TIGRIS MUDDLE

Evening Post, Volume XCIV, Issue 65, 14 September 1917, Page 2

TIGRIS MUDDLE

THE MEDICAL BREAKDOWN REVELATIONS FROM THE . COMMISSION Some of the most striking, passages in the report of the Mesc/potamia condition, dealing • with the failure ■of the early- campaign in the Tigris Valley, are those relating to the.failure of the medical arrangements. : , ', Many pages of the report are occupied by this section, and the Commissioners endorse the value and importance of the report of the' Vincent-Bingley commission, by reprinting it in the volume; Copious ■ quotations from the VincentBingley findings are given in the report, and in many cases adopted by the Commissioners. One of them was as follows : — ~" :, '•. . . i. ". ... i .But throughout. the campaign the. ueual form of ambulance transport has beenthei Army transport cart,' that is, a small, springless cart made of wood and, iron, drawn by mules or ponies, and ordinarily; employed for the carriage of supplies. When the evidence of the suffering caused by this . means of conveyance, particularly in cases of. fracture and severe injury, is considered, it is- difficult to avoid criticising the action of . those responsible for this deficiency in severe language: The following is another .quotation from the Vincent-Bingley report-with regard to the Battle of Ctesiphon :—• The medical establishment available on" this occasion was inadequate to meet the demands made on it, and that the arrangements for collecting the wounded on the battlefield, and accommodating them, pending evacuation to the river bank, were far from satisfactoiy. It. was very difficult for wounded men ;to ascertain where they had to go for medical aid, and when field ambulances and collecting stations were found, the- supply of food, tents, blankets, hot water, and a-ny kind of comfort was insufficient. Further, owing to the shortage of medical personnel, many of the patients both in the field amb.ulances near the battlefield and at _the encampments by the river bank did not receive proper treatment. There was some delay in evacuating the wounded to Laj, where the steamers to convey them to the 'ba-se • were moored, and it was not until the 25th that the last of the wounded were removed to this spot. In the meantime many suffered from exposure, want of food, and inadequate attention. The medical'and subordinate personnel for these steamers, which- was taken from field' ambulances,, was inadequate for the number of the patients. The supply of medical stores and appliances, and even pf food, was in some cases insufficient.. The arrangements, for cook-,, ing the food were defective, and the personnel, to distribute it. was wanting. The arrangements^ for water supply were unsatisfactory, the ; latrine accommodation ;,wps insufficient, and there were not enough sweepers and bed-pans for the necessities of those patients who could not struggle to the latrines..' Finally the wounded were huddled .together as close as they could be packed, on the decks, without beds^or mattresses, and it was almost impossible for .the medical officers to attend to them properly. In some cases the vessels had, moreover, been used for the carriage of animals, and it was impossible, in. the time available, to clean and disinfect *them. Wounds which required dressing and redressing were not attended to,''and the condition of many of the patients who travelled by. these steamers was, when they reached Basra, deplorable. There the wounds of many were found to be in a septic- condition, and in urgent, need of re-dressing. , ■■:_ ' [ r With regard to this the Commissioners say: We shall comment lateir on the | very different, description of things teleI graphed home, to the Secretary of State | "at the time, but we would say here that, had the authorities in India or at Home bad any inkliifg of the true state of affairs at the beginning of' December,, special efforts might have been/made, at' any rate to r-einforce the medical personnel in Mesopotamia in view.of future operations. • Full credit'should be given to all concerned for the fact that the' wounded were brought away in the retreat from Ctesiphon, and saved,from Arab indigni-. ties and brutalities.. -At the same time, we believe that, much of the sufferings of the wounded might have been avoided if adequate forethought' had . been 'shown in the planning arid preparations for the advance to Ba-gdad.. ■SIR WILLIAM BABTIE. -.-,.' In the March and April fighting;; the conditions had improved, and credit,is. given to the. administrative- and executive medical officers for-this.'■■■■•> < But whatever "\blame might ' have attached to Colonel Hehir. in not having made ' sufficient requisitions, the Commissioners say.that the primary responsibility in respect of such equipment must primarily rest with the authorities in India". Accordingly ■ some, space is devoted to' the medical administration of. Sir William Babtie,' .and the Commissioners ea,y :. ""• The gravamen of the criticism which we' feel bound to. pass on Sir William Babtie is that, kriowijig the Army Medical Sorvice.. in India to be organised only for frontier warfare, .knowing the provision of the field ambulances and< hospitals to be deficient, 'and knowing the.medical personnel*to be insufficient, he, yet made no adequate efforts to improve these defects so as to equip the Mesopotamian Expedition in a ""manner suitable for campaigning-in an unhealthy, tropical climate against an enemy who was in alliance with'and supported by the foremost exponents -of modern warfare. . Sir William Babtie's attitude on the subject of land transport for the wounded, is coirfmentedupon, and the report continues: — The only such special transport pro-' vided under the Indian org-irisation. consisted of stretchers, riding mules, and ambulance tonkas, which . arfe vehicles drawn by bullocks.- When the equip-! merit of the expedition was being considered tongas were ruled out by Sir William Babtio and the staff at Simlaas being unsuitable for the country, and Co!. Hehir was so informed. We have already dealt with the inadequacy of stretchers and riding mules, the only, land ambulance transport provided with the expedition. It follows that army 'transport carts were the only vehicles available for the eick and -wounded where land transport " was necessary. We 'have : received an overwhelming mass of evidence as to the inhumanity of using these carts for the. wounded. Padding for them was not a-lwajV. available. In some cases dead bodies were even used as cushions. Even when padded they were cruel and dangerous for.certain classes of wounded. Surgeon-General Babtie's_ omissions in regard to the Mesopotamian Campaign are all the more remarkable because' of his promptitude and firmness in pressing war provisions on the Indian Govern^ merit which were necessary for the'overseas expeditions generally. Thus, on the outbreak of war, he urged the formation of a-fleet of ocean hospital ships, the construction of hospital trains, and the expansion of the Army Bearer

