I was enjoying the last days of that 1936 July when Mary Redfern Davies, a Cambridge contemporary, rang up to ask me to make out a list of Medical supplies to the value of one hundred pounds. What had provoked this odd request was that the Committee for the Relief of the Victims of Fascism had received cash gifts earmarked for Spain. It seemed that the Army had just mutinied in an attempt to overthrow the Popular Front Government. I did the job with Mary in Hennekey's over a couple of Tio Pepes. Twenty-four hours later Mary told me that the Relief Committee had doubled the quantities as more earmarked money had come in. The Committee's secretary then wanted to see us so we went round and found her all bemused; she now had about nine hundred pounds and while we were there more came in bringing the total over the thousand - in those days that amount of money would have kept me for two years. I suggested that if it went on like this once she got over two thousand pounds she could buy a vehicle and stuff it with whatever the Spaniards might ask for.

There is nothing like activity to put a stop to introspective thinking: I had not come to terms with the seeming failure of Truda's all important visit. I soon had no need to bother anymore about myself, because within twenty-four hours the Committee for the Relief of the Victims of Fascism had bowed out and a Spanish Medical Aid Committee had been formed with me as one of its founder members. It was a solid affair with the Medical Advisor to the TUC, eminent Quaker worthies, some labour and liberal MPs, a couple of peers, a charming Italian-born peeress, and several Secretaries-General of major Trade Unions all ready to meet 3 times a week. This group represented a cross-section of all that was progressive and contactable in an England bent on enjoying the high summer of 1936.

The Committee started work on the first of August. Three weeks later I left London with a unit of twenty volunteers and the equipment for an advanced field hospital. The eminent doctors who had helped set it up were unable to abandon their London jobs and go to Spain themselves. I had no such constraints and was happy to volunteer for an emergency that, in the general conception, could not very well persist for more than a few weeks. I welcomed the intensity of activity as it counterbalanced the unanalyzed void of Truda's departure. About a week before we were due to leave for Spain, the Committee appointed me Administrator of the Field Unit. To have established the equipment list for a mobile hospital, then to procure and pack it all within three weeks, was in itself a remarkable logistic feat made possible by three forces working in concert. These same forces were to make possible our victory in the war of 1939/45. The first force in this triad was the energy of young people working together for something they really wanted to do; the second factor has been called "working-class solidarity" and the third is often referred to disparagingly as the "old boy network". These last two forces are isometric; upper class solidarity is the mirror image of the working class network.

When I was trying to buy drugs, dressings, sterilisers, hospital ward equipment, kitchen stores and field cookers - all on the same day, I seemed to get a lot of miraculous help. The Committee's Peers would telephone the top of a supplying company, while the warehousemen, hearing that it was for Spain, would service no other orders until ours were satisfied. There was a catalytic agent in all this ferment or, to change the metaphor, a current that passed by a selective circuit through our working group. It had an expediting effect, it resolved knotty questions and simplified debates. A determined minority can have a decisive influence in a democracy, the more so if it keeps a low profile. This phenomenon is, often enough, used by forceful minorities, and, often enough, it is deplored by the disappointed majority. This quiet but powerful mechanism has not been studied sufficiently.

On August 8 1936, a group of doctors, medical students and nurses met in London to consider ways of sending medical help to the Spanish republic. A month earlier, the civil war had broken out. One of those at the meeting was a young doctor, Reggie Saxton, who has now died aged 92.

Out of that meeting came the Spanish Medical Aid Committee and, on August 23 the first unit left for Spain. The English hospital was set up in a farmhouse at Grañen in Hesca, about 18 kilometres behind the Aragón front.

On September 29 1936, Reggie reached Grañen, where, he recalled, "there was only dirt and filth and rats and a stinking courtyard". Reggie became a popular figure at the Grañen hospital, dispensing poultices and pills from his knapsack, but was itching to help the war effort at a time when the main fighting was moving elsewhere.

The Spanish Civil War too had an impact on left-wing medical politics. The SMA, like others on the left, moved quickly to give practical aid to the Republic. Most notably this was through the creation, in late summer 1936, of Spanish Medical Aid, largely on the initiative of Charles Brook. The Association dominated Spanish Medical Aid. Its president was Christopher Addison; its chairman H.B. Morgan; its vice-chairman Hastings; and its honorary secretary Brook - all prominent SMA members. Originally conceived as a supplier of medical aid and equipment to the democratic forces in Spain, the positive response to Spanish Medical Aid allowed it, Brook later recalled, to initiate a "far more ambitious project - the dispatching of a fully-equipped and adequately staffed Medical Unit to the battle front". This was the First British Medical Unit, which served on the Aragon front.

