'Mesopotamia Commission. Report of the Commission Appointed by Act of Parliament to Enquire into the Operations of War in Mesopotamia, together with a Special Report by Commander J Wedgwood, DSO, MP, and Appendices. London: HMSO, 1917.' [‎42v] (84/248)

82
PART X.—MEDICAL BREAKDOWN.
E. Responsibility of Secretary of State, Viceroy and Commander-in-Chief.
* See Parts I. C and XI. D.
part of the organisation did this limitation of function fall more hardly than on the medical
service. In the all-important matter of medical personnel the establishment was kept
below what would be necessarv even for the mobilisation that was intended, because it
was expected that it would be possible to obtain from England whatever additional
personnel was necessary. The personnel was therefore short of the proper establishment,
and the medical equipment was intended only for use in India and on its frontiers.
78. On the outbreak of the war, the Indian Government found it impossible to furnish
the medical personnel required, and made no appeal to England for assistance in supplying
it. It is true that they had in March, 1914, informed the Secretary of State of the defi
ciencies in medical personnel which would arise in case of mobilisation for war. Further
in a telegram dated July 3rd, 1915, they called the Secretary of State’s attention to their
difficulties in meeting demands for medical reinforcements overseas, and also asked for
sixteen R.A.M.C. officers in order to maintain Force " D ” at its “ authorised strength.”
The Indian Government never, however, explained to the Secretary of State that the
“ authorised strength ” itself was gravely below what was required in Mesopotamia
Nor was the Secretary of State himself in a position to appreciate this technical fact,
inasmuch as, till the summer of 1916 he had no formal Medical Adviser at the India Office The department of the British Government to which the Government of India reported between 1858 and 1947. The successor to the Court of Directors. .
Sir Havelock Charles was President of the Medical Board to the India Office The department of the British Government to which the Government of India reported between 1858 and 1947. The successor to the Court of Directors. , but he had
no official status as Medical Adviser, and no administrative authority in regard to medical
developments in Mesopotamia. Our evidence is that Sir Havelock Charles was not respon
sible for the medical telegrams despatched to Mesopotamia, and that these were, like other
military matters, under the supervision of the Military Secretary, Sir Edmund Barrow y
who had of course no special medical knowledge. The Secretary of State was unable
therefore to give as much assistance and guidance to India in medical matters as he might
have done if his office had been better organised. For this reason we welcome Mr. Chamber
lain’s appointment of Sir Havelock Charles as Medical Adviser in the summer of 1916.
79. The lack of preparation in India for a European war raises a larger question than
concerns only the medical services and is dealt with elsewhere in our Report.* But in
respect to the medical services, it is quite essentially important to realise that this lack
of preparation made the medical equipment of the Mesopotamia Expedition from the
very first scanty and deficient, a deficiency which grew more and more mischievous as the
Mesopotamia Force became more and more numerous. Apart from river hospital
steamers, the want of which had the most calamitous influence on the proper treatment
of the sick and wounded, and apart from the lack of personnel, which ranks next in
importance, there were other deficiencies in equipment, such as water-carts, operating-
tents, ambulance transport and other necessaries.
80. During the whole of the first year of the campaign, that is, up to November, 1915,
while there was no medical breakdown there was an increasing scantiness of medical
provision, with regrettable hardship to the sick and wounded. The margin of security
against breakdown was dangerously slight.
81. The responsibility for the general want of preparation at the outbreak of the war
belongs both to the Home Government and the Indian Government. But the Indian
Government, and particularly the Commander-in-Chief and his advisers, are specially respon
sible for not realising more completely that the medical provision intended for the North-
West Frontier could not be sufficient or suitable for a campaign on the Tigris. Sir Beau
champ Duff in his evidence before us, put forward two main arguments in defence of his
administration. He pointed out that the purpose and plan of the Mesopotamian Expedi
tion were extended by the Home Government, by successive steps taken at very short
notice, from an occupation of the estuary of the Shatt-el-Arab as far as Basra, to an advance
to Ctesiphon on the road to Baghdad. The preparations which were sufficient or at least
not disastrously insufficient for an expedition to Basra, were not sufficient for an expedition
to Baghdad. But this consideration hardlv serves as a defence for the Commander-in-
Chief. The medical provision for the expedition was inadequate even from the outset,
and it was the business of the Commander-in-Chief and his advisers to recognise and remedy
this. Moreover, we had evidence that an advance even as far as Baghdad was known by
the Commander-in-Chief to be a contingency as early as December, 1914, and each stage
of the developments of the expedition beyond Kurna (which were precisely the develop
ments which overstrained the scanty medical provision), were made not merely with his
knowledge and consent, but as a result of suggestions by Sir John Nixon in which he con-