Diary 6 With the RAMC in EGYPT
WITH THE R.A.M.G. IN EGYPT
AN IMPROVISED GAGOLET FOR SITTING PATIENTS.
AN IMPROVISED CAGOLET FOR PATIENTS LYING DOWN.
With the R.A.M.C.
in Egypt
By
"Serjeant-Major, R.A.M.C."
With 32 Illustrations
Cassell and Company, Ltd
London, New York, Toronto and Melbourne
1918
TO THE OFFICERS AND MEN
of the
ROYAL ARMY MEDICAL CORPS
This Book is inscribed by
One whose pride it is to
be of their number
Preface
THIS account of the work of the Royal Army
Medical Corps in Egypt from the earliest days of
the British Occupation in 1883 to the close of the
Sinai Desert Campaign at the beginning of 1917,
is in no way official, nor must it be regarded as
in any sense officially inspired. Although its pre-
paration and publication have been undertaken with
the full sanction and approval of the authorities, I
personally am entirely responsible for all state-
ments made, facts recorded, and opinions expressed
therein.
It is due to the reader, however, to say at once
that, though the book must be taken solely as the
independent work of one man possessing no official
status whatever, it has been produced under privilege,
without which, indeed, it could never have been
written. For the facts as to the doings of the
R.A.M.C. on the battlefield, and in respect of the
Corps' many activities in other branches of medical
war service, the writer has been able to draw largely
on his own experience, it having been his lot to
serve as a member of the Royal Army Medical
Corps both with the Dardanelles Army and with the
Egyptian Expeditionary Force. But for all other
facts dealt with in these pages he has been indebted
Preface
to the official records in Egypt, all of which have
been placed unreservedly at his disposal ; and to the
personal evidence of R.A.M.C. officers and men from
the highest to the lowest, which* has been, in every
instance, readily and frankly accorded him. More-
over, the whole work, on its completion, was sub-
mitted to one very highly placed in the Army Medical
Service in Egypt, and was by him carefully con-
sidered and revised. The book, therefore, so far as
facts and figures are concerned, may be taken as
authoritatively accurate, although its general tenor
and outlook are the writer's own.
Very few names are here set down, albeit many
fine achievements and instances of singular devotion
to duty have been necessarily recorded. Seeing that
it was practically impossible to mention by name all
in the Service who had won, or deserved to win,
distinction, it was thought better to leave names alone
altogether, and to let the great sum of heroism,
enterprise, exertion, merge itself into the common
honour of the Corps.
"S.-M., R.A.M.C."
Cairo, Egypt, 1917.
Contents
Part I. Action
CHAPTER IPAGE
i RETROSPECT I
2. EGYPT AND THE GREAT WAR . . 15
3. " THE LONG, LONG WAY TO ACHI BABA " .52
4. THE R.A.M.C. IN DESERT WARFARE . . 69
5. KANTARA AND KATIA 83
6. THE DEFENCE OF EGYPT IN THE WEST . . 101
7. THE SINAI DESERT CAMPAIGN. THE BATTLE
OF ROMANI 109
8. EL ARISH MAGHDABA RAFA . . .125
9. EL ARISH AND AFTER 138
Part II. Ways and Means
10. CAMP SANITATION AND CONSERVANCY : DIS-
INFECTION AND DESTRUCTION OF INSECT
PESTS . 149
11. EPIDEMIC DISEASES : MEASURES TAKEN TO
PREVENT AND COMBAT THEM . . .172
12. FIELD AND BASE LABORATORIES . . .193
Contents
CHAPTER PAOB
13. ARMY DENTAL SURGERY IN EGYPT . 201
14. THE WORK OF THE MUSTAPHA RECEPTION
STATION, ALEXANDRIA . . . .210
15. THE MEDICAL ADVISORY COMMITTEE FOR THE
NEAR EAST . . '. . 217
16. MILITARY GENERAL HOSPITALS IN EGYPT . 231
17. THE EGYPTIAN LABOUR CORPS : THE MEDICAL
SIDE OF ITS ORGANISATION UNDER THE
R.A.M.C. / ., . . . .277
18. " IN ARDUIS FIDELIS " . . . 302
List of Illustrations
AN IMPROVISED CACOLET FOR SITTING PATIENTS \ ,,
I Fronhs-
AN IMPROVISED CACOLET FOR PATIENTS LYING /
DOWN J ^ ece
FACING PAGE
TURKISH SINGLE-HANDED STRETCHER SHOWING
METHOD OF CARRYING 60
AN AMBULANCE SLEDGE 78
TURKISH WOUNDED GOING TO HOSPITAL . . 78
OFFICIAL CACOLET FOR SITTING PATIENTS . . 82
IMPROVISED CACOLET FOR SITTING PATIENTS . . 82
IN AN R. A.M.C. CAMP 92
CAMELS WAITING FOR THEIR LOAD OF WOUNDED 92
A MULE-DRAWN SAND-CART .... 104
DESERT AMBULANCE DRAWN BY FOUR CAMELS . 104
A TYPICAL LANDSCAPE ON THE EGYPTIAN-PALESTINE
FRONTIER , 116
R. A.M.C. ON THE MARCH 116
EVACUATING A WOUNDED BRITISH OFFICER BY AERO-
PLANE 130
PORTABLE STRETCHER ...... 130
A CAMEL AMBULANCE
List of Illustrations
FACING PACB
DESERT HOSPITAL TRAIN . , /r . . 136
EL ARISH . ' . ". V . . . . 144
CAMELS WITH FANTASSES (WATER-TANKS) , ,. 144
DISINFECTING STATION, KANTARA . . . 164
DISINFECTING NATIVES AT THE DISINFECTING COM-
POUND ATTACHED TO AN EGYPTIAN HOSPITAL . 164
WOUNDED COMING INTO CAMP ~'. . .180
Box CACOLETS ,_ . . . . *. . 180
INTERIOR OF A FIELD LABORATORY , . : . 196
FIELD LABORATORY, ROMANI f . . , v 196
TRANSPORT LINES OF A FIELD AMBULANCE . . . 222
THE MEDICAL OFFICER GOING His ROUNDS . .. 222
MEDICAL AID POST, SUEZ CANAL ZONE . . 240
SCENE AT A GENERAL HOSPITAL, ALEXANDRIA . 240
IN-THE CAMEL LINES, SINAI DESERT - * 1 . . 292
CAMEL-BORNE FIELD LABORATORY .. * v 292
PART I. ACTION
With the R.A.M.G. in Egypt
CHAPTER I
RETROSPECT
THE story of the work of the British Army Medical
Service in Egypt begins thirty-five years back so
long ago as the late summer of 1882 when Sir
Garnet Wolseley and his force arrived to quell the
rebellion of the Egyptian Army under Arabi Pasha.
The campaign lasted about three months, and some
idea of the heavy work which devolved on the
medical contingent of the British Force may be
gathered from the fact that during this period 7,600
sick and wounded men were treated in the field
hospitals; while during the remainder of the year
a period of a little over eleven weeks a further
6,800 cases passed through the hands of the medical
staff, bringing the number of cases dealt with in
less than six months under the most trying conditions
up to a total of 14,400.
But heavy as was the work entailed by the
campaign itself on the Army Hospital Corpus as
the medical branch of the Service was then termed
With the R.A.M.C. in Egypt
there were still more arduous, if less exciting, times
in store when the British Expeditionary Force settled
down in Egypt as virtually a permanent Army of
Occupation.
The two great cities of Egypt, Cairo and Alex-
andria, had to, be garrisoned, and suitable barrack
accommodation found for the troops. But to quote
from the official report of the time "every available
barrack and public building was in so foul a state
as to be uninhabitable by Europeans, and it was
impossible to find any unobjectionable camping
ground, affording sufficient space with water-supply
available, that was not, for military considerations,
too far distant.'* Medical and sanitary science in
Egypt, indeed, were at the time at so low an ebb
as to be practically non-existent. Though a soi-
disant School of Medicine, founded in the bad and
brilliant Mehemet Ali days long ago, still persisted,
all sanitary, quarantine and hospital buildings in
the country had fallen into rack and ruin for want
of funds. Cairo was 'described as "a city of cess-
pits," most of these overflowing into a system of
archaic covered channels, which in turn discharged
their contents into the canals and the River Nile
the river which constituted the city's only water-
supply.
Alexandria was in no better case. The Mahmou-
dieh Canal, which was the sole source of water for
the town, was virtually an open sewer. Every con-
dition favourable to the development of epidemic
disease was present, not only in the great towns, but
4
Retrospect
throughout Egypt generally. Hardly had the British
medical authorities succeeded in housing our troops
in some sort of decency and comfort when they were
called upon to face a new situation, which could only
be described as appalling the incidence of the great
cholera epidemic of 1883.
There were at the time some 6,500 British troops
stationed in Egypt, these being distributed in various
quarters in the two large towns. The cholera first
appeared at Damietta, a town close to the Mediter-
ranean seaboard; and a description of the place at
the time leaves not only little room for wonder at the
appearance of the epidemic, but causes a feeling of
astonishment that disease had not wiped it out long
ago. No condition favourable to the spontaneous
production of almost any epidemic seemed to be
wanting. Damietta lay in the midst of a network
of half-inundated plains, stagnant canals and lakes,
and low-lying river-levels of the foulest mud.
" Sanitation was utterly unknown in or about the
town. The houses were very old, ruinous and over-
crowded, and the narrow streets indescribably
filthy." In addition to these normal conditions
rendering the place at any time a veritable hot-bed for
disease, the date of the outbreak of cholera coincided
with the existence of special and extraordinary cir-
cumstances. It was the time of the great annual fair,
when the 30,000 or so constituting the ordinary popu-
lation of the already overcrowded town had been
augmented by the influx of some 15,000 people from
neighbouring districts. " These 45,000 human beings
B 5
With the R.A.M.C. in Egypt
were subsisting on ' fasek ' (fish allowed to putrefy
in the sun) and diseased meat (for the cattle plague
had been raging all round the neighbourhood), and
drinking the Nile water polluted by hundreds of
carcases of beasts which had died of bovine typhus,
whose skins were stored up in rotting heaps in the
interior of the town."
This epidemic of cholera in 1883, after its first
appearance at Damietta, rapidly spread over Egypt,
and before it was finally stamped out had accounted
for some 60,000 deaths, an estimate which, however,
is probably far short of the actual figures. Among
the British soldiers only 200 cases occurred, which
fact is a remarkable tribute to the energy, skill and
ingenuity of our medical officers. These caused a
wholesale prompt removal of the troops from in-
fected areas, and set in train a host of preventive
and protective measures against intercommunication
of disease within the Force, while bringing all the
resources of medical science to bear on existing cases.
Nursing cholera patients was then, and indeed ever
will be, a particularly hazardous employment; and
it is, therefore, not surprising to read in the official
report of the time that, in regard to infection, "the
men of the Army Hospital Corps suffered out of all
proportion to the other branches of the Service."
Looking through the Army Medical Department
Reports of the thirty-two years coming between our
first military occupation of Egypt and the beginning
of the Great War in 1914, we find an unbroken record
of steady, quiet work done by our Army authorities,
6
Retrospect
or under their aegis, towards the improvement of
medical and sanitary conditions in the country.
British students of Egyptian history during this
period may well be proud of all their countrymen
accomplished in the direction of economic, military,
financial and political reform, and that in the face of
every kind of opposition that Oriental inertia and an
incredibly corrupt bureaucracy could together bring
to bear on it. But it is a question whether anything
finer has been done for Egypt than was done by the
handful of British medical men during those patient,
laborious years, when they succeeded at last in creat-
ing something approaching to hygienic order out of a
chaos that outrivalled the very worst that ever existed
in Europe, even in the darkest time of the Middle
Ages.
But the record of the British Army Medical
Service in Egypt during this period has much more
to show than these results of the plodding labours of
peace. Though, after the crushing victory of Sir
Garnet Wolseley over the mutinous Egyptian Army
under Arabi Pasha in 1882, Egypt proper settled
down to a state of tranquillity and peaceful progress,
it was far otherwise throughout the vast area of the
Sudan, where the Khedive's authority had, two
years later, become so precarious that complete
evacuation by the Egyptian troops had been finally
decided on. Disaster after disaster had befalleh the
native forces sent against the Mahdi. General
Gordon, who had been dispatched to the Sudan on
behalf of the Egyptian Government to conduct the
With the R.A.M.C. in Egypt
evacuation and secure the safe withdrawal of the
Egyptian garrisons, had not only failed in this object,
but was himself shut up in Khartoum and obviously
in danger. Though, as Lord Cromer points out,
"the British Government were under no moral
obligation to relieve the Egyptian garrisons, they
were under a strong obligation to prevent General
Gordon from falling into the hands of the Mahdi."
The Nile Expeditionary Force, consisting of some
11,000 men, was therefore sent out under Lord
Wolseley, and in the autumn of 1884 took the field.
No detailed account of the achievements of the
Medical Staff Corps (as the Army Medical Service
was then named) during this campaign can here be
attempted. But the arduous nature of the work of
the Medical Staff Corps officers and men can be fairly
well estimated from the fact that over 9,000 cases of
sick and wounded were dealt with under circum-
stances of extreme difficulty.
There followed, in 1885, the Suakin Expedition
against the dervishes under Osman Digna in the
Eastern Sudan. Here the British and British-Indian
troops numbered about 13,000. The work of the
Force was carried through under, if anything, still
more trying conditions, and again the Medical Staff
Corps contrived to perform its part with singular
devotion and energy.
The Nile Expeditionary Force which was organ-
ised four years later to assist the now rehabilitated
Egyptian Army to repel the threatened invasion of
Egypt by the dervishes did not actually take part
8
Retrospect
in the operations except in regard to its cavalry. The
battle of Taski, which terminated the campaign, was
fought and won by the Egyptian forces under Sir
Francis Grenfell and his British officers before the
purely British contingent arrived on the scene. But
the preparations for the campaign made by the
Medical Staff Corps involved an enormous amount of
work, and a considerable number of sick cases were
dealt with. Actually some 600 patients were admitted
to British hospitals in connection with this campaign.
The year 1896 was fraught with consequence for
British medical men in Egypt, for in it occurred the
second severe epidemic of cholera, and it was also the
year in which the Dongola Expeditionary Force
which marked the beginning of the reconquest of the
Sudan came into being. Of the cholera visitation
no more need be said here than to state briefly certain
pregnant facts. Whereas in 1883 this scourge of
Eastern peoples levied a toll of more than 60,000 lives
in the country, the present attack was stopped when
little more than a quarter of that number had suc-
cumbed. Moreover, among the British garrisons,
while the first epide.mic produced 200 cases, the
present accounted for only six. The great difference
in these figures is obviously due to the undeviating
and insistent influence of our medical men through
long years on local sanitary conditions, and it pays
special tribute to the efficiency of the work of the
Egyptian Sanitary Department, headed then as now
by Englishmen, members of the British Army
Medical Service.
9
With the R.A.M.C. in Egypt
The campaign which in the autumn of 1896 ended
with the occupation of Dongola was carried through
mainly by the Egyptian Army under its Sirdar, Sir
Herbert Kitchener, the wholly British forces engaged
numbering in all less than one thousand. Here
again, however, both the British doctors with the
Egyptian Force and the members of the Medical Staff
Corps earned, and deserved, great credit for their
work on the lines of communication as well as in the
field. Heat, dust, frequent sandstorms, the fact that
enteric fever was rife in the districts traversed by the
troops, and cholera raging in all the villages round
the camps, all united to create a situation fraught
with great difficulty and anxiety for the. medical
authorities. But though the cholera obtained a foot-
ing among our troops the number of cases reached
only twenty-four, of which, however, but three re-
covered, such was the virulent type of the disease.
This rapid survey of the work of the British Army
Medical Service in Egypt from the time of our first
occupation to the beginning of the Great War must
close with a brief narration of events in 1898, which
year saw the final destruction of Mahdiism in the
Sudan, and the restoration of the Khedive's
authority so long set at naught in that unhappy
province.
The Nile Expedition of 1898, the successful con-
duct of which won for Kitchener his peerage and the
beginnings of fame, occupied some nine months ; and
the story of the campaign from the point of view of
the Medical Service is full of interest. We find our
10
Retrospect
organisation once more changed in name, bearing at
last the title with which we are all familiar to-day
the Royal Army Medical Corps. But the change was
not only in name. The science of the treatment of
sick and wounded in war w^aged in tropic countries
may be said at this time to have first emerged from
the tentative, experimental stage, and to have blos-
somed out into a proved and practical system, based
not only on the experience gained in past Egyptian
campaigns, but specially devised to meet the exig-
encies of the present.
Lord Kitchener's army consisted of some 25,000
men, of which about 8,000 were British troops. The
campaign included the two great battles of Nakheila,
on the Atbara, and of Omdurman, close to Khar-
toum ; and from first to last the arrangements made
for the care and conveyance of sick and wounded
worked almost without a hitch. What this means
can only be realised by a study of the conditions,
geographical and climatic, under which the opera-
tions were carried through. The country traversed
was for the most part sandy desert, where at the time
high winds and almost incessant sandstorms raged.
Throughout nearly the entire campaign the heat was
tremendous, generally reaching 100 degrees in the
shade, and for one period of four days remaining
well over 120 degrees. The battle of Omdurman,
which finally broke the power of Mahdiism in the
Sudan, was fought under a temperature of 108 degrees.
The difficulty of maintaining the purity of water
supply for men and animals was at all times very
ii
With the R,A.lVi.C. in Egypt
great. The Atbara the branch of the Nile near
which the whole force was encamped for eighteen
days consisted, at the time, of no more than a series
of pools, from a single one of which the entire army
had to draw its supply, and to ensure a sufficiency
of potable water from this source must have been a
well-nigh insuperable problem. Yet the task \vas
accomplished, and well accomplished, as the light
sick-list of that period shows.
Transport, also, was a constant source of grave
difficulty to the medical contingent of the column.
Beyond railhead, which was at the junction of the
Atbara and the Nile, still some 200 miles from
Khartoum, everything had to be moved either by
river-boat or on the backs of animals, chiefly camels.
Not only had the wounded and sick to be evacuated
to the rear by these means, but all material and
equipment of the R.A.M.C. units marching with the
column were dependent on the same modes of con-
veyance. Naturally the fighting men had the first
call on the transport facilities, and the Medical Corps
had often the greatest difficulty in securing the neces-
sary boats and camels for their work. Thus, after the
battle of Omdurman, the wounded had actually to be
placed on board the barges while these were still
loaded with ammunition and stores. But the in-
domitable spirit and resource which then, as now,
characterised the Army Medical Staff, were equal to
this as to all other difficulties incidental to the cam-
paign. Indeed the whole story of the part played
by the R.A.M.C. in this final stage of the Sudan
12
Retrospect
operations is one that will scarcely be dimmed, and
assuredly never forgotten, for all the Corps has since
achieved in the infinitely larger arena of the great
European War.
In the years that followed, though the clash of
arms, it seemed, had finally stilled within the
Egyptian frontiers, there was yet work enough for
the Royal Army Medical Corps. The crusade
against disease and insanitation was pursued by our
medical men as unremittingly as ever; and year by
year they had the satisfaction of seeing their ideas
taking deeper root, and reforms, long and vainly
advocated, at last becoming accomplished facts.
Though now on a peace footing, the British gar-
risons in the country were uniformly maintained at
an average total strength of 3,000 or 4,000 men; and
the permanent Military Hospitals at Cairo and
Alexandria, as well as the smaller establishment at
Khartoum, had no lack of patients. Nor was the
tried and proved efficiency of the R.A.M.C. con-
tingent of the force in any way allowed to degenerate
throughout these quiet but busy years. The
headquarters of the Corps had been established at
the Citadel, Cairo, during practically the whole
period of the Occupation, the normal strength of the
33rd Company, which was latterly the medical unit
for Egypt and Cyprus, being 17 officers and 120 of
other ranks. Year after year the men were system-
atically and regularly trained in their duties both as
hospital orderlies and as workers in the field, especi-
ally with regard to the conditions obtaining in the
13
With the R.A.M.C. in Egypt
sub-tropical country where they were stationed. As
an instance of the care with which this training was
organised, it may be mentioned that so late as the
winter of 1913-14 a Field Ambulance with Camel
Transport was mobilised at Mena, near the Great
Pyramids, and a special Desert Training was carried
out for a period of two months, during which time
every man of the company received not less than a
fortnight's instruction and exercise in ambulance
work under desert warfare conditions. How soon the
experience and efficiency thus obtained were to be
put to practical test, more exacting than any that had
yet fallen to the lot of the old 33rd Company,
approaching events were very soon to show.
CHAPTER II
EGYPT AND THE GREAT WAR
THOUGH, in the following pages, our single purpose
is to present a chronicle of the work of the British
Army Medical Service during those stirring scenes
of the War which were enacted in and about Egypt,
it is not possible to do so without including, from
time to time, some brief narrative of the general
course of events.
The situation in Egypt, following the outbreak of
war in August of 1914, constituted a deeply interest-
ing though anxious study for all who knew that
country and had its welfare at heart. It was clear,
however, that so long as Turkey maintained her
neutrality, the position was not without many reassur-
ing features. Obviously nothing would be done by
the Central Powers to drive Turkey into the arms of
the Allies : an attack, therefore, on any part of the
Ottoman dominions, such as Egypt then was in
name at least, seemed little likely to ensue. More-
over, Egypt was possessed of superb natural frontier
defences. To the north lay the Mediterranean, where
the Allied fleets could be depended on to ward off an
attack. Eastward stretched the Sinai Desert, which
from time immemorial has presented a well-nigh in-
superable barrier against an invading army. To the
15
With the R.A.M.C. in Egypt
west was the Libyan Desert, equally impracticable
for an attack in force, while, both geographically and
politically, any sort of menace from the south was
highly improbable. As regards Egypt itself, thanks
to the past wisdom of Cromer and Kitchener, the vast
majority of the population had become thoroughly
content with its lot under the British Occupation,
and little likely to seize the opportunity of our
embroilment elsewhere, to create internal trouble.
The Imperial Government was, therefore, quite right
in regarding Egypt as, for the moment, outside the
pale of hostilities, and in devoting almost the entire
strength and resources of the Empire to deal with
the great conflagration raging so much nearer home.
The major portion of the British garrison in Egypt,
and with it most of the men of the Royal Army
Medical Corps stationed in that country, were drafted
to Europe where their services were most needed.
Egypt was left, in the main, to the protection of its
own army, now thoroughly reorganised and re-
generated after more than thirty years' tuition at the
hands of its British officers. Moreover, part of the
immediate scheme of the authorities at home was to
use Egypt as a vast training-ground and depot of the
human material for the new Imperial Army, a pur-
pose for which the country was peculiarly adapted,
by reason of its central position between the eastern
and western portions of the Empire. Though there
was an interval a highly dangerous interval, as sub-
sequent events were to prove when Egypt was well-
nigh denuded of British arms, our troops soon began
16
Egypt and the Great War
to pour into the country. Whole fleets of transports,
packed with Lancashire Territorials, Australians,
New Zealanders, the flower of the Indian Native
Army, arrived at Alexandria or filed through the
Suez Canal, and the dangerous dead-point was passed
before it was well realised. How far, and for how
long, the secret agents of the enemy had been at
work in Egypt against us, it would avail little here
to inquire. The fact that they failed, that the great
opportunity for a popular rising passed by harm-
lessly, must be reckoned as one more spray in the
perennial laurel-wreath of Cromer, for it was his
wisdom that had created a contented peasantry in
Egypt. This fact alone it was that now saved the
day; the fellaheen, to the lasting credit of their good
sense, refused to rise against us, and the danger
passed.
It has been said that at the outbreak of war the
strength of the contingent of the Royal Army
Medical Corps then doing duty in Egypt was greatly
reduced. Few officers and N.C.O.'s and men re-
mained for service with the depleted garrisons.
Before the end of 1916, however, the strength of the
Corps in Egypt had risen enormously. How that
army of doctors, field-ambulance men, and hospital
orderlies came into being and what it accomplished,
remains now to be told.
To the aid of the mere handful of Medical Service
men staffing the two military hospitals at the Citadel,
Cairo, and at Ras-el-Tin, near Alexandria, came first
of all the three East Lancashire Field Ambulances,
With the R.A.M.C. in Egypt
forming part of the 42nd (Territorial) Division which
landed in Egypt towards the end of September, 1914.
Then followed early in December the Indian troops
destined primarily to guard the Suez Canal, accom-
panied by their field ambulances and two complete
General Hospitals, which were stationed one at Cairo
and one at Alexandria. The New Zealand Imperial
Force with its field medical contingent arrived in
Egypt about the same time, and towards the end of
the year the First Division of the Australian Imperial
Force reached Alexandria, bringing with it five com-
plete units of the Australian Army Medical Corps
fully equipped.
In the meantime Revolution in quite other and
much more happy guise had come to Egypt. Her
age-long master and oppressor, the Sultan of Turkey,
had thrown in his lot with the enemies of the British
people, and thus at a single stroke solved one of the
most complicated problems that had ever perplexed
our home statesmen. More than a hundred years ago
Mehemet Ali, the first and the greatest of the
Khedives, had said, " England must some day take
Egypt as her share of the spoil of the Turkish
Empire.'* And now, by the Sultan's own insensate
act, the way to the fulfilment of this prophecy was
suddenly opened. We made Egypt our own, indeed,
but strictly in accordance with the Empire's ancient
altruistic precedent. We made her a sovereign, in-
dependent State under her own Sultan, and straight-
way set about the task of fighting her battles for her
in the old-time British way.
18
Egypt and the Great War
That Egypt was now in for troublous times was
apparent to all capable of the necessary world-wide
view of a war that was destined soon to take practi-
cally the whole earth for its arena. It was clear that
no enemy of Britain, wishing to do the Empire
greatest harm, could fail to see that the destruction of
the Suez Canal must constitute one of the most fatal
blows that could be dealt us. But equally clear to all
sides were the extreme, well-nigh insurmountable,
difficulties of the task. That Turkey essayed this
single-handed in January-February of 1915, trans-
porting over some 150 miles of sandy, rocky, and
almost waterless desert a force of 12,000 to 15,000
men, dragging with them half a dozen batteries of
field-guns, at least one six-inch gun, and a number
of heavy metal boats in which to effect the Canal
crossing, must rank as no less than an act of heroism.
This quixotic venture resulted, as all the world
knows, in the complete defeat of the enemy, the
capture of many prisoners, and the break-up of the
attacking force. The preparations made by the
Medical Service for the engagement were admirable.
In addition to the field ambulances with the troops
stationed at intervals in the length of the Canal, a
number of temporary hospitals were established in
the vicinity of the expected operations, and carefully-
thought-out arrangements made for the treatment of
such enemy wounded as should fall into our hands.
Three hospital trains were also constructed and fitted
out by the Egyptian State Railway, by which all
wounded were rapidly removed from the Canal Zone
'9
With the R.A.M.C. in Egypt
and conveyed to the base hospitals in Cairo. The
whole operation was a valuable one in many ways,
for it not only gave a practical lesson to our
R.A.M.C. men in field-ambulance work under desert
conditions, but it brought the authorities in the
Anglo-Egyptian Command to a full realisation of the
quality of the Turk as an antagonist a lesson that
was destined to be driven home in much sterner
fashion, as swift-marching events were soon to show.
With the repulse of the first Turkish attack on
the Suez Canal, the part to be played by Egypt in
the titanic struggle of the nations entered upon a
new phase. The war, it seemed, was to be carried
into the enemy's country. The Mediterranean Ex-
peditionary Force under Sir Ian Hamilton arrived in
Egypt, established its base at Alexandria, and in
April set out for the Dardanelles. Thence onward,
instead of dealing, as hitherto, with a series of more
or less disjointed happenings, it becomes possible to
present a fairly well connected narrative of the work
of the Royal Arrny Medical Corps in this part of the
Near Eastern area of the war.
It is a story now of a great crisis triumphantly met
and overcome. It begins properly with the earliest
days of the memorable year 1915, when vast camps
had to be established in various quarters to accom-
modate the British, Colonial, and Indian troops which
were flocking into Egypt for training in such enor-
mous numbers. Camp-life is safe and salutary
enough, albeit on the largest scale, if certain element-
ary principles of sanitation and disposal of waste pro-
20
Egypt and the Great War
ducts are rigidly observed. Even in a small camp,
moving on at no widely separated intervals to clean
ground and fresh surroundings, these laws must be
punctiliously adhered to, or harm will follow. But
when large numbers of men and animals are crowded
together within a circumscribed space and remain
there for a prolonged period, the undeviating observ-
ance of all laws of sanitation and conservancy becomes
literally a matter of life and death.
The true cause of the large amount of sickness
which now occurred among the troops, mainly among
the Colonials encamped in Egypt, lay not in a want
of theoretical knowledge or ability on the part of the
officers whose duty it was to safeguard local con-
ditions, but in their inexperience of military life in
time of war. An officer of the Royal Army Medical
Corps is required, and rightly so, to be much more
than physician, surgeon, and sanitary specialist : he
must be able not only to instruct, direct, and dis-
cipline his own ambulance men in their work in
hospital or field, but must be conversant with every
detail of army camp-life and understand the soldier
and his habits through and through. In these purely
military matters the Colonial Medical Officers in
charge of the hastily recruited Dominion troops,
eminent as many of them undoubtedly were in their
profession, could hardly fail to be deficient. That
they eventually learnt their lesson, and learnt it well,
is known to all. But in the meantime the inevitable
happened. Among the troops encamped a very large
number of cases of infectious disease occurred, these
C 21
With the R.A.M.C. in Egypt
being mainly cases of measles, mumps, and intestinal
disorders. Of mumps alone some 1,200 cases were
treated among the Australian troops, and it is
estimated that during the first few months of 1915
there was a continuous daily average of 2,000 men in
hospital from these causes a sick-list which might,
and should, have been obviated if the ordinary right
procedure established in the British Army, as to
measures of prevention in infectious complaints, and
isolation of early cases, had been adopted in time.
But wherever lay the fault for this condition of
things, it entailed a grave responsibility on the Army
medical authorities in Egypt, and marked, indeed,
the beginning of that long period of strain, ultimately
developing into a supreme tax on all the medical
resources of the country, for which, to those who took
part in it, the year 1915 will be ever memorable all
that devolved on Egypt consequent on the launch-
ing of the British Expedition against the Dardanelles.
When the time arrives in which the whole story
of the War can be reviewed in all its hydra-headed
significance, this achievement of the Army Medical
Service in Egypt in dealing with the sudden enor-
mous influx of sick and wounded from Gallipoli in
the spring of 1915 will, it is safe to prophesy, stand
out well in the fore-rank of all that British energy
and ingenuity have accomplished from first to last.
Human foresight, based on whatever past ex-
perience of warfare, could scarcely have computed
aright the medical needs of an expedition such as that
which was hurled against the Turks on the Gallipoli
22
Egypt and the Great^War
Peninsula. But some conception of what might soon
be demanded of them seems to have dawned on our
medical authorities at an early stage in the campaign,
and they got to work betimes. Urgent demands for
additional hospital supplies and personnel were cabled
home. The two permanent military hospitals in
Egypt were expanded. The two Australian hospitals,
which had arrived In January, 1915, and had been
established respectively in the Heliopolis Palace
Hotel, near Cairo, and in Mena House, near the
Pyramids, were also enlarged. The two Indian
hospitals which had come out with the force from
India, were similarly treated. The local medical
resources of Egypt had already been requisitioned
during the first Turkish attack in February, 1915,
and now under the new crisis the Egyptian Govern-
ment was again applied to for all possible aid.
Meanwhile additional hospitals were on their way
out from home. No. 15 General Hospital with its
equipment, stores, and personnel, reached Alex-
andria on March 15, and by April i had taken posses-
sion of the building ordinarily occupied by the
Abbassieh Secondary Schools with 1,040 beds ready
for the reception of sick and wounded. A second
complete hospital, No. 17 General, arrived shortly
after, and was located in Victoria College, Alex-
andria. Other hospital units were soon to be on the
way. Two well-appointed hospital ships were in
readiness to bring the wounded from the prospective
seat of war at Gallipoli to the Egyptian Base. There
was a shortage of hospital sisters and nurses. In-
23
With the R.A.M.C. in Egypt
deed, how little the authorities at home had pre-
estimated the true nature of the coming campaign
may be judged from the fact that the two General
Hospitals, Nos. 15 and 17, had been sent out without
feminine personnel, it being intended that these base-
units should land and be established on the Penin-
sula. This shortage of nurses in Egypt, however,
could, it appeared, on an emergency, be made up by
temporarily making use of local help, while detach-
ments of trained Army nurses were being sent from
home. It seemed, therefore, that all probable de-
mands on the Medical Staff had been foreseen and
provided for, and that there was nothing more to do
but to await events.
The event, as it proved, amounted to little less
than a cataclysm. What now followed came upon
Egypt with all the unexpected suddenness of a
thunderstorm on a serene summer's day. The
Mediterranean Expeditionary Force had sailed for
some destination unknown, or known only to the few
in authority. The great camps were almost denuded
of troops. Egypt's wonderful April sunshine filled
the land with a golden calm, and the most bellicose
of R.A.M.C. orderlies looking out from a hospital
window over slumbering sunlit desert, or the
Mediterranean's tranquil blue, could scarcely con-
ceive of war but as something infinitely remote and
incredible. And then, with hardly a rumoured word
of warning, the storm broke.
On the 25th-26th of April the first fateful landing
on the Gallipoli Peninsula took place, and within a
24
Egypt and the Great War
few days the wounded began to pour into Egypt,
Shipload after shipload of desperately maimed and
stricken men arrived at Alexandria. They came
almost without intermission. In the first ten days no
fewer than 16,000 cases were landed and distributed
among the hospitals ashore. In Alexandria all avail-
able beds were immediately filled ; and the rest of the
wounded, the great majority, in fact, passed on to
Cairo. There was a period very brief, indeed, but
still fraught with possibilities unthinkable when the
sudden strain thus thrown upon the resources of the
Medical Staff in Egypt seemed too great for the
avoidance of hopeless congestion and disaster. But
there were a strong hand and a cool head ruling the
affairs of the Army Medical Service in the country.
Everywhere, without an instant's delay, the expansion
of existing hospitals was taken in hand, and other
establishments created, either in permanent buildings
requisitioned for the purpose, or in little townships of
canvas pitched in carefully chosen spots. In Alex-
andria, No. 15 General Hospital was expanded to
1,500 beds. No. 17 was increased to the same num-
ber, and eventually the accommodation at this
hospital was raised to a total of 2,460 beds. A Ger-
man hospital in Alexandria the Deaconess's which
had recently been commandeered for our troops, was
also pressed into the service, additional buildings
acquired, and the military No. 19 General which soon
arrived on the scene, installed in the premises. An-
other British Hospital, No. 21, arriving about the
same time, was located in the Egyptian Army
With the R.A.M.C. in Egypt
Barracks at Ras-el-Tin, and was rapidly opened out
to a capacity of more than 1,000 beds. The old
permanent British Military Hospital in Alexandria
was more than doubled in accommodation. The
Greek Hospital in the same town was called upon for
aid. The Egyptian Government Hospitals in Alex-
andria, Port Said, Suez, and in six of the large pro-
vincial towns immediately prepared to receive British
wounded and sick.