Practical activity abroad was complemented by agitational and propaganda work at home. Addison, `contrary to the advice tendered by some people in high places', chaired a large meeting at the Albert Hall in support of Spanish Medical Aid. On a rather smaller scale, Dr Cedric Hill, previously in charge of a front line dressing station in Spain, organised an appeal for funds for pro-Republican German and Spanish doctors stranded in France. Edith Summerskill and Stella Churchill were among the sponsors of the "National Women's Appeal for Food for Spain", while in 1938 the Glasgow branch devoted its energies to canvassing doctors and chemists for medical supplies for Spain. And, returning briefly to medical refugees, Spanish Medical Aid successfully brought to Britain professionals who would have been in danger had they remained in Spain. These included Joseph Trueta, who had worked during the Civil War in a Catalan hospital. The experience he gained and the skills he developed were later to be used extensively in the Allied armies, a further example of the `beneficial' effects of war for medicine. He left Spain for Britain in 1939, published a number of articles on the impact of civilian bombing based on his experiences in Barcelona, and in 1949 became Nuffield Professor of Orthopaedic Surgery at Oxford.

The Association was actively involved in providing practical help to the Spanish Republic, and perhaps because of the nature of such aid seems to have avoided the sectarian conflicts which bedevilled the rest of the labour movement." It also drew two particular lessons from the war. The first concerned blood transfusion. In MTT in late 1937 Sinclair-Loutit, administrator of the First British Medical Unit, described the new technique of having available chilled blood, ready for transfusion. From such surgical advances, he went on to make more general points. Despite the war, research continued, with surgeons free from the "tyranny of the Old Men". The experience of a year at the front illustrated how "medicine, given freedom, and support from the State, has surged ahead". Even in war, it found "time and peace to make the world richer by its research". The significance of chilled blood was not missed by the Spanish Medical Aid Committee, which sent three refrigerators to the British Unit in autumn 1938

Another SMA member who had served at the front, Reginald Saxton, took up these points. In spring 1939 he gave detailed plans, based on his Spanish experiences, of the requirements of a blood transfusion service should Britain become involved in war. The current situation, however, gave little cause for optimism. The authorities had "learnt little from our experiences of actual war". A national blood transfusion service prepared for the onset of conflict while augmenting peace-time arrangements, was required. Only then would experience gained in Spain `enable us to make of it something of inestimable value in the practice of modern surgery'. Saxton continued to emphasise these points, for example in August 1940 when deploring the authorities' slowness in adopting methods which had proved `invaluable in Spain'. In later recollections of Saxton's plans, both Murray and Hilliard credited him with the formulation of the service which the government adopted and integrated into the NHS.

Of the "unofficial" responses to the Civil War, probably the most important, and certainly the earliest, was the Spanish Medical Aid (SMA) campaign, launched in August 1936 by the Socialist Medical Association with backing from the communists and rank-and-file Labour Party members. Due to the urgent sense of crisis in which it was born and its avowed humanitarian aims the SMA was never treated as harshly by the labour movement as many other "unofficial" organisations were. Indeed, initially the SMA was regarded as part of labour's own operations - TUC Chairman Arthur Findlay had been present at the departure of the first unit. The SMA was only abandoned when it was plain that it would not be subservient to the NCL.

Finally, a group of us - three well-known medical men, a famous scientist, several trade unionists, and one communist - formed a committee for the purpose of collecting money for medical supplies to be sent to the Spanish Government forces. We called it the Spanish Medical Aid Committee. I had already talked to a prominent Labour leader, who later became a peer, and he had told me that the British public was not interested in Spain. When I told him that I wanted to collect money to send medical supplies he had smiled and assured me that I would get nowhere with such an idea. He knew the British public. He had years of experience. I had none. "I'll try, anyway," I said. "If I can't do more I'll send a box of bandages to Spain." As it turned out it only took a few weeks to prove how wrong he was about the British public; or had he been asked by the British Government, as later I thought might have happened, to play down Spain as much as possible?

When we got to work it soon appeared that our Medical Aid Committee provided one of the few outlets in England for popular feeling about Spain. Except for the communists recruiting for the International Brigade very little was being done in England at that time. Our committee put appeals in the newspapers and money began to pour in from the very beginning. Although the British Press had muzzled itself on the Spanish situation, so that to get anything like accurate news you had to read foreign newspapers, plenty of people in Britain were thinking for themselves. The next twelve months were the beginning of a real political education for me. I learned about the practical workings of political parties, and something also about international politics in action. I began to speak at meetings up and down England. I soon saw how strong popular sympathy was for the Spanish people who were struggling not only against Moroccan troops and generals in revolt, but against the power wielded abroad by Juan March, the Spanish financier, who was already installed at Mussolini's side in Rome...

The Medical Aid Committee soon produced results, and before long we had not only collected medical supplies but also had a team of doctors and trained nurses, ambulance drivers and medical orderlies, all of them volunteers.

As far as I myself was concerned I had worked hard to put the thing over but soon there was no need to put it over. Popular enthusiasm was pushing us. Now I found myself at international conferences in Paris, and I was beginning to find that I was not afraid of being a public speaker (extemporary speaking is something nearly all actors dread) and that people really seemed quite ready to listen to me. I had to go through some tough platform ordeals, though, such as being heckled by opponents at meetings in London ; but the knowledge of popular support, and above all the fact that I believed in what I was doing, made me forget about what is usually known as self-consciousness.

