'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.' [‎76r] (151/248)

as was employed in Mesopotamia a complete depot of
medical stores, located within reasonable distance, upon
which all units could draw, was clearly necessary. We
are glad to say that this has now been realised and that
such a store depot, with ample supplies to meet demands
from medical units of all descriptions, has been established
at Basra. But it was not apparently until January, 1916,
that the necessity for such a depot was recognised, and
the depot was not actually opened until March. The
arrangements for the supply of medical stores are, how
ever, now satisfactory, and every effort is made to see
that stores indented for are despatched to their destination
as speedily as possible. Prior to the establishment of this
depot the inconvenience caused to medical units outside
Basra, by the delay in the receipt of supplies, was great.
It is difficult in ordinary circumstances to foresee many
months ahead the exact requirements of a hospital when
little is known of the climatic and other conditions ; but
the hospital authorities in Mesopotamia had other diffi
culties to contend with in this matter. In the first place,
it was impossible for any hospital to foretell the number of
patients which it maight be called upon to accommodate.
A 200-bed hospital might be expanded to 500, or a 600-bed
hospital to 1,000. Further, the hospital stores were
liable to depletion at any moment to supply advanced
medical store depots and river convoy units, and on
occasions even field ambulances. In the second place,
it was inconvenient that hospitals up-country, some of
which were situated 200 miles up the Tigris, should have
no depot nearer than Bombay upon which to draw for
supplies in an emergency. The inconvenience of this
system was indeed such that the regulations were not
adhered to. On inspection of the advanced medical
depot at Basra we found that, in practice, articles were
frequently supplied to the various hospitals there, and
the advanced depot, which should normally have been
equipped with 36 boxes of particular articles required for
field and regimental medical units, supplied a number of
hospitals with various requirements, thereby undertaking
duties for which it had neither the requisite staff nor equip
ment. The attention of the Deputy Director, Medical
Services, Mesopotamia, was apparently drawn to this
on the 19th July, 1915, for we find that an application
was made to the Director of Medical Services, India,
for additional personnel for the advanced medical store
depot at Basra, on the ground that the stock of medicines
there must be increased. To this demand the Director,
Medical Services, India, replied that it would be more
satisfactory if frequent and smaller indents for medical
stores were made and that no additional personnel could
be sanctioned until an increase in the stock was found to
be necessary. We draw attention to this correspondence
as it indicates, in our opinion, a failure to realise the danger
and inconvenience of the system then followed. Surgeon-
General Hathaway must have been congizant of the
position of affairs and of the delay and inconvenience that
constantly occurred in procuring medical supplies. He
was also aware, from inspection, of the fact that the
advanced depot was being used in great measure as a
general depot, and that it was undertaking duties for which
it was not equipped. He failed, however, to take the
opportunity of placing the whole question of medical
stores on a sound footing by asking for the establishment
of a general medical store depot at Basra. On the other
hand, it appears to us that when the Director of Medical
Services, India, criticised the accumulation of any reserve
medical stores in Basra, he did not appreciate the import
ance of having, in Mesopotamia, a large reserve of medical
stores from which urgent requirements could be met in
time of need. It is only fair, however, to say that the facts
were not clearly put to the medical authorities in India,
and that the delays and inconvenience which the system
then in force entailed, were not fully explained. We
cannot but think that if the facts had been properly put,
the necessity for doing what has since been done, namely,
the establishment of a properly equipped depot on the
spot, would at once have been realised. The fact, how
ever, remains that up to March, 1916, no such depot was
established.
97. Another and possibly a more potent cause of
inconvenience in the case of hospitals outside Basra
was the difficulty of securing prompt delivery of medical
stores up-country. Under present arrangements, when
indents are received by the medical store depot, the
articles required are packed for delivery without delay
(C 48—176)
and are made over to the medical embarkation officer,
whose duty it is to see that they are despatched to their
destination with reasonable expedition. As soon as the
indent is complied with, the consignee is advised by wire
of the fact, and if delivery is delayed he can at once make
inquiries as to the cause, from the authorities at the base.
There are a certain number of steamers and barges which
return up river at frequent intervals when sick and
wounded have been disembarked at the base, and these
afford reasonable facilities for the transport of medical
stores if the embarkation officer is energetic and intelligent.
The consequence is that, as a rule, medical stores ar§ now
delivered promptly. But this was not so under the system
which prevailed before March, 1916. Throughout the
campaign there has been a great shortage of river
steamers and, in consequence, all consignments of articles
by water have frequently been delayed. The first
requirements of an army are food, ammunition, and men
to replace casualties,. and when there is a deficiency in
transport, the despatch of all other articles has to be
deferred until these demands have been met. It follows,
necessarily, that in such circumstances the despatch of
medical stores must be a difficult matter and the utmost
vigilance and energy are necessary on the part of the head
of the medical services if his demands are not to be over
looked and subordinated to the demands of other adminis
trations. From what we have seen we doubt if the de
mands of the medical services were pressed with sufficient
energy by Surgeon-General Hathaway, and the omission
up to January, 1916, to appoint a medical embarkation
officer to supervise the despatch of consignments of
medical stores, was a serious oversight. Cases of medical
stores from the advanced depot, intended for units in the
field, used to be made over to the transport authorities to
be conveyed to the front and there the matter ended.
Similarly cases from Bombay, consigned to the front,
were landed at Basra and presumably made over to the
transport authorities, the duty of forwarding these articles
to their destinations being left to that agency An office of the East India Company and, later, of the British Raj, headed by an agent. . In such
circumstances, and in the rush to secure space on the
steamers, we fear that medical supplies were often
neglected to meet the more insistent demands of other
administrative services. We freely recognise the efforts
made by particular officers of Surgeon-General Hathaway’s
staff in this matter ; but it was clearly impossible for them
to attend to this work in the midst of their multifarious
other duties. In some cases also we fear that the delay in
forwarding consignments was increased by a want of
proper organisation. It is not surprising, therefore, that
many of the medical officers examined by us have com
plained of the delay that has occurred in the receipt of
medical stores, and we think that much of this inconveni
ence might have been avoided by the establishment of a
general medical store depdt at Basra early in the war,
and by the employment of a medical embarkation officer
to see that the despatch of consignments up-river was not
delayed. It would not, we think, serve any useful
purpose to quote instances of inconvenience caused by
these delays, though it would not be difficult to do so.
It is possible, indeed, that the citation of individual cases
in which the delay was due to lack of organisation, might
give rise to a more unfavourable impression than the
facts warrant. We are content to say that, for the reasons
given above, the supply of medical stores to various units
in Mesopotamia was, up to recently, far from satisfactory.
98. Hospital ships .—Another point to which we draw
attention is the question of suitable transport for the
conveyance of sick and wounded from Basra to India.
When the expeditionary force set out, it was not accom
panied by any hospital ship or by any special staff for
employment on a transport, in case it should be necessary
to use such a vessel as a hospital. There was a certain
amount of sickness among the troops on the journey,
and the Turks did not surrender possession of the important
city of Basra without a struggle. The consequence was
that in December, 1914, two ordinary transports had to
* be used for the evacuation of the sick and wounded to
India, the necessary staff and equipment for these vessels
being furnished from the limited medical resources of the
expeditionary force. In January, 1915, the hospiral ship
“Madras,” which was the gift of a private organisation, was
sent to Basra, and in July a second hospital steamer was
detailed to assist in the work of evacuating the sick and
wounded. Since then, a numberof other hospital ships hav*
also been employed for this purpose ; but the accommoda -
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