Meanwhile, in Cairo, still more extensive develop-
ments were set in train. It was to the capital that the
authorities mindful of the danger of creating a state
of congestion in the hospitals at the port of entry
transported the greater number of cases received from
the Dardanelles. The permanent Military Hospital
at the Citadel had its bed accommodation at once
doubled, the number of beds here eventually reaching
775. No. i Australian General Hospital, which had
been established in the Heliopolis Palace Hotel on
January 25 with 200 beds, and had since been increas-
ing steadily, was now swiftly expanded to 1,000. As
the influx of sick and wounded steadily augmented,
additional buildings in the neighbourhood were
pressed into the hospital service, until over 6,000 beds
were available in this quarter alone. The Egyptian
Government lent its civilian hospitals in Kasr-el-
Aini and the Army hospital at Pont de Koubbeh.
The Saidieh Government School building was also
handed over to us, and within a few weeks had been
opened as a hospital by the Red Cross Society with
a complement of 200 beds which rapidly increased to
26
Egypt and the Great War
650. The Anglo-American Hospital immediately
placed its wards at the disposal of the British Army
Medical Service. Later, a hospital was opened at
Choubra for infectious cases. No. 5 Canadian
Stationary Hospital was established in the Cavalry
Barracks at Abbassieh; and the fine building of the
Egyptian Government Primary School, known as
Nasrieh School, became a British Military Hospital
with 584 beds. In addition to all these arrangements
effected for the reception of the wounded and sick
among our white troops, there were the men of our
Indian Forces to care for. These were received by
the No. 5 Indian General Hospital at Alexandria,
which was rapidly expanded to 950 beds; and by
No. 8 Indian General Hospital, which was installed
at the Citadel Bijou Palace, and contained beds to
the number of 900.
But the provision of hospital accommodation, as
enumerated above, for the vast numbers of sick and
wounded which so suddenly and unexpectedly poured
into Egypt from the Peninsula, formed only part of
the work of the Medical Staff. Extensive as were the
arrangements made, they would have proved wholly
inefficient but for an ingenious scheme of additional
camps and depots where the men could be received
and cared for during the period of their convalescence.
These convalescent establishments were, from the
very first, of the utmost help to the authorities in the
almost superhuman task of avoiding congestion in
the main hospitals.
In the first rush of wounded from the Dardanelles
27
With the R.A.M.C. in Egypt
at the end of April, 1915, they enabled the already
existing beds to be cleared of patients suffering from
minor ailments, and in this way a very large amount
of hospital accommodation became immediately avail-
able for critical cases from overseas. Thus at
Heliopolis during the first week of May, when the
wounded were pouring into No. i Australian General
Hospital and its hastily equipped auxiliaries at the
rate of 400 or 500 a day, the conversion of the large
El Hayat Hotel, Helouan, into a convalescent depot
immediately relieved the situation. Later a seaside
convalescent camp near Alexandria was formed in
connection with the same group of hospitals, and
proved equally valuable. Other convalescent depots
were immediately established at Mustapha near Alex-
andria, one specially for enteric cases in some build-
ings near Port Said, lent by the Suez Canal Com-
pany, others in the Palace Hotel at Boulac el Dacrour,
in the group of mansions at Montazah lent by the
Sultan of Egypt, in the Grand Hotel at Helouan, and
at what was called the "Rest Camp" at Abbassieh,
which alone developed an accommodation of 2,300
beds; while a convalescent hospital which received
officers only was established in the Sirdar's house at
Cairo. The Red Cross Hospital at Giza, Cairo,
obtained the loan of the Walda Palace at Helouan
from the Sultan, and thither dispatched its own con-
valescents. Lastly, to deal with cases where a long
period of convalescence under medical and nursing
care must intervene before the patients could be
again fit for duty, the great Luxor Convalescent
28
Egypt and the Great War
Depot was organised, all the hotels at that place, six
in number, being requisitioned for the purpose.
It is easy to construct in this way a catalogue of
the hospitals and convalescent homes which thus, as
if by magic, sprang up in all quarters of Egypt to
meet a sudden crisis, the like of which perhaps never
yet faced any Army Medical organisation in the
history of the world. Such a list, however, reveals
to the reader almost nothing at all of the real
magnitude of the task involved. It conveys no idea
of the enormous amount of physical labour which
devolved on the all too scanty staff of the Royal
Army Medical Corps and of the Australian A.M.C.,
leaving out of account the mental strain of devising
and directing the multiplicity of operations.
At the beginning of the year 1915 the Director of
Medical Services in Egypt had at his disposal for
white troops hospital accommodation to the extent of
at most 2,000 beds, counting all sources. By May
this number of beds had been increased to 13,000;
but, under the spur of continued necessity, the amount
of hospital accommodation in Egypt for our sick and
wounded soldiers of all races eventually reached a
total of some 36,000 beds. During the eight critical
months of the year 1915, extending from May to
December, when the Gallipoli Campaign was in pro-
gress, thousands upon thousands of desperately
wounded or disease-stricken men were landed in
Egypt* yet in spite of the enormous influx, there was
not a single one but had his needs well and promptly
met. For each were provided shelter, a decent bed,
29
With the R.A.M.C. in Egypt
the best of medical, surgical and nursing skill, food
and sick-room comforts without stint, clothing where
needed, easy transit from place to place by road or
rail, and a cheerful comfortable home in one of
Egypt's famous health-resorts wherein to grow strong
and fit again for the Empire's service, if that might
be; or, in the case of permanent incapacitation from
duty, a berth in a homeward-going hospital-ship,
excellently appointed and staffed.
How all this was successfully achieved on so large
a scale and under such pressure of time and circum-
stance, becomes only the more remarkable when we
consider in detail the difficulties encountered.
Though, as soon as the situation was made known
to them by cable, the home authorities took immediate
steps to send out an adequate supply of medical
personnel, stores, and equipment, the early and most
vital part of the crisis had to be met with local
resources alone. It was difficult enough to obtain
at a few hours' notice the necessary buildings in
which emergency hospitals on a large scale could be
established, and, when found, still more difficult to
prepare them for occupation. In no single case of all
the buildings pressed into service could use im-
mediately be made of the premises on any consider-
able scale for the accommodation of wounded men.
In all, the sanitary arrangements and cooking
facilities were either woefully insufficient, or totally
lacking. The two great public schools in Alexandria,
where Nos. 15 and 17 General Hospitals were in-
stalled, possessed, it is true, well-appointed kitchens,
30
Egypt and the Great War
but these had to be enlarged at once and additional
latrine accommodation provided. The old Egyptian
Army Barracks at Ras-el-Tin, where No. 21 General
Hospital succeeded eventually in establishing itself
on so commanding a scale, was at , first not only
entirely destitute of anything that could be called a
sanitary installation, but it was in an indescribably
filthy condition and, moreover, infested by vermin.
The cleansing of this Augean stable and its transfor-
mation into a thoroughly good hospital in record
time, was one of the most notable feats performed by
the men of the R.A.M.C. The friends of the late Sir
Victor Horsley, who was attached to this unit of the
Medical Service in Egypt, will be interested to hear
that the great surgeon, setting a fine example to the
desperately overworked staff, himself insisted on
taking a share in the cleansing operations, going
down on his knees with the rest in the work of
scrubbing the floors.
At Cairo, especially in the development of the
group of hospitals which sprang up round the
original Australian establishment at Heliopolis Palace
Hotel, this difficulty in preparing the buildings taken
to house the incoming thousands of wounded men,
may be said to have reached its culminating point.
The first patients arrived at Heliopolis from the
Dardanelles on April 29, 1915. By that time the
original hospital had been considerably expanded.
The tent equipment belonging to the hospital had
been erected on the Aerodrome site about three-
quarters of a mile away, and subsequent develop-
With the R.A.M.C. in Egypt
ments had resulted in the capacity of this camp being
increased. The skating rink at a pleasure resort
known as Luna Park near the first hospital had been
enclosed, furnished, and established as an overflow
hospital. An infectious hospital had been formed in
the Race Course Casino. In the emergency which
had now arisen all this accommodation originally
intended, for the most part, to serve the vast camps
which had grown up round about Cairo, was pressed
into the new service, the patients previously in pos-
session, or rather all those not too seriously ill to be
moved, being transferred to a convalescent hospital
which was immediately established in the great hotel
of Al Hayat at Helouan. This was furnished at
once and lent itself to expansion at a pinch.
At the same time No. 2 Australian General
Hospital, which had opened at Mena House near the
Pyramids in the early part of the year, was in-
stalled in the Ghezira Palace Hotel, Cairo, and
was rapidly equipped, Mena being retained as an
overflow.
As time went on, and the rush of wounded con-
tinued, the Luna Park establishment was largely
increased. A large workshop at Heliopolis, known
as The Atelier, was taken, equipped and opened,
being filled in a single day. Soon after, the Helio-
polis Sporting Club pavilion was also commandeered
and converted into a hospital which was rapidly
enlarged. Subsequently hospitals for infectious
diseases were opened at Choubrah, and in the
Artillery Barracks at Abbassieh. In addition to all
Egypt and the Great War
this, the outlet for convalescent cases from this
Australian group of hospitals was greatly widened
by the establishment, in the Ras-el-Tin School at
Alexandria, of a seaside convalescent home. Also in
the Palace, or rather group of mansions, at Montazah
near the same town, which, as has been previously
stated, was lent by the Sultan of Egypt for the
purpose, an admirable convalescent hospital was
created, where Australian patients could be housed.
The work involved in the preparation of all these
establishments was enormous; and it fell entirely
on a staff which, under normal conditions, was
required to perform only the duties of a General
Hospital of limited size. Perhaps no better way of
conveying an idea of what was accomplished by this
devoted band of doctors and orderlies of the Aus-
tralian Army Medical Corps can be chosen than by
giving an extract from the quartermaster's diary at
the time. It deals with only 48 hours of a long-en-
during crisis :
"June 8th Qth. During the twenty-four hours a
large number of patients were admitted to the hospital.
To each man my department issued lime-juice, biscuits,
pyjamas, shirts, towels, mug, soap-bowl, plate, knife,
fork, spoon, socks, handkerchiefs, and shoes. On the
night of the 8th, or rather in the early morning oi
the gth, we worked until 3.30 a.m. The ambulance
train did not arrive till 2 a.m. Prior to the arrival ol
the train, we received word that parties of wounded
men were leaving for England and Australia by train
in the morning. We had consequently to prepare
33
With the R.A.M.C. in Egypt
twenty-four hours' rations for these men, assembling
for work about 6.30 a.m. on the gth. Most of them
were on special individual diet. Furthermore, a number
of them entered the hospital naked, and had to be
issued with hospital clothing for the voyage.
"After these were dispatched we went to work to
make provision for the large army of wounded men
who had arrived overnight. The extra rations, etc.,
were duly provided.
"Later in th? day we received orders to convert a
machinery workshop (the Atelier) into a hospital, to
supply linen, blankets, stove, hospital and cooking
utensils, to erect a kitchen, and to make special sewerage
and ventilation arrangements. The beds were ready for
occupation within twenty-four hours. While this work
was in progress, word came that the club-house of a
local golf club had been commandeered, and beds were
to be erected immediately. At 3.30 p.m. on the gth
I had a lime-juice at the bar in the club-house, and
the people had then no idea of our intended occupation.
At 6.30 p.m. the first mattresses and beds were delivered,
and the hospital commenced. To-night, the loth, the
hospital is fully equipped and ready for occupation.
"The hospital completed yesterday is to be occupied
to-night.
"It is extremely doubtful if any quartermaster's
department in the Army Medical Corps has ever been
called upon to accomplish so much in forty-eight hours,
when it is remembered that our staff is only for an
establishment of one-seventh of the beds now available.
Only one of my men failed to stand the strain, and,
as he was dropping asleep at his work through sheer
exhaustion, I sent him to bed.
34
Egypt and the Great War
" We now control six hospital buildings and two
nurses' homes in Heliopolis."
The above extract fairly represents the state of
things prevailing at the time throughout the entire
hospital system of the country. It does not touch,
however, on several important aspects of the crisis :
notably what was done to organise and extend the
female nursing section, how the supply of hospital
equipment and material was maintained, how the
transport by road and rail of such vast numbers of
helpless sufferers was effected, and perhaps the most
difficult, if not the most important of all how the
problem of feeding the multitude was solved.
FEMALE NURSING SERVICE
In reviewing the part played by the members of the
Queen Alexandra Imperial Military Nursing Service
and of the Colonial nursing organisations during this
period of storm and stress, it is difficult to award a
due measure of praise without incurring the charge of
dealing in extravagant eulogy. At the beginning of
the Callipoli Campaign there was no more than a
handful of trained sisters and nurses at the Base in
Egypt, and these were already fully employed.
When, therefore, the avalanche of wounded from the
Dardanelles descended so unexpectedly on the
country, it was inevitable that a certain amount of
confusion should result. That the resources of the
Q.A.I.M.N.S. and of the Australian and New Zea-
land contingents, though at one time strained almost,
35
With the R.A.M.C. in Egypt
to the breaking-point, did not in fact break, but mag-
nificently stood the strain, must be set down to two
factors : in the first place to the admirable system of
training in the Alexandra organisation, which, rather
it must be admitted to the astonishment of the merely
masculine part of the Army Medical Service, succeeds
in developing among women, apart from technical
knowledge, the qualities of hard endurance, instant
resource, and unflinching readiness to accept respon-
sibility, to a high degree; and in the second place it
must be ascribed to the ability and genius for or-
ganisation of the Matron-in-Chief for Egypt, Miss S.
E. Oram, R.R.C. with Bar, upon whose shoulders
from a very early period of the crisis fell the whole
brunt in the management of nursing affairs.
Looking back on those first few weeks of stress
and turmoil, when the wounded and sick were pour-
ing into Alexandria, it is not easy to understand how,
temporarily at least, a condition of*absolute chaos and
deadlock was avoided. But avoided it was; and, in
the case of the female nursing service, by a variety of
ingenious devices combined with whole-hearted self-
sacrifice and devotion to duty. There were not only
the hastily improvised hospitals and convalescent
depots in Egypt to staff; the ships bringing the
wounded from the shell-swept beaches at the seat of
war, and the hospital trains transporting so many of
them to Cairo and elsewhere,' had to be supplied with
sisters and nurses. In this latter regard especially,
as, indeed, in all other departments of the nursing
service in Egypt during the war, the V.A.D. contin-
36
Egypt and the Great War
gent of the Red Cross Society and Order of Saint
John rendered invaluable aid.
It has been said that there were comparatively
very few Army sisters and nurses in Egypt at the
commencement of the Gallipoli operations. Rein-
forcements of' nurses were already on their way out
from home, and immediately the authorities became
aware of the true nature of the campaign, further de-
tachments were got together and dispatched by nearly
every ship sailing for the scene of hostilities. At a
very early stage in the crisis adequate supplies of
nurses had arrived in Egypt, and the situation had
been relieved. Before the year was out, upwards of a
thousand were available for duty. The extreme diffi-
culty, however, of coping with the demand made
upon the hospital nursing-staff in those first critical
weeks cannot well be overrated. Great credit is due
to the Australian nurses, 186 in number, who had
come out in the Kyarra, at the beginning of the year,
and had not only staffed the Australian hospitals, but
had supplied detachments to various other medical
units in Egypt. Until a sufficient number of the
regular Army nursing-staff had arrived on the scene,
the main work of tending the wounded devolved upon
these, and on the New Zealand sisters, augmented by
any trained local assistance that could be found, and
by all the untrained yet willing helpers that the
women of Anglo-Egypt could muster between them.
Thus No. 15 General Hospital, which, it will be
remembered, came to Egypt without female nursing-
staff, was at first entirely supplied from local re-
37
With the R.A.M.C. in Egypt
sources, these being gradually replaced by Army
nurses augmented by the V.A.D. To illustrate the
methodical, yet unavoidably heterogeneous way in
which the nursing-staffs of the various hospitals were
finally got together, an extract is given below from
the diary of No. 17 General, which, like No. 15, had
been originally provided with male personnel alone :
"April 29, 1915. Two nurses were locally
engaged.
April 30, 1915. Four Australian nurses lent from
Mena House arrived.
May 2, 1915. Two Q.A.I.M.N.S Reserve nurses
arrived from Cairo.
May 4, 1915. Six Australian nurses arrived for
permanent staff. Ten Dispensary nurses arrived from
different parts of Egypt for temporary duty here.
May u, 1915. Six Australians arrived, lent from
Mena House.
May 14, 1915. Four Q.A.I.M.N.S. Reserve from
England.
May 26, 1915. Ten nurses (Lady Carnarvon's)
arrived here.
June 15, 1915. Thirteen Australian nurses arrived
for duty here.
June 21, 1915. Ten Australian nurses arrived.
July i, {915. Ten Q.A.I.M.N.S. Reserve arrived
from England.
July 2, 1915, Fifteen New Zealand nurses arrived
here."
The ten nurses who joined the hospital on May 26
Egypt and the Great War
were part of a detachment of 50 which the Countess
of Carnarvon was instrumental in obtaining from
England.
TRANSPORT : ROAD, RAIL, AND MARINE
Transport was from the first one of the gravest
difficulties encountered. It began on the Peninsula
itself, where the number of hospital-ships attached to
the Expeditionary Force at the outset proved wholly
insufficient for the task of evacuating the wounded,
and many troopships had to be pressed into the
service.
But the main difficulty lay at the Egyptian Base.
Motor ambulance vehicles to convey the wounded
from the harbour landing-stages to the hospitals in
and about Alexandria, to the railway station en route
for Cairo, and again in Cairo between the trains and
the various hospital units there, were woefully few in
number considering the magnitude of the work en-
tailed. The motor ambulances available belonged al-
most entirely to the Australian and New Zealand
medical units thirty fine cars, the gift of the Aus-
tralian Red Cross Society, having been brought to
Egypt in the Kyarra early in the year, and twenty
additional cars were eventually added to this fleet
from the same source. A number of the ambulances
were drafted to Alexandria, but the main body was
installed in two large garages at Heliopolis and
Ghezira, where they were in immediate call for
service. For a long period they were under almost
constant requisition night and day, but so well was
39
With the R.A.M.C. in Egypt
the service organised and apportioned that practically
no material delay in the conveyance of the wounded
ever occurred.
The same may be said for the service of hospital
trains between the great towns. These trains were
provided and equipped by the Egyptian State Rail-
way, and the service admirably maintained through
the periods of crisis. There were six separate trains
for the service, these being kept at Gabbary Station,
Alexandria, which is conveniently near to the docks.
The trains were designed to accommodate 100 lying
down, or 150 sitting cases; and during the year 1915
many thousand cases were carried.
Upon the hospital ships, however, devolved the
main and most vital part of dealing with the vast
multitudes of sick and wounded men which flowed
into, and out of, tgypt at this critical time. From a
very few regularly appointed hospital ships supple-
mented by hastily improvised * 'carriers*' and troop-
ships, which constituted the service at the beginning
of the Peninsula operations, the number of these
vessels was steadily and swiftly augmented until over
sixty were eventually running. From the end of
April to the end of December, 1915, many thousand
cases were brought to Egypt; while during the same
period as many invalided men were carried home
to Great Britain, Australia, New Zealand, and India.
All these ships, except those employed on the Indian
line, were staffed by the Royal Army Medical Corps
and the Alexandra and Colonial Nursing Services.
In regard to the work done on these ships by the
40
Egypt and the Great War
doctors, orderlies and nurses of the Army Medical
Service, the following quotation from an official
report of the time will be of interest :
41 1 can attest to the care with which in both hospital
ships and ambulance carriers the sick and wounded were
dealt with, for it is within my personal knowledge that,
during the days of stress following battle, neither officers,
nurses, orderlies, nor ships' companies thought of rest
or refreshment. In the carrier ships, without many of
the conveniences provided in regular medical establish-
ments, difficulties were multiplied ; and yet the apparently
impossible was achieved, and the wounded suffered no
avoidable hardship.
"Where all did so well, it may appear invidious
to select any class of worker for particular mention,
but I cannot refrain from bringing to notice in a very
special manner the work performed by the Nursing
Services under Miss S. E. Oram, R.R.C., the Matron-
in-Chief. Whether belonging to the Regular, Terri-
torial or Overseas Services, the untiring devotion dis-
played by these ladies in the very trying conditions on
board ship at the Front is a recollection that can never
be effaced from the memories of those to whom they
ministered, and of every officer and man associated with
them in their labours."
And, it may be added, many of these heroic British
women died at their posts, while many more were
permanently invalided as a result of hard work and
privation. The dangers, difficulties, and hardships
to be met with on these sea-going hospitals arc,
indeed, scarcely realised by the public at home. Apart
With the R.A.M.C. in Egypt
from the risk from enemy torpedoes and mines
witness the fate of the Braemar Castle, Britannic,
Marquette (where nine of the nurses were drowned),
the Gloucester Castle, and many others the day's
work on a hospital ship continuously passing from
port to port with the most exacting and portentous
cargo that vessel could possibly carry, is as much as,
sometimes more than, human energy and hardihood
can support. Here is a very terse, disjointed series
of extracts from a diary kept on board one ship alone,
the Dunluce Castle, which fairly represents the sort
of life a ship's staff of the R.A.M.C. lives as a matter
of every day :
"Throughout summer of 1915 up to time of evacua-
tion of Peninsula continuously carried sick and wounded
between Gallipoli and Egypt and Malta. Then ship lent
to French service in winter 1916, and went to Valona
and carried Serbians to Bizerta, Bana and Algiers.
She then carried patients from Egypt to Sicily for
transhipment to Britannic. Then from Egypt to England
with full cargo of sick and wounded. Back to Egypt
again with equipment and personnel of a stationary
hospital for Mesopotamia. Then to Salonika to fetch
wounded. Then to and fro between Salonika and Malta
up to October, 1916, with many wounded, also large
numbers of dysenteric and malarial cases (on one voyage
alone, out of the total patients, two-thirds were cases
of malaria). In October ran between Malta and Mudros,
also one trip home to fetch No. 41 General Hospital
for Serbians. Then Egypt to England, carrying a
number of mental cases. After disembarking at South-
42
Egypt and the Great War
ampton went immediately (same day) to Havre, and
brought over cases, including 130 sick and wounded
German prisoners. Remained for rest of winter months
doing cross-Channel work. Back to Egypt in spring."
The above may well be left to speak for itself,
except it may be here remarked no words can
possibly convey to the unprofessional reader an idea
of the difficulty of properly tending a ship full of
dysenteric patients during a long voyage; nor of the
responsibility, the anxiety, the constant vigilance
needed, in the care of "a number of mental cases"
under the same trying circumstances.
One item in, the excerpt, however, may be
amplified here, by way of illustration of the kind of
work which an R.A.M.C. ship's contingent may be
called upon to perform. Here set down in plain sober
language are the real facts as concentrated, or rather
concealed, in the laconic phrase "went to Valona and
carried Serbians to Bizerta."
"On the afternoon of February loth, 1916, the
Dunluce Castle started to embark Serbians, some from
an Italian hospital ship, and some from a small vessel
that had come down from Durazzo that morning. The
men were in a more deplorable condition than can be
imagined. They were of those who had fallen out in
the retreat, and, by some means,, had made their way
to the coast. Two died while being transferred to our
ship. The embarkation was completed by 8 p.m., and
we were instructed to leave for Bizerta at daybreak.
By that time, however, in spite of the closest attention,
43
With the R.A.M.C. in Egypt
eleven bodies were awaiting burial. I have never seen
worse cases, and their moaning was pitiful; many of
them had been unable to look after themselves for several
days, and their condition cannot be described. All were
infested with lice, some with maggots, and many had
horrible sores to which their rags were sticking. Nearly
all were suffering from marasmus of diarrhoea, and many
were in the typhoid state. The odour in the wards
and throughout the ship was indescribable, and dis-
infectants had to be freely sprayed everywhere. To
avoid any risk of infection, the captain insisted on all
clothing being burnt, as several cases could not be
definitely diagnosed, typhus, cholera, and, in one case,
smallpox being suspected. Many had to be fed hourly,
and nearly all very carefully; but in spite of all that
could be done by feeding, infusion, or any other means,
the total deaths reached fifteen in the first twenty-four
hours.
"An Anglo-Serb vocabulary of about fifty words was
prepared, and a copy given to each Sister, which was
a great help, and gradually the men began to throw
off their intense depression. The weather on leaving
Valona was by no means propitious, and added largely
to the labours and difficulties of all those working in
the wards.
" Bizerta was reached during the morning of Sunday,
February I3th, by which date the death-roll had reached
a total of thirty-nine. The improvement in the general
appearance and condition of the patients during their
stay on the ship was really wonderful, and we found
them a most grateful people, whom it was a pleasure
to serve. After disembarkation the ship was fumigated
44
Egypt and the Great War
throughout, and kept in strict quarantine for a period
of five days."
MEDICAL EQUIPMENT AND MATERIAL
"There has never at any time been any shortage
whatever of drugs, dressings, etc., in Egypt."
This, and in his own words, is the testimony of
the one, of all others in the Anglo-Egyptian
Command at the time, best qualified to speak ; and in
view of the enormous demands made on the supply
department of the Royal Army Medical Corps
during the year under review, 1915, the words have
very great significance.
The adequacy of medical supplies for our armies
in the Near East, the base for which was established
in Alexandria, depended then as now on the skill with
which the necessities of the various departments could
be foreseen and provided for greatly in advance of the
time they would be needed by the different units.
Everything had to be brought by sea over about 3,000
perilous miles, a journey that never occupied less than
three weeks, and might take eight weeks or more. To
ensure, therefore, that the stores would be ready by
the date required, they had to be ordered from home
at a period so largely ahead of events that their exact
nature and quantities could not possibly be gauged
by the ordinary methods.
The requisition of these supplies would have been
difficult enough if the problem had been merely one
of meeting the medical needs of a single force of
known extent within a well-defined and accessible
45
With the R.A.M.C. in Egypt
sphere with good lines of communication. But the
task was far otherwise in Egypt. The armies, first at
the Dardanelles and then at Salonika, had to be
supplied over long lines of sea communication, the
most difficult known to military science. Not only at
these places but on both the Eastern and Western
Egyptian frontiers, there were great numbers of field
regimental medical units, field ambulances, Casualty
Clearing Stations, and Stationary Hospitals all
depending on the Alexandrian Base. There were the
Base Hospitals in Egypt those ordinarily in
existence and those which sprang up everywhere at
such short notice ; also many convalescent dep6ts and
camps ; and the one constant demand of these was for
an unremitting supply of necessary medical stores.
There was a fleet of 50 or 60 hospital-ships, as well as
transports and other forms of craft, all depending on
the same Base. The ambulance trains looked to
Alexandria for everything they needed medically.
Moreover, the Mex Peninsula and the sea-board for
some miles from the Egyptian port were thronged
with camps where troops were continually coming and
going in vast numbers. With every camp and with
every unit there was a Medical Officer responsible for
the health of its personnel, and medical stores were
constantly required by each of them.
All these different centres of activities focused
their demands on the one establishment at Alexandria
demands that were not only extraordinary : many
of them were unprecedented in scale. And yet,
* 'there was never at any time any shortage whatever
46
Egypt and the Great War
in drugs, dressings, etc., in Egypt.'* x How was it
done?
The explanation is very simple, and can be stated
in half a dozen words: Organisation, foresight, and
energy rightly applied.
A new system was inaugurated. Instead of a
number of Base Depots for medical stores, each one
obtaining its supplies direct from England, a single
Main Medical Store Depot for the armies in the Near
East was established at Alexandria. This Store
Depot may be likened to a wholesale Business house
in civil life, and the various Base Depots to retail
shops. A wholesale business house is successful or
otherwise according to the accuracy with which it
forecasts the needs of its retail customers. This
forecast must necessarily be made many months in
advance, or the goods will not be ready by the time
they are wanted. And not only must the right goods
be available at the right time, but they must be there
in the right quantity not less, or trade will be
restricted; and not more, or there will be unsaleable
surplus to be jobbed when the demand has ceased : in
both of which cases there will be loss of profit.
The Main Medical Store Depot at Alexandria was
run on exactly the lines of a wholesale business house,
and with all, and more than all, the courage,
judgment, and foresight indispensable to such an
enterprise. The future needs of the armies in the
field and all subsidiary services were carefully studied,
and the probable quantities and kinds of material and
equipment that would be required as carefully
47
With the R.A.M.C. in Egypt
estimated. It was a gargantuan task. There were
not only the wards of the hospitals to supply with
dressings and appliances : there was an infinity of
different kinds of drugs and medicinal preparations
for the dispensaries, instruments for the operating-
theatres, outfits and various appurtenances for the
X-Ray rooms, laboratories, and dental departments,
the thousand-and-one indispensable articles that
modern medical science has called into being. And
all these things had not only to be provided in
advance, but provided on such a scale as would, on
the one hand, defy the possibility of shortage under
any conceivable demand, and, on the other, avoid
the creation of useless surplusages.
That the Main Medical Store Dep6t for the Near
Eastern armies accomplished all this, that it supplied
the needs of four campaigns and kept a great fleet of
hospital-ships replenished, that it weathered success-
fully the storm of the Gallipoli crisis, and that of all
the battalions marching through Egypt it left none
with a single medical need unsatisfied, is now part of
the history of the war and requires no recapitulation
here. Incidentally, however, some few details of the
organisation and work of the Dep6t may be given.
The unit sailed from England in March, 1915, as
part of the Mediterranean Expeditionary Force, and,
on arrival in Egypt, it was established in what had
been the Austrian-Lloyd Company's shed at the
docks, Alexandria. In April the Dep6t was opened,
and almost immediately it was working under high
pressure, heavy demands being made on it at an early
48
Egypt and the Great War
stage, especially for dressings for the Gallipoli
Peninsula. It soon outgrew its original premises,
and took over several of the large chounahs, or cotton
warehouses, adjoining. The Depot eventually com-
prised a floor space of 85,000 sq. feet. Apart from
the main work of supply a great deal of work has been
done in refitting and refilling Medical and Surgical
Panniers, Field Haversacks, Fracture Boxes, Water-
testing Cases, and other items of Field medical
equipment. The duties of forwarding medical stores
to other and remoter theatres of war, when these were
landed here en route, were also undertaken by the
Depot, the goods being temporarily warehoused, and
reshipped, or railed to another port for shipment, as
opportunity offered. As another instance of the
usefulness of the Depot, it may be mentioned that a
complete electro-plating outfit was installed in one of
the buildings, and an expert cutler continuously
employed in renovating surgical instruments and
appliances which had been returned to the Base as
unserviceable. In this way a great number of
expensive articles were made fit again for use, and
re-issued to the medical units; thus an important
economy was effected.
HOSPITAL COMMISSARIAT AND SUPPLY OF INVALID DIET
The proper feeding of the great multitudes of sick
and wounded men who were so suddenly and
unexpectedly thrown on the resources of the medical
authorities in Egypt during 1915 was from the first
a source of great anxiety.
49
With the R.A.M.C. in Egypt
The ordinary channels of Army food supply were
very heavily taxed during the first few weeks of the
crisis, but magnificently stood the strain. The main
crux of the situation, however, fell on the hospital
kitchen staffs, who, even when the difficulty of
obtaining the raw material of sustenance in sufficient
quantity was overcome, had then to convert it into a
form suitable to the needs of desperately hurt and
helpless men. And to contrive thai the kitchen
organisation of each hospital and convalescent camp
should keep pace with the swiftly expanding wards
was a still greater problem. It is difficult to convey
any real notion of the strain which thus fell on the
quartermasters' departments of the Army Medical
Service at this time : still more to explain how the
difficulties were met and so triumphantly overcome.
No doubt the quartermasters of the Royal Army
Medical Corps, and in no less degree those of the
Australian and New Zealand contingents, here added
conspicuously to their already hard- won laurels. It
is a fine thing to gain * 'reputation at the cannon's
mouth." The men who "go over the top' 1 against
a whistling hurricane of bullets, throwing away life
as they would a spent match-stalk, deserve all the
honour and glory that an appreciative but very busy
nation has leisure to bestow on them; but there are
times notably this of the great rush of Gallipoli
wounded to Egypt when the skimming-ladle and
the butcher's cleaver alone stand between tens of
thousands of human beings and the neglect which
means death. If the merit for bringing this war to
Egypt and the Great War
a successful issue were to be apportioned according to
the amount of shoe leather outworn in the country's
service, quartermasters would not be far behind in the
reckoning.
Not the least of the many services rendered to the
Army medical organisation in Egypt by the
Red Cross and St. John Committee, must be
accounted the way in which that body now carried
out an ingenious and very useful scheme. This was
to instal and furnish supernumerary kitchens at
nearly all the hospitals, where the lighter and more
delicate articles of sick-ward diet could be prepared.
At a time when the regular staffs of the main hospital
cook-houses were literally run off their legs with
work, this assistance of the* Red Cross ladies proved
as opportune as it was invaluable.
And in this brief account of the means taken to
feed the multitude of sick and wounded from
Gallipoli, we must not leave unacknowledged the
services of the many Egyptian catering firms. In
the case of many of the hastily improvised hospitals
and convalescent depots, either by reason of special
conditions or because of the impossibility of obtaining
cooks and cooking-plant in time, recourse was had
to the services of these local caterers : and in almost
every instance the task entrusted to them was well
and faithfully carried through.
CHAPTER III
" THE LONG, LONG WAY TO ACHI BABA "
DURING those interminable weeks and months of
toil, when every man of the R.A.M.C. in Egypt kept
loyally, unremittingly to his task of succouring the
sick and wounded that poured into the country from
Gallipoli, the thought must constantly have arisen in
many minds: what sort of place could this be, and
what the conditions, where such very work of Hades
had been brewing ?
Those of our Medical Corps men who lived
through the dread days of the landing on the
Gallipoli Peninsula, cannot easily be got to talk of
their experiences. There is a point beyond which
fullness of heart does not make the mouth speak :
rather it tends to check utterance, as though words
were powerless to convey any true expression of
things done and seen.
There is one fact which stands out very clearly
against the sombre yet lurid background of this
Gallipoli story. It is the necessity of having in the
ranks of the Army Medical Corps a large number of
men in the prime of their sturdy youth, equally with
those of other services. There are too many
uninformed, perhaps uninformable, persons at home
who loudly express the opinion that non-combatant
5*
"The Long, Long Way to Achi Baba"
units should be composed of men physically, or by
reason of age, unfit for the supposedly more exacting
duties of carrying arms. There is little profit in
attempting to dispel illusions born of ignorance, even
if that were either necessary or possible. But
the plain, practical testimony of experience can
always be depended upon to speak for itself;
and from first to last the story of the work of
the Royal Army Medical Corps on Gallipoli is one
long tale of triumph over difficulties insuperable
for manhood other than at its full tide of youth and
strength.
