Shetland's medical provision in 1914 was limited. The main hospital, the Gilbert Bain, was small and had only been open twelve years. The initial effect of the war was to decrease the Gilbert Bain’s flow of cases, as the season fish trade came to a halt along with the large numbers of fishermen and fishworkers it brought. It was able to deal with a huge increase in service patients and shipwrecked mariners. There was at least one crisis when an ammunition hut exploded in Lerwick.
Since the islands were far from the Western Front, Shetland wasn’t a part of Britain that encountered the immense medical effort to deal with those casualties. Shetlands' wounded were treated further south and convalesced there. If their "Blighty" (a wound needing treatment in Britain) merited leave they made a long and very welcome journey home.
The main Royal Naval unit based in Shetland, the Tenth Cruiser Squadron, provided its own medical care. HMHS Berbice, a hospital ship, was stationed at Busta Voe. Although the squadron suffered casualties in action, much of Berbice’s work was dealing with cases not directly caused by the war – fevers, accidents, and so on.