In August, when our first medical aid unit left for Spain, I went with it. There was some discussion in our committee, I can remember, as to what name I should go under in Spain or whether I should go at all. It was clear that many of the excellent members of our committee, although fully in support of the Spanish cause, still had lurking suspicions as to the fate of a full-blown aristocrat presenting himself in the Catalonia of the Civil War, where the F.A.I., the popular organization of the anarchists, was very much in evidence. I found the English mentality interesting. We seemed to have no scruples in allowing young nurses and doctors and medical students to go into the danger and presumed turmoil of Spain, but when it came to sending a real live lord it was another matter. I appreciated their concern for me but I took a different view. First, I didn't feel like letting all those young people go to Spain if it was unsafe for me to go myself. Secondly, there were my own feelings. If the people I was trying to help were so stupid as to bump me off on account of so unsubstantial a thing as a title, then my ideas as to what human life could be about were so far from the mark that it might be as well if I were put out of my misery quickly before the title became a millstone around my neck.

The other consequence of the Spanish appeal was the SMAC. Isabel Brown asked Sinclair-Loutit and another student to see Dr Hyacinth Morgan, the Medical Adviser to the TUC and Medical Officer to the Union of Post Office Workers. At a second meeting he agreed to do what he could to set up a committee. Morgan was a wise choice. He not only had close connections with the Labour and trade union movements, but was also a Roman Catholic, having been born of Irish parents in the West Indies.

Morgan saw Dr Charles Brook, a general practitioner in South-East London, a member of the London County Council and founder and first Secretary of the Socialist Medical Association, a body affiliated to the Labour Party. Brook, who was a keen socialist and supporter of the people's front idea, though not sympathetic to Communism, was the main architect of the SMAC. At lunch-time on Friday 31 July, he saw Arthur Peacock, the Secretary of the National Trade Union Club, at 24 New Oxford Street. Peacock offered him a room at the club for a meeting the following afternoon, and office facilities for a committee. Although it was the first day of the Bank Holiday weekend, Brook managed to summon a number of people by telephone and postcard and to bring the press. (Those present variously recall between twenty and sixty people being there.)

Brook spoke of the need for medical aid. It was agreed to set up a committee and to send personnel as well as medical supplies to Spain. The committee had a people's front character. Morgan was elected Chairman and Brook Secretary. Isabel Brown, mindful of the English love of titles, proposed Christina, Lady Hastings (Marchioness of Huntingdon), a left-wing, Italian-born aristocrat, as Treasurer. With her, Viscount Churchill and J.R. Marrack, Professor of Biochemistry at Cambridge, were joint Treasurers. Dr Somerville-Hastings, a surgeon and a member of the LCC, was Vice-Chairman, and Dr Christopher Addison MP, was President. Most of the Committee were doctors, members of the Socialist Medical Association, including Philip D'Arcy Hart, who had been on holiday in Spain, marooned in San Sebastian during the initial fighting and evacuated in a British destroyer. Isabel Brown handed up £50 from her committee, and was elected. So were Ellen Wilkinson MP, Leah Manning, President of the National Union of Teachers, and Arthur Peacock. Lord Faringdon, a left-wing Labour peer and Frederick Le Gros Clark, a well-known nutrition expert and peace campaigner who had been blinded in the First World War, were among those co-opted. Later members of the committee included Janet Vaughan, Professor Julian Huxley, Victor Gollancz and Sir Walter Layton, owner of the News Chronicle, Megan Lloyd George MP, D.N. Pritt MP, Eleanor Rathbone, Independent MP for the Combined English Universities, the Earl of Listowel, Sir Archibald Sinclair MP, leader of the Liberal Party, Rebecca West and the veteran leader of the 1889 dock strike, Ben Tillett. William Temple, Archbishop of York, later of Canterbury, gave his support.

Whilst I had been absent from London, the Committee, with which I was to be most closely associated during the Spanish war, had been formed. Isabel Brown, a dedicated communist, had been receiving sums of money from all over the country to be used for Spanish relief. Medical aid was urgently needed doctors, nurses, trucks and their drivers, and supplies of all kinds. Isabel set about finding people willing to sit on an all-party committee who would undertake the task of raising funds, interviewing personnel, and sending all these things and people to Spain. She brought together the Spanish Medical Aid Committee. We had three doctors on the committee, one representing the T.U.C., and I became its honorary secretary. The initial work of arranging meetings and raising funds was easy. It was quite common to raise £1,000 at a meeting, besides plates full of rings, bracelets, brooches, watches and jewellery of all kinds. Isabel and I had a technique for taking collections which was most effective, and, although I was never so effective as Isabel (I was too emotional and likely to burst into tears at a moment's notice), I improved. In the end, either of us could calculate at a glance how much a meeting was worth in hard cash.

