'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.' [‎46r] (91/248)

PART X.—MEDICAL BREAKDOWN.
80
F. Supplementary.
designs were prepared for ambulance trains on the railways in Mesopotamia then being
constructed ; additional hospitals were asked for and despatched.
103. Altogether the energy displayed and the speed with which new proposals were
carried through compares well with previous conditions
104. As regards the state of things in Mesopotamia itself, it is evident that Surgeon-
General Treherne, who succeeded Surgeon-General Hathaway as Principal Medical Officer
to Force “D,” dealt energetically and in a businesslike way with the problems facing
him. The health records of the troops during this period show that there was much
cause for anxiety, and that there was much disease, but this was met by good and syste
matic organisation. The work of the Army Sanitary Committee sent out by the War
Office and supplementing that of the officers on the spot, has undoubtedly been valuable.
Sanitation and the prevention of disease are now properly oiganised, and appliances of
all kinds are being continually improved, as better transport facilities on the Tigris dis
tribute the necessary machinery and apparatus. Altogether we believe that the public
may be assured that a new spirit exists in the medical command in Mesopotamia.
Work of Executive Medical Officers.
105. There are two possible misapprehensions of this section of our Report which we ?
should like to forestall. The first is that the severe criticisms and censures, to which we have
been impelled, impl}/ that the sick and wounded have been systematically and intentionally
neglected. The very contrary is the case. We believe that, with the means at their
disposal, and within the limits of their powers, the executive medical officers have
unfailingly spent themselves in alleviation of the sufferings of their patients, and there
have been but few isolated exceptions to this praiseworthy rule. \\ hen the disaster of
Ctesiphon was upon him, Surgeon-General Hathaway, whose administrative capacity has
been so seriously called in question by ourselves and the Yincent-Bingley Commission,
took off his coat and worked strenuously at embarking the wounded. The trouble has
been throughout failure to foresee, rather than failure to mitigate, disaster. Speaking of,
perhaps, the worst period of the medical breakdown, the fighting in January, 1916, the
Vincent-Bingley Commission say “ the evidence before us abundantly proves that, generally
speaking, the energy, kindness and industry of the executive medical officers . . . was beyond
all praise.” We endorse this encomium and would extend it to the whole campaign,
in accordance with the consensus of the witnesses who have appeared before us.
Sanitary and Preventive Work in Mesopotamia.
106. Our second caveat is that we do not wish to be thought to belittle much good work
done by the medical authorities in combating epidemics. Mesopotamia is a hot-bed of
ravaging diseases. Blague, small-pox, cholera, malaria, dysentery and typhus, if not
actually endemic, are always menacing in this swamp-ridden and unsanitated country.
Each one of these diseases appeared amidst the forces, and any one might have decimated
them. On every occasion the efforts of the medical authorities were successful in cir
cumscribing the epidemic and limiting its incidence. These are not despicable results
for a large force of British and Indian troops accompanied by a horde of oriental camp-
followers and whose headquarters was a Turkish town of some 80,000 inhabitants. But the
indictment against the authorities is not a lack of courage in dealing with disease so
much as a lack of foresight in dealing with the predisposing conditions of disease. In
such matters as water-supply, sanitation, diet, mosquito and sun-protection, &c., the
evidence before both Commissions teems with instances of the failure to take up sufficiently
early the weapons which existed in the armoury of modern science against the onslaught of
disease Our opinion is that, though the protection of the Mesopotamian Expedition
against disease was by no means ineffective, it might and ought to have been a good deal
better, if the matter had been earlier taken in hand on a proper scale. The vigour and scope
of the sanitary and preventive measures found necessary by Surgeon-General Treherne
are the sternest criticism of the omissions of his predecessor, Surgeon-General Hathaway.
We are aware that the rate of sickness was comparatively low in the summer of 1915
under Surgeon-General Hathaway, and that such sick-rate was greatly exceeded in the
summer of 1916 under Surgeon-General Treherne. In this connection we must, however,
remember that the increased aggregation of troops in Mesopotamia doubtless made the
medical problems of the summer of 1916 more difficult and increased the liability to disease.
(C 48-176) M