For how else is it possible to account for the facts
of the collection of wounded from those early battle-
fields of Gallipoli; their medical treatment in the
dressing stations and their conveyance to the hospital-
ships with such expedition that within the first ten
days thousands were landed in Egypt 200 miles away
overseas ? The physical strain, the mere expenditure
of bodily energy, involved in this task, apart from
the mental and nervous wear-and-tear, is scarcely to
be exaggerated. Indeed, youth and strength alone
must have stood between success and failure in the
work success, which meant the saving of
innumerable lives and the avoidance of untold
suffering; and failure, which could only have meant
for thousands the worst of torture ending in the worst
of deaths.
Here is what Sir Ian Hamilton, in his dispatch of
August 25, 1915, says of the work of our Field
Ambulances on the Peninsula:
E 53
With the R.A.M.C. in Egypt
"The Royal Army Medical Corps have had to face
unusual and very trying conditions. There are no roads,
and the wounded who are unable to walk must be
carried from the firing-line to the shore. They and
their attendants may be shelled on their way to the
beaches, at the beaches, on the jetties, and again
though I believe by inadvertence on their way out in
lighters to the hospital ships. . . . Efficiency, method,
and quiet heroism have characterised the evacuation of
the many thousands of our wounded."
And here, from the same dispatch, is a picture of
the country, and the circumstances, in which the work
was done :
"The country is broken, mountainous, arid, atid void
of supplies. The water found in the areas occupied by
our forces is quite inadequate for their needs. The
only practicable beaches are small, cramped breaks in
impracticable lines of cliffs with the wind in certain
quarters no sort of landing is possible. The wastage
by bombardment and wreckage of lighters and small
craft has led to crisis after crisis in our carrying capacity,
whilst over every single beach plays fitfully throughout
each day a devastating shell-fire at medium ranges. . . .
Upon such a situation appeared quite suddenly the enemy
submarines."
" Efficiency, method, quiet heroism" Sir Ian
Hamilton, ever happy of phrase in his official
dispatches, could scarce have hit upon words more
singularly apt than these in his designation of the
work of our Field Ambulances, officers and men alike,
on the Gallipoli Peninsula. The efficiency and
54
'The Long, Long Way to Achi Baba"
method were there as a matter of course, the common
qualities of all trained units; but the peculiar variety
of heroism which may be called "quiet" is not a
military trait at all. In soldiers you find stolidity, a
sort of dogged dumb indifference, in the face of
danger half the recorded deeds of heroism in this
war have been done with the same clenched teeth and
tongue-tied, derisive grin that doctors so often see in
men suffering from some hideous dismemberment,
who are brought to the aid post to be dressed.
Magnificent as it is, it belongs rather to the physical
than the moral side. But ' 'quiet* ' heroism is wholly
another thing.
The Commander-in-Chief of the Mediterranean
Expeditionary Force was right when he applied the
words to the work of the R.A.M.C. on those back-
aching, nerve-racking days and nights that followed
the memorable landing near Cape Helles. But he
was not wholly right. For he used the words in
special commendation as of an extraordinary effort,
whereas the sober fact as all joining the R.A.M.C.
should be made to know is that an ambulance man
is useless in warfare unless courage of the "quiet"
kind forms an ordinary, indispensable part, a sine
qua non, of his professional kit, and as such calls
for no commendation.
' 'Quiet" heroism has none of the physical, it is
even beyond the intellectual, perhaps it is wholly a
spiritual thing. It has no impulses, nor great
vaulting occasions, nor has it anything of the
1 'thunder and blunder" obsession about it, such as
55
With the R.A.M.C. in Egypt
made Balaclava. It has no times or seasons : it is as
ready at three o'clock in the morning as at high noon.
It does not need war whoops, nor screels of bagpipes,
to awaken it to instant service. You cannot see it or
define it, or associate its possession with outward
evidences of noble brow, or flashing eye, or bulldog
jaw. The men that have it most are often of the
gentle-mannered, diffident type the last men in the
world, you would say, to prove of the stuff of heroes.
But whatever it is, the sober fact as proved in this
and all other theatres of war is that our Medical
Service men possess it in abundance, from the
* 'attached*' M.Q. in his dug-out close to the firing-
line, with a bullet in his own back, who "quietly"
finishes dressing the wound of a man, to the
R.A.M.C. cook at the dressing station below, who as
"quietly" takes his turn at stirring the dixie while
his mate, who a moment before was wielding the
ladle, is now on his way to the doctor with shrapnel
in his throat.
There is, indeed, no single department of the
work of the R.A.M.C. in the field wherein a ceaseless
levy on this particular quality is not made; and the
story of the Gallipoli Campaign, so far as it deals
with the work of our Corps, serves but to bring this
truth more vividly into relief, whether during those
first critical days, or later, when the opposing forces
had settled down into the grim unlovely methods of
trench warfare.
On that far-off spit of land, cut off from all the
world, any and every sort of courage, indeed, was
56
"The Long, Long Way to Achi Baba"
badly needed. It is of course universally known that
there was no such thing as a safety zone on the
Peninsula. Every yard of ground, from firing line
to sea, was open to shell and rifle fire and to bombs
from aeroplanes, not to mention the hail of returning
shrapnel bullets sent up by our own guns against
enemy aircraft. In the summer, the heat and the
plague of flies were all but unbearable. The autumn
brought storms and floods, when the gullies and
ravines, the deep zigzag crevices in the yellow sand-
stone heights so characteristic of Gallipoli wherein
fc our troops lived like rats in a drain became
impassable mountain torrents. Winter came with
more gales and deluges, and a cold that seemed to
have in it a bitter quality of unearthly searching
deadliness. Through it all the work of aid-post,
advanced dressing station, and casualty clearing
station, the unceasing toil of the stretcher squads, the
lading of hospital-ships, fared unconcernedly on.
Much has been written more than enough,
perhaps about the deeds done and perils lived
through during the first exalting months of the
Dardanelles Campaign. Too little, assuredly, is
known, or ever will be known, about the life that
followed a life, or, rather, a bare existence, wherein
endurance of every conceivable discomfort and
hardship and danger became habit engrained,
wherein long use brought to men a second nature of
skulking in rabbit burrows, and their old birthright
of freedom to walk the earth under blue sky and
sunshine was whittled down rabbit-like to occasional
57
With the R.A.M.C. in Egypt
furtive skurryings from hole to hole. To live
that sort of life for long, and keep a sound
heart and mind within him, was test of worth for
any man.
Luckily for the particular strain of humanity
which is attracted to the Army Medical Service, the
conditions could be viewed from a different point
from that necessarily occupied by the righting man.
The latter is out to kill all honour to him for that in
the present war at least but neither his training nor
his temperament had in the slightest degree prepared
him for what he perforce encountered on the Gallipoli
Peninsula. The killing spirit chafed itself sore and
raw in the sepulchral environment of dug-out and
trench. On the other hand, the healing spirit the
business of staunching wounds, and heartening
helplessness and easing pain which had brought the
R.A.M.C. man to the same ominous pass, did not
leave him in the like predicament of mind. It is not
here contended that the Medical Service man goes to
war with cleaner hands or nobler motives than he who
seeks and is trained to kill his country's enemies for
the common good. But the fact is self-evident that the
one kind of duty tends to nourish faculties which are
spiritual, while the other tends to destroy them, or at
least to keep them in abeyance and subject to all the
perils that accompany disuse.
The word self-sacrifice has been on everyone's
lips since the beginning of this war; but nearly
always it has been applied to those who, while exerting
every art and device to kill the enemy, have them-
58
"The Long, Long Way to Achi Baba"
selves been killed by him. This is self-sacrifice in
the truest sense, if you will : although soldiers in
general agree that, in this regard, the term has been
worn rather thin. Not enough, however, is heard of
it in connection with those whose duty carries them
equally into the thick of every fight, but who have
none of the warrior's stimulus, the sporting sense of
giving blow for blow the upholding, satisfying
spirit which poor humanity will ever find in the
ancient doctrine of tit-for-tat.
Here is the story, simply even baldly told, of one
specimen day in the routine of an attached
R.A.M.C. Medical Officer to a regiment on Gallipoli,
which serves to illustrate as well as another the
"quiet" heroism of which Sir Ian Hamilton wrote.
It is given nearly in the original words of its recorder.
There is nothing remarkable, nor even exceptional,
about it. Taking it thus almost at random, the story
of all the long weary months of the campaign may be
realised as much or as little as we may realise a whole
edifice by looking at a single stone :
" When the stretcher-bearers pick up a wounded
man, they carry him to the Medical Officer in his
dug-out. This is close behind the firing-line, and
is simply a hole in the wall of one of the main com-
munication trenches, with ledges cut for the doctor
and his assistants and any patients who are there, to
sit or lie on. Round about are arranged the medical
and surgical panniers that are thrown open ready for
use now that an action is on. It is imperative that the
doctor be at some spot which all the officers and men
59
With the R.A.M.C. in Egypt
belonging to his unit know, and to which the slightly
wounded can walk and the severely wounded can be
carried. This arrangement is necessary, as it is
impossible for the Medical Officer to do good work
in the firing trenches themselves, which are scattered
and cramped.
" The work done at the Regimental Aid Post, as
it is called, is always carried out under grave risks,
and the losses amongst medical men who have died
at their duty have occurred mostly at these places.
During an action the shells and bullets may be
falling like hail, and yet there is never a lull in the
work of dressing and bandaging. The wounded men
sit or lie round, waiting their turn. Every now and
then the bearers squeeze along the narrow trench
leading to the doctor's place carrying a man whose
grave condition demands immediate attention. The
doctor turns aside from the shattered legs and arms,
and bends over the prostrate figure, his assistants
deftly cutting away the clothes here and there, till the
wound is properly exposed. Swiftly he does what is
needful or possible. The wound is swabbed clean
perhaps a tourniquet is applied to stem the red gush
that is carrying life away with it the doctor turns
again to the patients whose needs have had to give
way before the greater danger, and one by one their
wounds are bathed and dressed, and they are carried
off by the bearers waiting near.
" If you are to picture the scene at the Medical Aid
Post during an action, as indeed at all the more
advanced places of medical treatment, you must
60
TURKISH SINGLEHANDED STRETCHER, SHOWING
METHOD OF CARRYING.
"The Long, Long Way to Achi Baba"
realise the awful circumstances of the time. The air
is torn with the din and crash of the heavy guns that
belch forth destruction on all sides, and with the
constant crackle of the rifles and machine-guns. The
bullets fly past with a hiss and a hum. As the shells
cross a hollow in the ground, the sound of their flight
gathers into a roar that is prolonged long after they
have passed overhead. It is as if a thunderstorm had
burst forth at your very ears and that seems as if it
would never cease.
" Every now and then the doctor and those around
him stand for a moment listening intently, and then
duck suddenly as a shell tears past with a scream and
falls a few yards off, shattering., everything in its
course. A few seconds later, perhaps without a trace
of warning, there is a terrific crash overhead as if the
storm had concentrated all its fury for one supreme
moment. The shrapnel spatters the parapet and the
trench with its deadly charge, and the doctor turns
again to his work. He feels a sharp twinge in his
arm where he thinks a lump of earth struck him, but
that is nothing, and his work is pressing, paramount.
The man on the ledge before him, whose hand he has
just finished dressing, sits for a moment gazing at the
opposite wall, and then rolls over heavily with a bullet
through his brain. He is carried out gently, and it
is then seen that the same shrapnel charge has found
two of the other patients, who by this time have
collected in a crowd round the doctor's dug-out,
waiting their turn. They must all be seen to, and
sent down the line as quickly as possible : faster than
61
With the R.A.M.C. in Egypt
ever the work of bathing, dressing, and bandaging
goes on.
1 The doctor and his orderlies swab and cut and
snip and tie until the crush is well-nigh over. His
arm has been aching to the socket, but there has been
no time to see to it, with so many that must be dressed
and passed on, waiting by. His orderly has seen the
blood oozing through his shirt sleeve and running
down his arm; but there is blood everywhere, and
who minds blood on such a day ? With the lull that
leaves a gap for thought, the doctor wonders if a lump
of earth could really cause such pain, and there is a
stream of blood trickling down after all. With a
feeling akin to annoyance, he finds a bullet hole right
through his arm, and knows now that he himself must
be dressed and bandaged, and join the throng that is
passing on down the line."
But all this might be anywhere, albeit it bears the
stamp of actuality in every line. Here, however, is
something manifestly of Gallipoli; and of nowhere
else. It is little more than a succession of brief and
broken glimpses notes, for the most part, hurriedly
jotted down in the rare intervals of leisure coming in
the midst of busy days and nights. The writer was
surgeons' orderly in an Advanced Dressing Station
near the firing line at the top of one of the wildest
ravines on the Peninsula, where he remained
''quietly" until the last hours of our occupation :
"Life seems a weird affair up here, especially
towards the small hours of morning. We have just
got the last wounded man of the last batch of
62
"The Long, Long Way to Achi Baba"
stretcher-cases bedded down with the rest ready for
evacuation on the morrow. The M.O. has gone back
to his dug-out pretty well fagged to death, and no
wonder. R and U are already snoring under
their blankets in the corner. By rights I ought to be
doing the same. Instead of that, I am sitting on the
operating-bench swinging my legs, my pipe faithful
friend through many a trying hour well alight, and
my thoughts browsing over the events of the day that
is gone.
"Yes: this is a weird existence. It is quiet
enough up here now quiet, that is to say, except
for the snores and groans of some forty wounded men
huddled side by side and head to foot completely
covering the floor of the long dressing station, and
almost invisible under the dim light of the one smoky
oil lamp. The big guns on the heights have been
silent a long while now, and the rifle fire from our
trenches has dwindled down to no more than an
occasional shot when some vigilant sniper thinks he
has got a chance.
" It has been an awful day one of the worst I
have been through, and I have seen a good many. I
get down from the bench and, lifting the moth-eaten
blanket that does duty for a door, stand out in the
porch for a little while, to think it over. It does not
do to go out too far. Though amidst the general
hum of the night I can distinguish only the shots fired
from the adjacent trenches, the air is full of the sound
of passing bullets. They make a shrill high tune in
the night as though a cloud of gnats were dancing in
63
With the R.A.M.C. in Egypt
the moonshine. Now and again one passes ominously
near a couple indeed in quick succession bury them-
selves in the bank close at hand. They are spent
bullets, mostly, but still capable of harm. I keep well
under the iron and earth of the jutting roof-eaves, and
turn over the events of the day that has gone.
"It was Sunday. Word had come down to us
betimes of what was brewing, and we had prepared
for a busy day. The plan was simple. We knew the
sappers had long been at work on a great mine. At
two o'clock precisely our artillery was to open the
ball, and our riflemen were to keep the Turks busy
in their trenches in expectation of attack. Then the
mine was to go up, and our men were to go over.
"Well before the allotted time we had the
dressing station prepared to the minutest detail,
doctors and orderlies in their places, coats off and
shirt sleeves tucked up ; panniers open, dressings and
bandages, solutions, splints, and instruments ready to
hand. Every man of our bearer-section had gone up
to the front hours ago. It wanted still some minutes
to the time appointed. As we stood about with
nothing to do, a low desultory talk went from man to
man. But though each put in his word, nobody
listened. We had ears only for what we expected
outside the boom of the first great gun which was to
be the signal for the 'big do.' Suddenly overborne
by the tenseness of the situation, I came out then as
I have come out now came out to look upon one of
the serenest pictures that ever eye could dwell upon.
"It was a typical Sunday afternoon, drbwsy,
64
'The Long, Long Way to Achi Baba"
golden, and still. Above stretched the winter sky, of
an unsullied tender blue. The deep ravine zigzagged
away below me, its steep sides rising on either hand
of a rich tawny ochre streaked and spotted with
luxuriant green growth. Sheer above, against the
blue sky, a tuft of yellow blossom nodded in the
breeze that I could not feel down in the shelter of the
gully. In the thicket of the opposing scarp one
solitary bird, I knew not of what kind, was singing
loud and clear. The flower was the only thing that
moved, the bird's song the only sound, in all the
dreamy tranquil scene. I remember an odd catch in
my throat as I looked out from the dressing-station
door, suddenly aghast at the contrast between what
was and what was soon to be. 'God help us,' I
thought, ' for a lot of wicked wanton lunatics ! ' But
I had only a moment for this woman ishness. The
long expected signal-gun crashed out from the battery
on the heights, and the shell flew screaming away
towards the Turkish lines.
"There is one word to which, in his letters home,
the soldier invariably resorts when he is trying to
convey a notion of what a real engagement is like.
But to call war Hell, in letters to home-keeping
English folk, is of little avail, seeing that it is but
comparing one unknown quantity with another.
War, at least in its modern form, is really indescrib-
able, incomparable. All you can do is to set down the
facts in plain unvarnished words, and leave their
sheer accumulation to work what it can.
" The warning shell flew northward. We never
65
With the R.A.M.C. in Egypt
heard it burst, for within the merest fraction of time
all the guns of our batteries had got to their work,
and every rifle in the trenches had joined in the fell
chorus. We could hear nothing but the one mighty
sound. The ground trembled underfoot as though
we stood on the deck of some fast-going destroyer.
The earthen wall at the rear of the dressing station
threw out a dry sweat of dust and little stones and
flecks of soil. If one wished to speak to one's
neighbour, it could only be done by shouting in his
ear.
" The Turk soon joined in. To the uproar from
our own batteries and trenches was now added the
sound of enemy shells. These began to fall
uncomfortably near. Peering through the wirework
and cotton netting that served us for window glass,
I saw spurt after spurt of smoke rise from -yarious
parts of the ravine smoke white, and grey; clouds
of greenish-yellow, shaped like toadstools, sprang up
in an infinitesimal space of time; huge, soaring,
top-heavy cloud-pillars of Cimmerian black. These
last were always the biggest, and brought with them
a hideous double thunder-clap that was the very voice
of mischief.
"The minutes dragged by for us in what was
nothing else than an Inferno of inactivity. Half an
hour passed. And then the winding sunken path
that led from the gully-track to the dressing station
filled up with a jostling crowd of men.
" From that moment until long after dark we were
dressing and bandaging for dear life, in the literal as
66
"The Long, Long Way to Achi Baba"
well as the figurative sense of the word. The laden
stretchers, or as many as the place would hold, were
brought inside. The rest were set down hurriedly
without, and each bearer-party seizing a fresh
stretcher from the pile in the corner, made off back to
the firing-line for another load. With the bearers
had come many wounded men who could walk, and
these waited in a long queue outside.
" Can words ever tell to those who have never been
through it what it means to do a day's work like
that? I have heard men of the R.A.M.C. say that
they soon got used to the horror of their trade, and
came to think no more of handling shattered human
bodies than of anything else. I envy them, but
cannot understand them. All that long use ever
brought to me was a great endurance, more readiness
of resource, more dexterity and celerity of hand. To
grow hard and callous in the face of unimaginable
suffering may be a great comfort : it can never, I
think, be anything else than a great misfortune alike
to the dresser and the dressed. I never worked under
a surgeon really high in his profession, who was not,
beneath his surface of calm, firm capability, all pins-
and-needles and tenter-hooks of compassion. In his
humbler sphere, the surgeon's dresser does well to be
the same.
" That day ran through the whole of war's gamut
of horrors there was scarce any kind of dreadful
laceration that shot and shell can produce that did
not, at one time or other, come dripping and
groaning through our door ; or come with that stark
67
With the R.A.M.C. in Egypt
silence, that uncanny shapelessness, most hopeless of
all. We kept doggedly on, hour after hour, and at
last the full tide of wounded slackened, the stream
thinned to a mere trickle now and then a stretcher
case, the bearers staggering and dragging their feet
from sheer exhaustion ; now and then a couple of
walking cases delayed on the shell-swept road ; last of
all, one who had missed the path altogether. And
then darkness and the gradually slackening fire.
Midnight saw the work finished, and our first chance
with the bully and biscuits, and the dixie of tea that
had been cold these last three hours.
" Yes : this is a weird existence; and standing out
here in the darkness under the great canopy of
flinching starshine, puffing at my pipe and listening
to the song of the bullets, I can see no end to it all."
Within a month Gallipoli was surrendered
gloriously evacuated with all the triumphant subtle
art of retreat which is finer than victory, if you will.
The Mediterranean Expeditionary Force was back at
its base in Egypt. Already the new Commander-in-
Chief, Sir Archibald Murray, was at work on his
great scheme of Egyptian defence which was destined
to bear such portentous fruit.
68
CHAPTER IV
THE R.A.M.C. IN DESERT WARFARE
IT has been said that no adequate account of the
work done by the Royal Army Medical Corps in
Egypt can be given without touching almost at all
points on the general history of the War in this part
of the arena. This necessity becomes all the more
obvious now that we have to deal with events follow-
ing the evacuation of the Gallipoli Peninsula.
As to the wisdom or unwisdom of that step, it is
no part of the present writer's business to inquire. It
seems to have been largely a question of choice
between two policies having a common main object.
That object, supreme in its importance to the
Empire, was the preservation of the integrity of
Egypt, which at bottom meant the protection of the
Suez Canal the great artery through which the best
of the life's blood of our Empire flows. No doubt
the simplest and surest means of attaining this end
would have been a direct blow aimed at Constanti-
nople, such as was at first attempted by what seemed
the most likely method the forcing of the Dar-
danelles. Even when matters had reached such a
desperate deadlock on the Peninsula, it was still a
question whether, by holding the main Turkish
army before us in that far-off region, we were not
F 69
With the R.A.M.C. in Egypt
serving our principal object, the preservation of the
Suez Canal, if not in the best conceivable, at least in
the best possible way. But, rightly or wrongly, the
opposite decision was taken. Our army was with-
drawn from the Dardanelles, and the greater part of
it transported to Egypt, there to be reorganised under
a new command for the same task but under very
different conditions.
Perhaps in all the thirty-five years of our occupa-
tion of that country no more interesting, indeed
fascinating, problem has ever faced our military
chiefs than that which confronted Sir Archibald
Murray at the beginning of the year 1916. The
original Turkish plans as regards Egypt were well
known. There was to be a simultaneous invasion of
the country across the Desert from the east and from
the west, culminating in a grand central rendezvous
of Moslemism at Cairo, the conquest of which place
was to mark the final expulsion of the Christian and
the termination of his power in Egypt. The Turkish
army was to traverse the Sinai Desert, and force a
crossing of the Suez Canal ; while the Bedouin tribes,
owning allegiance to El Sennussi, the chief Sheik
and paramount influence in the Western Desert, were
to combine under that leader assisted by Turkish
officers, and so effect the invasion of Egypt from the
west.
The situation which faced Sir Archibald Murray
on his appointment as Commander-in-Chief of the
British Forces in Egypt early in 1916, was one of
considerable gravity.
70
Desert Warfare
Though the first Turkish attack upon the Suez
Canal in the early part of the previous year had
resulted in disaster to the invading host and its more
or less complete disintegration as an army, it had not
destroyed the Turkish power for mischief in this
quarter. Considerable bodies of the enemy remained
in the Desert east of the Canal wherever water was
available; and throughout the following spring and
summer made frequent raids on the shipway, their
twofold object being to retain as large a number
of our troops as possible in the Canal zone, and,
if practicable, to lay mines in the Canal and
thus put it out of use by sinking a big ship in the
fairway.
Obviously, such a risk to the Canal was to be
avoided at all costs, and we were compelled to main-
tain a large force in the area, constantly patrolling
the Canal banks with a view to detecting and beating
off the raiding parties that continually menaced its
safety. It became evident, however, as time went on,
that such half-measures might soon prove wholly in-
adequate for their object. So long as the enemy
retained a footing in the Desert within striking dis-
tance of the Canal, the uninterrupted traffic of this
great highway of the world could never be ensured,
and might, indeed, be rendered at any time abso-
lutely impossible. Such a danger to the main com-
munication of the Empire was clearly no longer to
be tolerated. The great scheme, therefore, of the
defence of the Suez Canal "in depth "-that is to say,
by the creation of a defensive line throughout its
With the R.A.M.C. in Egypt
whole length, some miles eastward out on the Desert
was immediately set on foot. Simultaneously with
this new Canal defence scheme the inception of
which, it is only right to say, was due to the late
Lord Kitchener preparations were begun for an
eastward advance in force, having for its initial ob-
ject the expulsion of the Turks from the Sinai Penin-
sula, and for its ultimate object, as all the world
knows to-day, the invasion, conjointly with other
Allied Forces, of the Ottoman Empire. At the same
time an expedition was organised against the revolted
Bedouin tribes in the Western Desert, which will be
dealt with in its place.
Before embarking on a narrative of the services
and achievements of the Royal Army Medical Corps
in these Eastern and Western campaigns, it will be
useful to give an account, as briefly and concisely as
may be, of the general organisation of the Corps and
its procedure during the time ot active service, par-
ticularly of the various modifications of its systems
brought about by the peculiar conditions of Desert
warfare.
Practically none of the R.A.M.C. units in Egypt
had had any previous experience of active service
under Desert conditions. The experience gained on
the Peninsula had been of very little preparatory
value, except as regards general endurance of hard-
ship and the perils of war. Our men had, therefore,
all to learn in the new life that was now to begin for
them, and this was especially true in the case of the
officers, both commanding and executive, upon
72
Desert Warfare
whom devolved the responsibility for the work of the
Corps.
The functions of the R.A.M.C. in war-time are
many and onerous. Foremost among these stands
the preservation of the health of the troops. The
paramount object towards which the Army Medical
Service directs all its energy and knowledge is the
maintenance of fighting efficiency; and this can only
be assured by a high standard of physical fitness
throughout all ranks. The work of preservation of
bodily health among the individuals collectively
forming an army has endless ramifications. The
physical training of the men must be systematically
looked after. Food must be of the right constituents,
quality, and quantity. There must be a constant and
sufficient supply of potable water. Clothing of the
troops must be adapted to the exigencies of the
climate of the country wherein operations are pro-
ceeding. Camp-life must be rigorously supervised,
the choice of camping-sites carefully made, the
disposal of excrement of men and animals, as
also of all camp refuse, systematically carried out.
All this falls within the province of the Medical
Service.
In addition to the above, there are the collection,
treatment, and evacuation of wounded and sick from
the theatre of war, their care in the base hospitals,
and their subsequent treatment as convalescents or,
in the case of permanent ineffectives, their convey-
ance homeward. Moreover, the R.A.M.C. is re-
sponsible for the provision of all medical and surgical
73
With the R.A.M.C in Egypt
equipment and material needed by the expeditionary
force from first to last.
During war-time the system on which the
R.A.M.C. normally works is as follows :
An Army is composed of a number of Divisions,
each Division consisting of three Brigades, and each
Brigade being again subdivided into four Infantry
Battalions. Each Brigade, in addition to its head-
quarters section, has also detachments of mounted
troops, Field Artillery, Engineers, and a complete
Field Ambulance of the R.A.M.C. The Brigade, in
fact, is a little Army complete in itself.
Each of the four Battalions composing a Brigade
has its own attached Medical Officer, who is a
member of the R.A.M.C. The duties of an attached
M.O. are among the most exacting that can devolve
upon a doctor in the Army. He is not only general
physician to all the men in his battalion during the
intervals of a campaign when there is no fighting
on, but the whole work of first-aid to the wounded
falls upon him during every action. This, however,
by no means represents the entire scope of his activi-
ties. A good M.O. is nearly as much a moral force
with his men as their medical factotum. By keeping
close to them in all engagements and sharing all
their dangers, with the single object of being in-
stantly on hand when his services are required, he
radiates confidence among the men in the battalion
to an extent not to be easily over-estimated. In in-
juries where a major blood-vessel is involved, life
itself often depends on the promptness with which
74
Desert Warfare
skilled assistance can be obtained, and well the men
know it. The proximity of the Medical Aid Post to
the firing-line is a source of real comfort to the troops
engaged, for it gives them that sporting chance at a
crisis beloved of all British soldiers.
The work of the Field Ambulance which is at-
tached to each Brigade begins at the Medical Aid
Posts. The Ambulance is divided into two sub-
sections a Tent Sub-section, and a Bearer Sub-sec-
tion. The Tent Sub-section mans the Advanced
Dressing Station, which is situated in some conveni-
ent spot in the rear of the firing-line. It also staffs
the Main Dressing Station, which is established still
farther in the rear. The Bearer Sub-section divides
its strength between the four Battalion Aid Posts,
and it is its duty to receive the wounded from the
Medical Officer attached to Regimental units,
and to convey them to the Advanced Dressing
Station, the bearers journeying to and fro between
these two points so long as the action lasts or there
are injured men to be brought in.
At the Advanced Dressing Station the wounded
receive any further treatment which may be necessary
but which has been impracticable amidst the stress
and hurry of the Aid Post. They are then passed
on by ambulance wagon, or other available means of
transit, to the Main Dressing Station, which is, or
should be, at such a distance from the firing-line as
to be in a comparatively safe situation.
These Main Dressing Stations, of which there is
one to each Brigade, evacuate the wounded to the
75
With the R.A.M.C. in Egypt
Casualty Clearing Station of the Division. The
Casualty Clearing Station is the rearmost medical
unit of the righting army, and is established at the
head of the Line of Communications, this being
usually the nearest point on a railway. These
Divisional Casualty Clearing Stations pass the in-
jured down the line by hospital-train to the Station-
ary Hospital, which in turn evacuates to the General
Hospital at the Base. Each Stationary Hospital will
receive wounded from one or two or even more
Casualty Clearing Stations, and each Base Hospital
will be fed by probably several Stationary Hospitals.
The system, in its entirety, may be likened to a
series of sieves with progressively diminishing
meshes, by which the various degrees in gravity of
wounds or sickness are automatically separated.
Very slight cases get no farther than the Dressing
Stations, or even the Aid Post, whence after treat-
ment they may be summarily returned to duty.
Minor injuries and simple cases of indisposition
likely to recover in a short time are intercepted by
the Casualty Clearing Stations, being thence re-
turned straight to their units when sufficiently well.
The Stationary Hospitals retain all cases which,
though serious, will need no prolonged period for
recovery. The General Hospital at the Base re-
ceives all gravely injured men and those suffering
from prime disorders. Here all necessary medical
and surgical treatment takes place, those cases
making a good recovery being in due course trans-
ferred to convalescent depots, thereafter eventually
76
Desert Warfare
finding their way back to their units; while those
who are permanently incapacitated from military
duty are invalided home in hospital ships.
The system briefly described above was with
certain important modifications dictated by local con-
ditionsthe one actually followed by the Royal
Army Medical Corps throughout the greater part of
the time occupied by the Egyptian Campaign and its
subsequent developments. At an early stage in the
hostilities, however, certain experimental changes
were made. It was realised that as operations were
to be carried out in a terrain consisting, for the most
part, of nothing but trackless desert sand, the or-
dinary methods of transport by ambulance wagon or
motor would be out of the question. Beyond the rail-
headwhich throughout these operations has neces-
sarily been far in the rear the wounded and sick
unable to walk could only be conveyed on the backs
of camels or in light ambulance-carts with wheels
specially devised for travelling over sand.
In respect of the camels, several kinds of litter
were designed to accommodate lying-down cases.
Each camel carried a pair of these pannier-fashion,
the most convenient pattern being that which con-
sisted of a padded metal frame, fitting over the
animal's back, to which the already loaded stretcher
could be clipped or bolted. These litters, or cacolets,
were also made in seat-form, to take patients whose
injuries allowed them to travel in the sitting
posture.
The Desert ambulance carts, now for the first time
77
With the R.A.M.C. in Egypt
brought into use, may be best described as large,
double wire-spring mattresses under canvas canopies,
running on a pair of wheels with very wide tyres,
which rode over, rather than ploughed through, the
loose, shifting sand. These wheels were boxed in
on both sides, so that they had the appearance of
revolving wooden drums rather than wheels. The
carts were drawn commonly by a quartette of mules
or horses, but draught-camels were also employed
on occasion.
At one time it seemed likely that a sand-sleigh
drawn by two mules or horses and accommodating
one stretcher, would be a valuable and feasible
method of transport for sick and wounded over the
Desert; and almost every Field Ambulance had a
sledge of its own manufacture. But officially the
sledge idea never came to much, the article eventually
supplied by Ordnance proving in practice too heavy
and cumbersome for routine work over long stretches
of sand. The only units which made extensive use
of- the ambulance sledge were the Australian and
other Mounted Field Ambulances.
The early experimental modifications in the
R.A.M.C. system for collecting and evacuating
wounded in battle involved certain fundamental
changes. In the operations on the Desert, large
bodies of our troops in the form of a mobile column
were often thrown rapidly forward in advance of the
main force, and it was considered that a Field
Ambulance, even with special Desert transport
equipment on the lines indicated above, was too
78
Desert Warfare
bulky and ponderous a unit to move as a whole with
such a mobile column.
For a time, therefore, instead of the Field Ambul-
ances working in sections in the old way, each
ambulance was divided into what were called a
"Mobile Section," two "Ambulance Convoys," and
a "Non-Mobile Section" which had all the heavy
tentage and paraphernalia of the unit, and went by
train. The Mobile Section was a section with a
special cut-down equipment, the object being, while
retaining the maximum efficiency, to give the trans-
port camels as little weight as possible to carry. This
Mobile Section was provided with camels for cacolets
both lying and sitting, for carrying stores, and for
conveying water in fantasses light oblong metal
cases. A fleet of sand-carts was also provided. The
equipment of the Mobile Section enabled it to
establish a Dressing Station, and to collect wounded
from the Brigade with which it was working.
Evacuation from this Dressing Station was effected
by the two Ambulance Convoys, which also each
possessed their equipment of sand-carts, camels for
lying and sitting cacolets, and camels for carrying
water and stores.
These Convoys formed the connecting link be-
tween the Mobile Section and the so-called Non-
Mobile Section the more heavily accoutred part of
the Field Ambulance situated in the rear which
moved only by train. The intention underlying the
provision of two separate Convoys was that, where the
interval between the fighting troops and the main por-
79
With the R.A.M.C. in Egypt
tion of the Ambulance became unduly lengthened
owing to the advance of the force engaged, the two
Convoys could operate in relay, one behind the other,
and thus prevent the gap from becoming unworkably
large.
In practice, however, this organisation developed
serious defects. It was too inelastic to fit the varying
needs of Desert warfare. It was therefore soon given
up, and a return made to the original tri-sectional
formation, but with special modifications indicated by
local needs. The Sections of each Field Ambulance
officially designated A, B, and C were still divided
into Bearer and Tent Subdivisions as heretofore, But
with modified equipment. And two of the Sections,
B and C, were rendered specially mobile, the Tent
Subdivision of the A, or Headquarters' Section, tak-
ing the surplus equipment, thus being only semi-
mobile and still dependent on the railway. Despite
this partial return to old and tried methods, however,
something very like a revolution took place in the
composition of the Field Ambulance, so far as its
equipment for transport was concerned. The old
Field Ambulance possessed :
10 Ambulance Wagons. 6 G. S. Wagons. 4
Limbered G. S. Wagons. 3 Water Carts, i Maltese
Cart. 104 horses and mules.