That evening Isobel Brown took me to the CPGB's King Street Headquarters. Harry Pollit, about whom I knew but little and whom I had never seen before, turned out to be a warm friendly man with a manner that made personal contact easy. He had with him someone called Campbell who, in contrast to Pollit, seemed curmudgeonly; I felt he disapproved of me and my accent. Since Pollit's manner encouraged the direct approach, I led off by saying that, as he probably must have heard, I was going to Spain with a medical unit supported by all shades of decent opinion in Britain. I felt that I had a very heavy reponsibility towards its members and towards those who were sending us. We were a small unit and I was not going to do anything behind the backs of its members. They would always know what was happening, and I needed to know that nothing would be going on behind my own back. Pollit commented that this seemed to him an entirely right attitude, but why did I feel the need to express it to him? An old hand, like Pollit, would not have returned the ball to an apprentice player like me unless he had wanted the rally to continue. Thus encouraged I went on to say that a party fraction was being established in the Unit and since I was sure that its members had the work as much to heart as the rest of us it was hard to see why it had seemed necessary to create it. I had nothing to hide and nor conceivably could they. I was ready to demonstrate this by making my administration entirely open. With one exception, everyone in the unit had either been pre-selected or approved, by me. Pollit asked who the exception was, and when I said O'Donnel, he let out a laugh in which Cambell did not join. As I did not seem to be getting very far I then played my only other card saying, "If you won't let them come out into the open let me come inside. Let me join you, as we can't have a Unit being pulled two ways". This did indeed provoke Cambell who was emphatic saying that the Party was not a darts club a man can just walk into at will when it suited him. To which I remarked that this was exactly what I felt about the Unit. Pollit seemed to be enjoying himself and came back with a friendly bit about the lad having a point. He went on to say that the Unit was a real Popular Front activity. He asked Campbell to get that well across to O'Donnel and, turning to me he said something like, "The world's very far from perfect. You'll have to take the rough with the smooth out there". Turning to Cambell he said, "I am going to give him something to show that, in the spirit of today, we trust him." To me he added, "Keep it in a safe place like inside your belt. Only use it if you really need to. The party will always back that Medical Unit; you've helped a lot by coming to see us". He went to his desk and typed a few lines, reciting them as he did so, requesting that I should be given every help. He signed it and put a rubber stamp on it. Then, to my surprise, he cut the document down to minimum size with a pair of scissors. When he put in my hands I realised that it was not typed on paper but on a piece of white silk.

That evening Mary Redfern Davies very neatly opened the seam of a leather belt and slipped in the little bit of silk. Until typing these words in 1995, the only people outside Pollit's office to know of the existence of that scrap of silk have been myself, Mary Redfern Davies and Thora Silverthorn. It is just possible that when O'Donnel was told to behave himself, he was also told that I was carrying a word from Harry Pollit. I was to have reason to consider this a year later.

So on the 23rd of August 1936 a friendly group of relative strangers, dressed in khaki drill from Millet's Army Surplus stores, arrived at Victoria Station. Our destination was Barcelona. For me it was a completely overwhelming occasion; I was dropping with physical fatigue. Seeing us off, we were faced with a galaxy of Mayors in their robes and chains, Trade Union Banners, the leader of the Parliamentary Labour Party Arthur Greenwood, and 10,000 others - all on parade. It was an immensely impressive experience for the staff of that First British Medical Unit. Our little group had not realised before that what we were doing was considered so important. Such a send-off provoked in us all the beginnings of our sense of collective responsibility. One thing that sticks out in my mind about that journey was the solicitude the railway men showed to us everywhere, in England as in France.

Everyone liked and admired Aileen Palmer, an Australian, for her friendliness, devotion, and hard work. Everyone trusted her, although she was a self-confessed party member. Another self-confessed party member was Thora Silverthorne, a highly skilled surgical theatre sister. Despite a hard streak, she was friendly and amusing. I also liked Ruth Prothero, a charming, migrant doctor from Vienna. I talked fluent German and she introduced me to some of her Swiss and German friends. Margot Miller, another Australian, was a journalist and party member. She was a robust, efficient hard worker and later became a well known writer of detective stories. I enjoyed her company. A fifth female member of the original party I never did get to know. She was a complete loner and soon separated from us.

The males were worse than the females. Lord Peter Churchill was a good public relations figure, a fair administrator, and a friendly person; but I was worried that his fairly obvious homosexuality or bisexuality might run the unit into legal trouble, although I knew little of the laws in Spain. Kenneth Sinclair-Loutit, the official leader of the unit, was a likeable medical student and an obvious secret party member, but I did not think that he would be a good leader. He had a weak streak. O'Donnell, the chief administrator, who had made the bad speech in Paris, was even worse when I met him. I thought him stupid, conceited, and erratic. I certainly did not like the idea of his being in charge. The quartermaster, Emmanuel Julius, also seemed second rate and rather schizoid. The only surgeon, Dr. A. A. Khan, who was studying in the UK for the FRCS, was reserved, non-political, and rather worried. Of the other two male doctors, one was an American, Sollenberger, and the other, Martin, a former member of the Royal Army Medical Corps. I took a poor view of them both. In addition there were two other medical students.

I did not have very close contact with the drivers. Harry Forster, a cheerful London taxi driver, proved a great success as an electrician on one occasion, but he moved on all too quickly. Alec Wainman, a Quaker photographer, was a charming, if neurotic, character, whom I liked but never got to know. Leslie Preger, an open communist, was rather a shocker. He admitted that he had only got into the unit because he had claimed that he spoke Spanish and knew about first aid. Both claims were false, but no one seems to have checked. The remaining drivers were the two Charlies, Hunt and Hurling. They were two young, extrovert, working class volunteers who wanted adventure and women. I enjoyed their presence at first, but they quite definitely disliked me, particularly my Cambridge accent. Fortunately they were not permanent. They motored backwards and forwards between London and Spain, so that I saw them only infrequently.

