'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.' [‎79r] (157/248)

and of limejuice and fresh vegetables was deficient. It
has, indeed, been suggested that it was only when a
medical officer attached to the force wrote to Simla,
representing the facts, that a supply of medical comforts
was received. Colonel Hehir, I.M.S., Assistant Director,
Medical Services, fith Division, has not been examined by
us though we have studied his war diaries, and the facts
stated above have been obtained from other sources.
We are satisfied that owing to the heat, the want of iee
and of proper hospital accommodation, medical comforts
and drugs, the sick and wounded suffered considerable
hardships during this part of the campaign.
130. Battle of Es Sinn and capture of Kut-el-Amara .—
The next phase of the operations is that which terminated
with the battle of Es Sinn on September 28th. We
regret that we have to conclude that in this action also the
medical arrangements were not satisfactory. The medical
staff available for the treatment of the sick and wounded
was below the normal scale and consisted of 14 field
ambulance sections as against 20 sections, and 2 sections
of a clearing hospital instead of 4 sections. For the
transport of wounded by land, two motor cars only were
available, and for the great majority, transport carts
had to suffice, causing the usual suffering necessarily
attendant upon their employment. We have it, on
Sir John Nixon’s authority, that the supply of these
carts for ambulance purposes was, owing to bad staff
work, insufficient for some time. There were, as on
previous occasions, no river hospital steamers, and there
is evidence that the patients, who were evacuated by
ordinary river craft, suffered considerable discomfort.
The Turks made a counter-attack on the evening of the
28th, which resulted in the estimated casualties being
largely exceeded. For these reasons the collection and
treatment of the wounded was delayed, and some left
out at night were robbed and wounded by Arabs.
The field ambulances were overcrowded—one field ambu
lance having to deal with at least 500 patients. The
supply of blankets and food in the field ambulances was
short. We may mention that the defects observed on
this occasion, particularly in the collection of the wounded,
were sharply criticised by the Army Commander. It
appears also that the discomfort necessarily attendant
on a journey of some days in a vessel not suited for
hospital work and ill-equipped in the way of personnel,
medical appliances, stores and comforts, was in some
cases accentuated by a delay in starting. One steamer,
the “ P. 4,” did not apparently leave the front until
October 3rd. Although the hardships endured on this
occasion were no doubt considerable, we do not think
that they were nearly as severe as in later actions.
131. Battle of Ctesiphon. —It has been impossible, in
the absence of Colonel Hehir, A.D.M.S., and other officers
of the 6th Division, to obtain anything like complete
evidence as to the arrangements made for the collection
and evacuation of the wounded from the battle of Ctesi
phon ; but we have on record abundant proof that these
arrangements proved defective and were the cause of great
suffering. We are aware that Sir John Nixon, in a
telegram dated December 7th, 1915, stated that the
“ medical arrangements, under circumstances of consider
able difficulty, worked splendidly.” We regret that we
are unable to concur in the views of that distinguished
officer. It is true that the medical officers on the spot
displayed the greatest resource and energy in the discharge
of their duty, and we have overwhelming evidence of their
unceasing efforts to alleviate the sufferings of the wounded.
We admit also, that the difficulties of evacuating a large
number of wounded, after a reverse, followed by a retire
ment through a country infested with hostile Arabs, who
did not hesitate to attack convoys of sick and wounded,
were very great; but in the face of the evidence on record
of the sufferings of the wounded on this occasion, and of
the breakdown of the medical organisation, we do not
think that it can be said that the medical arrangements
‘‘ worked splendidly.”
132. In the first place, the evidence proves that the
casualties, were, in fact, heavily under-estimated, that
the medical establishment available on this occasion was
inadequate to meet the demands made on it, and that the
arrangements made for collecting the wounded on the
battlefield, and accommodating them pending evacuation
to the river bank, were far from satisfactory. 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 any kind of comfort was in
sufficient. Further, owing to the shortage of medical
personnel, many of the patients both in the field ambu
lances 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 base 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. On the morning of the 23rd, there was a
violent dust storm which increased their discomfort, and
to make matters worse the largest of the collecting stations,
which was located at a place already referred to and known
as “ Vital Point,” was under heavy shell fire for some time
during a counter attack by the Turks.
133. In the second place, save for two motor ambu
lances which were employed with great success, no proper
ambulance land transport was provided for the removal
of the wounded to the river bank. There were a number
of steamers at Laj, some 8 or 9 miles from the battlefield,
two only of which, however, had been in any way prepared
for the reception of the sick. Many of the wounded
were, it is true, able to walk or ride to the river bank,
but for the conveyance of stretcher cases the two motors
already mentioned, and ordinary transport carts, alone
were available. We have already criticised the use of
these carts for ambulance purposes and we only wish to
add that on this occasion it was productive of intense
pain and suffering. We are aware that it is not possible
to provide proper ambulance transport for all the wounded
on such occasions, but we do feel very strongly that for
all serious stretcher cases, more especially for cases of
fracture, proper land ambulance transport is essential.
134. Thirdly, the lack of properly equipped river
hospital steamers proved, as may be well understood, in
the circumstances, disastrous. In the absence of any
such steamers some attempt was made to equip the
“ Blosse Lynch ” and the “ Mosul ” for the evacuation
of sick and wounded to the base. These two steamers
were, however, only made over to the medical officers at
the last moment on the journey up, when it was impossible
to fit them out properly. They were already partly
filled with 500 sick and wounded who, owing to the
shortage in river transport, had not been evacuated to the
base before the battle, in accordance with normal practice.
The number of wounded at Ctesiphon was 3,852 and the
accommodation, such as it was, which these two steamers
afforded, was insufficient for a fraction of that number.
The result was that as soon as they were filled with patients,
the remainder of the wounded had to be crowded on to
other river steamers which had not been prepared in any
way for the reception of sick and wounded, and many of
which, indeed, were not fit for passenger traffic according
to ordinary standards 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 of
food was in some cases insufficient. The arrangements
for cooking the food were defective and the personnel to
distribute it was wanting. The arrangements for water
supply were unsatisfactory, the latrine accommodation
was 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. As
might be expected, the suffering and discomfort caused
by a long journey in such conditions were, despite the
untiring efforts of the medical officers and others on board,
in many cases great, and we cannot doubt that the recovery
of some patients was retarded by the hardships experienced
and that the chances of complete recovery in others were
prejudiced. The conditions varied on different steamers,
as some were better equipped than others and carried
fewer patients. On some vessels the proportion or
slightly wounded, who were able to assist thrir less
fortunate comrades, was larger than in others, and th.«