulchre.

In the Holy City the wounded and ailing crusaders were cared for in an ancient hospital founded in A.D. 600 as a pilgrims’ hostel. It was destroyed four hundred years later by the mad Caliph E1 Hakim. Pious merchants of the Republic of Amalfi, then one of the most powerful maritime states but today a small town, rebuilt and enlarged the hospital. The monks who staffed it adopted the symbol of Amalfi, an eight-pointed white cross on a background of black, and this is still the emblem of the Order of St. John.

The crusaders rescued the rector of the hospital from the Moslems in 1099, and under him custody of the hospital passed to a group of knights who, tired of bloodshed, turned to charity. They formed themselves into a monastic brotherhood and took the vows of poverty, chastity and obedience.

The hospital in Jerusalem entered modern history in 1882, when it became, under the Order, “The Ophthalmic Hospital of St. John of Jerusalem”. The English Knights, who were responsible for this advance, decided that their hospital should specialize in the treatment of trachoma and other diseases of the eye so prevalent in the countries of the Middle East.

Twice more destroyed ( in the first world war and in the Arab-Jewish riots after the second world war ( the hospital has now a fully modern building completed in 1960. An average of 63,000 patients are treated and 5,000 major operations are performed every year, an eye bank has been established, and there is a school for Arab doctors and nurses.

Treatment is still free. The Order of St. John is true to its pledge to help all persons in need “without distinction of race, class or creed”.

In Europe, the Knights did not fit in as a military force with nineteenth century battle conditions, but their renown for courage under fire and their record of care for injured and ailing people brought them to notice in another role. The battlefields of Europe needed organized medical services, and the field ambulance service given by the Order of St. John in the Crimea and in the Franco-Prussian war won acclaim.

In 1888, Queen Victoria granted a Royal Charter to the Order and assumed the title of its Sovereign Head. Queen Elizabeth II bears this title today and H.R.H. the Duke of Gloucester is the Grand Prior. Since then the Order has spread to many Commonwealth countries, performing its practical humanitarian work through its foundations: the St. John Ambulance Association, the St. John Ambulance Brigade, and the St. John Ophthalmic Hospital. It is the oldest order of chivalry in the Commonwealth.

In Canada

The eight-pointed cross of the Order of St. John was being worn in Canada as early as the seventeenth century. At one time, all the French colonies in America were governed by Knights of Malta.

It was in 1883, however, that the Order began its service work. Today there are St. John branches in most communities and the Brigade has more than 12,000 members.

A big step forward was taken in 1934, when there came into existence “The Commandery in Canada of the Grand Priory in the British Realm of the Venerable Order of the Hospital of St. John of Jerusalem” ( an office designed to take charge of all branches of the work of St. John in Canada. In 1946 the Canadian organization graduated to Priory status, the highest branch of the Order outside England.

Below the level of national headquarters, the elements of the Order are administered by provincial councils. These are charged with providing training through the Association and rendering service through the Brigade.

There are several organizations supporting the work of the Order. The Canadian Ladies’ Guild of the Hospital of St. John of Jerusalem, formed in 1937 as the Linen Guild to supply one-fifth of the linen required for the ophthalmic hospital, has assumed many varied duties. It provides the hospital with radios, film projectors, bedside tables and wheel chairs. As its centenary project the Guild presented the hospital with a number of battery-driven trucks for use in the wards. Every year a number of bales of hospital clothing are shipped to Jerusalem.

The Margaret MacLaren Bursary Fund, which provides awards to students who have been accepted in a hospital school of nursing, was set up in memory of Margaret McLaren who was Superintendent-in-Chief of the St. John Ambulance Brigade 1946 to 1963. This fund is supported by all Members of the Order in Canada.

The world wars

In August, 1914, the task of organizing and training voluntary aid detachments for war service was assigned to the St. John Ambulance Association, with personnel being drawn from the St. John Ambulance Brigade.

By the end of hostilities, 200,000 members of the Canadian Expeditionary Force had been taught the important principles of first aid, and more than 61,000 persons in Canada received instruction leading to St. John certificates.

A hospital of 520 beds was provided at Etaples, France, by the Canadian Association, and staffed by the Brigade. Dr. Cluny Macpherson, distinguished member of the Order, was primarily responsible for devising the first successful “smoke helmet”, which provided protection against gas without immobilizing the wearer.

When war came again in 1939, thousands of persons flocked to first aid and home nursing classes to qualify themselves for air raid precautions duties and other war work.

It had been agreed upon the outbreak of war that the Red Cross Society should be responsible for collecting and distributing funds and materials, while the Order of St. John would train in first aid all male personnel required for war service. Closer liaison came about when the St. John-Red Cross Joint Board met in 1943 under the chairmanship of Morris W. Wilson, President of The Royal Bank of Canada.