In July 1937 I got in touch with the committee in England that was sending medical supplies and personnel to work in the hospitals. I agreed to write news for them, to visit the hospitals and find out what the personnel needed in their work, deliver supplies to them and take photographs.

Then began for me a time of hard work, intense living and an education in the wonders of the human mind and behaviour. The personnel of the British Medical Unit was scattered about Spain from Murcia to Aragon. My first problem was transport... Many a time I waited on the Madrid road and begged a ride. Once I made the mistake of thinking that telegraph wire would make a good seat. I sat at the back of the truck and every time it went over a bump I went up in the air and came down hard on my coil of wire. For days afterwards I could not sit down in comfort. Another time I put up an umbrella to keep off the driving rain; that was the last of the umbrella. On these journeys I used to carry a blue flannel dressing gown which I wrapped round my shoulders and head in the manner of a shawl, until the happy day when I bought a real sheepskin jacket with the wool inside. It probably looked just as funny but I kept warm. I reached the Teruel Front in January by ambulance, truck and car.' The roads were so deep in snow that at one hill we had to get out and, roping the ambulance, six of us let it clown the hill while the driver tried to guide it straight....

When the famous Ebro offensive of 1938 began I went up to that front. I found our people working in a large cave in the side of a mountain. It was not far from the river and only the worst cases were brought in there. Men died as I stood beside them. It was summer time and they had been in long training before they crossed the Ebro. Their bodies were brown and beautiful. We would bend over to take their last whispers and the message was always the same: "We are doing well. Tell them to fight on ... till the final victory."

It is so hard to make a man, and so easy to blast him into death. I shall never forget the Ebro. If one went for a walk away from the cave there was the smell of death.

I arrived in Barcelona in April 1937 in a mixed state of exaltation and despair and wearing a brand-new ambulance driver's outfit in which a cynical friend in London had pretended to mistake me for one of Hitler's Brownshirts. My exaltation sprang from the thought that I was preparing to risk my life for socialism, or the European working class, or something, and my despair from a more down-to-earth appreciation of my motives: I was making use of Spain as an escape from an impasse in England. I was in Barcelona just long enough to learn that Orwell and his wife were in danger of imprisonment or worse as "Trotskyists", and then proceeded to Valencia where the comrades in charge of the British medical aid services turned out to be an English peer, who might have come straight from Pall Mall, and an Anglo-Italian peeress, who might have come straight from the Lido. With an English friend, Robert Wheeler, I was drafted to an American-run hospital about fifty miles from Madrid, and for the next month or so I spoke to scarcely anyone except Americans, nearly all of whom came from New York and, to my surprise, talked Yiddish among themselves. There were not many patients in the hospital, but there was one whom everyone dreaded handling and of course it was to Robert and myself, as newcomers, that the job was given.

Existence is a misery. Rain is coming in. Rats run across the floor. Our rations are tinned meat, chick peas and five almonds each. We are afraid to undress night or day because of the bombing.

We have no milk, eggs or potatoes for the typhoid patients (Yet owing to good nursing only 8 per cent died). I cannot say enough about the splendid way Ada Hodson, Patience Darton and Lillian Urmston are working. How Ada makes us laugh when she tries to drink the peculiar liquid which is neither tea, coffee nor cocoa, but a mixture of all. Lillian's morale is never destroyed; I admire her.... By now Dr Saxton has started a canteen in which we sell mouldy bread and jam, cognac and Malaga wine.

We felt cut off. We even lost our radio. I cannot remember whether it was broken, stolen, or confiscated, but its loss increased our sense of isolation. The most political subject discussed was the problem of secret communist meetings and separate reports to the committee and the British Communist party. I was by this time on friendly terms with Sinclair-Loutit, Thora Silverthorne, and Aileen Palmer, and I think I raised the subject with them, pointing out that although we accepted that the communists and secret communists made up most of the unit, we did not think it reasonable for them to hold secret meetings. These were undoubtedly disruptive. I pointed out that three people had already left the unit, possibly because of this. For a time a compromise was reached, in which I was allowed a seat on their committees. I was able to speak but not to vote. Later O'Donnell came up and denounced this, but I think finally the secret meetings were given up. There was also a lot of criticism of Dr Sollenberger as a disruptive element, but he did not leave until much later.

We have become accustomed to air raids although they still worry me a great deal: I dread them. The planes were over last night, dropped bombs but did no damage. Considering the number of raids surprisingly little damage is done. The swine deliberately attempt to bomb hospitals - it's inhuman. The other day, an English nurse who works in a village some distance from here came along to stay the night with us for a change. She was very shocked. She'd had a nasty experience the day before. She was sitting talking to a comrade when a bomb was dropped quite near them. She was thrown off her chair and her companion was killed. Then she saw a bunch of kiddies killed by another bomb. Its really awful but I can assure you its absolutely true - the nurse told me all about it. Poor dear, she was badly shaken up.