The Ambulance as modified for Desert warfare
possessed much greater equipment.
These innovations, though time was destined
thoroughly to prove their worth, were at first not
unattended by difficulties. Some of the early arrange-
So
Desert Warfare
ments proved faulty in practice. At first the camels
were not permanently stationed with the Ambulances,
but had to be fetched from the Camel Transport
Corps when needed. An Ambulance under orders
to mobilise for action would send to the C.T.C. for
the necessary animals. These would eventually
arrive in a long string, possibly only a few hours
before the Ambulance was required to march with
the fighting column. Before a move could be made,
however, the cacolet saddles had to be fitted to the
camels' backs.
Now, whereas these saddles were made all to one
rigid standard size and pattern by a decree seemingly
as unalterable as the laws of the Medes and Persians,
an unkind Providence had so ordained things that no
two camels' backs were of the same shape or dimen-
sions. Some were narrow and others broad : some
had their humps steeply and sharply pyramidal,
many were of the flat tableland formation. But the
camels had all to be saddled somehow in spite of
these deterrents, though the process often necessitated
hours of anxious contriving. Moreover, the camel
train frequently arrived very late. On one occasion
which came under the notice of the writer, the fight-
ing column was due to move off at three o'clock on a
pitch-dark morning, but the camels for the Ambul-
ance did not put in an appearance until half an hour
before. Obviously it was impossible for the Ambul-
ance Transport to be ready in time.
This camel difficulty was, however, soon removed
by permanently allotting to each Ambulance its own
81
With the R.A.M.C. in Egypt
special animals for the cacolet work. The requisite
number of camels, with their native drivers, were
parked with or near the Field Ambulance constantly ;
and the care and upkeep of the cacolets were made
part of the general duty of the camel-men. This not
only lightened the work of the R.A.M.C. orderlies,
but it gave them a chance of learning to direct native
labour and to pick up a knowledge of Arabic
acquirements which proved of no little service during
the subsequent campaign.
For the rest, there was a great deal to learn, even
in the case of the most experienced R.A.M.C. man,
in the treatment of the sick and wounded under the
novel and trying conditions of the Desert. The
faculty of ready adaptation to environment, for which
the British soldier is famous, was now to prove doubly
a necessity with the British Field Ambulance man.
The Turks were not the only foes that opposed us on
the Sinai Peninsula. Heat, dust, vermin, blinding
suffocating sandstorms, the terrible Khamsin which
is a red-hot hurricane seemingly straight from the
throttle of Hades want of water and everything else
needed to support life, the miles of daily march over
an eternal sameness of shifting sand all combined
to make up a life that called for stoutness of heart,
even more, perhaps, than of shoe-leather. That our
Ambulance-men "made good" through it all, in the
fullest sense of that expressive gutter-snipe among
popular phrases, it will now be our business to
demonstrate by following the course of the campaign.
CHAPTER V
KANTARA AND KATIA
THE mere layman in military affairs, bringing an
otherwise fairly well-trained intelligence to bear on
the problem of the defence of the Suez Canal, could
scarcely fail to be struck, from the very first, by
certain obvious necessities in the situation.
Clearly it was, and always had been, impossible
effectively to secure the Canal from harm, still less
to maintain uninterruptedly its 'usefulness, if fthe
waterway itself were looked upon as constituting its
own first line of defence. If the problem had been
simply to defend Egypt from the east, if the deep
broad waters of the Canal could be regarded merely
as a barrier to stop an enemy, on the principle of a
castle-moat well and good : it might then be sound
military strategy to employ the Canal as a first
defensive line against a hostile force advancing over
the Desert a line which, with the western Canal
bank properly fortified and manned, might well prove
impregnable. But obviously we could not afford to
use the Canal in this way, seeing that, even in times
of peace, it formed the great highway of the Empire,
while now in war-time it was more thronged than
ever by our shipping, its inviolability more than
ever necessary to the Nation's life.
83
With the R.A.M.C. in Egypt
It was not difficult, therefore, to understand why,
on the direction of affairs passing into the strong
hands of Sir Archibald Murray early in 1916, a
fundamental change of policy in regard to the
defence of the Suez Canal became at once evident.
The Canal was no longer to be expected to defend
Egypt : Egyjk was going to defend the Suez Canal,
and that in the thorough-paced British way. No
time was lost in putting precept into practice.
Parallel with the whole 85-mile stretch of the ship-
way, and at varying distances eastward of from two
to ten miles, the construction of a barrier of defensive
works was at once commenced, with lines of com-
munication to the Canal bank in the rear at half a
dozen different points. In addition, certain vast areas
of low-lying land eastward of the Canal were flooded,
and kept flooded by pumping machinery, thus render-
ing them impassable to an enemy and materially
shortening the line to be protected.
Upon this new defensive frontier of Egypt miles
out over the waterless Desert, a large force a little
army, in fact was established and continuously
maintained. Roads were made, light railways were
thrown out; waterworks, which drew their supply
from the Sweet Water Canal westward of the ship-
way, were erected, and an abundant supply of pure
water was conveyed to the troops manning the new
defensive line by means of pipes laid from each of
the six bases. In addition to these measures, the
Desert for many miles out was rendered as inhos-
pitable as possible to any detached bodies of the
84
Kantara and Katia
enemy that might be lingering in the district, by
destroying certain natural sources of water that
existed here and there. Chief among these latter
was a congeries of rock cisterns and pools at a place
called Wady Urn Muksheib, some forty miles distant
south-east from Ismailia. Our engineers raided this
spot, and within four days succeeded in draining
away a big accumulation of fresh water, and, by
blasting, rendering further accumulations impossible.
But all these measures, commendable and neces-
sary as they were to the protection of the Canal, con-
stituted only an initial step towards the solution of
the far greater problem the defence of Egypt gener-
ally. Though, since their repulse in the early part
of 1915, the Turks had given us little more trouble
than that arising from various skirmishes between
the patrols, we were well aware that the launching of
a second and much more formidable expedition
against us was very likely to be undertaken. Our
evacuation of Gallipoli had released for employment
elsewhere a force of the enemy which, on a moderate
computation, could not be far short of 250,000. How
many of these w r ould go to swell the army now
gathering against us, we had as yet no means of
ascertaining; but our air reconnaissances had re-
vealed the fact that the enemy was in great strength
in Southern Palestine and in North Sinai, and that
a move on his part might conceivably take place at
any time. Moreover, we had our own plans now fully
developed in this region, and preparations for them
as well advanced as circumstances would allow.
G 85
With the R.A.M.C. in Egypt
There are three ancient caravan routes over the
Sinai Desert, by which an approach to Egypt is
possible. There is a southern route starting from
Akaba and finishing at Suez, by which the Mecca pil-
grims ordinarily travelled. There is the middle route
which commences at El Audja on the Turkish fron-
tier, and passes through the Megara hills and the
Djebel Yellog, reaching the Canal about midway in
its course, at Ismailia. This was the road followed
by the main part of the Turkish army in its first
attack on the Canal in January-February of 1915.
The third and most northerly route skirts the
Mediterranean shore through Rafa and El Arish,
striking the Suez Canal at Kantara. It is the only
route of the three upon which fresh water in any
but negligible quantity is to be found. Such wells
and natural springs as exist, however except in the
Katia district some 25 miles from the Canal at
Kantara are so sparsely supplied, and are situated
at such widely separated intervals, as to be of little
practical service to any but the few Bedouins who
roamed the district, or the caravans that occasionally
passed that way. In bringing a force of only 12,000
to 15,000 men across the Sinai Desert against us in
1915, the Turks had accomplished the seemingly
impossible; to the ordinary student of the situation
the question now presented itself how would they
fare when hard experience had taught them that
nothing but an army of real magnitude could be of
any avail in the task that they were apparently about
to essay ?
86
Kantara and Katia
The plan for the defence of Egypt adopted by
Sir Archibald Murray was one of characteristic
originality. Though he had made adequate arrange-
ments for the protection of the whole Suez Canal
front, he very early realised that the only practicable
arena for hostilities on a large scale lay in the north.
The Rafa-El Arish-Kantara road was the only one
by which the enemy could hope to advance against
Egypt in any considerable force. Obviously his
design would be first to seize and hold the well-
watered zone radiating east and south-east of Katia,
and then to use this as his advanced base for his
main operations against the Canal. Just as obviously
it was our business to forestall him in the manoeuvre.
Katia, as Sir A. Murray had from the first recog-
nised, was the true strategic base from which the
Suez Canal could alike be most advantageously
attacked or defended. Katia, therefore, at the
earliest possible moment must be occupied in strength
by British troops.
It was a momentous decision, for it proved the
beginning of the great British offensive-defence
policy as regards Egypt, which has since had such
far-reaching results.
Thus much for the general initial outlook and con-
duct of affairs relating to the Egyptian Eastern
Campaign which opened in the early months of 1916.
We must now take up again the thread of the
story of R.A.M.C. doings in this part of the
Near East at the point where we left itthe close
87
With the R.A.M.C. in Egypt
of the unhappy, if glorious, adventure at the Dar-
danelles.
Transference to Egypt from the shot-and-shell-
swept heights of Gallipoli was, to our (war-worn
Ambulances, much like emerging out of stormy
winter twilight into the serene haven of a perfect
summer's day. On their arrival there, the various
medical units were drafted to different localities in
Egypt on the commendable theory that they were now
to enjoy a brief but well-earned rest : the Field
Ambulance to which the writer belonged was sent to
the camp which had been pitched on the Desert near
the Great Pyramids some ten or twelve miles from
Cairo. Many things have been done well in this far-
away part of the theatre of the War, but none so
well perhaps as the creation of this vast camp. Of all
the thousands of British soldiers who were quartered
there from time to time, it is difficult to believe that
one of them went away without carrying with him
an impression of good that shall last as long as
memory serves. There were no lotus-eaters at Mena
Camp, nor was it all fair weather. It was too early
in the year for the Khamsin the dreaded furnace-
blast of the Desert, with which we were later to be-
come so familiar. But there were sandstorms in
plenty to be lived through, and the mirage of rest
that had journeyed before us so glamorously, turned
out to be made of much the same stuff as mirages
generally. It vanished very early in our stay at
Mena, and hard work became the order of the day.
These weeks of training, however the intermin-
88
Kantara and Katia
able stretcher-drill, and Swedish exercises, and long
route-marches over the burning, yielding sands
proved invaluable preparation for the work on the
Sinai Peninsula which was to follow. And all too
soon for the life was pleasant enough in spite of its
drawbacks we were striking camp and on the march
again for the great unknown land awaiting us beyond
the Suez Canal,
One who had known Kantara only in times of
peace when it was but a slumbrous little post of the
Canal Company with a flag-staff and a few low build-
ings breaking the eternal straight lines of the banks
would have been amazed to see it as we saw it on the
bright spring day of our arrival there. The great
tidal wave of War had swept down upon it, and at a
bound Kantara had sprung into world-importance.
The waterway now reminded one of the Pool of Lon-
don with its congestion of shipping and busy life.
Both banks were crowded with new buildings, and
the surrounding country white with innumerable
camps. A hum of work pervaded the place. Cars
and lorries and vehicles of all kinds thronged the new-
made roads and floating-bridges. The ground
quaked under regiments on the march. Companies
were drilling everywhere. The air was full of the
clarion of bugles and the mingled sound of working-
tools steam-saw and pumping-engine, hammer and
adze, whistles blowing and syrens booming, all the
deep hubbub of labour that one associates with a busy
commercial town. We marched through to our
allotted camping-ground on the edge of the Desert
89
With the R.A.M.C. in Egypt
beyond the shipway, feeling that we were once again
an integral part of the great machine of war.
There was much for our R.A.M.C. men to do at
Kantara, but still more to learn. The ordinary
routine work of the medical units distributed through-
out a military camp of such dimensions was neces-
sarily heavy. There were hospitals to staff, disinfect-
ing stations to run, various outlying dressing posts
to be manned, all the sanitary supervision of the great
busy centre to be ceaselessly attended to. Hospital-
ships improvised from Messrs. Cook's Nile
steamers plied to and fro on the Canal between
Kantara and the General Hospitals at Port Said, and
these ships had also to be staffed and worked. But
beyond all this there was something more important
still. The fighfing column was swiftly making ready
for its move on Katia, and the broad-gauge railway
steadily forging eastward through the waste of sandy
hill and dale. When the column moved the ambul-
ances must be ready to move with it. And there was
a great deal, in fact all, to learn about medical work
in war-time carried on under the wholly novel con-
ditions of the Desert. Almost the entire equipment
of the Field Ambulances had to be changed. In the
soft, yielding sand of the Desert the old methods of
transport for sick and wounded, as well as material,
were obviously useless motor-ambulances, ambul-
ance-wagons, water-carts, G.S. wagons, all would
have to be left at the Base. In their stead, the light
sand-cart, with its wide-tyred, boxed-in wheels, would
be the sole practicable vehicle, and this only where
90
Kantara and Katia
the going was exceptionally favourable. In the main,
the camel formed the only dependable means of con-
veyance for anything and everything, once the rail-
head was left behind.
In addition, therefore, to his already multifarious
accomplishments, the R.A.M.C. man had now to
learn all about camels and their ways. Not only that,
but it became also necessary to learn how to manage
and direct the camel-men, which meant that some
smattering of their language must be acquired. Now,
though the camel-drivers were fairly keen of wit and
so amenable to orthodox methods, the camels them-
selves were far otherwise. Of a truth, the camel is a
wearisome, uninspiring beast. He has not a trace of
the sporting instinct about him. He takes no interest
in anything but his meals, and his one end and aim in
life is the avoidance of an over-load by keeping up a
ceaseless grumbling protestation all the while his
burthen is being adjusted. Also he is an inveterate
backbiter. His cruel jaws are ever ready at the dis-
service of friend or foe, and many an ambulance man
will carry with him to his grave the marks due to this
peculiarly mean-spirited kind of rearguard action.
But with it all, the camel is strong, enduring; the
Desert sun and sand are his 'native element; he can
carry a four days' water supply within his own body ;
his diet is of the simplest; he was indispensable, in
fact, to the work our army had in hand.
Slowly but surely the railway forged ahead over
the shifting torrid sand; our troops pushed steadily
forward in front of it ; farther eastward still were the
9*
With the R.A.M.C. in Egypt
mounted patrols, for ever scouring the waste of un-
charted hill and dale for signs of the enemy. Our
mobile ambulances got on the move at last. Kantara
was left behind, and life on the Desert began in real
earnest.
It is often said by the righting troops that the men
of the Medical Service have a "cushy" job in war-
time plenty of food and water, none of the heart-
breaking digging fatigues that 'make up too large a
part of the life of the infantryman, warm shelter in
times of cold, and a cool cover during the many hours
of broiling sunshine, with various other advantages.
During the intervals -of quiescence, when active
operations are in abeyance, there is no doubt a
certain foundation of truth in this good-humoured
but rueful comparison.
But in the case of ambulances attached to a mobile
column on the march, there is little to choose between
the two Services. The same discomforts and priva-
tions fall to the lot of each. There are the same
sweltering, perspiring marches with heavy pack over
the burning sands, the same restrictions in rations
and water, the same fatiguing duties at the end of
'each day, when a camp has to be prepared.
The ambulance, indeed, has then not only its own
arrangements to make for the night it has to provide
for the needs of others. Even when going in light
mobile order it must carry with it sufficient tentage
accommodation for any casualties that may arise from
an emergency action. Failing the occurrence of
hostilities the six bell tents it carries are pretty sure
92
IN AN R.A.M.C. CAMP.
CAMELS WAITING FOR THEIR LOAD OF WOUNDED.
Kantara and Katia
to be needed for men who have fallen out exhausted
by the long hot march, and from other causes; and
these tents must be pitched as. soon as the Brigade
halts for the day the first duty must be to provide
food, shelter, and treatment fgr the sick. Then there
are all the multifarious duties in the formation of the
ambulance camp itself, always a large one in com-
parison with the number of its personnel the draw-
ing of rations and water for man and beast, lighting
of fires and erection of cookhouse, latrines, inciner-
ator, and a host of minor necessities. Lastly, there
are the night's bivouacs to be prepared.
The construction of a "bivvy,*' simple as it may
seem, is in reality no easy task, and the novice
usually makes a failure of it in the beginning. Our
ambulance men were no exception to the rule, but a
very few nights on the Desert served to bring pro-
ficiency. The official theory as to the "bivvy" seems
to be that it can be made out of nothing, for nothing
is provided for the purpose. It is wonderful, how-
ever, what ingenuity can contrive even out of this
slender material. A hole excavated in the sand long
and broad enough to accommodate two men lying
side by side, a stick thrust into the ground at each
end, with a piece of string tightly stretched between,
and a blanket flung across the string hip-roof fashion,
with its edges sanded down and there were leggings
for the night. The great difficulty on the Desert was
to prevent the sand running in after the trench had
been dug. But even here experience found a way out
of the trouble. It was the surface-sand only that
93
With the R.A.M.C. in Egypt
"ran," we soon discovered: that below was more
stable, and would hold up fairly well provided it was
not touched. A ground-sheet for a floor, and another
blanket for bedding, and the menage was complete.
Later on, when the summer heat came, palm branches
were often collected by our men and used for night-
cover. They made admirable shelters, and had the
additional advantage of rendering the camp incon-
spicuous should there be hostile aircraft about. The
tops of the bell tents were also decorated with these
palm branches under a like protective policy.
The advance in force upon Katia from the Canal
Base at Kantara was necessarily slow, as the pace
was set by the progress made by the railway. Week
by week, however, permanent posts were pushed
farther and farther ahead, and by the beginning of
April such progress had been made that a flying
column was able to carry out a reconnaissance so far
eastward as Bir-el-Abd, some 15 miles on the other
side of Katia, where, though no resistance was en-
countered, we discovered and destroyed some tents
and stores belonging to the enemy. On the gth of
April a second reconnaissance to Abd was under-
taken, and this time a strong party of Turks was dis-
covered occupying a ridge to the north-east of that
place. Our troops promptly attacked, and a sharp
skirmish ensued, the enemy being driven from his
position ; but the heavy nature of the sand prevented
our cavalry from undertaking a prolonged pursuit,
and we eventually retired.
These two reconnaissances, of little significance in
94
Kantara and Katia
themselves, turned out to be of prime importance, for
they marked the beginning of the memorable Eastern
Campaign of the Egyptian Expeditionary Force.
Their special significance lay in the fact that they
revealed the presence of the enemy in force within 15
miles of Katia, the well-watered zone towards the
permanent occupation of which our main efforts were
being directed. Evidently the Turks meant to dispute
its possession with us ; For, vital as it was to our own
plans to secure this vantage-ground, it was no less
than matter of life or death to the enemy with 100
miles of practically waterless desert now behind him.
It was to be a race for Katia, the prize would go to
the swiftest, and all efforts were redoubled on the
British side. By April 30 our engineers had suc-
ceeded in advancing the railhead as far as El Arais,
only 7 miles from Katia. By the same date bodies of
our mounted troops were holding and entrenching not
only Katia itself but several other strategic points in
the coveted water-zone. The times were ripe at last
for our long planned advance in strength, and the
order for the great general move was given.
We had, however, a doughtier and more resource-
ful foe to deal with than we had reckoned upon. The
futility of any attempt to forestall us in regard to the
Katia position must now have become apparent to
him. Nevertheless the attempt was made. On April
23 a force, aggregating in all some 3,500 men with
five guns, was suddenly launched against three of our
outposts ; and though the post at Dueidar repelled the
attack with great loss to their assailants in spite of the
95
With the R.A.M.C. in Egypt
fact that our men were outnumbered by about 10 to i,
the troops garrisoning the two other posts at Katia
itself and at Oghratina, some seven miles north-east
of it after prolonged and gallant fighting were over-
whelmed and all either killed, wounded or captured.
The fight at Dueidar is memorable in the annals
of the Royal Army Medical Corps in Egypt, for it
was the first serious affair in which our ambulances
were engaged in the long Desert Campaign. Only
a small section, consisting of one R.A.M.C. officer
and seven men with a couple of sand-carts, was
stationed at Dueidar. As soon as word came through
that fighting had occurred, another Ambulance
Section was pushed up to assist in the treatment and
evacuation of tfce wounded. This section went under
infantry escort and took with it a full complement of
sand-carts, and camels for carrying cacolets as well as
stores and water. The following account of the
journey, as given to the writer by the officer com-
manding the Ambulance, will be of interest not only
in itself but because it affords a glimpse of the kind
of work which the Medical Service men may at any
moment be called* upon to do, and of the risks run in
the ordinary course of their duty :
"The journey to Dueidar was unmolested, though
at Hill 70 we were held up for some time until the way
could be pronounced clear of the enemy by our
patrols. Dueidar was reached by midday on April
24. The place was quiet, but showed marked evidence
of the fierce fight on the previous day. Dead animals,
horses and camels, and dead Turks were still lying
96
Kantara and Katia
about. The men stationed there were full of the story
of the fight. The Turks had got close to the barbed-
wire of the redoubt : one man was actually killed on
the parapet. The detachment of the Field Ambulance
stationed there had a very arduous and exciting time.
The Medical Officer was severely wounded through
both legs, one R.A.M.C. man was killed, while the
N.C.O. and two of our privates were wounded. I
got the story from one of the survivors of this little
band, and I give it here in his own words :
" * We were wakened suddenly at 4.30 a.m. by
whistles blowing, and then we heard rapid rifle-fire.
We all went to our posts. We knew exactly where to
go, as we had had a false alarm the previous week.
My post was at the water-tanks, to stop any leakages
that might be caused by bullets. Captain Roberts,
the Post Commandant, gave instructions that the
Medical Officer was to go up at once to the redoubt
on the right, where there were casualties. Lieutenant
Miller, R.A.M.C., ran across, taking Colthart with
him. McKinnon and a stretcher-bearer went across
to the redoubt in front to attend to wounded, but the
officer in charge would not let them take the casualties
back, as the firing was too dangerous.
" * About 7.30 a.m. Captain Roberts gave instruc-
tions that a man, who was carrying a message from
the redoubt on the right, and who had been struck
about fifty yards from the trees, should be brought in.
McDonald rushed out and bandaged him up, Ritchie
following with a stretcher. Just before Ritchie
reached them McDonald was struck in the face, but
97
With the R.A.M.C. in Egypt
merely wiping the blood away, he gave Ritchie a
hand with the stretcher. Ritchie was immediately
afterwards struck in the shoulder. In spite of their
wounds these two managed to carry the stretcher
about twenty yards. But by this time blood was
gushing freely from McDonald's wound, so Wright
and Wood doubled out and succeeded in bringing
the stretcher in under cover of the trees. At the same
time Corporal Raffin, R.A.M.C., seeing both Ritchie
and McDonald struck, dashed out to give them a
hand, but was wounded by bullets through both
thighs just when he got beyond the trees. I was
standing near, waiting for an opportunity to run over
with water to the men in the redoubt. I dropped the
water-bottles I was carrying and ran across and
brought Raffin in by gripping him under the arms.
He crawled twenty yards by himself before I reached
him. I then carried him across to the opposite side
of the trees where our dressing-tent stood.
" * By this time a relieving company of infantry
had arrived on the scene. Their C.O.'s orderly came
up shouting for R.A.M.C. men as some officers were
lying out wounded. I went along with two men and
brought in Adjutant Crawford and Captain Bruce,
A.S.C., who had both been wounded to the left of the
trees some twenty yards out. Captain Bruce had been
hit while endeavouring to bring Lieutenant Crawford
in under shelter. I attended to Captain Bruce, but
his wound was hopeless, and he died half an hour
afterwards. Then I went back to the tent to get more
dressings. McDonald had, I found, dressed the
98
Kantara and Katia
wound on his face himself, and he had also contrived
to dress and bandage Raffin's wounds. I saw Wood
lying dead beside him : McDonald told me that he
had been shot through the throat just after he had
brought some dressings out to him. Between us we
then set to work to get the patients away from the
exposed front part of the wood, where the bullets were
by now falling thickly. We succeeded in carrying
them all back 200 yards or so, and then re-dressed
those of the wounds requiring it.
" ' Two more Medical Officers and some additional
R.A.M.C. orderlies had by this time followed the
relieving troops. I saw Lieutenant Miller, R.A.M.C.,
being carried in. I heard afterwards that he had said
to Colthart that he would have to leave the redoubt
and run across to see how some of the men were
getting on. He did not know that other Medical
Officers had arrived by this time. He had seen men
dropping amongst the trees and believed that his
services were wanted there. He was strongly advised
not to risk exposing himself in the open, but he per-
sisted, and he was badly shot through both thighs
and in the hand soon after leaving the redoubt.
11 * McDonald and Corporal Raffin were extremely
plucky throughout the action. At the end the men
crowded round McDonald and shook hands with him,
congratulating him on what he had done. Even
though his wound on the face was severe, he stayed
on duty till eight o'clock at night, only leaving when
all the wounded had been dressed and sent off. Cor-
poral Raffin also, in the absence of Lieutenant Miller,
99
With the R.A.M.C. in Egypt
remained for a considerable time supervising the
collection and treatment of the wounded. He also
came across to see how I was getting on at the water-
tanks. He was very plucky and cool throughout.' "
Both Corporal Raffin and Private McDonald, it
may here be added, received the Military Medal for
their conduct during the action.
This raid upon Katia, carried out so boldly and
determinedly by the enemy, though it was partially
successful, left the general situation wholly un-
changed. The attacking forces were eventually
driven off with heavy loss, and so effectually was
their discomfiture completed by our mounted troops
and aircraft during their retirement eastward, that
they were able to make no further attempt to oppose
our advance for several months to come. We were
left to complete our railway to the coveted water-
bearing zone and there to establish ourselves firmly
in accordance with our original scheme.
100
CHAPTER VI
THE DEFENCE OF EGYPT ON THE WEST
WHILE plans for the defence of the Suez Canal
against an attack from the east were being carried into
effect, as already narrated, the protection of Egypt on
its western front had been by no means neglected.
The problem here in the west was very different
from that confronting us in the Suez Canal area.
Egypt has been very aptly described as a streak of
mud drawn through a desert of sand. This streak,
conterminous with the course of the Nile, stretches
from Alexandria on the Mediterranean coast due
southward to the Sudan, a distance of about 600
miles. Leaving out of account the wide and fertile
Delta, this streak of deposited river mud, perhaps the
richest soil in the world, has a breadth of from one
mile to fifteen miles. There is also the coast-line,
more or less cultivable on account of its appreciable
rainfall, stretching westward from Alexandria for a
distance of about 200 miles. Throughout the Desert,
lying within and near the vast right-angle formed by
these two streaks, there are numerous, though widely
separated oases, inhabited by various Bedouin tribes.
It was against these tribes that we were now called
upon to protect the western frontier of Egypt a
frontier which, owing to the peculiar configuration
here described, extended practically for 800 miles.
H ii
With the R.A.M.C. in Egypt
The question of the defence of this frontier did not
seriously obtrude itself until the late autumn of 1915.
The semi-political religious sect of Bedouins,
taking its name from that of a prominent and power-
ful Sheik, El Sennussi, was widely distributed along
the hinterland of North Africa. This sect came
seriously into collision with the Italians in the war of
1912 in Tripoli. The headquarters of the Sennussi
were at Siwa, one of the most extensive, as well as
most distant, of the western oases.
The Sheik, El Sennussi, himself had hitherto
always expressed a friendship for England, though
he was bitterly opposed to the Italians; but when
Turkey entered the war against us, the Sheik came
under the malign influence of some Germanised
Turkish officers, particularly that of Nuri Bey, a
brother of Enver Pasha, and he began to waver in
his allegiance. For some time he did not openly
declare himself against us, but about November, 1915,
he gathered together a force of his followers, with the
assistance of Turkish officers, and advanced against
the coast of Northern Egypt.
The coast villages of Matruh, Barani and Sollum
were at that time garrisoned by detachments of the
Egyptian Coastguards. On the arrival of the
Sennussi at Sollum and Barani, these Coastguards
offered no resistance, and a considerable number of
them deserted and joined the enemy. The local
Bedouins and Arabs of the coast for the most part
threw in their lot with the invaders.
At this juncture our Western Frontier Force took
102
The Defence of Egypt on the West
the field. We reached Matruh in advance of the
Sennussi, and occupied and held it. After some
months of more or less defensive action, a bold push
was made, the Sennussi were driven back, and event-
ually decisively defeated in two major engagements.
Thereafter operations consisted mainly in seizing
and occupying the various oases and routing there-
from the scattered remnants of the enemy. Most of
these, together with the local Arabs, eventually gave
in their submission and were disarmed. It became
necessary, however, to garrison with British troops
the oases and the most important places on the
western fringe of Egypt, to overawe the population,
among whom a certain amount of disaffection existed
owing to a wide-spread sympathy with the tenets
of the Sennussi sect.
The work of the R.A.M.C. on this frontier was
peculiarly difficult and arduous, not only during the
time of active operations, but throughout the tedious
periods spent with the garrisons occupying so many
remote and inaccessible spots. The climate of these
western oases, as well as of the terrain lying im-
mediately westward of the Nile, is such that, in the
opinion freely expressed at the time by those best
qualified to judge, our troops would not be able to
withstand it unharmed during the summer heats.
Malaria, plague, enteric fever, dysentery, smallpox,
and typhus were said to be indigenous to the district,
and this by no means exhausted the list of local
disabilities. To be forewarned, however, is to be
forearmed; and our medical authorities laid their
103
With the R.A.M.C. in Egypt
plans with commendable thoroughness and foresight.
During the actual fighting period the main
difficulty of dealing with the sick and wounded lay
in the matter of transport, a peculiar condition of the
country being the vast distances that often intervened
between the scene of hostilities and the base. Luckily,
however, we were not dependent to any great extent
on camel transport for helpless men, which had been
such a trying feature of the campaign in Sinai. The
camel cacolet is at best a cruel means of conveyance
for a seriously wounded man. Its motion, when the
animal is on the march, may be likened to that of a
small boat in a choppy sea. If the camel had never
before earned its title of "The Ship of the Desert,"
some British sufferer would now certainly have hit
upon the simile, but probably from no access of poetic
fervour, and assuredly with a more than generous
garniture of adjectives. Fifteen or twenty miles in a
camel cacolet with a fractured femur would vitiate the
vocabulary of a saint.
Fortunately the sand of the western Desert, owing
to the limestone substrata, was often so compact and
smooth that the use of light motor ambulances with
good axle-clearance was found quite feasible. This
was generally the case within the coastal area of
operations, and, in a less degree, on the tracks be-
tween some of the oases; while throughout the
country contiguous to the Nile, the motors were
almost universally employed. Where, however, the
motors could not penetrate, sand-carts drawn by four
mules necessarily took their place.
104
A MULE-DRAWN SAND-CART.
DESERT AMBULANCE DRAWN BY FOUR CAMELS.
The Defence of Egypt on the West
In the subsequent treatment of sick and wounded
on this frontier, in view of the great distances between
the posts held by the troops and the inadvisability of
evacuating all the cases to the General Hospitals at
the Base of the Force in Cairo, an ingenious arrange-
ment was effected. Along the course of the Nile
facing the Desert there are certain small towns at
widely separated intervals, and in each of these towns
there is a more or less well-appointed native hospital.
Such places are Fayoum, Beni Suef, Minia, Assiut,
Sohag, Kena, Esna, and Assuan. Negotiations were
concluded with the Egyptian Public Health Depart-
ment itself under the direction of a British R.A.M.C.
officer for an allotment of space in the hospitals at
all these places, to be used for British patients and" be
exclusively under the care of an R.A.M.C. personnel,
M.O.'s and orderlies, as well as a Q.A.I.M.N.S.
Matron and the necessary staff of nurses. The male
medical staff for these hospitals was wholly drawn
from the various Field Ambulances acting with the
Force; and the arrangement was specially useful in
that it gave the R.A.M.C. ambulance men the
privilege of learning to work under Nursing Sisters
a faculty in which some otherwise capable orderlies
are sorely lacking while it also proved a good oppor-
tunity for gaining experience in nursing duties and
general hospital routine.
In addition to the partial use of these Egyptian
State Hospitals, Field Ambulance Camp Hospitals,
for the treatment of less serious cases, were established
in all the more important camps. The patients were
105
With the R.A.M.C. in Egypt
in almost every instance accommodated in the very
convenient E.P.I. P. tents, though reed huts were
provided at certain places, and existing local build-
ings were occasionally used. Either the regulation
iron bedsteads, or the native angerib like an oblong
basket made of palm staves and turned upside down
were provided in all the camp hospitals, and a special
schedule of equipment was added to the Field Ambul-
ance Establishments to bring them up to the standard
of Casualty Clearing Stations.
Cases requiring special or prolonged treatment
were sent to the Cairo General Hospitals, and during
the hot weather it was found advisable to send a con-
siderable number of men to convalescent hospitals in
Cairo before returning them to duty. In the cooler
months of the year, however, very few convalescents
were sent away from the area, most of the cases being
re-drafted to their units direct from the West Force
hospitals.
But the treatment and care of the sick and
wounded formed only part, and not the larger part,
of the work of the R.A.M.C. on the western Desert.
Under the trying climate and soil conditions, the
maintenance of the health of the troops by rigid
sanitary surveillance of the camps and the adoption
of preventive measures against disease became all-
important.
It was realised from the first that the health of the
British troops in such an environment, especially
during the trying heats of summer, could only be
ensured by giving the men in the permanent camps
106
The Defence of Egypt on the West
a high standard of bodily comfort, not neglecting
also the psychological aspect of the question.
It was stipulated that all troops should be housed
in double-skin tents, the well tried and proved
E.P.I.P. tent where available, but failing this, the
bell tent with double top. Meals were not to be taken
in the sleeping-quarters. Mess-huts, made of light
wooden framework, covered with grass matting, were
to be provided ; and these huts were also to serve as
resting-places during the hottest time of the day.
Fly-proof larders- for storage of food, and properly
sheltered cook-houses, were installed; shelters were
also erected for stables, so that the men would not
have to groom in the sun. Personal cleanliness
among the troops was encouraged in all possible
ways, ablution-places, and wherever the water-
supply would allow it shower-baths, were provided
on a liberal scale. Lastly, and not least important,
all camps were established, when anyhow practicable,
well out on the clean Desert sand, experience having
proved that the proximity of cultivated land always
meant the presence in the air of a disagreeable and
highly infective dust which could not prove otherwise
than a source of danger.
