'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.' [‎82v] (164/248)

162
and Arabic enabled him to do much for his patients which
a doctor ignorant of those languages could not have done.
168. The hospital was at first under the management of
Dr. Bennett, with a sufficient staff, including his wife,
who was also a qualified medical practitioner. Any extra
personnel or surgical and medical equipment required
were provided by the military authorities, who made a
capitation grant to the management of seven annas per
day per prisoner. In addition to this a sum of Rs. 10,000
was allotted to Dr. Bennett for the needs of his patients,
and in consideration of these allowances Dr. Bennett fed
the prisoners until July, 1915. In that month Dr. Bennett
proceeded to India, the hospital was shut, and its patients
were interned in a ward of the Indian General Hospital.
In December, 1915, Dr. Bennett returned, and his return
coinciding with a demand for more space for our own
sick, the Lansing Hospital was reopened. Shortly after
this a new prisoners of war camp was established to
accommodate healthy prisoners pending their evacuation
to India. A hospital hut in this camp was used for
slight cases of illness, the more serious ones being sent
to the Lansing Hospital. In the first week of February,
1916, fever broke out in this camp and in the hospital,
which, first diagnosed as malaria, proved ultimately to
be fever of a malignant character. The commandant of
the camp, Captain Burgess, was taken ill. Captain
Hebbert, I.M.S., specially detailed to be resident in the
camp to investigate the disease, was attacked by it and
subsequently died. Dr. and Mrs. Bennett and some
members of his staff were also taken ill, and Mrs. Bennett
died. At the same time there was severe mortality
among the prisoners. Systematic efforts were made to
eradicate the disease, and the Assistant Director of Medical
Services at the Base was removed to another appoint
ment.
169. The Lansing Hospital was then taken over by the
military authorities and staffed with a section of an Indian
field ambulance under Lieutenant Stocker, I.M.S., while
the prisoners of war camp was placed under Major Sealey,
I.M.S. The abnormal death rate disappeared, and con
ditions in both the Lansing Hospital and the prisoners of
war camp improved. To avoid any possible risk of
recrudescence of the disease at the Lansing Hospital,
that building is, for the moment, disused. For a time,
the services of Turkish medical officers taken prisoners
were utilized for the treatment of their own sick, but owing
to their want of efficiency they have been replaced by
Indian Medical Service officers.
170. On the capture of Nasariyeh, the Turkish Military
Hospital was found to contain 125 sick and wounded
Turks. These were looked after by their own medical
officers, who seem to have been jealous of professional
interference on the part of our medical staff. The sick
from the prisoners of war camp at Nasariyeh were sent
to this hospital, but the condition of the patients therein
was not satisfactory, and eventually they were all
evacuated to Basra. The death rate among the Turkish
prisoners, generally, was high, being due no doubt partly
to the inefficiency and neglect of the Turkish doctors,
and partly to their own want of cleanliness. This latter
trait has rendered them a source of danger, not only to
themselves, but to all with whom they have been brought
in contact.
171. Summary. —To sum up the position, we find that
from a very early stage in the campaign, the sick and
wounded have undergone avoidable discomfort and at
times great suffering owing to defective medical arrange
ments. The main causes of the hardships were :—
(1) The lack of river hospital steamers ;
(2) Insufficiency of the medical personnel; *
(3) The shortage of river transport;
(4) The omission to provide proper means of evacuat
ing the wounded by land ; and
(5) In so far as the operations in January are
concerned, the very unfortunate omission on the
part of the embarkation staff at Marseilles to
despatch the medical and supply establishments
of the 3rd and 7th Divisions with the combatant
units.
172. The suffering thus caused, slight during the earlier
actions, and varying as it did on different occasions owing
to differing local conditions, was intensified at Ctesiphon
by the presence of powerful enemy forces, and by the
length and insecurity of the line of communications. In
January, 1916, when it culminated, the hurrying of two
fresh divisions into action before their medical personnel
or equipment were available, and very unfavourable
weather, greatly aggravated the situation. The state of
affairs after the action of January 21st can indeed only be
described as deplorable. We are satisfied, also, that the
failure in the medical organisation had a material effect
on the moral of the troops. We recognize, however, that
in Mesopotamia, even with the best medical organisation
possible, the sufferings of the wounded, during cold, wet
weather, after an unsuccessful action, must always be
very great.
173. The fundamental defect has been the shortage of
river transport which has reacted on the medical organisa
tion, both directly and indirectly. Not only has it
prevented a permanent allotment of river steamers to the
medical services for use as hospitals, and frequently
retarded the despatch of medical units and stores to the
front, but it has, on many occasions, forced the military
authorities to curtail the equipment and personnel of
medical units in the field to a dangerous extent. Its
indirect effects have been equally important. It has
delayed the completion of hospital buildings and impeded
the provision of comforts for the sick. It has also affected
the health of the troops in that it has, from time to time,
been the cause of incomplete rations being supplied to
them. We believe, also, that if river transport had been
more plentifid, better arrangements would have been made
for supply ing the troops with pure drinking water.
174. There has never been, in our opinion, anything
more than a minor and temporary shortage of any of the
ordinary kinds of medical stores at Basra; but, for various
reasons, the shortage of these stores up country has from
time to time been a cause of trouble, and the more expensive
necessaries for hospitals in the tropics, such as ice machines,
electric plant and electric fans, have been throughout,
and were at the time of our leaving still very deficient..
Where there has been any deficiency at Basra, this has
been intensified up-river, owing to lack of transport;
and even when Basra has been fully supplied with some
particular class of stores, this has not always been available
at places on the line of communications.
175. The medical personnel and subordinate staff have
always been deficient in numbers, the deficiency in
assistant surgeons and sub-assistant surgeons being very
marked, and it has only been the continuous and untiring
labours of a devoted but overworked staff that has again
and again prevented an absolute breakdown. The position
in this respect both in the higher, in the lower, and in the
menial grades, was still serious when we left Mesopotamia.
As the deficiencies in personnel and river transport have
not yet been made good, and as no adequate medical
transport, either by land or by river, has yet been
provided, it follows that the danger of a repetition of
avoidable suffering is not yet past, though every effort is
being made to improve the situation. Probably only
the completion of the contemplated railway will render
the position quite safe.
176. As to the responsibility for this state of affairs,,
we think that it was in great masure due to defects inherent
in the medical organisation of the Army in India. M e
also consider that the rigid economy which before the war
was exercised in respect of military expenditure in India,
and the spirit which this policy has engendered as to the
comparative merits of economy and efficiency, have
contributed materially to the breakdown. But though
much may be attributed to the system and the spirit
which it has fostered, we feel that a grave responsibility
for that part of the suffering which resulted from avoidable
circumstances rests with the Senior Medical Officer of the
Force, Surgeon-General H. G. Hathaway, and with
General Sir John Nixon, the General Officer Commanding
the Force, from April 9th, 1915, to January 19th, 1916.
General Hathaway did not represent with sufficient
promptitude arid force the needs of the services for which
he was responsible, and in particular failed to urge the
necessity for adequate and suitable transport for the sick
and wounded with that insistency which the situation
demanded. General Nixon did not, in our opinion,
appreciate the conditions which would necessarily arise if
provision for the sick and wounded of his force were not
made on a more liberal scale.
V