'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.' [‎73v] (146/248)

144
field ambulances, which were already inadequate, should
be further depleted. We do not think that demands of
responsible officers in such a situation should have been
met in this spirit. The correspondence on this subject
illustrates, in our opinion, the danger of applying ordinary
secretariat methods to urgent demands in war time.
Instead of accepting the views of the local officers as to the
necessity for additional pessonnel, their figures were
challenged and suggestions made that one medical unit
should be depleted in order to make good deficiencies in
another, and that one man should be counted as equal
to two. In the meantime, while this discussion went on,
little or nothing was done to relieve the situation.
69. Again in July, the Deputy Director of Medical
Services, Mesopotamia, submitted a full statement of his
deficiencies and requirements and asked that 13 Royal
Army Medical Corps officers, 12 Indian Medical Service
officers, 1 assistant surgeon and 47 sub-assistant surgeons
should be sent to his assistance. As to the first of these
demands, the reply was to the effect that certain Royal
Army Medical Corps officers were expected to arrive in
India in August, and that some of them would be sent to
Mesopotamia. As to the remaining deficiencies, after
discussion as to the correctness of certain figures supplied
by the Deputy Director, a reply was finally sent in
October, that is, three months later, that steps were being
taken to make good the deficiencies in Indian Medical
Service officers and that 12 sub-assistant surgeons would
be sent at the first opportunity. On August 27th, the
Deputy Director of Medical Services again reported his
deficiency in sub-assistant surgeons, but the authorities
in India w^ere unable to afford him any relief, and it was
not until November, 1915, that 10 additional sub-assistant
surgeons were actually sent.
70. Of late the demands of the expeditionary force
have, we think, been more reasonably met, and the
situation has certainly improved. In the first place, the
deficiencies in the existing medical staff have been partly
made up out of a 6 per cent, monthly reinforcement
-which was sent from June, 1915, and which proved to
be more than was needed to replace actual wastage. In
the second place the medical units of the 3rd and 7th
Divisions, including well equipped hospitals of all classes,
reached Mesopotamia early in 1916, and the medical
staff of the force has been materially increased in other
ways. While, however, we admit that the situation is
now far better than it was in 1915, we cannot say that
the medical arrangements when we left Mesopotamia
were satisfactory in all respects. Not only were many
of the patients unsuitably housed, but most of the medical
units acting as hospitals were overcrowded and being
used for purposes for which they were not equipped.
Further, the paucity of the medical and subordinate
personnel was, particularly in some hospitals, a cause
of anxiety. According to a statement furnished to us
by the Assistant Director, Medical Services, India, the
total accommodation in general hospitals is now sufficient
for 2,000 British and 2,100 Indian patients. In addition
to the hospitals specified in this statement, we were
informed by the authorities at Basra that the personnel
of two additional Indian general hospitals of 500 beds
each have arrived in Mesopotamia. The total accommo
dation in the Indian general hospitals is, therefore, 3,100
beds. The staff of some of these hospitals is, however,
below the standard scale, and until reinforcements arrive
the position will not be entirely safe. The strength of
the force in April was 122,000 men, of whom 38,000
were British. The percentage of sick and wounded in
April, 1915, was approximately 7 per cent. The accom
modation provided in general hospitals, even taking into
consideration the fact that a certain number of sick
and wounded must always be detained in field ambu
lances and stationary and clearing hospitals, is thus
barely sufficient for existing needs. The total number
of clearing hospitals in the country is four, which is
also insufficient according to the normal establishment
of the force engaged. This deficiency is, however,
engaging the attention of the Director, Medical Services,
India.
71. Future medical requirements .—It may be advisable
here to indicate the manner in which the local medical
authorities propose to deal with the situation during the
hot weather of 1916. In December, 1915, the Director
of Medical Services, Mesopotamia, submitted an estimate
of medical requirements for the coming year. lie then
calculated that accommodation in general hospitals
should be provided for 1,800 British and 5,200 Indian
patients. He stated that, including the Bengal Stationary
Hospital which, though normally equipped for 200 patients,
can accommodate satisfactorily a very much larger
number, the existing accommodation in general hospitals
was adequate for 1,000 British and 2,400 Indians. This
left a deficit of 800 British and 2,800 Indian beds, and
this deficit the Government of India undertook to make
good as early as possible. The position was, however,
complicated in March, 1916, by the arrival of the 13th^
Division, and on March 23rd, 1916, on this account and
presumably for other reasons, the Director of Medical
Services submitted revised estimates of the requirements
in the way of general hospitals, estimating that he needed
equipment and personnel for 3,000 British and 6,000
Indian patients.
72. This estimate has been accepted by the Director
of Medical Services, India, and to meet the demands for
further accommodation for British patients, in addition
to the medical units of the 13th Division, a large British
general hospital on the English scale, accommodating
1,040 patients, has been despatched to Mesopotamia. To
meet the deficiency in Indian general hospitals, one
Indian general hospital of 500 beds has already been
sent from Egypt, and the personnel and equipment of
six complete hospitals* of 500 beds each, and also of
three additional sections, each accommodating 100
patients, are being despatched from India. When the
demands of the Director of Medical Services, Mesopo
tamia, have been fully met, and the sick and wounded
are accommodated in suitable buildings, provided with
proper equipment and fitted with electric lights and fans,
we think that the requirements of the situation will have
been satisfied. The maximum average daily number of
sick and wounded last year in any one month amounted
to 9.5 per cent, of the strength, though on one particular
date the percentage of sick and wounded exceeded
12.5 per cent. If 10 per cent, is taken as an approximate
percentage for the coming year, we think that the pro
posed provision of accommodation in general hospitals
will be sufficient, as a certain number of patients must
always be retained in field ambulances and stationary
and clearing hospitals. Further, it is probable that the
evacuation of the sick and wounded by hospital ships
this year will be effected more expeditiously than last
year. In these circumstances we can see no reason to
criticise this estimate, though at least one of us is a little
apprehensive of the result of any sudden outbreak of
disease and the effect of the hot weather on a large force
of British troops not accustomed to tropical conditions.
We ought to state here that a telegram has recently
been received from the Director of Medical Services,
Mesopotamia, stating that he is about to submit revised
estimates of his requirements, and that a further increase
in the medical establishment will be required. We do
not doubt that this proposal will receive careful con
sideration. As to clearing hospitals, the situation is not
so satisfactory, the present number of hospitals of this
class being, as already stated, insufficient for the needs
of the force ; the Director of Medical Services has, how
ever, been asked to state what his requirements are in
this respect. The number of stationary hospitals will
really depend on the length of the lines of communication,
and possibly when the general hospital accommodation
is increased as proposed, and the existing stationary
hospitals are available for their legitimate duties, no
larger increase in their number will be necessary. We
are glad to say that a number of Royal Army Medical
Corps and Indian Medical Service officers have recently
been sent to Mesopotamia, for employment in general
hospitals and to furnish the necessary personnel for
river steamers and transports used for the evacuation
of sick and wounded. The despatch of these officers
will afford great relief to medical units in that country.
A large number of additional field ambulances have
also been sent.
73. River transport .—In the course of our enquiry
manv witnesses, to whose evidence we attach great
weight, have laid stress on the fact that nearly all the
* These include the personnel of two Indian general
hospitals of 500 beds each, which have already arrived
in Mesopotamia and are referred to in paragraph 70.
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v