The provision of water, good alike in quality and
quantity, was an ever-urgent problem. It was not
merely a question of providing drinking-water that
prime necessity of Desert life which should be free
from taint of disease. That used for washing and
bathing had also to be safeguarded. Our R.A.M.C.
bacteriologists had firmly established the fact that
107
With the R.A.M.C. in Egypt
the germs of a distressing and incurable ailment
called bilharziosis, largely prevalent among the native
population, lurked in nearly all natural sources of
water in Egypt, not excluding the Nile itself; and
mere skin-contact with the infected water was quite
enough to communicate the disease to British troops.
Fortunately the problem of dealing with water in
large quantities so as to render it safe for use was
simplified in this case by the fact that mere straining,
and storing for 48 hours, would serve to eliminate the
danger. It needed, however, in addition, constant
vigilance to prevent the contraction of the disease by
men surreptitiously bathing in the river or any of
the canals, or the water-holes of the oases, all of
which were probably swarming with the bilharzia
organism. This, indeed, has been an ever-present
danger to our troops quartered in any part of Egypt
and the Sudan, and has from the first received the
closest attention from the medical authorities.
In addition to the work of rendering the Army
water-supply free from disease-producing organisms,
the duties of camp sanitation and conservancy the
disposal of waste products have closely occupied the
attention of the R.A.M.C. Sanitary Sections on both
Fronts. These are questions, always of prime im-
portance in warfare, which assume still graver pro-
portions when hostilities are being carried out by
European troops in a tropical or sub-tropical country.
The work of our Sanitary Sections in Egypt gener-
ally will, however, receive separate treatment later on
in these pages.
108
CHAPTER VII
THE SINAI DESERT CAMPAIGN :
THE BATTLE OF ROMANI
ON the Eastern Front, after the Katia affair at the
close of April, 1916, when the Turks made such a
determined attempt to forestall us in the possession of
that important water-bearing area, a prolonged lull
in hostilities ensued. Some ten or twelve weeks
elapsed before the opposing armies again came to the
brunt of battle ; and this fact alone is sufficient proof,
if proof were needed, of the severe handling on the
part of our mounted troops and airmen which had
been dealt out to the retiring foe.
The interval, however, was full of activity on both
sides. For our part, having once secured the point
of vantage for which we had been striving, we had
no intention of forcing on a Desert campaign during
the hot season that had now set in. Clearly our
policy was, after thoroughly establishing our new
defensive line, -4o confine ourselves to making
preparations for the future, while at the same time
carrying out such reconnaissances in force as might
attain a useful object, and ceaselessly harassing the
enemy by air-raids.
But the Turkish point of view was very different
from our own. Though after the Katia engagement
109
With the R.A.M.C. in Egypt
the Turk had withdrawn to a respectful distance, it
must have been clear to him that he could not hope
to make any effectual progress in his avowed project
of an attack upon Egypt unless he could secure a
main base much farther westward than his present
position at El Arish. And for the collection and
maintenance of such a force as would be needed, there
was no other possible area but the neighbourhood of
Katia within effective striking distance of the Canal.
The probability, therefor^, was that as soon as he was
able to gather together a sufficiently powerful army
he would make another advance against our position,
and this indeed proved to be the case.
Though up to the middle of July no considerable
body of the enemy existed in Sinai nearer than Mazar,
some 40 miles from Katia, it then soon became
evident that a move on a large scale was impending.
On July 19 our airmen reported that a large force of
the enemy was on the march westward from El Arish.
Five days later, carefully reconnoitred by our aircraft
en route, they had reached and strongly entrenched
themselves in a series of positions facing our own line,
at distances roughly averaging about fifteen miles.
This enemy force, as we eventually ascertained,
numbered about 18,000 men, and consisted of the
Third Turkish Division, with mountain guns, heavy
artillery, and special machine-gun companies manned
chiefly by Germans. There were also large bodies of
camelry, wireless sections, field-hospitals, and a
supply section with German personnel. The whole
force was under the command of a German officer,
The Sinai Desert Campaign
Colonel Kriss von Kressenstein, and was in fine
physical condition, and, moreover, admirably
equipped in every way.
It was nearing the end of July, and the situation
was a curious one. Our own troops had been
strongly reinforced, and were established on a care-
fully chosen line extending from Mahemdia on the
sea-coast southward through Romani to a point just
eastward of Katib Gannit Hill. Thence the line
curved backwards round the southern slope of the
hill, after which it turned north-eastward towards
Et Maler. The Turkish line faced ours, running also
roughly north and south. Fifteen miles of Desert
intervened between the two positions. What the
enemy intended to do, having now entrenched
himself, was not immediately clear. But our own
intentions were not long in doubt. Sir A. Murray
resolved to take the initiative, and to attack with the
least possible delay.
The necessary preparations were at once set on
foot. For an advance in force over fifteen miles of
Desert, camel-transport on a complete scale was
required. By August 4 all formations were ready to
take the field. But for several days previously the
enemy had been drawing in, and it had become
evident that he would himself probably assume the
initiative. By August 2 he had advanced his line
considerably, and on the night of August 3-4 com-
menced an attack on our position.
During the three or four days following, the battle
raged almost without intermission, but resulted in the
in
With the R.A.M.C. in Egypt
complete defeat of the enemy, the capture of 4,000
prisoners with many guns, horses, and camels, and
large quantities of ammunition and* stores. Two
complete field hospitals with most of -their equipment
also fell into our hands. Our own casualties, owing
to the prolonged and determined character of the
fighting, were far from light; but the total losses of
the enemy in this 'battle of Romani could not have
been short of 9,000, practically half his force. The
remainder of Kressenstein's army beat a rapid retreat,
continually harassed, however, by our mounted
troops and aeroplanes, who inflicted further heavy
losses upon it. This pursuit was kept up as far
eastward as Salmana. Subsequent air observation
revealed the discomfited enemy still in full retreat
through Mazar towards El Arish.
The battle of Romani will be an ever-memorable
one in the history of the R.A.M.C. in Egypt, for it
was the first major engagement carried through under
entirely Desert conditions. In it the new equipment
and organisation of our ambulances were put to the
supreme practical test, and invaluable experience was
gained in the work of the collection, treatment, and
swift evacuation of wounded in a district wholly
devoid of roads or even tracks of any kind. There
was the railhead, but beyond and around this there
existed only a pathless wilderness of interminable
sand-hill and scrubby plain, into which those
engaged in the succour of the wounded had to pene-
trate often for distances of many miles.
The full-dress historian of the war on this Front,
112
The Sinai Desert Campaign
whoever he may be, will have no lack of excuse for
dipping his pen into the purple ink-horn when he
comes to describe the achievements of our fighting
troops in the battle of Romani. In their way,
however, the doings of the men of the R.A.M.C.
throughout this engagement are little less worthy of
note; though, in the major chronicle, they are likely
to be given but a few scribbled words from the stub
of a lead pencil. The truth is, the services of
ambulance men in a battle do not lend themselves to
the heroic method of description. There is no con-
tinuous graphic story to be made of them. In the
bulk they form just a medley of isolated deeds well
and faithfully and methodically done, and it is only
as a more or less detached series of pictures that our
own pen can deal with them.
Some of the medical units were grouped round
the railhead at Romani, the rest being established at
various stations along our defensive line.
It will be of interest to follow the fortunes of one
of these units from the time of the Katia engagement
up to and including the battle of Romani. Here are
a few extracts from a communication received from a
member of its personnel, covering the period
named :
"When the Turks made their raid on Katia,
our Ambulance was at Kantara working the
Casualty Clearing Station. During the attack on
Dueidar we formed an advanced Dressing Station at
Hill 70. One of the cases that passed through our
hands there was that of Lord Quenington, only son of
"3
With the R.A.M.C. in Egypt
Lord St. Aldwyn, who had been very severely
wounded when his regiment, the Yeomanry, was
surprised and so badly cut up. He died on the way
down to our hospital at Kantara, where his body was
embalmed by native doctors specially sent from Cairo.
"By May 10, the Engineers had pushed on the
Desert railway as far as Pelusium. Our Ambulance
was then ordered to proceed with the Brigade to
Mehemdia on the North Sinai coast. We went by
rail to Pelusium where all our effects were dumped off.
There we spent the night on the open Desert without
any cover, a heavy sea-mist soaking our blankets and
our clothes through to the skin. Very early in the
morning we moved off with the Brigade for a long
march northward over the Desert. We were only
allowed half a bottle of water each, as the supply was
scarce. This was one of the worst treks we have ever
gone through, and we have been through plenty.
We marched in our full equipment water-bottle,
haversack, two blankets, greatcoat, and all personal
belongings, as we knew anything left behind would
never be seen again. It was a blazing hot day with-
out a breath of air, and after four or five hours' steady
tramp up and down sand-hills, we lost all sense of our
surroundings and toiled on mechanically though our
legs could scarcely support us. Many of the infantry
had to fall out, exhausted to the last notch. But late
in the afternoon we caught sight of the far-off white
line of glistening sea, which cheered us somewhat;
and an hour or two later we were lying in the cool
surf the finest sensation of our lives.
114
The Sinai Desert Campaign
"At Mehemdia the Ambulance worked under
great difficulties. All evacuation of sick to the base
had to be carried out by camels, and it was more than
a month later before we got the branch railway up
from Romani, or the light railway along the strip of
coastal sand-bank from Port Said. At Mehemdia we
had an extraordinary experience. This was a plague
of ladybirds the only time we have ever seen this
insect in Egypt. They came over in incredibly vast
clouds and for a day or two swarmed over everything,
but ultimately disappeared as mysteriously as they
came.
"May 16, or thereabouts. A frightfully hot
scorching wind blowing from the south, and the
number of heat-exhaustion cases among the troops
very high.
"July 14. Just when the blessing of train-
evacuation was getting into order, and the canteens
beginning to flourish in Mehemdia, we were relieved
by the Ambulance, and ordered to Romani. On
the way down in the train, the tender jumped the rails
as we were traversing an embankment; but the usual
miracle happened and no one was hurt nothing
worse than a long wait during the night till the
breakdown-gang arrived.
"August 4. Battle of Romani, and second
anniversary of the outbreak of the war. The first
we knew of the coming fight was the Turkish aero-
planes swarming overhead in the early morning and
dropping bombs, many of which fell near our camp.
The camp was pitched on the top of a sand-dune some
"5
With the R.A.M.C. in Egypt
distance north of the railway-siding at Romani. A
little later the Turkish artillery opened fire in our
direction, their objective being probably some of our
own batteries stationed behind the ridge in our rear.
But most of the shells fell short, and our camp got the
benefit of them. When on Gallipoli Peninsula, we
were always known as 'the Lucky Ambulance,' and
now we did not belie our old reputation. The shells
fell thickly all round the camp, and made holes all
over our transport-lines, but not a man nor an animal
was touched. One shell landed alongside our cook-
house, smothered our breakfast in sand, and drove a
hole through the cook's helmet, but without harming
him or anyone else.
"As another instance of our luck : one day, on
the Peninsula, we were working in conjunction with
the Ambulance. Our task was to convey the
wounded from the trenches down to a spot known as
4 The Sandbags.' From here the other ambulance
took up the running. On that day they had two or
three of their men killed, and 14 or 15 wounded. But
we escaped scot-free, although we were nearer the
firing-line, sometimes even working in the front line
trenches under continuous rifle-fire, and often with
the parapets battering down about our ears.
"Besides dealing with a large number of wounded
at this camp on the sand-dune, we formed an
evacuation-post close to the railway-siding, where the
bulk of the wounded were tended. Here it was a case
of working night and day, and a large number of
operations were successfully carried out more
116
A TYPICAL LANDSCAPE ON THE EGYPTIAN-PALESTINE FRONTIER.
(Showing the characteristic Wadi formation.)
R.A.M.C. ON THE MARCH.
The Sinai Desert Campaign
chloroform was used at this time than ever before in
the history of our Ambulance. Our Mobile Section
was also fully employed. It was stationed up at
Katib Gannit, two miles south-west of Romani, and
during the battle it was under continuous rifle-fire.
The dressing-tent was riddled by bullets, but the pro-
verbial luck of the Ambulance held good and not a
single casualty occurred among our own men.
"Our sand-carts did splendid work throughout
the whole of the fighting at Romani, collecting the
wounded from the redoubts along the line. These
redoubts were battered unmercifully by shell-fire.
On one occasion, when the carts were trying to reach
a redoubt which had been shelled incessantly for eight
hours, they had to halt some distance away owing to
the Turks' left wing swinging round on the position.
A communication trench had to be dug, but it was
late in the evening before the wounded could be got
out. The company defending the redoubt lost
altogether about 50 per cent, of their strength in
killed and wounded. Their Medical Officer was
decorated for his work on this occasion.
"Next day our Ambulance Convoy moved out to
a point S.S.W. of Romani, and took over from a
captured Turkish ambulance 90 wounded Turks.
This Turkish medical unit fell into our hands intact,
and, with a little assistance from us, were able to
collect and evacuate all their own wounded from the
sector.
"August 5th. During the hasty retreat of the
Turks on this day, we sent out individual sand-carts
i 117
With the R.A.M.C. in Egypt
broadcast over the country under fire, the carts re-
turning filled with wounded every time. This work
was exceptionally risky owing to the presence of
isolated groups of the enemy.
"Concurrently with the rapid advance of our
troops, our Mobile Section had to push well forward,
and at Kilo 47 a Main Dressing Station was formed.
Shortly afterwards the remainder of our unit moved
up to this camp, and for several weeks we undertook
the evacuation of sick and wounded from the whole
of our Front, many cases coming as far distant as
Mageibra.
"On August 29th a Turkish aeroplane dropped
a bomb close alongside of the camp, killing outright
two of the camel-men. Our own R.A.M.C. trans-
port-men were close by, but never received a scratch
our good luck again."
And here are a few thumb-nail sketches of the
doings of another Ambulance which was in the
Romani fight :
" Our hospital was right in the midst of the area
of attack. The main onset lasted for two days, and
shells and bombs rained down almost incessantly
upon the station. The patients' tents were riddled
by shrapnel-bullets. The wounded began to come in
early on August 4th ; by the evening the hospital was
crowded to overflowing.
"August 5th. Big action at Wellington Ridge,
and our Ambulance Convoy ordered out late in after-
noon to help collect and evacuate wounded. We
made a camp at Hod Abou Adi, whence we passed
118
The Sinai Desert Campaign
on wounded to another Ambulance which had a main
station at Et Maler. We were working all night,
taking the wounded down on camels, every cacolet
we possessed being in use. It was a fairly heart-
rending business walking beside the rocking cacolets
with their groaning human burdens. The scene at
Et Maler fairly beggared description. The station
was crowded with wounded, and was all in a bustle
and hum of activity in the darkness. In the centre
were two huge operating-tents blazing with light.
The whole thing reminded one of a show-ground at
a fair. In the tents the surgeons were continuously
operating, a stream of wounded steadily flowing
through their hands. One of the tents presented an
unique spectacle something we had never seen be-
fore and may never see again. On one side of the
tent were our own R.A.M.C. surgeons busy at their
operating tables. The tables on the other side were
under the care of Turkish surgeons, assisted by
Turkish orderlies, treating their own wounded.
These were the personnel of one of the enemy ambu-
lances which had fallen into our hands on the
previous day. It was splendid to witness the perfect
harmony and good fellowship which existed between
the members of the British and Turkish medical staffs,
only one common thought pervading the minds of
all the saving of life and relief of human suffering.
4 'August 6th. Another heavy day in the field
for our Ambulance men. Our Convoy was ordered
out to assist at Oghratina where an action had taken
place between our mounted troops and the retreating
119
With the R.A.M.G. in Egypt
Turks. On reaching Oghratina, we found the per-
sonnel of the Mounted Ambulance overwhelmed with
work, and wholly unable to cope with the large
number of wounded that had been brought in. There
they were, lying about in the open, waiting their
turn, many of them desperately wounded, and most
of them starving. Our men set to work, first , to
feed them, and then to dress and bandage their
wounds. We also erected shelters where they could
be protected from the pitiless blazing sun. Alto-
gether, this was one of the most arduous jobs our
men have ever tackled. And when all had been cared
for, our main Convoy had to evacuate them back to
a main station at Kilo 47, making several journeys
over a most difficult country with our whole available
transport. It was a day we shall never forget many
a back came near to breaking that day."
The following extract is from an account of the
work of still another Ambulance during the same
action. It illustrates again the great variety of work
which the men of the Royal Army Medical Corps
may be called upon to tackle in connection with an
engagement.
"At Mehemdia we opened up a large hospital
admitting patients from all the regiments quartered
in the area, and evacuating by the light railway to
No. 31 General Hospital at Port Said, and to 24th
Stationary Hospital.
"On the morning of August 4th several enemy
aircraft appeared and dropped bombs, causing many
casualties in the surrounding units.
120
The Sinai Desert Campaign
" The same day our Mobile Column was mustered
and left to take part in the battle of Romani, follow-
ing up close to the infantry. The column ultimately
took up its position at the railhead', Kilo 47, and were
detailed to attend to sick troops who had fallen out
on the march. Parties of stretcher-bearers, and also
camels with cacolets, were dispatched in all directions
to bring in the large number of men who had
succumbed to exhaustion owing to the excessive heat,
want of water, and the appalling difficulties of the
march. Even Sinai Desert seems to have excelled
itself that day in the matter of sweltering, almost in-
tolerable heat, and stifling dust. Our R.A.M.C. lads
were themselves already fairly done up, but they
toiled like Trojans at the job. In one little ho d, or
wood of palm trees, no less than 100 men were dis-
covered, many of whom were unconscious. Others
were lying, drinking the dirty brackish water out of
stagnant pools. One poor fellow, whom I lit upon,
was foaming at the mouth, semi-delirious from thirst.
When I knelt down to give him a drink from my
water-bottle, he fairly tore it out of my hands and
poured the water over his face in attempting to get
it down his throat. All the men we found seemed to
be absolutely ravenous for want of water. We
collected and brought in about 300 altogether that
day. The majority, after being treated and detained
at the dressing station for the night, were so far re-
covered on the morrow as to be able to rejoin their
units out on the Desert, but a good many serious
cases among them had to be sent down the line.'-
121
With the R.A.M.C. in Egypt
And the mention of "the line" brings us to the
consideration of one achievement of the R.A.M.C.
during this engagement at Romani, which deserves
very special notice. This was the improvisation of a
hospital-train service, by which many cases were
passed down the line to Kantara during the first ten
days from the outbreak of hostilities.
A specially appointed ambulance-train was in
course of construction for use on the Sinai Desert
railroad ; but it had not yet arrived, and some means
of rapid evacuation of the wounded from Romani to
the Base on the Suez Canal had now to be hastily
organised. No passenger carriages were available;
there was nothing but the ordinary goods trucks,
either opened or closed, for the conveyance of
wounded. The traffic on the line was frightfully
congested owing to the need for bringing up rein-
forcements and materials of war. Communication
over the 25-mile stretch of Desert railroad was inter-
mittent, and often impossible as the military had the
monopoly of the telegraph wires. Moreover, the per-
sonnel of the railway, and indeed of all R.A.M.C.
units in the zone of action, was already more than
fully employed.
Nevertheless a railway gang of Medical Officers
and orderlies was got together by hook and crook.
Seven closed goods trucks, or box vans, were com-
mandeered and fitted up to contain eight slung
stretchers each, the necessary devising and carpenter-
work being done by the men of one of our Sanitary
Sections. Other empty trucks were temporarily made
122
The Sinai Desert Campaign
use of, whenever available on the returning trains.
A senior Medical Officer was sent to the railhead at
Romani as Evacuation Control Officer. Six others
were told off to act as Train M.O.'s, and with them
as many R.A.M.C. orderlies as could be collected.
Equipment was issued, such as blankets, nursing and
medical companions, medical comforts, dressings,
bandages, and other emergency material. The
R.A.M.C. personnel was divided into three separate
train crews, each with its complete working rig-out.
These crews had to stand by ready to man a train
whenever a number of empty trucks could be secured.
Their equipment was loaded in with them and again
removed at the end of each journey when the wounded
were taken off. Closed trucks only could be used
during the daytime on account of the heat and dis-
tressing glare of the sun; at night open trucks were
brought into use, the service being thus materially
expedited.
But the conveyance of the wounded by these
means was attended by innumerable difficulties. The
trains, to which the ambulance trucks were attached,
were subject to unending delays and side-trackings to
allow the crowded down-trains to pass on the single
line. The frequent stoppages and shunting opera-
tions, and the jolts and jars due to loose couplings or
hastily laid 1 metals was Ihe cause of appalling
discomfort, even downright torture, to the patients,
many of whom were very seriously injured. The
work of the orderlies in charge of the wounded was
also greatly hampered owing to the fact that it was
123
With the R.A.M.C. in Egypt
impossible to pass from truck to truck except when
the train was at a standstill. But in spite of all
deterrents, the work went ceaselessly on day and
night, none thinking of rest or sleep until the last
stretcher with the last helpless man was safely
delivered at the Base. Here again notable work was
done. The Romani wounded were all taken to one
Casualty Clearing Station whose staff proved them-
selves beyond f real scientific cleanliness, was well-nigh
insuperable. It had to be tackled, of course. It
needed only a breath of wind from the right quarter,
blowing over a dirty neglected native camp, to carry
a cloud of infected dust and flies capable of spreading
contamination through a whole British division.
227
With the R.A.M.C. in Egypt
Here, the argus-eyed committee rendered yeoman's
service, going down into the deeps everywhere, and
unearthing sources of contagion which might well
have escaped the regular Sanitary Inspectors, no
matter how conscientiously they held to their task.
One very useful capacity in which the committee
served during its two years' sojourn in the Eastern
Mediterranean area is clearly indicated in these re-
ports, although it is little likely to attract general
notice. Whenever, and wherever, in the whole Near
Eastern war zone, some sharp, serious, inexplicable
outbreak of epidemic disease occurred, the committee
acted as a sort of breakdown gang or flying-squadron,
which would proceed immediately to the threatened
spot, and take expert measures to stamp out the mis-
chief. Over and over again the services of the com-
mittee were utilised by the regular Medical Author-
ities in emergencies of this kind, and with uniformly
good results. As an instance of this may be men-
tioned the sudden mysterious appearance of enterica
in the large camp at Moascar, near Ismailia,
in the Suez Canal zone in August of 1916. Within
a period of about a fortnight, twenty-three cases of
this intestinal disorder occurred, and the authorities
naturally took alarm, as in such a crowded district,
practically unlimited possibilities for the spread of the
disease were ready to hand. The Advisory Com-
mittee was promptly despatched to the spot, with the
result that the cause of the outbreak was immediately
discovered in some defective latrines, and what might
have developed into a serious trouble happily averted.
228
The Medical Advisory Committee
Again, one of the principal dangers to our
troops serving in the East consists in the distressing
and probably incurable tropical disease, bilharz-
iosis, which has been referred to in previous
chapters. That this parasitic disorder has not de-
veloped long since into a serious menace to the
efficiency of our Near East armies, must be entirely
set down to the vigilance of the medical authorities,
all conceivable precautions against it having been
sedulously adopted from the very beginning of hos-
tilities. But isolated instances of the trouble have
cropped up from time to time, traceable almost in-
variably to the neglect of the enjoined simple pre-
cautions on the part of the men concerned. The
disease, it has been clearly proved, can be acquired
by bathing in contaminated water, drinking such
water, or even by the handling of fish from an in-
fected stream.
In the autumn of 1916 some twenty cases of
bilharziosis were detected at an Australian hospital
in Cairo, among patients diagnosed as suffering from
quite a different complaint. These men all came from
one great military camp, and it was obvious that what
had occurred to these few might befall many more
if the source of infection were not immediately dis-
covered and removed. The Advisory Committee
were at once put on to the case. They interviewed
the men, and drew from them the admission that, con-
trary to orders, they had all on one occasion bathed
in a certain pool near the camp. Thereupon the
committee journeyed to the place, found the pool,
p 229
With the R.A.M.C. in Egypt
detected the bilharzia organisms in it by micro-
scopical examination on the spot, and caused the
necessary local measures to be taken to prevent a
recurrence of the mischief.
In this particular instance of the committee's use-
fulness, mention may be made of the special difficulty
encountered in the work, as throwing a little light on
the general conditions of their task. The bilharzia
organism lives a particularly complicated life, partly
in the water, partly as a parasite of certain species of
fresh- water snail, and partly within the body of its
human or animal host. The exact cycle of the various
stages of its life need not be here detailed, but the
thorough character of the committee's investigation
is evidenced by the fact that they went to the trouble,
in regard to this particular pool, of identifying the
organism in all its stages, and even determined in
what manner the original infection was conveyed to
this isolated patch of water by searching for and dis-
covering human faecal deposits, probably native, in
the vicinity in which the characteristic lateral-spined
ovum of the bilharzia worm was easily demonstrable.
It is not, however, possible nor is it necessary to
attempt, within the limited scope of these pages, any-
thing like a complete enumeration of this redoubtable
committee's doings. Enough has been said above to
show what a real influence for good its members
exerted on the health of our troops under all aspects
of the campaign.
230
CHAPTER XVI
MILITARY GENERAL HOSPITALS IN EGYPT
THE General Hospital forms part of the War Estab-
lishment of the R.A.M.C., and its normal capacity,
as officially laid down, is that of 520 beds, the odd
twenty being for sick officers. Its organisation,
equipment, and personnel are akin to those of the
larger military hospitals in time of peace; but the
General Hospital has, in addition, the means of
supplying to patients, on their discharge, such
articles of clothing, equipment, and odd necessaries
as they may stand in need of. In war-time it is no
unusual thing for a wounded man to arrive at a base
hospital shorn of all his previous belongings, or his
clothing may have been so completely destroyed as to
render it fit only for the incinerator. Of these General
Hospitals two are officially allotted to each Division
taking the field.
At the time of the outbreak of the present war,
there were two permanent British Army hospitals in
Egypt that at the Citadel in Cairo, and the smaller
one at Ras-el-Tin, overlooking the harbour of Alex-
andria. These, however, were equipped only on a
peace footing, with 250 and 120 beds respectively.
We have already described how, under the stress
of the Gallipoli crisis, the hospital system at the
231
With the R.A.M.C. in Egypt
Egyptian Base of the Mediterranean Expeditionary
Force was so established and developed as ultimately
to reach a capacity of many thousand beds. Build-
ings of all sorts had to be acquired for the service of
the wounded and sick in one form or another. In all,
twenty-three permanent buildings, nine hotels, two
places of entertainment, seven schools, four Egyptian
Army barracks, and fourteen private houses were
pressed into the service, and one large camp hospital
under canvas was installed. This list, however, does
not include certain Convalescent Depots, such as that
at Montazah, which alone took over a thousand
patients each.
There is, perhaps, no more exacting work in the
whole Army Medical Service than that which falls
upon the staff of a General Hospital, especially under
climatic conditions such as obtain in Egypt. In an
earlier chapter, that dealing with the time of the
Dardanelles avalanche of wounded to the Egyptian
Base, an attempt was made to record what sort and
measure of duty devolved upon our men and women
alike under circumstances of urgency perhaps un-
paralleled in the medical history of the war. But
even under the normal busy conditions, such as have
existed in Egypt almost without a break since -that
memorable time, the work in a General Hospital is
trying to the last degree.
Monotony which is static, which consists in a
ceaseless even round of small duties, none of them
making any great demand on energy or interest, is
bearable because the mind is free to wing away at
232
Military General Hospitals in Egypt
any moment into realms of compensating thought.
But monotony which is one never-halting press of
duties treading hard upon each other's heels duties
by turns brain and body-wearying; heart-aching or
soul-sickening; a day-long and night-long giddy
whirligig of sameness that gives one scarce time to eat
or breathe or close a tired eye on a world that seems
all suffering, sorrow, bloodshed, death; the man or
woman who can plod serenely, stalwartly on through
day after day, month after month, of such a life,
must be made of more than mortal tegument. He or
she must be qualifying for a Saint's aureola and
few there be of that ilk in the ranks of the R.A.M.C.
It is not pretended that life in the huge Base hos-
pitals of Egypt was always moving at this ding-dong
pace. There were intervals between the arrivals of the
convoys of wounded when the work eased up to such
a degree as almost to create a feeling of leisure among
the white-gowned orderly crew. But such moments
were all too rare. Generally, the great busy organ-
ism fared along like a powerful, well-oiled locomotive
pulling a heavy load; sometimes straining and
puffing at a steep gradient, sometimes swooping
easily downward, but for the most part driving
steadily forward at top-gauge pressure through hill
and dale the common give-and-take of busy days.
The object of these pages being the presentation
of an account, as complete as may be, of what the
Royal Army Medical Corps did in Egypt during the
Great War, it i's necessary to deal at some length and
in considerable detail with the subject of General
233
With the R.A.M.C. in Egypt
Hospitals, seeing what a conspicuous part these
played in the conflict from first to last. Perhaps,
however, tedium to the reader can be avoided, and the
desired object equally attained, if the story be allowed
to tell itself through the medium of certain extracts
from a diary kept by an orderly who was continuously
employed in one of these Base hospitals during the
most stirring period of the war. As far as possible,
where all did so splendidly, the names of individual
workers have hitherto been omitted from this
chronicle, and it is not necessary to depart from this
wholesome rule in the present instance. It will
suffice if it be mentioned that the operating-theatre
orderly, whose diary is here quoted at length, was
well trained in all branches of R.A.M.C. work, and
capable of an accurate estimation of and deduction
from facts. It is needful to bear this in mind, as the
extracts in question not only deal with the work
done, but constitute in some measure an independent,
just, and it must be owned rather intrepid criti-
cism of certain of the conditions under which it was
accomplished. The writer, however, may well be
left to "make good," or otherwise, on his own ac-
count :
" The Operating Theatre of a big military hospital
in war-time is, in a sense, the Eyes and Ears of the
place. There is little that happens in the whole hos-
pital that you do not see, or get to know. As theatre-
orderly your work takes you into almost every ward
or department at one time or another, and the business
of most of the other orderlies in the building brings
234
Military General Hospitals in Egypt
them to the theatre on various occasions. We hear
the surgeons talk between the cases, and thus get a
sort of second edition of matters discussed at the
Officers' Mess. The theatre sister"s bosom friends
or enemies come to visit her in odd hours of leisure,
and volubly and voluminously unburden themselves
of the latest rumours in feminine R.A.M.C. affairs.
The patients talk to us, telling us weird tales from the
firing-line that would never do for the papers. But
through it all, we ourselves, as the surgeons' order-
lies, and thus the creme de la creme of the hospital-
orderly class, maintain an attitude of immaculate dis*
cretion. We are at once exemplars of reticence and
receptiveness. We are like the closed wooden money-
boxes of our school-boy days quick to engulf coin,
but slow to yield it up again, even to the exploratory
persuasion of a dinner-knife. The inveterate gossip
though cautious men of the world do not emulate
him has nevertheless his part to play. Unintention-
ally, and for his own easement, he livens the dry
dust of your day's work, just as a full-cropped bird
of passage may cause the far mountain-peak to clothe
itself with verdure, or the desert to blossom like the
rose.
*****
1 They have been tremendously busy in the sur-
gical wards to-day, and that is sure to mean hard work
in the theatre to-morrow, and for many days to come.
Very early a big convoy of wounded arrived from the
Front. A whole fleet of motor-ambulances suddenly
invaded the quiet of the hospital-square in the blue
235
With the R.A.M.C. in Egypt
dusk of dawn, all loudly trumpeting like a stampeded
herd of elephants. Directly the first vehicle turned the
corner in the ghostly light, the bell clanged out to sum-
mon all G.D.O.'s to the work of carrying the cases up
to the wards. I stood midway along the great main
corridor, and watched the stream of laden stretchers
flowing by.
" It is hard work stretcher-bearing ; and none but
the youngest and strongest can keep on with it for
any length of time. I know, because I have done my
share of it in the past, until I got P.B.'d for shell-
shock, and the Desert and I parted company for ever.
I wonder if anyone at home, even the great D.-G.
himself, quite realises the amount and variety of heavy
work that ordinarily falls upon an R.A.M.C. man on
Active Service. Stretcher-bearing forms only a single
part of it. On a battlefield you often have to deal
with a wounded man single-handed get him un-
aided upon your own back and carry him to the zone
of safety, may be a quarter of a mile away or more.
Then a Field Ambulance moves with an ana voidable
mass of necessarily heavy things tents, medical and
surgical panniers, bedding, and what not : all these
must be loaded and unloaded, tents pitched and
struck, the water and food needed by the patients and
staff fetched and carried, animals and vehicles cared
for, cleansed; scarce anything we do but needs
muscle as well as mind.
" I stood and watched the steadily flowing stream
of wounded men that passed by me in the dawning
yellow light, and wondered how much energy and
236
Military General Hospitals in Egypt
hard work had been expended in the task of bring-
ing them into this haven of succour and security. The
last sunbeam of yesterday had probably seen them
lying out amid the sand-hills of Sinai, a hundred
miles away, helpless, maimed, and torn ; now, before
the sun could get another look at them, they were back
in the midst of law and order once more. One little
army of Red Cross men had contrived this laborious
miracle for them : here was another waiting, all the
resources of medical service at its beck and call, to do
more miracles in their service. Kind eyes, soft voices,
gentle, clever hands ; comfort and spotless cleanliness,
order and quietude; fresh-plucked flowers blooming
and waving near open windows, a scent of new linen
on the air, the first sunbeams of the summer's morn-
ing like Jacob's Ladders of gold dust gridding the
tidy wards; how, I bethought me, should all this,
the first impression of a General Hospital, strike a
wounded, helpless man, who but yesterday was brut-
ishly blood-giving and blood-taking under the roar
of cannon and reek of battle-smoke ?
" There were a couple of hundred in the convoy,
perhaps; and each man had to be got to bed his
clothes gently drawn or cut from him; his body
washed; splints and bandages readjusted, perhaps;
food given; his small personal belongings, if he had
any, neatly arranged in the locker by his bedside ; his
hospital-kit drawn for him; his military equipment
taken to the pack-store, and there left until he was
well enough to reclaim it, or until it was certain he
would need it no more. Then came the medical in-
237
With the R.A.M.C. in Egypt
spection. The doctor visited each bed in turn, and
made a thorough examination of the case, deciding
on future treatment. The cases were of all degrees of
gravity. Some needed only care and rest and nourish-
ment, to give Nature all the chance she asked for;
others required close attention, the constant vigilance
of doctor and nursing-staff through long weeks, per-
haps, before the patient would have drawn away from
the danger line. Others required special complicated
appliances and apparatus. Here and there a man was
marked down for operation as soon as the busy theatre
could find time to deal with him, or as soon as his
strength had been raised to the necessary point of en-
durance. And all of them meant increasing care and
hard work for the orderlies, sisters, and nurses of the
ward dressing and bandaging, blanket-bathing,
the preparation and administration of food and medi-
cine, constant sanitary service, the preservation of
cleanliness everywhere, the hundred-and-one nameless
little offices due to the helpless sick. And then there
were the special things dictated by the sub-tropical cli-
mate in which we were working. It was bad enough to
have to endure bodily pain ; it was too much to have
to put up with the added torment of heat and dust,
flies and mosquitoes. Little could be done to miti-
gate the heat, that is when it was really hot in Cairo
120 or so in the shade. But the dust-storms could be
somewhat mitigated by wire-meshed screens over win-
dows and doors; and mosquito-nets over the beds
would do the rest. In special cases also the fan
was a potent vehicle of mercy, in our hospital at least.