More than thirty hospitals and convalescent homes in England and Scotland had Canadian members of St. John on their staffs; hospitals on the Canadian coasts, receiving many hundreds of wounded men from the sea, were given voluntary assistance by St. John workers. Transport drivers from Canada served with more than a dozen ambulance units in Britain, and twenty St. John girls served in transport duties in France, Belgium and Germany.

On the home front, the Order expanded steadily. Halifax and Vancouver were specially active, the former because of the need to care for victims of the battle of the Atlantic, and the latter because of the war in the Far East.

Some home front examples

Canadians have every right to be impressed by the prompt and efficient response made by St. John personnel at times of catastrophe. Members of the Brigade have served with distinction through explosions, blizzards, hurricanes, fires, collapse of buildings, railway collisions, floods, and every other sort of emergency.

The Halifax explosion in 1917, resulting from the collision of an ammunition ship with a freighter, devastated half a square mile of the city, killed 1,630 persons and injured 5,000. Every hall, school, and church became an emergency hospital or dressing station, staffed by surgeons, nurses, and by members of the St. John Ambulance Divisions.

A tornado that levelled scores of houses in the Windsor area left in its wake seventeen dead and a hundred injured; an explosion wrecked a grain storage elevator at Port Arthur, killing twenty and injuring many; fire destroyed a cruise ship at Toronto, taking the lives of 121 persons; another ship fire at Sarnia injured 150 persons; an explosion in a mine at Springhill killed five workers and trapped 118 below ground; two years later another “bump” imprisoned 174 miners; a rain storm which caught 150,000 persons at a gathering on St. Helen’s Island, Montreal, resulted in 1,425 requiring treatment; an aircraft crashed near Toronto airport at 8 a.m. and by 8:20 a combined first aid and nursing corps was on the scene providing service; it took only an hour for ten ambulance men to reach the scene of the landslide at St-Jean VianneY…

…in all these cases trained people of the Brigade and the Nursing Division, in keeping with the principles of their ancient Order, were tireless in their errands of mercy, saving lives, providing first aid and nursing care, and giving comfort to survivors.

To illustrate the diversity of activity in which the members of St. John take part, consider the Springhill disaster in 1958. During the two weeks of rescue and recovery of the miners, the St. John people, in co-operation with the Salvation Army, the Red Cross, and the Civil Defence Force, served in the hospital and the morgue, guided out-of-town doctors to homes where help was needed, and drove cars and trucks. They performed many neighbourly tasks, such as sitting with the bereaved and those waiting for news about entombed men, or caring for their children.

More than 20,000 first aid dressings were used, and a major contribution by nursing members was the making of 4,800 face masks for miners to wear as they carried out their search and rescue work.

St. John units

St. John, as the man in the street comes in touch with it, is performing two essential kinds of service. The Brigade is made up of members who wear a uniform when they are on duty. This is a disciplined, trained body of men and women. The second service is that of the Ambulance Association, training 250,000 members of the public every year in first aid, home nursing, child care, and related subjects. The Brigade in turn has Ambulance Divisions (men), Nursing Divisions (women) and Cadet Divisions (young people).

Today’s Nursing Division has different, but no less trying, duties. When explosions at the Navy arsenal rocked Halifax and Dartmouth there was widespread alarm, calling for the best that the Nursing Divisions had to give in calm service. The official history of the Canadian Medical Services pays them this tribute: “The part played by St. John nursing personnel among the women and children was outstanding. It is to their enduring credit that their services were mobilized immediately when the need was greatest.”

Because of the shortage of hospital beds, which must be conserved for those who need them most, St. John is greatly concerned today with home care of ailing people. A textbook has been published under the title Patient Care in the Home, and it has been suggested that this title replace that of “Home Nursing”.

First aid in industries

St. John Ambulance is providing first aid training in industries. In some of the logging camps of British Columbia first aid is taught not only to the men but to their wives and children. Oil rig crews take this training; thousands have been trained in the mining industry; and training is given members of the merchant navy.

Many of the largest industries and public services have for many years had their own St. John centre or branch: Canadian National and Canadian Pacific Railways, Bell Canada, Northern Electric Company, Royal Canadian Mounted Police, Armed Forces and the Federal Government. Take Canadian Pacific as an example: its programme started 63 years ago with a class of 23 people; in 1971 it attracted 14,414 employees to courses.

To their surprise, research people have found that a major benefit of a first aid course within an industry is to be seen in the homes of the workers.

Male and female employees of Bell Canada who had taken the St. John training course had fewer away-from-work accidents than other employees. In Orillia, a research project is showing a significant increase in safety consciousness in the home and on the streets.