Corps. It may be that, as w,e have noticed iii other phase* of the expedition, Mesopotamia was in medical matters also regarded . as a. "small side-show," and did not for that reason receive proper attention to its special and unique requirements. At any ..rate, and for whatever reason, Surgeon-General Babtie's administration was marked by serious faults, for, which he must be blamed, and the importance of which cannot be minimised. But we recognise that the shortness of his experi-. ence as Director of- Medical Services when the war broke out, and the fact that he had to work in an atmosphere very unfavourable to reforming innovation, must be regarded as diminishing the weight of the censure he- deserves. He is undoubtedly a man of great ability, and,, having regard to all the circumstances, we desire to say that the faults of his administration were not, in our judgment, such as to prove him unfit for important, responsible administrative posts. . . FAILURES. / ■ _ Economy, the Commissioners consider, engendered a disposition to reticence, and in matters affecting the sick and wounded they were painfully impressed by tbe want of - frankness. There are two' methods of concealing a failure. The first is to suppress air mention of it.: The second is to obscure its significance by the glare of a contemporaneous achievement. The first method \vas used at the first battle of Kut. It was the second method which obtained after the battle of Ctesip'hon, When the military success of withdraw, .ing all the wounded in the face of a pursuing enemy diverted attention from the.. grave medical defects which were, disclosed in the course of that® operation. • . General Townshehd was obliged to retire before superior forces, with casualties amounting to approximately i^onn third of the force with which he entered into battle. Over 3500 wounded had to be removed from the battlefield to. the river bank, in some cases a distance of ten miles, without "proper ambulance transport, and with an insufficiency of medical personnel, of food, and of comforts, so that x a large proportion had to make their way on foot in spite of their injured condition. When they arrived at the river, the available steamer accommodation was gravely inadequate. The wounded and weary men had to be crowded into stearaers and barges' with out sufficient medical attention, appliances or conveniences. . Some of the wounded wer,e disembarked at Amarah, but the majority went" on down to Basra, a, journey from ,the battlefield which, in some cases, took ■as much as fourteen days, and the discomforts of which were, aggravated for the wounded by the presence on board of many cases of dysentery and other sickness. Amongst the horrors connected with' the medical breakdown'the condition of Shaikh Saod camp, up to 18th January takes a foremost place. It is thus desscribed by the Vincent-Bingley sion:"The .medical staff,/fovs so small that the woundf of many'remained undressed for some days. The camps , were in a very insanitary condition. ' The supply of surgical stores and appliances ran short, and. there was : practically no subordinate staff to see to the. welfare' of the patients. The suffering and discomfort endured by .the unfortunate wounded in these Icamps were very great, and even up to' 18th January, when the Meerut Stationary Hospital took over charge at Shaikh Saad, this condition, of affairs continued there. The officer commanding this hospital describes the condition of that camp, in the following words: 'On arrival here we .found about 195 British and 800 Indian sick and. wounded in an irregular camp situated on filthy muddy ground behind the viL lage. . . . ' There was one Indian temporary LM.S. officer in charge of the Indians, and he was ill. . He had no dressings left, and many cases ■ still had on. the »first field dressings.'. which had been applied on the battlefield; About ■200 of the patients had dysentery, and there w.ere no proper latrine arrangements. The state of the camp was indescribable. Near ' the middle of the hospital tents was a, pile of bags of atta, etc., mostly ruined 'by "the rain, which I was told represented ten days' rations.'" ' : . i-. ' ' ■