Peter Churchill - he did not use his title in Spain - found a suitable flat to be used as offices and rest centre. Later, a second base was found in Valencia. There was a political problem. At that time, each political group had its own militia, and the strongest political influence in Catalonia was the Anarchist Federation (FAR The POUM (Workers' Party of Marxist Unity, an ultra-left party of former Communists and former followers of Trotsky, led by Andres Nin) also had its base in Barcelona. But the Unit decided to link with the United Socialist Party of Catalonia (PSUC), which was affiliated to the Communist Inwrnational and included both Socialists and Communists, and with the Socialist trade union federation, the UGT, with which groups the SMAC and the members of the Unit were more in sympathy.

Where should they set up the hospital? Churchill lead been one of the youngest staff officers in the 1914-18 war and, using his experience, he took a Michelin map and chose Granen, about eighteen kilometres behind the Aragon front, near Huesca. Granen was the railhead for Barcelona and Lerida, and also a road junction. It had good access to the whole front, and if they had to retreat there was more than one way out.

Churchill and Sinclair-Loutit drove to Granen to find suitable accommodation for a hospital, going in Cochrane's car, which was "liberated' by Anarchists during the expedition. They were helped by Churchill's friend, Stanley Richardson, who had joined him on the way and was a fine interpreter.

The rest of the Unit travelled up by road on 3 September. Thora Silverthorne had had the foresight to fill a case with sweets, and these made them popular with children on the way.

The farm buildings chosen were very suitable for a small hospital: they had been lived in by a small landowner and doctor of fascist sympathies. There was even a sort of surgery, but the place was deep in filth and the attics held the debris of generations. For days everyone - nurses, doctors, drivers and all - were removing barrowloads of muck and were busy cleaning and scrubbing. Water had to be fetched by cart from the river. Harry Forster revealed remarkable skills. He fixed up heating stoves for sterilisers, a washing machine for laundry and reflectors for the lights in operating theatres. The wiring was primitive; there was no main fuse, but, working on an open circuit, he extended power to the whole hospital, dim thought it was when finished. The cleaning had to go on for weeks, but after the first few days there were twenty-five beds available (eventually forty, and seventy in emergencies), and two operating theatres, with nurses ready in starched uniforms.

On the first day, thirty cases arrived. In the first month, the hospital dealt with 811. A letter from Sinclair-Loutit to the Lancet (28 November 1936) recorded that by November the Unit had dealt with 1,523 cases and the ambulances had covered 14,000 miles. The hospital then had a surgical, a medical and a VD ward, two theatres and a reception room. The work was spasmodic. When there was fighting, they worked under pressure. On 25 October Thora Silverstone wrote to her family that the previous week there had been a "terrific rush" - 200 wounded had been brought in in three days. On 25 November she wrote, "the attack on Huesca has actually begun ... we've been doing major operations and working 14-hour days." In between there were long lulls. During the rushes the nurses worked with great dedication and courage under conditions of stress and shortages for which their training had given them no preparation.

There was a high mortality rate from penetrating head wounds. Many patients were Germans - refugees from Hitler who had formed the first Thaelmann Centuria of the International Brigades, which included Ludwig Renn, author of the famous pacifist novel Der Krieg, and whose leader was Hans Beimler, former Communist Deputy to the Reichstag, who was shortly afterwards killed in the defence of Madrid. The Unit was impressed by their bravery, and had plans, should the enemy break through, to join up with them. Casualties included refugees whose villages were being bombed by Franco's planes, and who were coming in from the mountains with wounds and foot ulcers. One was a blind woman in her eighties whose house had been destroyed while she was in the fields, but who only said, "Well, I've lost my house, but there's many a woman who has lost her children." Each day one of the nurses took her turn to care for the refugees and bathe their feet. Rebel casualties were given the same treatment as government wounded. When the villagers heard that one of Franco's young Moorish soldiers had been brought in with a gangrenous leg after lying for days in the sierra, they wanted to lynch him, but, though he was past saving, the hospital performed the amputation and gave him the best treatment until he died.

At first the methods were, in Sinclair-Loutit's words, "pure 1914". There was a first-aid post at the front with two drivers in attendance with stretcher-bearers and one of the nurses. The ambulances went up to the front, by night when they could, along roads that were little more than cow-tracks, and brought in the wounded. Those who were in fit condition were given an anti-tetanus injection and sent by train to hospitals in Barcelona or Zarimora. Those who could not be sent were treated at Grarien. When there was fighting there were too few ambulances, too few members of the team and no X-ray equipment. Urgent calls went to the Committee in London; reinforcements and a second unit were sent. In the end, as Sinclair-Loutit recalled, "Granen was remarkably efficient, rendering real surgical and medical service. It was unique for at least 100 kilometres." It was also the germ of a new kind of front-line mobile hospital.

Life was hard. Thora Silverthorne wrote home (25 November 1936), "We live a very enclosed life; our wireless has been taken away: (censorship of news!), papers from England don't arrive very frequently and we are altogether cut off." It was a new and anxious experience to feel the ground move under their feet when bombs fell. When beds were needed for the wounded, staff slept on stretchers or mattresses on the stone floors of the granary buildings.