“Save a Life”

No project undertaken in Canada by St. John Ambulance caught the public imagination and achieved such successful results as did the “Save a Life” programme. It started in May 1954 to encourage members of the public to take a course in artificial respiration as a precaution against summer water hazards.

This special instruction has been given to a million and a half people. Two hour classes in methods of artificial respiration are offered in cities and towns across Canada.

The knowledge is useful in emergencies due to electric shock, drowning, and carbon monoxide poisoning. In these cases there is usually a short interval when, spontaneous breathing having ceased, life may be preserved by prompt initiation of artificial respiration. The course given by St. John Ambulance has resulted in many people being prepared and qualified to provide this immediately-needed first aid, and the saving of many lives.

When crowds gather

One of the principal duties of the St. John Ambulance Brigade is to furnish a body of men and women properly trained to render first aid to the sick and injured. The sight of uniformed members of the Brigade has become familiar wherever people gather in large crowds.

An interesting sidelight on the work of a first aider is provided by experience at the Stratford Festival. After listing 38 sorts of casualty, the report adds: “We have many cases of fainting every year. In making our diagnosis we take into consideration whether the play is a gory one. Some patients are naturally excitable and are overcome by the acting in the play. Others become completely involved and associate themselves with some particular actor and react to all that actor does, even to collapsing.”

Two St. John Ambulance corpsmen were injured and 68 others mauled by teen-agers who were trying to reach the “Rolling Stones” in the Montreal Forum. Nevertheless, the ambulancemen handled thirty cases ranging from hysteria to cuts and bruises, and they averted what could have been a major riot.

At the Rockhill Festival in Ontario, three mobile units with twelve Brigade members did 24-hour-a-day duty, treating 500 cases. At the “Pop” festival at Manseau, Quebec, sixty Brigade members worked for three days and nights, treating 135 patients.

To the Brigade in Montreal went the honour of opening up a new field of endeavour in 1928, when members were sent on week-ends to the Laurentian ski area to provide first aid treatment for those injured on the slopes. Besides being qualified first aiders, all members on the ski patrol are proficient skiers, skilled in bringing a toboggan carrying an injured person safely down the steepest slopes. The most recent Brigade service is the development and operation of Snowmobile Divisions.

Here is part of a typical ski accident report from the Edelweiss Valley slopes in Quebec last winter. “A teen-age skier fell backward and struck her head violently on a hard surface. The St. John-trained member of the ski patrol called for a toboggan and other rescue equipment. Thirty minutes were required to move this seriously-injured skier to the first-aid cabin. During the journey the victim ceased breathing eight times and was given mouth-to-mouth respiration each time by first aiders who walked beside the toboggan. In the first-aid cabin, while awaiting arrival of the ambulance, the victim lost consciousness and ceased breathing seven times and was revived by artificial respiration. A first aider travelled in the ambulance, and was twice required to provide emergency revival treatment.”

Ancient to modern

The ancient emblem is preserved from medieval times, and so are the spirit of service and regard for human life, although the means and the occasions differ.

Colonel Nicholson tells us in his history that the four arms of the White Cross represent the Christian virtues of Prudence, Justice, Temperance and Fortitude. The eight points call to mind the eight Beatitudes set forth in the Sermon on the Mount, the qualities springing from the virtues.

While having no doubt that the St. John principles are relevant today, some members of the Order wish to bring the practice more into the environment of daily life. In an essay contest for young people in Manitoba the first-prize winner asked: “Why can’t St. John become one of the ‘in’ things for students?” The second-prize winner said that the bonds of camaraderie could be strengthened by “more outgoing get-togethers such as tobogganing, skating or fondue parties.”

As reported in the St. John News, official publication of the St. John Ambulance in Canada, the consensus was that if St. John is to continue to be successful, it must go to the people with interesting programmes directed to specific segments of the public.

Some suggestions were: special classes in child care for expectant and new mothers; a special first aid class for young married couples or couples with a young family bound to be accident prone; emergency first aid classes for taxi drivers, travelling salesmen, hotel employees, highway garage attendants, and transport drivers; basic instruction on patient care in the home by use of mass media.

More attention should be given, said the essayists, to making the community-at-large aware of the work of St. John. “Red tape” must be removed, they said, to encourage the flow of communication within the organization.

One thing is evident: there is a great awakening in young people of the desire to serve their fellow man, and these young people find in St. John an opportunity to express their good will, unselfishness and public spirit.

In its service to people, St. John is living very much in the present. It gives citizens of all ages, from cub and brownie to octogenarian, the opportunity everyone yearns for: to be of service to other human beings.

These citizens have built a reputation that is hard to beat: they are there when you need them.