'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.' [‎72v] (144/248)

sufficient number of sanitary latrines should be fitted on
each vessel. Suitable and sufficient galleys should be
provided for cooking food, and a supply of lamps, linen,
pillows, cooking utensils and the requisite crockery and
cutlery, should be stored on board each vessel. Finally,
some responsible person should be put in charge of these
articles of equipment and be detailed for permanent duty
on the vessel with a small subordinate staff to keep both
the vessel, and all the equipment, clean and ready for use.
If these improvements were effected, and an adequate
medical personnel with the necessary equipment supplied
on each occasion on which the vessel was used for trans
porting sick and wounded, we believe that the discomfort
at present caused would be much alleviated. We recognise
that the real remedy, however, for this defect is the pro
vision of properly equipped hospital steamers, and we
only suggest the above as a temporary expedient and as
a practical method for immediately improving the existing
condition of affairs.
61. Inadequacy of medical personnel and equipment .—
Another defect of the first magnitude has been the in
adequacy of medical personnel and equipment. The force
originally despatched to Mesopotamia consisted of one
division, and the medical establishment was four combined
field ambulances of five sections each (that is, two sections
British and three sections Indian), one combined clearing
hospital of 200 beds (one section British and three sections
Indian), two and a half sections, comprising 250 beds, of
a British general hospital, six sections of an Indian
general hospital of 600 beds and one Indian stationary
hospital of 200 beds. This establishment was possibly
adequate for one division according to the authorised
scale, though a comparison with the standard prescribed
in the official manual entitled “ War Establishments,
India,” shows that the British general hospital establish
ment was short of the personnel and equipment for 50
beds. On the other hand, it is fair to say that the Indian
general hospital complement was 100 beds in excess of the
authorised scale.
62. By February 1st, 1915, the expeditionary force
had increased to 20,000 men, and in March it was decided
to augment the strength to two divisions by the addition
of the 12th, 30th and 33rd Infantry Brigades, and also to
send the 6th Cavalry Brigade as a further reinforcement.
No corresponding increase was made in the medical estab
lishment. One combined field ambulance of four sections
was despatched to Mesopotamia for service with the
33rd Infantry Brigade, and an Indian cavalry field ambu
lance consisting of three sections was sent with the 6th
Cavalry Brigade. No field ambulances accompanied
the 12th or 30th Infantry Brigades, and no additional
clearing, stationary, or general hospitals were sent for the
new division. In regard to one of these items, viz., the
field ambulance of the 30th Infantry Brigade, it is right
to state that the military authorities in India addressed
General Barrett, who was the General Officer Commanding
the expeditionary force, as to the necessity of sending a
field ambulance for this brigade, and that he replied that
he could manage without it. No satisfactory explanation
has, however, been offered as to the failure to send other
units, and the net result was that whereas the force was
increased to two divisions plus a cavalry brigade, the
medical establishment was, save for the addition of seven
sections of a field ambulance, that which had been thought
necessary for one division only.
63. We find it difficult to understand the principle upon
which this establishment was considered sufficient. It
was known that the campaign in Mesopotamia would have
to be conducted under singular^ unfavourable conditions
Much of the country is low-lying and marshy and is
constantly liable to floods. The atmosphere is in many
parts excessively humid, and the temperature is very
high, rising in the hot weather, as we were informed, to
125 degrees. It might, therefore, have been anticipated
that a high rate of sickness would prevail among the troops.
Further, the Turkish force in occupation of the territory
invaded was considerable and the countryside swarmed
with hostile Arabs. There was, therefore, in our opinion,
no reason to think that the ordinary scale of medical units
rs laid down in “War Establishments, India,” would
■not be needed. Experience has indeed shown that, if
anything, that standard requires to be increased.
64. In the early part of the war, the insufficient pro
vision of field ambulances was, however, less serious than
the insufficiency of hospital accommodation, which
became evident as early as April, 1915. At this period,
the British General Hospital of 250 beds and the Indian
General Hospital of 600 beds, which had been established
at Basra, were overcrowded. For some time the staff
of these hospitals had been depleted by sickness, and by
the fact that the personnel for transports, which were
used for the evacuation of sick and wounded, had to be
provided out of the medical units of the force. At the
same time the sick and wounded began to increase
alarmingly, so much so that after the battle of Shaiba the
patients in the Indian General Hospital numbered over
1,000. The actual personnel available to treat these
patients was 15 medical officers and 19 medical subordin
ates, against an authorised scale of 22 medical officers
and 40 subbrdinates. During this month, the Deputy
Director, Medical Services, Mesopotamia, was, it may be
added, so impressed with the need for increasing the
hospital accommodation, that he ordered the Indian
General Hospital to expand to 1,000 beds and the British
General Hospital to 500 beds. As, however, no personnel
was at the time added to deal with the increased number
of patients, this order was of little value in effecting any
relief. It has been suggested, indeed, that the only
result was that the hospital authorities were thereby
empowered to draw cerain articles of equipment from the
Supply and Transport Corps. But this is perhaps hardly
just, as small additions to the establishment were subse
quently made from time to time.
65. As the hot weather advanced, the deficiency in
hospital accommodation became more and more marked
and on June 15th we find the position was this, that the
British General Hospital which had started as a 250 bed
unit with 7 medical officers and 10 assistant surgeons,
had a staff of 6 officers and 8 assistant surgeons to treat
635 sick ; and that in the Indian General Hospital 13
medical officers, 1 assistant surgeon, 19 sub-assistant
surgeons and 38 sepoy Term used in English to refer to an Indian infantryman. Carries some derogatory connotations as sometimes used as a means of othering and emphasising race, colour, origins, or rank. ward orderlies (that is, a staff
smaller than the staff authorised for the treatment of
600 patients) was endeavouring to treat 1,671 sick and
wounded. On June 17th the Officer Commanding the
Indian General Hospital reported that he had only 12
sub-assistant surgeons fit for duty. These deficiencies
were not completely made up throughout 1915, although
from time to time additional officers and subordinates
were sent out. The figures furnished to us by the office
of the Adjutant General at the Base indicate that the
only additional complete hospital units sent out to Meso
potamia, between November, 1914, and December, 1915,
were the Bengal Stationary Hospital (which is an institu
tion maintained by private subscription and equipped
normally for the treatment of 200 patients) and one
section of a British General Hospital, sufficient for the
treatment of 100 patients.
During this period, the strength of the force increased
approximately from 12,000 to 40,000 men, and the
information which we have been able to collect makes
it clear that, from the date on which a second division
came to Mesopotamia, the general hospital accommodation
was insufficient for the needs of the force. Fortunately,
as the weather got cooler, sickness was not so prevalent,
and after July and August the number of patients in the
hospital decreased for a time, but even then the personnel
was often insufficient. It is true that when the 3rd and
7th Divisions arrived in Mesopotamia during December
and January, additional stationary, clearing and general
hospitals were sent with them ; but, as explained later,
these units arrived so long after the fighting portions of
the divisions, that for some time the lack of hospital
accommodation and personnel was as apparent as it had
been during the hot weather of 1915. Another cause
which contributed to this result was the despatch of a
number of additional brigades to Mesopotamia from
India in the autumn of 1915 without any hospital units.
Indeed the figures supplied to us show that the maximum
number of patients in the British General Hospital at
Basra in the month of January, 1916, was 1,038, the staff
consisting at the time of 9 Royal Army Medical Corps
officers, and 11 assistant surgeons. In the same month
the average number of patients in the Indian General
Hospital was 1,230, the establishment being 12 medical
officers as against an authorised scale of 28, and 20 medif*#.