This man was an American International Brigader at whose feet a grenade had exploded. His eyes, I think, were destroyed, as his face certainly was; and there appeared to be no part of the front of his body from head to feet that was not disfigured and in pain. It had been decided that he should be carried down to the courtyard every day to get the sun, and Robert and I had to do it. He kept up an almost ceaseless and barely intelligible lamentation even when undisturbed, and I find my memory jibs at recalling the effort it required to grasp him round the waist and haul him from his bed on to a stretcher. In pulling back the bed-clothes, if the sheet brushed against his foot he would scream, "My toes! My toes! Damn you!" and it seemed beyond the limit of horror that a man whose face and body had been pulped should be sensitive even in his toes. This was my first lesson, which was later to be heavily reinforced at the front, in the distinction between squeamishness and sympathy. I never lost my squeamishness about wounds, but my capacity for sympathy became almost atrophied. What I felt was more like horror than sympathy or pity. Or rather, I learned to my shame, that pity is not incompatible with a feeling of reproach against a man for having got wounded. He seems a bird of ill omen, a bearer of evil tidings. "Look what has happened to me. It could happen to you too.

It's jolly hard work of course. Often you don't get more than five hours to your night. We have had as many as 150 cases to handle in a day. I reckon that I alone have driven my ambulance over 11,000 miles on truly villainous roads - not bad going in about three months. Before we arrived on the scene the wounded had to be dragged down from the mountains on mules.

We've a very nice set of English chauffeurs with us. I should say English speaking there are also Americans and there was a Canadian. One of them John Boulting, who used to have long hair, states that he came to tea with you with Bill Ball before he left for Spain. In the last two battles our chauffeurs who have to go right up near the front line with their ambulances have had heavy casualties - 4 killed, 2 missing, I wounded, I seriously ill.

The group had been in Albacete a few days when Neumann, a delegate from Andre Marty, came to tell them they were being attached to the XIVth Brigade under its Medical Officer (MO) Dr Dubois, a courageous and flamboyant Pole, trained in France, whose real name was Domanski. This was the Franco-Belgian Brigade, but at the time Number One British Companywas part of it, commanded by George Nathan, a former British army officer, known as a fine soldier and something of a dandy. They were also, to their surprise, handed insignia of military rank. Tudor Hart, as the oldest and most experienced doctor - he had qualified at St Thomas's Hospital in 1931 and had been in the Communist Party since 1929 - was put in charge over Sinclair-Loutit, who had gained experience of organisation in wartime conditions while managing the unit at Granen. Sinclair-Loutit would have liked to continue as an administrator and the appointments caused embarrassment and bad feeling for a time among some members of the team. But before very long Sinclair-Loutit was elected as their Political Delegate by the group, and this gave him the rank necessary to administer a military hospital.

Being halfway between Valencia and Madrid, the hospital was often used as a port of call by nondescript people who had come to Spain with vaguely helpful or cryptically political intentions. One of these, a young English Communist or fellow traveller, found some priest's vestments in our disused chapel. He amused himself by dressing up and playing the fool in them, intending no doubt to do some anti-religious propaganda. Then he began to ring the chapel bell. Whereupon an old man working in the garden rushed in with bulging eyes, chattering teeth, almost foaming at the mouth, and snatched the rope away from him. This presumably showed that the bell was an intolerable reminder of hated religious tyranny. But I suppose it is also possible that it was a protest against sacrilege. If it had merely been because the bell was normally used for some other purpose, such as a fire alarm, the old man's frenzy would be inexplicable.

After six months in Spain I was beginning to feel that there was no place for me as an organiser unless I was a Communist or prepared to be a Communist stooge. It would have been easy to get back into the front line ambulance service before the battle of Teruel, and equally easy to take the frequently offered advice: "A man like you is wasted out here. You ought to be back in England doing propaganda." In the end I did neither. I went back to England, but not to "do propaganda", an activity for which I had developed an insuperable distaste. I got in touch in London with the Quakers' Spanish relief organisation and returned to Barcelona to work for it...

Within Spain, however, from mid-1937 to the end of the war in the spring of 1939, the prestige of Stalinism was such that any foreigner who was not a Communist was made to feel at best an outsider and at worst a potential victim of the political police. In this shadowy and impalpable but all-pervading reign of terror the business-like Quaker organisation was an oasis of sanity. Its atmosphere was not particularly inspiring, but it was almost the only foreign organisation in which you knew for certain that everybody had a definite job and was doing it and in which there were no nondescript hangers-on with nominal jobs or none but who nevertheless seemed to be in some mysterious way "on the inside". It was the one organisation in which you felt sure that nobody was a Stalinist heresy-hunter.

A Moor ... had been shot in the leg and so immobilised somewhere in the mountains... Five days before they found him... (he was a) starving wizened little chap with this horrible septic leg... he came in and the leg was crawling with maggots... the Spanish surgeon had to amputate... he was hardly fit to stand an amputation... After the operation he was weaker still, nevertheless the local Anarchist military chief came in and cross examined the poor fellow... He died within a day or so.