238
Military General Hospitals in Egypt
On some brazen, breathless afternoon I have passed
through a ward and seen a fan steadily going over a
flushed half-conscious face, may be that of a man just
reviving from an operation; and returning, perhaps
an hour after, there would be the fan still at work
a woman doing it very likely, but just as often one
of the orderlies : a man soon learns the trick of deli-
cacy in these little things, and, of course, he can keep
on much longer at the job.
"If in the surgical wards of a General Hospital
the work of an R.A.M.C. orderly is trying enough
with its incessant, nerve-harrowing crises and
ghastly scenes, it is perhaps even more so in the
medical division. Every hospital orderly by nature
and temperament falls into one or the other of these
two great categories, surgical or medical, and the
qualifications requisite for each are wide as the poles
asunder. You cannot make a good surgical orderly
out of one whose tendencies and abilities naturally
belong to the medical side ; while any attempt to bend
one trained in surgical nursing to the meticulous
round of medical affairs, is but to waste time and
good human material. For medical ward work you
must have a natural love of routine, a memory as
exact and unfailing as a ship's chronometer, and a
tireless, cheery patience ; and then I am not sure that
you will last long at the job unless you are further
equipped with a sense of humour of the hardy-
perennial kind, or at least a lively appreciation of the
grotesque. You will need this humour to preserve
your sanity. The women in hospital work, at least
With the R.A.M.C. in Egypt
in tropical countries, are wiser than we are. They
keep themselves mentally salubrious by a periodical
letting-off of steam they run amok, so to say, among
the gentler sex, their male coadjutors get the neces-
sary reaction pirate-wise, somehow or other-
emerge smiling, rejuvenated, ready again for peace
and quiet, forgetfulness and forgiveness, such as the
hammer may be supposed to feel towards the nail
after the due amount of clamorous collision. You
must not mind sparks, nor what produces them, if
your life as an orderly in a General Hospital ward
is to be worth the living. But that is another story,
which needs a different mood from that which besets
me now. I will jot down somewhat about it later in
its place.
" No; I do not envy the medical orderly his job.
The more I see of it the more thoroughly it fills me
with something very like aversion. I can do anything
for a wounded man, but a sick man somehow chills
me off. It is a psychological matter, I think. Sick-
ness, disease, are abnormalities perhaps they are the
fruit of demoniac obsessions in the real biblical sense,
who can certainly deny it? at least they change a
man physically, mentally, almost spiritually, one
might say, while their sway is over him a man is
not himself when in their clutches ; who, or what else,
he is, belike we shall never really know.
"The day's round of duty in a medical ward is
indeed a round the ring to which there is neither end
nor beginning. For, if you take your work to heart,
you can never wholly separate yourself from it,
240
MEDICAL AID POST, SUEZ CANAL ZONE.
Photo by Lt.-CoL Edington, R.A.M.C. (T.).
SCENE AT A GENERAL HOSPITAL, ALEXANDRIA.
(Outgoing Convoy being loaded on Motor Ambulances.)
Military General Hospitals in Egypt
whether your spell of duty comes by day or night.
You come on duty at, say, 6 o'clock in the morning,
and find the night orderlies preternaturally wide
awake, bustling about in the early sunshine taking
temperatures, or lingering over little odd jobs, loath
even then to break the spell of action that is on them,
and be away to their beds. There is that curious
heavy atmosphere in the ward that dwells over sleep-
ing men at night, and never oversleeping men by day.
The night-sister is still in the bunk you can see her
through the open door busy over her report, and dis-
playing an alabaster-like prettiness under the pure
white virgin light of the morning. She is in no
hurry to go either. The junior orderlies, just up fresh
from early roll-call, are already on their knees in a
row at the far end of the ward it is scrubbing-day
to-day, and the whole ward must be cleaned through
before breakfast. The harsh chorus of the scrubbing-
brushes, and swish of the water, join with the glad
note 4 of the birds that comes in through the open
windows from the garden outside. As orderly-in-
charge you walk down the long rows of beds and take
a look at each patient in turn, exchanging a word
with those who are awake. This is a time of alternate
pleasure and keen disappointment. Cases you well-
nigh despaired of overnight have, perhaps, taken a
wonderful turn for the better; others who were im-
proving, have lost ground temperature up again, all
the old perilous signs alight once more in wandering
eye and flushed, congested face. And perhaps a form
lies uncannily still and silent un'der the blue counter-
241
With the R.A.M.C. in Egypt
pane in the far corner. The watching orderly nods
grimly as you approach. You take one quick look at
the waxen mask on the pillow, then draw the screens
about the bed. Sharply you tell the orderly to fetch
the stretcher-squad; and sharply you admonish an-
other man hard by, who indeed is doing his work
well enough. To lose a case is the most trying,
irritating thing of all.
" Does anyone at home I mean among the plain
workaday men and women in the street really know
what sick-nursing in a hot sub-tropical country like
Egypt actually means ? Who has any more idea of it,
beyond the old pretty popular fancy of measuring out
medicine three times a day, cooling a fevered brow
with lavender-water, and sticking a few roses in a
bedside vase ? All these things and many more, are
done, of course, by the ministering angels of an
R.A.M.C. hospital-ward in the East; and pleasant it
is, truly, to see the ladies of the Q.A.I.M.N.S. and
the V.A.D.'s flitting about a ward in their spotless
white aprons and dainty caps, carrying a sense of
decent order and decorum wherever they go. No one
knows, or is more ready to acknowledge the real value
of, nay, the absolute necessity for, the presence of a
female nursing-staff in a Military Hospital at all
times, than the writer of these lines. If we orderlies
did not fully and frankly acknowledge this, there are
thousands of grateful soldier-patients in the Army
who would soon set the public right in the matter.
But what the public does not know, and what it is our
right and our duty to tell them, is that practically all
242
Military General Hospitals in Egypt
the hard work, and assuredly all the dirty work, of a
hospital ward is done by the male nursing-staff of
the R.A.M.C.
" And what work it often is! It is difficult in a
publication designed for the general reader, where
technical phrases must be avoided, to convey a true
impression of this matter without going into revolting
details; but a few guarded, necessarily scanty words
must be essayed. Despite all sanitary precautions in
the Field, many thousands of our troops were attacked
by bowel disorders enteric fever, dysentery, and the
like. The greater number of these were helpless, bed-
ridden cases, involving constant care of the most inti-
mate personal kind. Not only had each patient to be
maintained in a state of cleanliness as regards his per-
son and everything with which he came in contact, but
where his complaint was infectious, all sorts of anti-
septic precautions had to be scrupulously observed.
Dejecta had to be disposed of in certain ways medi-
cally laid down. Utensils, garments, and bed-linen
had to be antiseptically treated, this rule also applying
to the wards themselves and everything they con-
tained. To put the matter in plain words, the
orderlies in charge in these cases had literally to be
elbow-deep in filth of a highly dangerous kind,
morning, noon, and night.
"This element of danger in nursing cases of in-
fectious disease must not be overlooked. It applies
of course in a great degree to the doctors and female
staff of the wards; but it is the orderlies, who have all
the dirty work to do, who run the principal risk, as
243
With the R.A.M.C. in Egypt
our Corps Records of sickness amply show. And yet
there is never any difficulty in securing volunteers
among them for emergency-duty when outbreaks of
exceptionally fatal diseases, such as smallpox and
cholera, occur. The fine spirit shown by our men in
this regard during the whole of the Egyptian Cam-
paign has been beyond all praise. To be shut up in
an Isolation Ward for weeks and months on end,
doggedly enduring a life such as no malefactor ever
had meted out to him by an outraged law, and doing
it cheerfully, faithfully, to the end, is just to behave
like a hero there is no other word to fit the case. It
would not be a bad idea if a special decoration were
instituted for men and women of this stamp, and it
might be called the Father Damien Order. I know
many a one who would deserve it; and get it, too,
if deserts had all to do with its award.
" Much the same need of incessant dabbling in
loathsomeness obtains in tfre Surgical Division of a
hospital, where so many perfectly helpless cases are
continually under treatment; and here there is the
element of the horrible added to that of the revolting.
I am not saying that a surgical orderly normally goes
about with his heart in his mouth he would be of
little service if he did. Personally, long use has so
accustomed me to the sight and handling of shattered
and yet living human bodies, that there is, I believe,
no terrible thing of this kind which could break my
nerve. But all the same, experience does not lessen
rather it heightens sensitiveness. The more you
see of War's terrible work, though you are the more
244
Military General Hospitals in Egypt
sternly tempered, the more you dread it. The more
you see of suffering, the more you suffer with it
and the more sternly capable in the work of its assua-
sion you become.
" I have said that the climate has a deal of in-
fluence over hospital-work in Egypt. Only those who
have lived the year through in a hospital here can
fully realise what that influence is. In Egypt, even
in mid-winter, the days are always warm so long
as the sun is up. It is only the nights that are cold,
sometimes bitterly cold. The Egyptian winter is very
short, however. Both days and nights, for the greater
part of the year, are hot, with a peculiar dead, dry,
scorching heat that is particularly trying to sick and
well alike. And there is always an impalpable dust
in the air that even on the stillest days steadily collects
upon everything a dust that in all probability is
capable of carrying the germs of almost every known
disease. When the wind gets up, the dust gets up
with it ; and the harder the wind blows, the more dust
it brings. The dust-storms in Cairo must be classed
among the most unpleasant things that it is possible
to conceive.
" But there is something still worse that the old
Arab city keeps for us when in its most venomous"
mood. The heat alone is bearable, and heat and dust
together keep ordinarily just within the limit of
human endurance. But when a great sand-storm
comes raging in upon the city off the Desert, and
heat, dust, and sand unite their forces against poor
humanity then the stoutest heart may well grow faint.
Q 245
With the R.A.M.C. in Egypt
1 always pity the white women, and especially the
little, pale, peaky English children of Cairo at these
times. If ever there was a time when an orderly
should not * answer back ' in counter to unreasoning
feminine assailment, it is this. Many have attempted
to describe a really bad sand-storm over Cairo City,
and in spite of heaping Ossa upon Pelion of ejacula-
tion and superlative, have wholly failed to convey an
idea of the real thing. I am not going to enter the
futile competition. I can only put in bald words how
the thing strikes me. Suppose all Egypt were made
of brass, and suppose the sun gradually, through
many portentous days and nights, developed enough
furnace-heat to bring this brass first to the melting-
point and then to dissolve it into lambent yellow
vapour; and then suppose all the winds of heaven to
join together in one mighty hurricane to gather up all
the sands of the Sahara to itself and hurl vapour and
sand together in one incessant red-hot, resounding
avalanche upon the town then you will get some
notion, may be a trifle exaggerated, of what Cairo
is like in a typical summer sand-storm Khamsin-
Haboub or whatever you choose to call the infernal
thing.
"Now conceive yourself one of the medical staff
in a big military hospital full of sick and wounded,
frying to preserve some degree of decency and com-
fort among the patients under these conditions. The
sand and dust are everywhere. Closed windows and
doors are of no avail against them. They drive in
through every chink and crevice, and smother every-
246
Military General Hospitals in Egypt
thing patients, food, floors, furniture all alike. A
deep yellow twilight looms over the city, such as Lon-
don never saw in its palmiest days of November fog :
the electric lights have been switched on in the wards
all the morning. And added to this, the wind outside
keeps up a dreadful, hollow, banshee-like wail, and
makes every door and casement and skylight in the
hospital rattle savagely, so that you can scarce hear
a human voice a dozen yards away. Of course these
full-dress visitations of the elements are not of every
day they are, indeed, rare : one or two at most in a
season. But once experienced they are never to be for-
gotten. It is small wonder the Israelites were keen on
getting out of Egypt. I am keen enough that way,
myself, sometimes.
" It is in the wards, of course, that the great bulk
of the outward obvious work of a General Hospital
is done; but there is a vast amount of other work,
equally necessary, which the R.A.M.C. staff has to
get through daily, but which does not meet the eye
of the casual visitor. Take the quartermaster's de-
partment, as a first instance. Generally speaking, we
have no use for the genius in the Army Medical
Service. We form together, so to speak, a great
machine, concerning whose composition it is of vital
importance that every one of its parts should be of
exact gauge and flawless metal, but in which a single
part of superlative merit is nowhere needed. But
there is one exception to this rule. The quarter-
master of a great military hospital in war-time should
be a genius in his own particular line. All our
247
With the R.A.M.C. in Egypt
quartermasters in Egypt must have been so, or the
hospital service could never have held up, as it has
done, against the mammoth strain to which it has been
subjected.
"This hospital of ours is by no means one of the
biggest, and yet in 'one year alone, 1915, we took in
thousands of cases. All these people as well as the
large R.A.M.C. staff had to be fed. Every patient
had to be provided with bed-linen needing frequent
change, a suit of hospital clothes, and a long list of
odd necessaries. On discharge, all deficiencies in his
service-kit had to be made good ; often this meant an
entire new rig-out of clothing. The hospital required
innumerable things furniture, utensils, cooking-
gear, household materials and implements, and the
like most of which needed periodical renewal. And
everything except a few perishable foodstuffs, had to
be obtained from home, some three thousand miles
overseas. I take off my hat to the quartermasters of
the R.A.M.C. That they have done what they have
done is obvious, in the face of the accomplished fact.
But how it has all been accomplished fairly beats me.
11 Then there are the Clinical Laboratories and the
X-Ray Rooms. To the laboratories go numerous
specimens of blood, sputum, faeces, etc., for micro-
scopical examination and bacteriological treatment. In
our own little way here, taking the same year as
before, we dealt with some 4,000 or 5,000 different
specimens. Anyone conversant with laboratory pro-
cedure will realise the vast amount of work involved in
this. Each specimen has to be carefully prepared and
248
Military General Hospitals in Egypt
treated before the microscope will yield any informa-
tion about it. It may have to be subjected to various
reagents, and several kinds of bacterial stains. Cul-
tures on different media, at certain definite tempera-
tures, will have to be made and examined at stated
intervals. All has to be done under strict aseptic con-
ditions, so that no alien element may intrude itself
and vitiate the result. The most simply equipped
laboratory requires a bewilderingly extensive array of
instruments and apparatus, not to mention the brains
needed to use them. Moreover, a laboratory requires
other things just as indispensable to the main object
of its existence, which is the saving of human life by
prompt recognition of disease. There must be little
in the daily round of a military telegraph operator's
life to relieve the grave tedium of his task. But I won-
der if the man who sent the following wire des-
patched post-haste one morning detected a glimmer
of humour in it, coming as it must have done in the
midst of an ocean of important niessages bearing the
grizzly impress of War. The message ran :
" ' Please 'send twelve guinea-pigs by special mes-
senger. Urgent.'
" A touch of the like saving grace may have ap-
peared in the reply :
' Regret having run out of guinea-pigs, owing
to great demand for Mesopotamia. How about
rabbits ? '
" The X-Ray Room at a General Hospital does for
a wounded man much what the Laboratory does for a
sick one. It supplies at once vital information as to
249
With the R.A.M.C. in Egypt
his state, which probably could not otherwise be
obtained in time. The location of a bullet or buried
fragment of projectile, or the precise nature and extent
of a bone-fracture, if early ascertained, may make all
the difference to the injured man's chance of recovery,
or at least save him an infinity of suffering. Recourse
is therefore had to the Rontgen Rays before every
operation for extraction of foreign bodies, where the
making of a skiagraph is in any way practicable.
Having the photograph, or rather the shadow-graph,
of the injured part before him in the theatre for con-
stant reference, the surgeon is able to cut down
straight to the bullet or whatever may be embedded
in the tissues, without making unnecessary incisions
or spending time in exploration. In the case of the
fracture of a bone, the X-Ray picture enables a
definite procedure to be decided on, and all necessary
preparations made, beforehand; and the patient is
thus saved the. risk of prolonged subjection to anaes-
thetics. In many injuries involving fracture, the parts
are so swollen and tender as to render any bedside
examination in the ordinary way entirely out of the
question; and the patient therefore would come to
the operating table with practically nothing known of
his real state but for the help of the X-Rays.
" The Dispensary is another department of a
General Hospital where a vast amount of work is
done. Though the medicines prescribed in the wards
are standardised as far as possible, the usual combina-
tions of drugs are subject to continual variation to
suit the needs of the different cases, and to accord with
250
Military General Hospitals in Egypt
the ideas of different Medical Officers, so that stock-
mixtures can be employed in only limited degree.
In addition, an enormous number of special drugs
have to be kept in readiness, and the list of these is
continually extending. The same applies to surgical
instruments and appliances, all of which pass through
the Dispensing Department of a hospital. Of instru-
ments their name is Legion. It is amazing what the
development of modern surgery has rendered abso-
lutely necessary in this way, even in a Field Surgical
Outfit designed for use close up to the firing-line;
while the surgical equipment of an operating theatre
in a great base hospital has reached truly astounding
proportions. This is equally the case with all kinds
of surgical and medical material specially devised
splints for each variety of fracture; bandages of all
shapes, widths, and species of fabric ; dressings plain
or antiseptic ; surgical lotions of all imaginable kinds.
In regard to splints, and special appliances necessary
for the support of fractured limbs, so great a demand
for these arose in Egypt that the medical authorities
established a factory in Alexandria where all such
articles could be made and served out to the various
units immediately, thus avoiding the delays which so
often occurred in awaiting supplies from home.
This factory was started in May, 1915, and eventually
20 or 30 carpenters, metal-workers, and saddlers found
continuous employment there. First intended to
supply only the Mediterranean Expeditionary Force,
its products eventually came to be distributed to most
of the war-centres in the Near East. Besides turning
With the R.A.M.C. in Egypt
out large quantities of splints of the regulation pat-
terns, it was particularly useful as a place where any
special appliance could be promptly manufactured to
the design and specification of Medical Officers
throughout the war area.
4 ' There is a department common to most General
Hospitals which is euphemistically termed the Lavage
Room. It is actually a special surgery and dispensary
attended by all patients suffering from venereal
diseases, who are undergoing a periodical course of
treatment. Here a very considerable amount of really
hard, and invariably disgusting work is done by the
R.A.M.C. personnel attached to the branch
dangerous work, too, as many a surgeon and
orderly has found out to his cost. But the work must
be done by someone, and it is tackled by our men with
the same sangfroid, readiness, and patient skill
shown by them in all other activities of the Corps.
It is not necessary here to go into details of the work of
the Lavage Room. It involves many minor surgical
operations, the carrying out of many intravenous and
intramuscular injections, and a sharp supervision over
a variety of matters of a personal kind. Closely
allied with the work of the Lavage Room is that apper-
taining to the Venereal Wards. That these wards are
practically detention compounds is a fact upon which
no other comment need here be made than that
experience has proved it to be a necessary fact, and
one which adds inordinately to the difficulties of the
staff employed. It is easy to criticise the whole
present scheme of treatment of venereal- patients in
252
Military General Hospitals in Egypt
the Army, but not so easy to suggest amendments.
At least it is certain that all that can be done in the
stress and hurry of war-time is being done in Egypt.
But this, and the whole group of social questions from
which it arises, will have to be reopened and dras-
tically reconsidered hereafter, as a national concern.
It would be well if it were placed in the hands of a
strong Commission from which all lecture-room
cranks and Puritan visionaries will have been rigor-
ously excluded, and in which none but practical,
level-headed, large-hearted, far-seeing Christian men
of a practical Christian world will have any say or
sway. And such a Commission ought to be given
power to act. I am not addicted to italics, as a rule ;
but I feel the need for them here. The Army to-day
will be the Nation to-morrow. If it be true, as one
military surgeon of long experience declared in my
hearing, that when our soldiers return from the war
ten out of every hundred of them will be tainted with
venereal disease, it is a tremendous fact that brooks no
dissembling. The trumpet-call that heralds Peace
must be for us, as a nation, but a call to another war
that will need more than strenuous waging, if we
mean to keep our place on the earth."
" Looking through the odd casual jottings of this
notebook, it strikes me as curious that I have never
yet set down anything about my own special sphere
of work that of orderly in the Operating Theatre.
Perhaps this is because, seeing so much of it all day
253
With the R.A.M.C. in Egypt
and every day, and often during the night, I am gjad
enough to forget it when I am off duty, and can sit for
a while in the barrack-room window as I am doing
now smoking, and 'scribbling in my lap.
" Our theatre here can be taken as a type of the
theatres in all other General Hospitals in Egypt,
except that, as it does not belong to one of the largest
hospitals, its statistics of work done are probably
below the average figures. Even with this proviso,
our record for a year, the year 1915, is a sufficiently
remarkable one. In that period we performed 1,160
major operations. These were mainly for injuries
received in battle, but included many of the ordinary
type, such as operations for the cure of rupture,
appendicitis, haemorrhoids, and the like. The
surgical work was performed by various surgeons;
but the rest of the work appertaining to the theatre
was entirely carried through by four people the
sister-in-charge, a staff nurse, and two orderlies.
"There is a great deal more to do in an operating
theatre than wielding the knife. To begin with, the
theatre itself its whole interior, floor, walls,
windows, doors, ceiling, and every article of furniture
it contains must be thoroughly washed at frequent
intervals, and treated with antiseptics. Not a speck
of dust or dirt that could harbour a microbe can be
tolerated for a moment in a modern operating theatre.
Then the science of asepsis perfect surgical cleanli-
ness must be studied in all its endless ramifications
by everyone concerned, and its dictates punctiliously
carried out in practice. All that the surgeons use or
Military General Hospitals in Egypt
wear, or that comes into contact with the area of
operation, must be sterilised. Sharp instruments are
steeped in antiseptic solution. Blunt instruments are
boiled. Dressing-gauze, lint, swabs, towels, sheets,
overalls, and all other textile articles are treated in the
high-pressure steam steriliser. The surgeon's wear
rubber gloves, armlets, caps, masks, gowns, and
aprons, all of which must be sterilised, and renewed,
of course, at each operation. Every utensil employed
bowls, jugs, dishes, trays, odd glass ware and china
ware of various kinds must be subjected to the like
process. And it must all be done ' over again and
over again for ever, all the antiseptic cleaning, and
steeping, and boiling, and firing, and steam sterilis-
ing, and renewal of every single thing used or even
touched during one operation", before the next opera-
tion can be taken in hand.
" And not only has the theatre staff to carry out
all these multifarious and difficult duties, but it has
in our theatre, at least the patients to prepare for
their ordeal, and always the actual operation to
superintend throughout. It has to attend to the
anaesthetist and provide him with all he requires no
light task in itself. Finally, it must convey the patient
back to the ward and deliver him to the ward sister
together with final instructions from the operating
surgeon, the responsibility of the theatre ceasing only
when the unconscious man is safely delivered into bed
and is seen to be under proper surveillance.
" It may be interesting to the reader if these
rough notes, set down at odd moments in a busy life,
With the R.A.M.C. in Egypt
ever achieve the dignity of print to run over the
routine of an average day in an operating theatre : it
will at any rate serve to show what this branch of
R.A.M.C. work actually amounts to under the
special conditions prevailing in Egypt.
" In our theatre each day's work really began
overnight. The orderlies would receive the list of
intended operations for the morrow, and would then
bring each patient to the theatre in turn for the neces-
sary preparation ; or, if the patient's condition was too
critical for him to be moved, the orderly would have
to take all his material to the bedside and there carry
out what was required. The theory of this
preparation was that the site of the proposed incision,
together with a large surrounding area, should be
rendered bacteriologically clean and kept so for ten or
twelve hours previous to the operation, so that by no
possibility could toxic matter be carried in by the
knife. The area of the operation had first to be
carefully shaved. Then it was thoroughly swabbed
by three different antiseptic lotions, each having
special bactericidal properties. Finally, this area was
covered up with sterile lint, the lint being bandaged
securely in place. The whole work had to be carried
out under the same aseptic conditions as if the opera-
tion were being actually performed. It was a point of
emulation with us to carry through these overnight
preparations with all the celerity possible, consistent
with the thorough performance of the work, as indeed
was necessary with a long list of such preparations
before us. But even then the whole evening was fully
256
Military General Hospitals in Egypt
taken up. An average of half an hour given to each
case would represent a pretty good night's perform-
ance. Many of the cases could not possibly be
prepared in this time. Take, for instance, that
wherein excision of varicose veins from both legs was
contemplated, and the surgeon, as was usual, had
ordered * abdominal preparation.' This meant that
the entire body, from the ankles up to about three
inches above the navel, had to be shaved, treated with
the lotions, and covered and bandaged, as described
above.
" The day's work in the theatre commenced at six
o'clock in the morning, when the whole place
already spotlessly, distressingly clean, an outsider
might say received a thorough mopping and damp-
dusting with cloths wrung out in cresol solution.
The various boilers and sterilisers were set going.
The theatre was laid out with all necessaries for the
first operation a long list of articles, each having its
preordained traditional place. A typical programme
for a day's work in our theatre would be, say, one
major amputation, an appendicitis case, two or three
inguinal hernias or haemorrhoids, a bullet extraction
or two, with perhaps a screen case a phimosis or
kindred operation to follow. In addition to these,
there might be, and generally was, an emergency
operation brought in at any moment, and before
which all else would have to give way. A favourite
time, however, for these emergency cases was the
small hours of the morning. To fling out of bed in
the dead dark of night, rush down to the theatre, and
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With the R.A.M.C. in Egypt
set all going pell-mell for a critical operation an
amputation, trephining, intestinal stoppage, or what-
not was no unusual experience in our work as theatre
orderlies. And a malicious Fate generally arranged
matters so that these portentous times came at the end
of the hardest day's work in the week, when there had
been left to you only sufficient energy to drop your
clothes on the floor and crawl into bed, dizzy and faint
with interminable hours of duty. But a theatre
orderly worthy of the name never really minds these
emergency calls. It is saying a good deal, but there
is p'robably more pride, more esprit de corps among
the theatre orderly class than in any branch of the
R.A.M.C. service. We know our responsibility,
nay, indispensability ; and keep a pretty stiff neck
accordingly. Conceit and gunpowder between them
will go far to win any war.
11 In these operating theatres attached to the great
base hospitals in Egypt we have tried to reproduce,
as nearly as may be, the exact methods of procedure
appertaining to the best theatres at home. But we
have not quite succeeded. The climate makes its
influence felt at every turn, and modifies conditions,
sometimes very materially. The surgeon fresh out
from home has a deal to learn before he becomes used
to things. The excessive dryness of the air at all
times, the phenomenal heat of summer, and the
eternal dust, create together a new situation. It may
take, for instance, a whole twenty-ounce bottle of
ether if that anaesthetic alone be used to keep a man
1 under ' for the length of an ordinary operation. The
Military General Hospitals in Egypt
heat, too, in a theatre, despite all precautions, is often
appalling. With the thermometer standing at 115
or 1 20 degrees in the shade, to have to dress up in
waterproof apron, thick linen gown, rubber gloves
and armlets, mask and cap, is something that may
well appal a newcomer. Then the flies and other
winged torments of Egypt are not to be wholly
excluded from the theatre by any means that
ingenuity can devise. A few are sure to find their
way in, where doors are so frequently opening and
shutting. A surgeon trussed up in the way described
is wholly at the mercy of any evil-disposed fly who
chooses to a'ssail the small portion of his face which
is necessarily left uncovered. He is perfectly helpless
against his tormentor. He dare not brush it off as
his hands are sterile, and his face and the fly are very
much the reverse. His sole chance of deliverance lies
in a watchful orderly; and it is no exaggeration to
say that, with two or perhaps three surgeons and a
charge sister all 'sterile/ and therefore a helpless
prey to attacking insects, our day's work was materi-
ally increased by continual fly-killing forays. I have
seen a very eminent surgeon a ' great gun ' from
Harley Street attached to the R.A.M.C. 'for the
duration 1 fairly beside himself with impotent rage at
a fly which was clinging to his eyelid, and thus en-
tirely stopping him in the task of plating a fractured
femur.
" Nor were the flies our sole source of anxiety in
this way. Perspiration was equally a bete noire with
us. The subject verges on the ridiculous, but its
259
With the R.A.M.C. in Egypt
serious side is not to be gainsaid. Surgical work,
especially when an amputation is in progress, is often
very hard work indeed; and, swaddled up as he is,
with the thermometer at 100 degrees or so, the surgeon
is sure to perspire profusely. As is well known,
perspiration is highly septic, and should a drop by
any chance fall into the incision, the consequences
might be serious life itself might easily be lost in
that way. Herein dwells a fearful responsibility for
the orderly. He must silently pervade the scene,
towel in hand, and woe betide him if he fail in his
duty. One particular surgeon, whose bad habit it
was to operate without the usual mask, used to be the
terror of all concerned in this way. He was a man of
a generous habit of life, and moreover a trifle short-
sighted, so that his custom was to bend much over
the case. Many a time I have caught the agonised
eye of the charge sister, and rushed up with a towel
just in time to prevent disaster. We soon developed
an acrobatic agility at this game. But it had its use
in leavening somewhat the over-tragic side of our
employment.
" Who would look to the operating theatre of a
hospital to provide a spectacle that, on a small scale,
may be said to rival Irving's celebrated staging of the
scene on the Brocken ? And yet such a spectacle does
come, ancl not infrequently, in the round of a day's
theatre work. Sometimes a bullet, or shell fragment,
is embedded in a man's body in such a situation as to
render the taking of an X-Ray photograph imprac-
ticable. In this case the operation for the extraction
260
Military General Hospitals in Egypt
of the bullet, or other foreign matter, may be
performed in the X-Ray room itself ; and then ensues
a scene which, for lurid picturesqueness, would be
hard to equal in any kind of theatre. Here is the
scene, as nearly as a somewhat stubbly pencil-end
may serve to reproduce it.
" The room is large, but lit only by a single
electric bulb a sort of robber's cave hung round with
innumerable weird appliances over which play the
shadows of those grouped about the central table.
The table is of wood, a sort of sarcophagus, with a
pane of glass let into its side. The subject lies
naked on the table with the anaesthetist at his head,
now engaged in administering the chloroform.
Round the table stand half a dozen silent, motion-
less forms completely concealed in robes and head-
dresses of white linen, like a band of Druid priests
at some dreadful prehistoric rite. We do not
talk, because speech would serve us little in the din
that is going on. A great dynamo is blaring and
burring in the corner. Another electric contrivance
of fantastic shape stands upon a high pedestal near
by. It utters one long unearthly screech, loudly
clacking a myriad tongues the while. Outside the
room a gas-engine proclaims its existence sonorously.
There is a rush and ripple of water somewhere in the
background. It would be useless to talk where none
could hear : what intercommunication is necessary
between us from time to time is carried on by signs
and gestures. At last, as we wait in the dim ghostly
light, the anaesthetist looks up and nods to the sur-
S 26;
\
With the R.A.M.C. in Egypt
geon. The surgeon nods to the X-Ray operator.
The latter turns to his apparatus, falling to work upon
certain handles and levers. Out goes the light and
we are left for a space in utter darkness. And then
we are all suddenly transported to the diabolical
precincts of the scene from Faust. Across the dark-
ness overhead shoot out long cloven tongues of vivid
blue whip-lashes of steel-blue light flickering and
swaying everywhere. Then through the glass of the
table springs up another light, this time of a pale
absinthe green, which in a moment floods the whole
room, illuminating its remotest recesses. But it does
more than that. It does a thing which is perfectly
horrifying to one witnessing it for the first time. It
enables you to see through a man. The case on the
table is one of a bullet lodged near the lung. We see
the man himself now made apparently of semi-
transparent green jelly, wherein we can dimly trace
the form and order of his ribs, a jumble of heaving
vague shapes within, which are heart, lungs, and
other vessels; and low down in the muscular tissue
opposite the base of one lung, a mysterious dark
oblong patch which we know to be a Turkish bullet.
The surgeon takes his scalpel in hand. His work is
comparatively simple now. Half an hour later the
senseless, stertorously breathing man is on his way
back to the ward, free of a danger that had like to have
meant festering death to him or at least a source of
discomfort, disability, journeying with him to his
grave.
Military General Hospitals in Egypt
"Sister Z and I 'had words* last night; or
rather we should have done if I had not promptly put
on my old and well-tried suit of mail, of a genial but
scrupulously respectful silence, when she descended
upon me like a queen hornet disturbed from her nest.
The theatre was filthy, she cried the floor like a pig-
sty everything smothered in dust and dirt she was
perfectly ashamed of the place it wasn't safe to do
as much as dress a cut finger in it. She flounced off
into the sterilising room with a tempestuous rustle of
petticoats. A moment later she was calling me angrily.
' Just look at the brasses ! ' quoth she. ' I don't believe
they have been touched for a week. And the cobwebs
black upon the ceiling ! And the foul linen not yet
seen to ! And all this rubbish lying about ! What you
lazy men do with your time fairly beats me.' I looked
round and saw my face reflected a dozen times in the
unsullied splendour of nickel-plated dressing drum
and copper urn. There was no sign of a cobweb that
I could see. The linen was still drying after its bath
of cresol, and therefore could not yet be dealt with.
The ' rubbish ' was something she had herself left, and
forgotten about. But, like the Tar Baby, I kept on
saying nothing. Presently she fell to pacing up and
down the room, twisting her handkerchief into tight
little knots behind her. At last it all came out, as I
knew it would. ' That laparotomy of B Ward has
gone septic,' she explained, making a furious dab at
her eyes with the handkerchief. ' And Captain Q x
says But I am perfectly sure it is no fault of the
theatre ! It is absolutely impossible ! Why, the
With the R.A.M.C. in Egypt
place is kept like a new pin ! And all the care in the
world spent on everything, and nothing ever forgotten
by any of us. There's no theatre in Egypt kept like
mine : I told him so straight to his face. The very
idea ! But I won't worry myself any more over such
a trifle. And good gracious ! it's past eight
o'clock! Why haven't you gone off duty? I do
believe you orderlies would never leave off work unless
I drove you away from it ! '
" And that is a fair sample of the way things go
between the masculine and feminine nursing staff of
the R.A.M.C. in Egypt; or, for the matter of that,
anywhere in the Service. It is the old story, of
course. You may train a woman's head and hands
for any responsible work in the world ; but you cannot
train her nature. Beneath it all she remains a woman
the thing created out of Adam's rib ages and ages
ago complete, finite, unalterable in essence. And
the real thing is sure to crop up through the surface
time and again, no matter whether she be queen,
scullery-maid, revue star, or a hospital sister wearing
the R.R.C.