Everyone liked and admired Aileen Palmer, an Australian, for her friendliness, devotion, and hard work. Everyone trusted her, although she was a self-confessed party member. Another self-confessed party member was Thora Silverthorne, a highly skilled surgical theatre sister. Despite a hard streak, she was friendly and amusing. I also liked Ruth Prothero, a charming, migrant doctor from Vienna. I talked fluent German and she introduced me to some of her Swiss and German friends. Margot Miller, another Australian, was a journalist and party member. She was a robust, efficient hard worker and later became a well known writer of detective stories. I enjoyed her company. A fifth female member of the original party I never did get to know. She was a complete loner and soon separated from us.

The males were worse than the females. Lord Peter Churchill was a good public relations figure, a fair administrator, and a friendly person; but I was worried that his fairly obvious homosexuality or bisexuality might run the unit into legal trouble, although I knew little of the laws in Spain. Kenneth Sinclair-Loutit, the official leader of the unit, was a likeable medical student and an obvious secret party member, but I did not think that he would be a good leader. He had a weak streak. O'Donnell, the chief administrator, who had made the bad speech in Paris, was even worse when I met him. I thought him stupid, conceited, and erratic. I certainly did not like the idea of his being in charge. The quartermaster, Emmanuel Julius, also seemed second rate and rather schizoid. The only surgeon, Dr. A. A. Khan, who was studying in the UK for the FRCS, was reserved, non-political, and rather worried. Of the other two male doctors, one was an American, Sollenberger, and the other, Martin, a former member of the Royal Army Medical Corps. I took a poor view of them both. In addition there were two other medical students.

I did not have very close contact with the drivers. Harry Forster, a cheerful London taxi driver, proved a great success as an electrician on one occasion, but he moved on all too quickly. Alec Wainman, a Quaker photographer, was a charming, if neurotic, character, whom I liked but never got to know. Leslie Preger, an open communist, was rather a shocker. He admitted that he had only got into the unit because he had claimed that he spoke Spanish and knew about first aid. Both claims were false, but no one seems to have checked. The remaining drivers were the two Charlies, Hunt and Hurling. They were two young, extrovert, working class volunteers who wanted adventure and women. I enjoyed their presence at first, but they quite definitely disliked me, particularly my Cambridge accent. Fortunately they were not permanent. They motored backwards and forwards between London and Spain, so that I saw them only infrequently.

Another busy day. A German's leg amputated during the night, and a number from the Battalion of Death (Anarchists) with minor wounds from Tardienta in the a.m. The German had been seven days without food, and his leg was alive with maggots as he had been lying among the fascist wounded. We have had about a dozen fascist wounded prisoners here, treated exactly as other patients, to their astonishment. Also officials who interviewed them questioned them politely.

Later in the day a fair number of wounded were brought in from the Carlos Marx battalion. A lung case and one with 11 perforations in the abdomen were admitted to the ward. A very busy day. The Political Commissar, on the eighth day after his perforated stomach, began vomiting and haemorrhaging. A very bad patient, possibly his own fault, as he drank water from the ice bag. He has been given blood transfusions and all manner of things but he will probably die. It is a hard job getting used to the ward in these conditions. Two hernia operations were done today as well.

How willing was the British Establishment to learn from the Spanish experience? There were those who were put off because the new ideas were coming from the "wrong side", and there were those who were conservative because the medical and military Establishments had almost always been conservative. But there were others who, whatever their politics, had ears for those who had been in Spain, especially as it looked ever more likely as the months passed that Britain, too, would soon be at war.

When Sinclair-Loutit returned to St Bartholomew's Hospital in the summer of 1937 to complete his training, he found that a number of influential people wanted to hear about his medical experiences. Sir Girling Ball, the Dean of Bart's, spent a long time questioning him, and Sinclair-Loutit wrote articles in the St Bartholemew's Hospital Journal on medicine in Republican Spain, These showed the way in which the organisation of front-line services and the triage principle could be applied in case of air raids on London. Others who showed interest included Lord Horder, the King's Physician, and Wing-Commander Hodsoll, Inspector General of Air Raid Precautions. These people were Conservatives, but they were also pragmatists.

Two who were particularly interested in the Spanish experience were E.M. Cowell and P.H. Mitchener. They listened to Sinclair-Loutit, and Cowell visited Trueta in Barcelona in 1938, together with other doctors. In 1939 he and Mitchener used the Spanish lessons in their Organisation and Practice in Air-Raids. Later, Cowell was General in charge of the RAMC in North Africa and Mitchener a leading surgeon in his service.

As war loomed, some British doctors became interested in the idea of blood banks. On 7 May 1937 the Manchester Guardian, and on 5 June the Lancet, carried accounts of Duran-Jorda's service. That month the Summer Meeting of the Association of Clinical Pathologists heard a report of the Spanish transfusion organisation. Duran Jorda published a monograph in 1937 and, through 1937 and 1938 and into 1939, the Lancet carried reports from Saxton about his blood-transfusion work. Further advances in the USSR and the USA were also reported.