" I often wonder whether Sir Alfred Keogh
realised what a Pandora's Box of mingled blessings
and troubles he was opening within his realm when he
created the present system, setting the women over
the men in the nursing branch of the R.A.M.C. Be
it understood here that I intend to put up no fight
against either the act or the fact. I admit that the
one was inevitable, and the other its necessary corol-
lary. We orderlies know perfectly well that we were
Military General Hospitals in Egypt
fairly and squarely beaten. It was a fair duel between
the sexes and we lost, as men must always lose in any
war of mere wits with women. We were good
nursing orderlies. We knew our job. But we had
one besetting sin, a craze for militarism. It was this
that prevented us organising and so made our down-
fall inevitable. While we were playing at soldiering
marching and forming fours, 'shunning' and
saluting, getting a dazzle on our boots and buttons,
and picking up all manner of other dandy military
tricks; just an inchoate, happy, hardworking rabble
of nursery kids the women were training and
organising; making themselves fit to command us.
That they got what they had so thoroughly prepared
themselves for we have no right to complain of, much
less to blame the Director-General. It is open to us,
however, while loyally and sportingly accepting the
situation thus created, to try and save a little from the
wreck ; to point out certain faults in, and abuses of,
the present system, which, as a matter of fact, cry out
very loudly indeed for redress.
" No one who has worked for long in a R.A.M.C.
General Hospital can overlook the truth that there
exists to-day a certain amount of unnecessary friction,
in some cases downright animosity, between the male
and female sections of the nursing staff. It is due,
I believe, not so much to the shortcomings of the
men, as to a lack of interest and understanding on the
part of certain of the women. The drawback to the
system of setting the women over the men in a
hospital ward is that its proper working depends too
265
With the R.A.M.C. in Egypt
much on personality. It either succeeds triumphantly,
or utterly fails, according to whether the woman in
power is great or small-minded. A charge sister who
governs her ward with consistent and invariable
justice, geniality, and regard to the susceptibilities of
her staff, will find ' roses, roses, all the way.' The
ward work will go like a summer song. But
capricious severity, favoritism, wilful illogic of deed
or word, want of heart and common charity, will make
for trouble all round. These together, or any one of
them separately, will cause otherwise really conscien-
tious men to do as little, instead of as much as they
can. They will create ' lead-swinging,' toadyism,
and general discontent. Men by nature frank and
independent-minded, are likely to develop under this
bad influence either an undisguised, insolent
opposition, or at least a covert hostility. The very
least that will happen is that orderlies thoroughly
suited for hospital ward work will be driven to apply
for service in the field ambulances, or even to
exchange out of the Corps altogether * anywhere out
of the way of the women,' as was said to me once by
a really competent nursing orderly whom I had lost
sight of in Cairo, and ultimately lit upon on a cook-
house fatigue somewhere out on the Desert. Of
this man it was said by the surgeon under whom he
worked that ' he was one of the best orderlies he had
ever had.' And yet, the capricious dislike of an
otherwise worthy young woman had succeeded in
driving him from the work for which, both by train-
ing and inclination, he was peculiarly fitted, and had
266
Military General Hospitals in Egypt
reduced him to peeling potatoes on Sinai Desert. He
peeled the potatoes very well indeed, but that only
added to the pathos of the situation. He stood for an
example of a preventable waste of man-power due to
a remediable abuse of woman-power; and I
respectfully lay the matter before the ladies of the
Q.A.I.M.N.S. both in and out of Egypt was it
right, though the potato peelings may have been as
thin as poppy leaves, that this man's higher capabili-
ties should have been lost to his fellows? In effect,
by the unreasoning act of one of your sisterhood, you
said to an unknown number of wounded soldiers,
4 You cannot have your wounds dressed, nor your
suffering bodies cleansed, but a lot of men will get
potatoes in their stew to-day a hundred miles away.'
Does the argument appeal to you ? I will own that
when I put it to Sister Z the other afternoon she
fired up, said I was talking nonsense, and immedi-
ately gave me the whole cupboardful of dressing
forceps to clean a good two hours' work even if it
wanted doing, which it did not. But a little later she
said, * Your friend will be soon avenged anyway.
Sister X has got a shift to Mespot much to her
disgust, and will be off next week. But I don't think
she'll be missed a great deal, except at Sault's or
Groppi's perhaps. Now put all that finnicky stuff
away, and be off to your tea.'
" How can a real, workable modus vivendi be
established in the hospitals, so that the men and
women may each be able to go about their several
tasks without friction or strained feeling? The
267
With the R.A.M.C. in Egypt
question is about as difficult to answer as that other
famous one, ' How can the state of matrimony be
rendered a state of unvarying harmony and good-
will ? ' Neither, of course, ever will be answered with
logical completeness. Something, however, can be
done, I think, if we approach each question from the
avowedly illogical standpoint of ignoring irremovable
causes, and confining our efforts to the nullification of
effects. Once, in a rueful hour, I conceived the
notion of writing a book, to be called * Practical
Suggestions to Ward Sisters on the Management and
Mismanagement of Men.' I have grown older and
wiser since that sore, indignant time. Now nothing
would induce me to put pen to paper in so uncouth
and visionary an enterprise. But I could talk to the
orderlies themselves through three fat volumes I
think, that is, if any of them could be induced to read,
much less to mark, learn, and inwardly digest.
11 Of a truth, nursing orderlies, the very best of
them, are steeped to the eyes in ignorance of women
and their ways. That is the bedrock cause of the
whole trouble. Not a hundredth part of all the
bickerings, misunderstandings, and little strifes, that
occur daily in the wards, would ever get beyond the
stage of a harmless, salutary breeze, if the men could
bring a little philosophy to bear on the occasion. It
is all really very simple. We have first to admit, and
fully to reconcile ourselves with, the fact that as
nursing orderlies we have been placed in subordina-
tion to the sisters of the wards, and in their absence,
to any feminine authority they may depute in their
268
Military General Hospitals in Egypt
stead. This is the system in force; and however
much we may disagree with it and dislike it, we are
bound loyally to accept it until such time as the
system may be mended or ended. Whether it ever
will be changed, is neither here nor there. For my
own part, I am not sure that any change in the direc-
tion of weakening feminine jurisdiction in a military
hospital would be a change for the better. It is
indisputable that the presence of women in the wards
acts as a potent check on the behaviour of the
patients, many of whom have only too great cause for
restlessness and ennui, which, with a certain class of
men, notoriously tend towards a slackening of
discipline. I doubt if a purely male nursing staff,
even if we were all N.C.O.'s used to the maintenance
of military order, would be able to keep a proper spirit
of discipline alive among the patients. You cannot
* strafe, ' and you cannot mete out the usual forms of
punishment to, a crowd of bedridden or semi-
convalescent men. But the mere presence of ladies in
a ward absolves all these difficulties. Everyone is
kept permanently on his best behaviour. The average
soldier does, and says, all things differently when
there are women about. The fact that there is a cool,
neat, quiet figure in nun-like robes moving about the
place, or even the knowledge that any moment such
a humanising apparition may come sailing in at the
door, keeps a check on all tongues, and prevents
horseplay or buffoonery.
"Moreover, there is another reason why the
retention of the system is desirable, and in my view
369
With the R.A.M.C. in Egypt
downright necessary, under the present conditions.
The Director-General gave the women the giantesses'
strength, and there is no doubt that a few of them
use it as giantesses, which is very wrong indeed.
But the great majority employ their power as alone it
should be employed in the due direction of affairs
according to their superior knowledge and attain-
ments. There is no blinking the fact of their
superiority to us in the matters of technical knowledge
and trained skill. The education which a R.A.M.C.
hospital orderly receives under the official curriculum
is manifestly inferior to- that possessed by a qualified
member of the Q.A.I.M.N.S. To deny this is to
deny the plain evidence of one's senses. It only goes
in support of what I have already said. Militarism
has been the real stumbling block of the R.A.M.C.
It has absorbed time which ought to have been
devoted to additional training in medical and surgical
matters. No doubt the soldier's coat and bright
buttons served the very useful purpose of an induce-
ment to enlist; and therefore commended itself to an
astute War Office. But R.A.M.C. orderlies ought
to be above these primeval promptings. Being mere
men, however, and young men at that, they were
nothing of the kind. They elected to be soldiers, and
as such of course, gave up their civilian right to
organise. The women were wiser, and their wisdom
bore its inevitable fruit. They saw that organisation
was everything. They created a magnificent institu-
tion which turned out a product of a quality opposing
excellence to our mediocrity. And in the nature of
2/0
.Military General Hospitals in Egypt
things we were bound.to go to the wall, where we are
equally bound to stop until we prove ourselves worthy
of other destinies. The sisters rule the wards simply
because they are more competent to do so than the
brothers ; and any other arrangement, for the present
at least, seems to be alike contrary to justice, to
public policy, and to common sense.
" In view of these facts there remains only one
thing for the male nursing staff to do, and that is
scrupulously to ' play the game.' It is a harder gamf
to play perhaps in Egypt's hot trying climate than in
the soft serenity of Netley, but there is nothing in it
that need surpass the wit of man. The main fact to
remember is that, though a woman may be a skilled
and long-experienced hospital sister or matron, with
half the letters of the alphabet after her name, by
nature and instinct she yet remains a woman and must
invariably be treated as such. The least that is due
to her at all times are an inexhaustible patience, and
a courteous, conciliatory manner, from each male
member of her staff. If all sisters were like Sister
Z , nothing more than these would be needed to
make things go as smoothly as any human relation-
ship can be expected to fare from day to day. Sister
Z has all the inconsequences of her sex, and some-
times she uses her tongue with as little selective intent
for harm, and as much dire execution, as one who
should swing a naked sword about in a crowded room
after the gas has gone out. Yet she has a true
woman's heart, and is, moreover, the Sest theatre
sister that I ever knew or heard of. But ward sisters
271
With the R.A.M.C. in Egypt
in Egypt are unfortunately not all like Sister Z .
The climate tries them sorely. In many cases they
are systematically overworked. Responsibility,
though they unhesitatingly assume it, is not
naturally a feminine attribute, and they assume it at
heavy cost, paid for in the suppression of many of
their finer qualities. Nor is it natural that women
should ' boss ' men ; and I think, in their heart of
hearts, they rather despise us for having come under
their yoke, which in itself is not a circumstance likely
to promote good feeling from either side. To these
ingredients of an admittedly delicate situation must
be added one more the undoubted fact that a few,
very few, possess not the smallest instinct of lady-
hood, a direful shortcoming indeed for any woman in
authority as well as for her unhappy subordinates.
' Yet in spite of all these complications, what is
our plain policy towards the establishment of the
much-desired modus vivendi advocated above ? The
answer is simple enough. It can be put in a nutshell,
or, rather, a series of nutshells. Perhaps, however,
the professional metaphor of a tabloid would be more
to the purpose ; and here are some tabloids which have
proved efficacious in the cure of many a little disorder
in my own somewhat chequered career as a nursing
orderly, and may be of like service to others. I set
them down haphazard as they occur to me :
" First and foremost, the hospital ward orderly's
sheet-anchor, his grand motto, his triple body-shield
* Patience, Endurance, Silence.' Any sort of
silence is silver ; courteous silence is gold : silence,
272
Military General Hospitals in Egypt
courtesy, sympathy, conciliation, ready amendment
of anything, anyhow and anywhere, make together a
diadem of precious stones. Keep this piece of regal
furniture always at hand, and put it on at the first
sign of an electrically overladen atmosphere.
" Always be in the right, but never say you are
so. Let facts speak for themselves. It is a great
mistake to suppose that women are by nature illogical.
The more unthinking of us get that notion through
judging them by first words and first acts, which, in
a woman, amount to no more than trying a pen on
the blotting paper before settling to write.
11 They are as little to be taken as guides to what
will eventually be thought or done than the first froth
on a wine vat is guage of the true quality of liquor
that will ultimately be beneath. Intuition really
guides a woman, and intuition is instant, although not
instantly perceived by her. She must ' feel about,* so
to say, before she gets into touch with it. Which
explains the apparently inconsequent preliminaries.
Trust the facts to do all the necessary talking, and at
the right moment. Hasty inopportune words often
put the Tightest man in the wrongest place. Many an
orderly has got C.B. merely because he had put the
truth in the wrong words at the wrong time.
" Never try for the last word. The real last word
is the true one ; and the true word, if it must be said,
is better said first than last. If circumstances compel
you to speak, say what you have to say once and
clearly, and have done with it. Reasseveration only
clouds an issue.
With the R.A.M.C. in Egypt
"Know your job as nursing orderly through and
through. But do not mind if ' She ' elects to teach
it you with unnecessary vehemence every time the
wind blows off the Desert, or the surgeon has found
fault with her; or she has had a letter, or hasn't
had a letter, as the case may be.
"If the sister has made a mistake in the course
of her ward work, try to obliterate its consequences,
for your own sake, quietly and unobtrusively; but
keep your mouth shut about it to her, and especially
to others. If the mistake is serious and likely to
attract action from high quarters, you may be com-
pelled to say and do what is necessary to prevent
yourself being drawn into the maelstrom of trouble.
Buf content yourself with the bare minimum in this
direction. Above all, do not seek to make capital
out of it for your own advantage. The orderly who
tries to ' score ' off the sister is about as sensible as a
man who plays football with a bee-hive. He is
deliberately forgoing his chance of future peace and
quiet for the sake of a little doubtful present enter-
tainment. Let Nemesis attend to her own job.
"Don't join in the * Ablution Room Parliaments'
the chance gatherings of orderlies in course of the
day's round for cigarettes and mutual confidences
which are a common feature of military hospital life
all the Empire over. There are times when an
occasional ' draw ' becomes well nigh a necessity
to most of us. Half a pipeful of tobacco has many a
time restored a tired man's nerve and sent him back
to the ward ready and bright for another long spell
Military General Hospitals in Egypt
of duty. But these precious stolen moments in the
day are best enjoyed in solitude. For some un-
fathomable reason, women always regard gossiping
as a heinous offence in men.
"Lastly it comes last in these random jottings,
but in importance it should come earlier resist every
tendency, or shadow of a tendency, to a familiar re-
lationship with any member of the female nursing
staff. All sisters are regarded officially as holding
the equivalent of commissioned rank. It is our
policy, as well as our duty, to insist that this fact
should never be lost sight of, either by them or our-
selves; and it is by far the wiser plan for an orderly
to include all nurses of whatever grade or qualifica-
tion, in the same inviolable category. There are
many women in the Army Nursing Service whose
normal attitude towards the men they work with is
one of exquisitely delicate forethought and Christian
charity women who never forget that orderlies are
human beings of a like creation with themselves, and
who love to leaven the dreary lump of the day's
common task with a word or little act of common
human kindness. With these it is a hard matter to
appear irresponsive, to let a kind word fall still-born
in the humdrum waste of daily affairs. Nor is it at
all necessary thus to drive a principle to the death;
there are a hundred little ways in which appreciation
can be shown outside the grosser form of spoken
phrases. But there are, equally, many women in
the Service from which it is alike perilous to accept
favours in word or in deed. You are never on
With the R.A.M.C. in Egypt
sure ground with them. One day you are over-
whelmed with an effusive urbanity, or find yourself
the recipient of private confidences that fairly take
away your breath. The next day the barometer has
fallen headlong. There is nothing but a lowering
sky for you, the chill patter of rain, and a steely
lightning-glitter of glances. Even your modest
claim to be regarded as human pabulum may seem
to be contemptuously rejected. The very doormat
of the annexe, in the lowly favours extended to it,
seems better off than you. Such a game of social
see-saw is intolerable for any self-respecting man.
The only thing to do is to meet all, advances and
repulses alike, with the same quiet unvarying civility,
being neither exalted nor cast down, and preserving
the even busy tenour of your way regardless as to
whether the road be rough or smooth, the atmosphere
balmy or tempestuous. If manhood stands for any
certain definite qualities in a woman's eyes it stands
for consistency, equanimity, magnanimity. Women
trust us, and depend on us, much more than they will
admit to us or to themselves much more, indeed,
than they ever know."
CHAPTER
THE EGYPTIAN LABOUR CORPS : THE MEDICAL SIDE OF
ITS ORGANISATION UNDER THE R.A.M.C.
IN the pages of this chronicle much ground which is
familiar to the general student of the War has neces-
sarily been traversed ; it is doubtful, however, if the
particular branch of R.A.M.C. activity in the
Near East now to be dealt with, will fall within the
knowledge of many : it is even possible that the vast
majority of British readers will never have heard of
it at all.
And yet the story of what the Royal Army Medi-
cal Corps has done for the great army of native
Egyptian workmen employed concurrently with the
British Forces in this part of the world, is a record of
what may well be called a remarkable, even a re-
doubtable, achievement. The device of making use
of Egypt's great natural resources in unskilled, yet
far from unintelligent labour towards the prosecution
of the War in its various zones, had its instigation
very early in the times of the Dardanelles Campaign.
Our overseas Base at Mudros, in Byron's romantic
isle of the ^Egean, splendidly fit and practicable a
fulcrum for a great military lever to work from, as it
eventually became, consisted at first of nothing but
the rawest of raw material from which to fashion a
s 277
With the R.A.M.C. in Egypt
great military depot and offensive port. Quays,
docks, landing stages had to be constructed, a
thousand and one various buildings erected, roads
suitable for the passage of large bodies of troops and
heavy impedimenta of war, had to be made between
the various camps. A water supply by condensation
on a large scale had to be devised, no source of fresh
water worthy of the name existing on the island. For
all these enterprises labour on a very extensive scale
was needed. The necessary skilled labour and super-
visory personnel was obtained through the usual
channels; but for the prosecution of the large amount
of " navvy" work involved we were up against a
difficulty. No local supply of labour was available.
We conceived, therefore, the project of importing
large numbers of workmen from our Egyptian Base
overseas.
Theoretically, the idea was a capital one, and, so
long as the men retained their health, it worked ex-
ceedingly well. Eventually we had in Mudros a large
number of Egyptians, these being principally em-
ployed in road-making, a class of work for which
there was great need, roads of any military value
being practically non-existent on the Isle of Lemnos.
But, unfortunately, the wild, bitter climate of these
^Egean Isles proved too much for the sun-nurtured
Egyptians, and a large amount of sickness prevailed
in their ranks. We of the R.A.M.C. did our best for
them, despite innumerable difficulties; but in the
absence of a properly organised medical system,
exclusively devoted to these dusky hordes from the
278
The Egyptian Labour Corps
South, their sick- and death-rates mounted incon-
veniently high. It was an experience dearly bought,
yet one by which we did not fail to profit in the time
that followed. When, after the evacuation of the
Peninsula, the great offensive-defensive scheme for
the protection of the Suez Canal came into force, and
again vast numbers of Egyptian labourers were
needed, the whole problem of securing their well-
being while in our employment was thoroughly taken
in hand.
Hitherto the vast proportion of preliminary work
within the Canal zone had been carried through by
Egyptian contractors, who supplied their own native
labour. But now the authorities decided to adopt
the principle of employing the Egyptian workmen at
first hand. The whole scheme was organised on
military lines. The Egyptian Labour Corps and the
Camel Transport Corps were created and placed under
British commanders, with staffs of British officers.
Recruiting stations were opened at convenient centres
throughout the Nile area. Fair terms, with clothing
and rations, for a minimum of three months' service,
were offered and readily accepted. The organisation
expanded rapidly, until eventually we had a force of
many thousand Egyptian labourers continuously
employed on military works and service in connection
with the Canal defences, and the expedition across
the Sinai Desert.
The Egyptian lower class workman, in fact, has
proved himself an invaluable asset to the Empire in
all sorts of ways. The Egyptian Labour Corps has
279
With the R.A.M.C. in Egypt
supplied all the unskilled labour necessary for the
construction of roads, railways, defence works, etc.,
throughout the whole Suez Canal defensive scheme.
It has also provided the men who built the railway
across the Sinai Desert to Gaza, who laid the wonder-
ful water-main over the same route, and who con-
structed a^ll the roads, reservoirs, and other innumer-
able works with which this 23o-mile stretch of
Desert is marked from end to end. It supplied, in
addition, men for various duties, such as sanitary
routine, scavenging and the like, in all camps and
permanent stations under the Egyptian Command,
east or west. The Camel Transport Corps has ren-
dered equally important service. Throughout our
advance over the Desert, where heavy-wheeled
vehicles were impossible, the C.T.C. has undertaken
the conveyance of all baggage, stores, water, am-
munition everything, in fact, that our troops,
operating month after month well in advance of the
railway, needed for the furtherance of their difficult
task.
The medical supervision of this big army of
natives would have been no light task, even if the
men had been concentrated in a single district. As
it was, however, the exigencies of their service caused
them to be scattered in large and small parties, over
hundreds of miles of desert ; and they were, moreover,
continually shifting their positions as the various
works progressed or the troops advanced. Any
medical surveillance of them, therefore, to be effec-
tive, had to be undertaken on complete and well-
280
The Egyptian Labour Corps
thought-out lines; and the present organisation was
instituted.
A separate department of the R.A.M.C. was
created and placed under the charge of an experienced
Medical Officer. Under this new organisation a
network of Egyptian hospitals, detention camps, etc.,
gradually came into being, eventually extending right
across the Sinai Desert and throughout the whole
Canal zone from Port Said in the north to Suez at
the southern extremity of the Canal. The Western
Desert was also included in the same organisation,
hospitals being established at Mersa Matruh and
Sollum. This service, at the date of writing, absorbs
the whole attention of twenty Medical Officers and 65
R.A.M.C. orderlies, these being assisted by 60
native doctors and some 400 native orderlies, or Ter-
margis. Taking one typical period of six months-
November, 1916, to April, 1917 we find that about
24,000 patients were treated in these hospitals, all
being men from the Egyptian Labour Corps or the
Camel Transport Corps. The conditions of service for
the staff in charge of these native hospitals were pecu-
liarly trying and difficult. Though several of the
hospitals notably those at Ismailia and Kantara
were permanent or semi-permanent in character, most
of them had to shift their ground in accordance with
the movements of the bodies of labourers whose in-
terests they were serving. As the railway was pushed
forward over the Desert, or our army advanced, the
native population moved with them, and hospital
accommodation had to be readjusted accordingly,
281
With the R.A.M.C. in Egypt
this chain of hospitals being so maintained that wher-
ever gangs of labourers or transport men were con-
gregated, or wherever dumps employing native labour
existed, medical aid was always within easy reach.
Apart from this peripatetic character of the hos-
pitals, which necessitated much heavy work on
occasion and materially increased the problem of
maintaining medical supplies, the actual conduct of
the hospital work was fraught with difficulty. The
average lower-cfass Egyptian is a prey to various
obstinate and often obscure diseases, of which, how-
ever, by far the most important, in regard to fre-
quency, is that known as relapsing fever. This fever
was so common among our E.L.C. and C.T.C.
native labourers that usually as many as 80 per cent,
of the patients in a hospital would be suffering from
it. It was the great cause of the depletion of man-
power in the two Egyptian Corps, and from the very
earliest days in the campaign all medical effort and
ingenuity were focused on the problem of its preven-
tion. At first its cause, and vehicle of dissemination,
baffled all attempts at discovery. But at length our
bacteriologists succeeded in clearing up the mystery.
The specific organism of relapsing fever was de-
finitely isolated, and the guilt of its propagation
finally brought home to an old offender the ubiquit-
ous body-louse. Thereafter the treatment of this
complaint, both curative and preventive, became
straightforward, if not easy. While as yet no actual
cure for the fever has been discovered, certain materia
medica have been employed against it with promising
282
The Egyptian Labour Corps
results ; and as regards the body-pests, the inveterate
war which was at once instituted against them among
the native workmen resulted in an enormous reduction
in the number of cases of the disease occurring. This
latter question, however, belongs properly to another
branch of the R.A.M.C. Egyptian hospitals
organisation, and will be dealt with in a subsequent
paragraph.
In addition to the large number of relapsing fever
cases treated in this widely comprehensive system of
native hospitals, there were a great many cases of
eye trouble, skin diseases, and of injuries due to
accidents and to camel bites. The camel has been
of the utmost service to us in this Desert war. In-
deed it is difficult to see how we would ever have got
our army through the Sinai Wilderness without his
aid. We owe him a heavy debt, but we have this to
lay to his charge as a usurer. He has proved himself
a very Shylock among quadrupeds, never failing
literally to take his pound of flesh whenever the chance
presented itself. These cases of camel bites are con-
stantly occurring among the native drivers. They
are always serious, the cruel jaws crushing through
everything, flesh and bone, resistlessly ; and the
wounds thus caused are nearly always septic, the
camel being a particularly unclean beast about the
mouth. This, and the many accidents which befell
members of the working gangs, necessitated frequent
operations in the Egyptian hospitals, and required
the provision for each of a full surgical equipment
and staff.
With the R.A.M.C. in Egypt
There is perhaps no more interesting or informa-
tive experience for the student in the art of Empire-
making than that afforded by a visit to one of these
field units under the sway of the Egyptian hospitals
branch of the R.A.M.C. In them you see the best
of Britain's traditions appertaining to the govern-
ment of Oriental races, in full, smooth, triumphantly
successful working order ; and you see them on a
scale sufficiently large, and under conditions suffi-
ciently varied, to enable a fairly accurate estimate to
be formed as to our chances of "making good," in
the Empire sense with this, which for all our lengthy
occupation of Egypt must be regarded as the newest
and latest of Eastern peoples to come under our sway.
For, so long as the old paralysing clog of Turkish
suzerainty remained upon Egypt, we were too busy
a nation to devote over much thought to a country
whose future, as part of the British Empire, seemed
indefinitely obscured. Now, however, that all this
ambiguity of relationship between Egypt and the
Empire has been finally cleared away, we, that is at
least, the men of the British Army in Egypt, who
may fairly be regarded as typical of their nation, are
looking at the country and the people with new eyes
and wholly new interest, as well as appreciation of
all that recent changes may portend for Briton and
Egyptian alike.
When we speak of the Egyptian people, it would
be as well to make it quite clear that we mean the
great bulk of the middle and lower class native-
born Moslem population the men who do all the
284
The Egyptian Labour Corps
work on the land, and who vastly outnumber every
other class. And of these men, albeit of the humbler
sort, you obtain a pretty clear perception in regard
to their qualities as human material by a quiet survey
of any of our native hospital camps. Practically these
camps are all under canvas, not only on account of
the need for mobility, but because the big canvas
marquee has proved itself most suitable for almost
every hospital purpose on the Desert.
Taking the same period of six months as before
November, 1916, to April, 1917 we find that there
were seventeen of these native hospitals under the
R.A.M.C. in various parts of the war area, including
the Egyptian Base, and that in these hospitals an
aggregate of some 2,000 beds was provided. Except
at the non-mobile establishment at Ismailia, where
iron bedsteads are in use, these beds consist simply of
a waterproof ground-sheet and blankets laid upon a
given space of sand within the marquee, this form of
accommodation being found sufficient for all native
requirements. At Kantara, where the whole system
can be very conveniently studied, there is, at the time
of writing, tentage sufficient for 1,200 beds; but this
provision can, and frequently is, extended to over
1,500. The Kantara Egyptian Hospital is situated
on a w r ell-raised plateau of firm sand immediately
eastward of the Suez Canal, and far enough from the
bustling war base to be as quiet as need be for sick
and suffering people. The first impression you get
on arriving within its precincts is one of a seaside
camp large and populous, but eminently quiet and
With the R.A.M.C. in Egypt
orderly. To all intents and purposes, the Suez Canal
with its clean, abruptly sloping, sandy shores, and
broad stretch of glittering blue water is the sea, and
when the wind blows across it the air is as pleasantly
salt-laden as on any breezy day at Margate. The
hospital is conducted as nearly as possible on British
R.A.M.C. lines, especially in regard to sanitary mat-
ters; but it is neither practicable nor necessary to
enforce " white man " routine in its entirety on these
bronze-visaged Orientals.
The Kantara Hospital was started in April, 1916,
with 150 beds, since which date it has steadily
expanded to the dimensions already stated, to keep
pace with the increase in the number of natives em-
ployed in the district. It now serves as the Base
hospital for over 50,000 Egyptians. The average
daily admissions are about one hundred. Beside the
Egyptian labourers, over 700 wounded Turks have
also been treated in it from time to time. The British
personnel consists of ten Medical Officers, and
eight R.A.M.C. men, the ward orderlies being
natives, mainly recruited from reservists of the
Egyptian Army Medical Corps. The material for
the following slight sketch of a day's routine, and the
work generally, of this admirably conducted hospital,
is derived from an account, given personally to the
writer, on a recent visit, by the Commanding Officer
himself, and it will be of interest, not only because it
indicates the difference between the systems of
management of our R.A.M.C. British and Native
hospitals, but because it incidentally throws various
286
The Egyptian Labour Corps
quaint sidelights on lower class Egyptian character
and temperament. In this hospital, it may be
remarked, the small separate tent is eschewed as far as
possible, the wards consisting of a number of large,
lofty marquees placed end to end, their canvas sides
being removed, except in the rare seasons of incle-
ment weather. The wards, therefore, are more in the
nature of long, spacious sun-shelters open on all
sides an arrangement admitting abundance of light
and air vastly to the health and comfort of the
patients.
Soon after 5 a.m. of each morning, the hospital
presents a busy scene as it is being cleaned for the
day. The whole site consists of sand, and the
patients are expert in giving this an attractive appear-
ance. The territory of each ward is marked out by
a small surrounding sand-bank, the entrances being
indicated in the same way. The surfaces of this bank
are carefully smoothed and sometimes ornamented.
The gangway down the middle of the ward is treated
in the same fashion, the patients then lying in a long
row on either side; the whole interior surface of the
ward is smoothed over, each patient attending to his
own small area. He will thus sit, or rather squat, for
hours, contentedly patting and stroking it with his
lean brown hands.
This daily grooming of the sand results in a fresh
surface being continually exposed; but at intervals
the whole superficies is removed, and new clean sand
brought in from outside. In the wards the patients lie
on the ground, each with his blankets and mackintosh
287
With the R.A.M.C. in Egypt
sheet, only the more helpless cases having beds in
the special wards. Before going to sleep, the men en-
case themselves entirely in their blankets, head and
foot, a method which effectively wards off winged
pests.
The helpless patients have their food brought
to their bedside, but the others gather for
meals in the open air in an enclosure, marked
off by the inevitable sand-bank, hard by each
ward. All are given milk at 6 o'clock each
morning. Breakfast is at 8 a.m., and consists of
rice-milk only for the " Milk Diets," but for the rest,
of lentils, dates and bread. At mid-day, tea and milk
or rice-milk only are given. Dinner is served at 4
p.m., and is made up of rice-milk, or meat, onions
or other vegetables, rice, and bread. The final meal
is taken at 8 p.m., and consists of milk only. The
meat at dinner is an unheard-of luxury for most of
this class of native ; the more affluent of them would
only get it once or twice a week at home. In the
hospital the official meat ration is a very small one
no more than two ounces daily. But all the men have
a pound of bread for their day's supply, which ^is
more than twice that given to the British soldier.
When eating, the Egyptian uses his fingers alone for
every purpose. The food is served out in fairly large
bowls, and a group of men squat round each bowl^
making common cause with its contents. There is,
however, never any difficulty with them as to sharing.
The procedure as regards the Medical Officer's
daily round does not differ from that common to other
288
The Egyptian Labour Corps
hospitals. All cases needing surgical treatment are
sent to the wooden hut which serves as operating-
theatre and dressing-station, only bed-ridden cases
being attended to in the wards. It is wonderful with
what fortitude, fatalistic composure, and child-like
faith in the skill of the " Effendi Inglesi," the native
Egyptian submits himself to the most painful wound-
dressing processes, and to what are no doubt the in-
explicable methods of British medical science. In
this regard the Egyptian compares very favourably
with his European confrere. Usually, very little dis-
cussion and explanation are required to obtain from
him a ready consent to an operation. The injuries
that befall him in his service to the Empire are often
of a very trying character, as beyond' the ordinary
accidents of the working-day, he is, as before men-
tioned, especially liable to camel bites, which are fre-
quently severe and always badly infected. They are
therefore very slow in healing, and involve many
painful dressings, while the worst bites may lead to
loss of a limb, or even the death of the patient.
With natives in hospital almost the entire day is
spent in talking. Interminable animated discussions
go on between them as they sit in conclave, the princi-
pal topics dealt with being their small money matters
and the latest exploits of the dreaded Turk. When
they are not wrangling together in their inimitable,
gentle, bantering way, they are telling each other
long tales of enchantment after the style of the
" Arabian Nights," or lie crowded together in every
spot of shadow, fast asleep.
289
With the R.A.M.C. in Egypt
At three o'clock of each afternoon those who are
fit for it go down to bathe in the Canal often 200 or
300 of them may be seen at a time splashing lustily
about, like a delighted covey of coots, or squatting
up to their necks in the shining, azure water. At
this time, also, they wash their thin summer suits,
both clothes and men under the fierce Desert sun
being sufficiently dry for reunion by the time they can
be prevailed upon to return to the hospital. Towels,
be it understood, are an unknown commodity in the
lower-class Egyptian world.
The great event of the day, however, takes place
at five o'clock on each evening. This is the Discharge
Parade. The Commanding Officer sits in State within
the big E.P.I. P. tent, which serves him for office, and
receives, one after the other, all those who are eligible
for discharge from the hospital, or seek to be liberated
for various reasons. Practically all are eager for their
discharge, hospital life under British control being
rather an ordeal for the native. Probably his sole ex-
perience of the healing art hitherto has been confined
to an occasional visit to the village barber, who, in
rural Egypt, still for the most part, fills the office of
medical man to the community quite in the mediaeval
way.
The- native hospital patient, however, is not
always in a hurry to exchange his snug quarters and
easy life for the rough-and-tumble of the Desert
again. Now and then a man will be found, ap-
parently willing and anxious to spend the rest of his
life in the hospital; and he will resort to every ex-
290
The Egyptian Labour Corps
pedient, and exhaust all his powers of persuasion with
the Medical Officer to that end. In this case he be-
comes an adept at making the most and the longest
of his affliction, and will feign all sorts of ills to get
his term of incarceration prolonged. Not the least
difficult of the O.C.'s duties at this Discharge Parade
is to discriminate between real and fictitious disabili-
ties. In this matter a thorough knowledge of the quaint
variety of Arabic spoken in rural Egypt is almost a
sine qua non with the officer. In fact, all R.A.M.C.
Medical Officers doing duty in Native hospitals, and
most of the British orderlies, are adept at this.
It would be well, indeed, if the possession of a fair
knowledge of Egyptian Arabic were officially re-
garded as a necessary part of the professional equip-
ment of all R.A.M.C. men stationed in Egypt. The
language is not an easy one to read or write, but it
can readily be picked up by ear, and a certain
facility in this direction should be required of all our
men coming into contact with the natives.
The sequel to this Discharge Parade is usually a
picturesque one. Those fortunate enough to obtain
their discharge, especially those whose time of service
has expired, and therefore, are now to return to their
homes, immediately go into paroxysms of joy at their
deliverance. Hastily gathering their belongings to-
gether, they make for the railway-station in a de-
lighted, vociferous crew, clapping their hands
rhythmically, chanting weird folk-songs, and waving
improvised flags. Generally, in their excitement, they
run all the way to the station. They crowd into the
291
With the R.A.M.C. in Egypt
open trucks that are to bear them away westward to
the Land of their Fathers; and long after the train
has disappeared round the curve of the line, the sound
of their rejoicing lingers on the evening breeze. You
turn your back to the hospital, feeling glad, somehow,
that the world is not all progress and culture, and that
there are still some odd corners left in it, where man,
as Nature made him, can yet find a little elbow-room.
The R.A.M.C. Medical Officer in command of the
Kantara establishment possesses all the dominant
racial traits which have made British rule over
Eastern peoples such a success wherever our flag
flies. But, in addition to these, his government of the
hospital evidences another quality, much rarer
though also essentially British that of being able to
tell one black man from another, to realise the funda-
mental divergences of character and temperament be-
tween the various coloured races, and to adopt his
methods accordingly. The writer has no experience
of the Oriental peoples under our sway "East of
Suez, where the best is like the worst; " but from a
fairly extended acquaintance with the lower class
Egyptian the typical E.L.C. or C.T.C. man he is
convinced that upon a true estimation of his peculiar
racial qualities depends all our success in governing
him both in the present time of war and hereafter.
The average Nabob from the Far East seems to
regard his authority over the native Orientals with
whom he comes into contact as dependent on the
preservation of a demeanour compacted of frigid
aloofness, suspicion, and contempt, the whole being
292
IN THE CAMEL LINES: SINAI DESERT.
CAMEL-BORNE FIELD LABORATORY.
The Egyptian Labour Corps
reinforced by a carefully nurtured reputation for a
ready resort to harshness, or downight brutality, on
occasion. But nothing of all this will do in Egypt, and
the sooner we realise it the better. The pure-blooded
Egyptian is at heart a child; and a child of, in
many ways, very attractive and lovable qualities into
the bargain. Childlike, what we choose to mae of
him now, he will become; and after the like kind he
will bring up those other children he is begetting in
such large numbers. After the nature of the child
all the world over, he possesses within him the seeds
of every good and every evil quality ; and the respon-
sibility lies upon us now to see that he develops on
the right lines. The most disastrous mistake we
could well make would be to attempt to rule him
mainly by the rod; not because he does not some-
times deserve, and indeed often gets, a sharp cut
from the cane of his British overseer, but because he is
by nature essentially unwarlike, and therefore, in the
main, incapable of profiting in the right way by
physical punishment.
This, indeed, must be the keynote of all our deal-
ings with the Egyptian, if he is ever to grow out of
childhood into real manhood under our hegemony.
As in the training of all children, the fact must be first
established that we are not to be trifled with, nor de-
ceived by dissembling or other elemental guile. But
once this wholesome spirit has been instilled intdiiim,
our further policy is clear. It must be frankly directed
towards the development of his undoubted qualities
of industry, sociability, a good and often keen under-
T 293
With the R.A.M.C. in Egypt
Sr
standing, and a trainable capacity for all those little
arts of life which, for want of a better word in his case,
we must call % civilised.
In these vaunting days, when we are all, high and
low, taking our turn at blowing the National Trumpet,
the writer need make no excuse for attempting here a
little fanfaronade on his own account. The greatest
good thing that ever happened to the middle and
lower class Egyptian or, indeed for that matter, to
every man in the country, Moslem or Christian, will-
ing to get an honest living by the work of his own
head or hands is the fact that Egypt has now uncon-
ditionally thrown in her lot with the British Empire.
The goodness and greatness of this thing may not be
so apparent to those in the country falling within
the category named "Upper-class." Hereditary
idleness, as part of an obsolescent national system,
never does expire amiably, nor even picturesquely.,
The mistletoe is able to live very comfortably at the
expense of the apple tree, and it can hardly be ex-
pected to display much enthusiasm during the first
acute stages when it is being compelled to subsist by
its own roots. But the sentiments of Egypt's mistle-
toe class of humanity need not concern us here. It
is the tree itself, the great mass of gentle-hearted,
courteous, ease-loving, yet truly industrious folk that
make up the bulk of the nation, towards whom we
must direct all our hopes and efforts.
It is not for nothing that Egyptians have been
a subject race, have lived under the yoke of one con-
queror after another, for thousands of years back.
294
The Egyptian Labour Corps
What they have lost in one way, they have immeasur-
ably gained in another. They lack initiative, and
dread responsibility as a cat dreads water, but they
have a chameleon-like power of ready adaptation to
imposed ideas that is almost Japanese in quality. We
have it in our power, therefore, now to make or mar
them ; and if the writer were asked to put into one
short phrase the vital policy which should govern all
ou/ future efforts to bring Egypt into line with the
rest of the Erapire, this would be the answer: treat
the Egyptians as if they were a nation of Boy Scout
recruits : start them right at the beginning of every
elementary principle of honour, discipline, good-form,
healthy hardihood of body and mind, and all the
wholesome, reasonable give-and-take comprised in the
word Neighbourliness. It will not be done in a month
or a year, nor perhaps in many years; but it can be
done. The raw material for the work is no sow's ear,
but good silk all through ; and the silk purse is sure
to materialise in time.
The Egyptian hospital system for the treatment of
the sick and injured of the two native Service Corps,
covers, as we have already seen, all the Canal zone
between Port Said and Suez, as well as the entire
Desert line-of-march between the Kantara Base on the
Canal and our furthermost trenches under Gaza in
Palestine. It also extends along the northern
boundary of the Desert to the west of Egypt. With
this system there exists concurrently a series of isola-
tion-hospitals for the treatment of any cases of cholera
that may occur among the native population. Such
295
With the R.A.M.C. in Egypt
cholera-camps have been established at Deir el Belah
and Sheik Nuran, on our extreme eastern defences,
and at Rafa, El Arish, and Kantara, on the Desert
line of communication. There is, in addition, a special
cholera-hospital containing 60 beds at Deir el Belah,
used exclusively for prisoners of war. The great bulk
of sick and wounded prisoners is dealt with at the ,
main R.A.M.C Prisoners of War Hospitals in Cairo,
Alexandria, and elsewhere, these establishments being
staffed by British orderlies and nursing sisters of the
Q.A.I.M.N.S., and in themselves form no inconsider-
able portion of the general work of the R.A.M.C. in
Egypt. But we have well-appointed camp-hospitals
of 200 beds each wholly confined to the treatment of
wounded prisoners, and those suffering from diseases
other than cholera, at both Deir el Belah on our ex-
treme front, and at Kantara. There is also a
Prisoners of War Hospital of 60 beds in connection
with the Egyptian Hospitals branch of the R.A.M.C.
at Port Tewfik, near Suez. Altogether, the enemy
can have no reason to complain of any neglect on
our part in respect of those who have fallen into our
hands, and are in need of medical aid.
Apart, however, from the immense amount of
hospital work which has fallen to the lot of the
R.A.M.C. in Egypt through casualties and sickness
occurring among the men of the Egyptian Labour
Corps and the Camel Transport Corps, we have had
much else to do in connection with these Native Ser-
vices during the whole of the campaign.
On the formation of these services, recruiting-
296
The Egyptian Labour Corps
stations were opened in all the important centres of
industry in Egypt, and at each of these, R.A.M.C.
Medical Officers were continually in attendance to
ensure that none but thoroughly fit men were accepted
for the work. During the same typical period of six
months hitherto dealt with, some 130,000 natives pre-
sented themselves to our doctors for examination at
these recruiting-stations, and of this number 30,000
had to be rejected for various causes, mainly eye-
trouble, to which the native Egyptian is peculiarly
liable. Once accepted for service the new recruit is
put through a regular curriculum before he becomes a
full-blown E.L.C. orwC.T.C. man.
Taking the methods adopted by the R.A.M.C.
95th Sanitary Section, attached to the Hadra Egyptian
Labour Corps Camp, as typical of those yi vogue
at other centres, we see a batch of recruits, on arrival,
at once proceed to what is known as the " Recruits'
Compound." This is a walled-in enclosure, fitted
with latrines, ablution-benches, shower-baths, cook-
ing-places, and living-tents, and is reserved entirely
for new recruits. Here the men are detained until
their turn comes for subjection to the very necessary
processes of being washed and disinfected. Pend-
ing this, each man has his head close-clipped and his
axillae and pubes shaved; and then, usually within 12
hours of his arrival, he is ready to proceed with his
squad to the disinfection-station close by, carrying
with him his blankets, and all personal effects. On
arrival at the steam-disinfector, he removes his cloth-
ing, wraps it, together with his other belongings, in
297
With the R.A.M.C. in Egypt
one of his blankets, and leaves the bundle to be dealt
with by the disinfecting staff. His other blanket
serves him as a robe on his passage to the bath-house.
The bath-enclosure being gained, these remain-
ing blankets are collected from the men and at
once put into another disinfect or, which exists on the
spot for the purpose. The recruits are then intro-
duced, two at a time, into a large bath of fluid, consis-
ting of a solution of cresol, soft soap, paraffin and
sulphur a combination which can be relied upon to
put an end to any insect-plague in or out of Egypt.
In this bath, each man gives himself and his com-
panion a thorough scrubbing, after which he has a
plunge into clean water, and then proceeds to the
equipment store, a few yards away, where he is served
out with a new E.L.C. uniform, consisting of brown
linen slacks and tunic, and also a great-coat. There
remains now nothing for him to do but to recover his
civilian belongings from the main disinfector, and
march back to the store, where the rest of his equip-
ment boots, puttees, cap, etc. is completed. The
whole process thus described occupies an average time
of three-quarters of an hour, in which period the new
recruit is changed into a fully equipped member of the
Egyptian Labour Corps, and is ready for service in
any part of the War area, be it Palestine, Salonika,
or France.
But this preliminary lustration, by which he is
started clean, sound, and fresh-clothed on his new job,
and his subsequent care in hospital if sick, by no
means exhausts the list of services rendered to the
298
The Egyptian Labour Corps
E.L.C. or C.T.C. man by the Army Medical Service
of Egypt. Having once got him and his belongings
clean, and free from vermin, our whole art is directed
to the task of keeping him so no easy task, as all
will agree, on coming to consider the conditions. In
the case of a great force of native labourers distri-
buted in large or small gangs over a wide and difficult
country, and these gangs continually shifting from
place to place, the most carefully devised system of
sanitary control is liable to aberration. In this matter,
however, the R.A.M.C. Sanitary Sections have
succeeded admirably, even perhaps a little beyond any
reasonable expectation. The ideal was conceived of
giving every native labourer in the service a
thorough antiseptic cleansing, and his kit a thorough
sterilisation, at least once a fortnight, and this ideal
has been fairly well realised. In addition to the dis-
infecting installations at all Egyptian hospitals and
recruiting-dep6ts, we established Disinfecting Sta-
tions at three of the most important centres in the
military system. These were able to deal with the
men within a large radius of their several positions.
But to reach those gangs of labourers scattered about
on or near the various ramifications of the Desert rail-
road, we had to work on a different plan. We
equipped~three~ DisinfectiorTTrainsT having sterilis-
ing-vans supplied with steam from the engine, and
carrying with them all appliances necessary for the
establishment of temporary Disinfection Stations in
sidings of the line within which the train might pull
up. Whenever, and wherever the train made a pitch,
299
With the R.A.M.C. in Egypt
all native camps in the surrounding area were duly
ratified, and the men willingly flocked in with their
belongings to undergo what could not fail to be a
very welcome process to all.
Throughout the period of hostilities, from the time
these systems came into vogue, our R.A.M.C Sani-
tary men have dealt with an average of 80,000 native
labourers monthly, which is a record of useful, if
rather unromantic service of which we may reasonably
be proud. Seeing that the"great scourge of these
lower-class Egyptians and principal cause of inef-
ficiency among them relapsing fever originates in
infection conveyed by the body-louse, it is small won-
der that, since our sanitary campaign against per-
sonal uncleanliness among the natives came into full
force, the incidence of this disease has decreased by 50
or 60 per cent.
Before leaving this well-nigh inexhaustible subject
of our work for the native Egyptians in our Army's
employ, we must briefly mention what has been done
in the matter of quarantine arrangements as between
Egypt and the eastern theatre of War. The system
of enlisting these labourers for so short a term of ser-
vice as three months, though it proved a popular
measure and thus materially swelled the stream of re-
cruits, had nevertheless one serious drawback; it
created a condition wherein there was a constant
dribble of time-expired men back from the War-area
into all parts of rural Egypt. Cholera being always
more or less present with the Turkish Forces, and the
danger of infection, through prisoners, deserters, &c.
300
The Egyptian Labour Corps
being therefore considerable, we had to take special
measures to safeguard Egypt against this scourge
through infection by our returning E.L.C. and
C.T.C. men. The difficulty was met through the
agency of the Egyptian hospitals branch of the
R.A.M.C., by establishing two great Segregation
Camps, the one at El Arish, and the other at Kan-
tara, where all time-expired labourers could be de-
tained for such period as would ensure their
freedom from contamination. In these camps
also, thorough disinfection of the person and
belongings of all men was carried out, so that
the men returned to their homes free from parasites,
as well as from germs of disease. Not the least im-
portant outcome of the work of the R.A.M.C. in
Egypt, lies, perhaps just in this small fact. Every
native, who enters our service, and then goes back to
his fellows, does so as a living illustration of the ad-
vantages of personal cleanliness, and with such a re-
ceptive, imitative people as the Egyptians, his ex-
ample cannot but have far-reaching results. The
Oriental who has acquired the daily habit of washing
himself has already taken a great step along the road
to Empire or to British ideas of Empire, at least.
301
CHAPTER XVIII
IN the pages foregoing an attempt has been made to
set before the people of the British Empire some ac-
count, albeit an imperfect one, of what the Royal
Army Medical Corps has done, and is still doing, in
Egypt. We of the R.A.M.C., in this part of the war
zone, are under no delusions as to the relative impor-
tance in the world-struggle of our work, compared
with that of the members of the Corps serving on
the great Western Front. The distance at which
we have laboured may have lent some enchantment
to our view of our own doings ; but it has not
destroyed our sense of proportion. Even so, how-
ever, we may fairly claim that our record, as
above imperfectly set forth, shows that we have
done much, and done it not unworthily, nor without
honour.
"In Arduis Fidelis " the Royal Regiment which
elects to bear upon its escutcheon a motto of that ex-
alting kind, needs to take itself and its work seriously.
That it has ever done so is within our knowledge
and prideful conviction as a Corps, and need not be
dwelt upon here. And that, in this part of the Near
Eastern theatre of war, the R.A.M.C. has still more
firmly established its right to the motto, no one who
302
"In Arduis Fidelis"
has followed the history of the campaign can reason-
ably deny.
Popular error dies hard; and the idea that the
non-combatant section of an army on active service
runs none of the risks of war, may yet linger in a few
adumbrated minds at home. For the information of
these folk, it may be well to set down here the follow-
ing facts as regards casualties and Military Honours
awarded to the men of the R.A.M.C., and the valor-
ous women, who served with the Dardanelles Army
and with the Egyptian Expeditionary Force up to the
end of the year 1916 that is to say, a period of
twenty-one months out of the three years of the war.
Eighty-two of our ambulance men were killed in
action during this period, these being Medical
Officers and men engaged in succouring the wounded
during battle. In addition to these, seventy-five
R.A.M.C. men actually died of wounds received in
course of their duty, while 610 were more or less
severely wounded. Disease accounted for 134 deaths
among us; seventeen are numbered among the
"missing," or known to have been taken prisoners
by the Turks; 150 were drowned at sea in the various
hospital-ships sunk within the period taken. Alto-
gether, our casualties amounted to 1,068. This figure
is not put forward as anything calling for praise, or
even worthy of special remark. It is merely set down
here in refutation if indeed refutation were needed
of the ancient idea that non-combatant regiments are
immune from the risks of war.
When however, we come to the question of Mili-
303
With the R.A.M.C. in Egypt
tary Honours awarded during the same period to men
of the R.A.M.C in Egypt, for conspicuous bravery
in the Field, or signal devotion to duty, we have every
right to be proud of our record, and to expect the
nation at large to share our feeling. Members of our
Corps have been " mentioned in despatches " no fewer
than 223 times. Men of the rank and file have been
awarded eighteen Distinguished Conduct Medals, six
Military Medals, and three Meritorious Service
Medals; while various foreign decorations have been
gained, such as the Medaille Militaire (2), Serbian
Gold Medal (3), Serbian Silver Medal (5), Italian
Bronze Medal (i), Serbian Silver Star, 2nd Class (2),
Russian Medal of Saint George, 4th Class (i), and
Serbian Cross of Karageorge, with Swords (i).
But the R.A.M.C. in Egypt is particularly proud
of the honours gained by its officers of all grades.
One has received the K.C.B., eight the C.M.G., and
three the C.B. No fewer than twenty-four of our
Medical Officers have been decorated with the Mili-
tary Cross, and eleven with the Distinguished Service
Order. Three have received the Hon. Order of the
Bath, 3rd Class, Military Division; and four have
gained the Distinguished Order of St. Michael and St.
George, 3rd Class. To these British decorations
must be added the following awards to our officers
from foreign countries: Order of the Nile (4), Ser-
bian Order of St. Sava (6), Croix de Guerre (2), and
Serbian Order of the White Eagle (6).
The women of the British Army Medical Service
in Egypt have equal right to be proud of the distinc-
3Q4
; 'In Arduis Fidelis"
tions conferred on them, as they have equally shared
in the dangers and privations of the War. Twenty-
two have laid down their lives in the Service, of which
number eleven were victims of the relentlessly cruel
and stupid U-Boat campaign. But, for the brighter
side of the shield, we have to record that forty mem-
bers of the Queen Alexandra Imperial Nursing Ser-
vice and allied institutions have been mentioned in
despatches; forty-one have been awarded the much-
coveted Royal Red Cross, ist Class; and seventy-
five have gained the 2nd Class decoration of the same
order.
All these lists of casualties and honours among
men and women of the Army Medical Service are
carried, it must be remembered, only up to the end
of 1916, when our account of the doings of the
Egyptian Expeditionary Force naturally terminates.
In the saying of a last word there lurks ever
a certain amount of pathos; and the writer neither
seeks, nor has reason for seeking, to dissemble his
regret at the conclusion of a task, which, while calling
for no little labour, has proved throughout both a
pleasant and informing one. To an already pretty
close acquaintance with both the personnel and the
methods of the Army Medical Service in Egypt and
Gallipoli, the work entailed in the preparation of this
record, by affording a truer perception of the magni-
tude of what has been done, has inevitably created a
nearer, deeper comradeship with, and admiration for,
the men and women who have done it so faithfully in
305
With the R.A.M.C. in Egypt
the teeth of so much real difficulty. It is therefore with
no feigned emotion that the writer, whose * 'fortune of
war " it has been to share those difficulties in both
spheres of action, will dip his pen to inscribe the
word " Finis " at the end of this page.
Before closing, however, brief reference should
be made to one matter not hitherto touched upon.
This is the assistance rendered to the official Medical
Service in Egypt by the Voluntary Aid Organisa-
tions, the Order of Saint John of Jerusalem and the
British Red Cross Society. Though this is professedly
an account of what has been done by the Royal Army
Medical Corps alone, and as such necessarily excludes
any but incidental reference to the work of the two
societies mentioned, it is felt that to close this volume
without a full and free acknowledgment of the in-
valuable aid rendered by these two societies to the
regular Army medical service would be alike un-
generous and unpatriotic. There is perhaps no mem-
ber of the R.A.M.C., from the highest to the lowest,
who does not clearly recognise the full measure of
good work which these societies have done in Egypt.
It is due, however, to the officers and men of the
official organisation-^-and such a statement can in no
way detract from the praise due to the voluntary
societies to record here exactly what proportion the
work of the societies bears to the whole volume of
achievement which is to be placed to the credit of
the British Medical Service in Egypt. This may be
accurately set down as about 3 per cent. The
estimate is not "official.'* The figure, indeed, is
306
"In Arduis Fidelis"
quoted from a speech delivered by Sir Courtauld
Thompson, the Chief Commissioner of the Red
Cross combined organisations in Egypt; and may
therefore be taken as unimpeachable. At first sight
such a figure applied to the work of these societies
may appear disappointingly, astonishingly small. It
is not, however, really so. A percentage is only a
relative term. We are not dealing, in this case, with
three per cent, of a molehill, but of a mountain; and
in that degree of estimation the work of the Red Cross
Societies can only be regarded as magnificent from
whatever standpoint it may be viewed.
307
Index
ABBAS SIEH, a hospital in the
Cavalry Barracks at, 27, 32
the "Rest Camp," 28
Acarus scabiei, the, and its host,
163
Aeroplane, an evacuation ol
wounded by, 131
Aeroplanes bomb ambulance
camps, 115, 118, 120
^Egean Islands, climatic con-
ditions of, 278
Akaba, a caravan route from, 86
Alexandria, a central bacterio-
logical laboratory at, 195
a factory for supplying splints
and other appliances at, 251
arrival of wounded from
Gallipoli at, 25
main medical store depot at,
47
military hospitals of, 13, 23,
25, 26
reorganisation of dental work
at, 206
sanitary conditions in the
'eighties, 4
Ambulance-carts, 77, 78
garages, 39
Anopheline gnats, 164, 165
Arabi Pasha, insurrection of, 3, 7
Army dental surgery in Egypt,
201 et seq.
Army Hospital Corps, the, 3
and the 1883 epidemic of
cholera, 6
(See also Royal Army Medical
Corps)
Army Service Corps, the, 156
Army sisters and nurses, short-
age of, at beginning of
Gallipoli campaign, 23, 37
Army, the, inoculations in, 212
Assiut, hospital at, 105
Assuan, hospital at, 105
Atbara River, the, 12
U 309
Australian Army Medical
Corps, extract from a
quartermaster's diary, 33
Australian hospitals in Egypt,
2 3, 26, 31, 32, 33, 229
Australian Imperial Force
reaches Alexandria, 18
Australian nursing sisters, 37
Australian Red Cross Society, a
gift of motor ambulances,
39
Australian troops, infectious
disease in the camps, 22
Australians, use of ambulance
sledge by, 78
Bacillus -pestis, the, 185
Bacteriological laboratory, Alex-
andria, 195
Bacteriology, value of, in
Egypt, 197, 282
Barani, arrival of the Sennussi
at, 102
Base hospitals and their func-
tions, 76
Bedouin tribes of the Desert,
IOI, 102
Bee's sting as a preventive of
rheumatism, 164
Beni Suef, hospital at, 105
Bilharziosis, prevalence of, in
Egypt, 108, 153, 229
Bir-el-Abd, reconnaissances to,
94
Bivouacs and their construction,
93
Black Death (see Plague)
Body vermin as enemies of sleep
and rest, 44, 169, 170, 213,
214, 300
steam disinfection of, 163, 170,
171, 299
(Cf. Bug, Flea, Louse)
Boulac el Dacrour, convalescents
at, 28
Index
British Expeditionary Force,
the, in Egypt, 4
Bruce, Captain, death of, 98
Bug, the, a "suspect" disease-
carrier, 169
Butterflies, 164
CAIRO, a camp near the Great
Pyramids, 88
a soi-disant School of Medi-
cine in, 4
arrival of wounded from
Gallipoli, 25, 31
cases of bilharziosis at an
Australian hospital, 229
dental surgery at, 205
establishment of an epidemio-
logical bureau in, 221
headquarters of the R.A.M.C.,
13
insanitary condition of, in the
'eighties, 4
military hospitals of, 13, 23,
26, 231
R.A.M.C. Prisoners of War
Hospitals, 296
Turkish designs on, 70
Camel-bites, 91, 283, 289
Camel cacolets, 77, 79, 81, 104,
119
Camel Transport Corps, 77, 81,
279, 280
Camel transport, difficulties of,
91, 104, 144
Camp life and sanitation, 20 et
seq., 73, 105, 108, 149 et
seq., 177, 187, 224 et seq.,
287, 301
(Cf. Sanitation and con-
servancy)
Canadian hospitals in Egypt, 27
Caravan routes in the Sinai
Desert, 86
Carnarvon, Countess of, forms
a detachment of nurses,
3 8 > 39
Central Military Bacteriological
Laboratory, Alexandria,
J 95
Cholera, appalling death rate
of, 6
camps, 296
Cholera (continued]
deaths of seven British
soldiers from, 172, 180
epidemics in Egypt, 5, 9, 10
first case of, in Sinai Ex-
pedition, 179
in Syria, 174
precautionary measures
against, by Turkish medi-
cal authorities, 173
re-inoculation and other pre-
cautions against, 172, 175,
176 et seq.
Romani outbreak of, due to
breach of rules by troops,
i73 'Si
segregation of "contacts," 178
the elusive spirillum, 180
work of field laboratories in
prevention of, 197
Choubrah, hospital at, 27, 32
Clothing, disinfection of, 144,
163, 170, 214, 227, 297,
299, 301
Colonial nursing organisations
in Egypt, 35
troops, sickness in the camps,
21
Colthart, Private, 97
Contamination, food and, 107,
'56, 157, 167, 227
Convalescents, accommodation
for, in Egypt, 27, 28, 32,
33, 106, 232
Crawford, Adjutant, wounded at
Dueidar, 98
Cromer, Lord, 16
Culex gnats, 165
DAMIETTA, outbreak of cholera
at, 5
Dardanelles Expedition, 52
arrival of wounded in Egypt,
24 et seq.
(See also Gallipoli)
Deir el Belah, cholera-camp and
camp-hospital at, 296
Dengue fever, carriers of, 165
Dental surgery in Egypt, 201
Desert ambulance-carts, 77, 78
Desert warfare, camp sanitation
in, 149 (Cf. Sanitation)
310
Index
Desert warfare (continued)
the R.A.M.C. in, 69 et seq.
training for, 14
water-sterilisation methods in,
140, 152 et seq., 175, 227
(C/. Water)
Diarrhoea, 103, 175, 180, 196, 219
Diphtheria, 197
Disinfection, necessity of sys-
tematic, 144, 163, 170,
171, 214, 227, 297, 299,301
trains, 170, 171, 299 (see Steam)
Dongola Expeditionary Force,
the, 9, 10
Dueidar, Turks repulsed at, 95,
96
work of the R.A.M.C. at, 96
Dunluce Castle, the, deplorable
condition of Serbians on,
everyday life of a ship's staff,
42
quarantined, 45
Dysentery, 103, 182, 196, 219
EAST Lancashire Field Ambu-
lance, 17
Egypt, a British Army of
Occupation in, 4
a period of strain for medical
staff, 22 et seq.
an apt description of, 101
and the Great War, 15 et seq.
army dental surgery in, 201
et seq.
Australian hospitals in, 23,
26, 31, 32, 33, 229
camp-life in, 20, 73, 105, 108,
149, 177, 187, 224, 287, 301
cholera epidemics in, 5, 9, 10
configuration of its western
frontier, 101
convalescent camps in, 27, 28,
32, 33, 106, 232
dangers of cholera recurrence,
J 74
defence of, on the west, 101
depleted garrisons in, 16, 17
diseases prevalent on western
frontier, 103
eastern defence of, 83 et seq.
enemy espionage in, 17
3"
Egypt (continued)
fellaheen of, 17
female nursing service in, 35
frontier defences of, 15
General Hospitals in : extracts
from an orderly's diary,
234 et seq.
hospital commissariat and
supply of invalid diet in,
49 et seq.
hospitals in, 13, 23 et seq., 31,
S 2 , 33> 37i I0 5> Io6 > I20 >
178, 210, 229, 231 et seq.,
281, 285, 295, 296
medical and sanitary science
in the 'eighties, 4
medical equipment and
material in, 45 et seq.
nursing -staff 9 of various hos-
pitals, 38
" Plague season " of, 184
racial problem of, 292
self-government for, 18
the Sudan, 7
the village barber and his
functions, 290
transport difficulties in, 12,
39 77. I0 4> M4 .
Turkish plans regarding, 70
Egyptian Expeditionary Force,
the, precautions against
cholera, 173
the venereal problem in, 215,
252
Egyptian Labour Corps, the, 179
disinfection and washing of
recruits, 297, 298
formation of, 279
multifarious duties of, 280
network of hospitals for, 281
recruiting-stations, 296
Egyptian native hospitals, 105,
285 et seq.
dietary of, 288
Discharge Parade, 290
Egyptian Sanitary Department,
the, efficiency of, 6, 9
Egyptians, characteristics of,
Britain's future problem,
293 et seq.
El Arish abandoned by the
enemy, 129
Index
El Arisfo (continued]
appalling sanitary condition
on occupation of, 141
arrival of the Rafa wounded
at, 132
British occupation : the water-
supply problem, 139, 140
cholera-camp at, 296
outbreak of scabies in, 144
population of, 140, 141
segregation camp at, 301
vaccination on a wholesale
scale in, 143
El Audja, caravan route from,
Enteric fever, 10, 103, 182, 197,
228
Epidemic diseases : measures
taken to prevent and com-
bat them, 172 et seq.
(Cf. Cholera, Plague)
Epidemiological Bureau, an,
established in Cairo, 221
Esna, hospital at, 105
E-t Maler, scene at the ambu-
lance station, 119
FAYOUM, native hospital at, 105
Fever, relapsing, frequency of,
in Egyptian Corps, 282,
300
Field ambulances, equipment of,
80
dentists and their functions,
203
laboratories, equipment of, 199
valuable work of, 196 et seq.
Flea, the, as disease carrier,
169, 185
Flies, organised campaign
against, 166 et seq., 259
plagues of, 57, 141, 142* i5 8 >
1 66
Food supplies and contamina-
tion, 107, 156, 157, 167,
227
GALLIPOLI, Peninsula of, a
surgeons' orderly's im-
pressions of, 62
an outbreak of dysentery on,
197
Gallipoli (continued)
climatic conditions, 57
difficulties of transport on, 39
evacuation of, 68, 69
R.A.M.C.'s arduous task, 52
Sir Ian Hamilton's dis-
patches, 53, 54
specimen day'a^ work of a
medical officer, 59 et seq.
wounded from, arrive in
Egypt, 25, 29, 52
(See also Dardanelles)
Gaza-Sinai Railway, construc-
tion of, 280
General Hospitals, Military, an
operation in the X-ray
room, 261
dispensary of, 250
influence of climate on work
of, 238, 245, 258
laboratories and X-ray rooms,
248 et seq.
Lavage Room, the, 252
nursing staff of, 242, 263
operating theatre of, 234, 254
quartermasters of, 247
stretcher-bearers, 236
the wards, 238 et seq., 252
theatre orderlies and their
duties, 234, 253 et seq.
ward sisters and orderlies, 263
Germ-carriers, 141, 158, 164 et
seq., 185, 226, 282, 300
Ghezira, ambulance garage at,
39
Giza (Cairo) Red Cross Hos-
pital, 28
Gordon, General, dispatched to
the Sudan, 7
in Khartoum, 8
Great War, the : a new British
forward policy, 125
Egypt and, 15 et seq.
iemale nursing service in
Egypt, 35 et seq'
Sultan of Turkey joins the
enemy, 18
Grenfell, Sir Francis, 9
HADRA E.L.C. Camp, 297
Hamilton, Sir Ian, 20, 54
Gallipoli dispatches of, 53
312
Index
Heliopolis, ambulance garage at,
39
an Australian hospital at, 23,
26, 31, 32
Helouan, convalescent depots at,
28, 32
Honours for R.A.M.C. officers
and men, xoo, 117, 304
Horsley, Sir Victor, in Egypt,
3 1
Hospital commissariat and sup-
ply of invalid diet in
Egypt, 49 et seq.
ships, an official tribute to, 41
lack of, in early stages of
Great War, 39
risks from enemy torpedoes
and mines, 42
valuable work of, 40
trains, 122, 133 et seq.
admirable service of, 40
INDIA, preventive measures
against the Plague in, 184
Indian hospitals in Egypt, 23,
- 2 7
troops' arrival in Egypt, 18
Inoculation, systematic, 212
Turkish, 173
Insects, destruction of, 164, 166,
213, 259 (Of. Body vermin)
Ismailia, 86
native hospital at, 281, 285
JAUNDICE, epidemic of, 182
KANTARA, 86
a day's routine at a native
hospital at, 286 et seq.
and camp hygiene, 152, 160,
161
busy times for the R.A.M.C.,
9
camp hospitals and cholera-
camp at, 296
Egyptian native hospital at,
281, 285
in war-time, 89
malaria in, 165
sanitary supervision of base,
151 et seq.
segregation camp at, 301
Kasr-el-Aini hospital, 26
Katia, a race for, 95
as base for offence or defence,
8 7
British advance upon, 94
British established at, 100
temporary enemy success at,
96, 100
water supply of, 86, 95
Kena, hospital at, 105
Keogh, Sir Alfred, a new
system of nursing, 264
Khamsin, definition of, 82, 88
(67. Sand storms)
Khartoum, Gordon in, 7
military hospital in, 13
Kitchener, Sir H. (Lord), ip, 16
his scheme of defence for Suez
Canal, 72
Kressenstein, Colonel von, in
LADY-BIRDS, a plague of, 115
Libyan Desert, the, 16
Louse, the, as disease carrier,
169, 282, 300 _
Luna Park, overflow hospital at,
Luxor Convalescent Depot, 28
MAGHDABA, enemy's crushing
defeat at, 129
Mahdi, the, native expeditions
against, 7
Maher, Surgeon- General, fore-
sight of, 174
Mahmoudieh Canal, 4
Malaria, 103, 165, 197
carriers of, 164
Matruh, hospital at, 281
Sennussi defeat at, 103
McDonald, Private, gallantry
of, 97, 98, 99
receives the M.M., 100
McKinnon, Private, 97
Measles, 22
Medical advisory committee,
appointment of a, 219 et
seq.
equipment and material in
Egypt* 45 et se s-
Staff Corps, the, 8 (Cf.
R.A.M.C.)
313
Index
Mediterranean Expeditionary
Force arrives in Egypt,
20, 68
the Commanders-'in-Qiief of,
55.68
Mena, Australian hospital in,
23, 3 2
mobilisation of a Field Ambu-
lance at, 14
Mice as Plague carriers, 185
Military General Hospitals in
Egypt, 13, 23, 231 et seq.
extracts from an orderly's
diary on, 234 et seq.
Miller, Lieutenant, 97, 99
Millet, food value of, 144
Minia, hospital at, 105
Mohammad Ali, a prophecy of,
18
Montazah, convalescent depot at,
28, 33, 232
Mosquitoes as malaria carriers,
164
Motor ambulances, 39
Mudros, Egyptian unskilled
labour at, 278
R.A.M.C. Base at, 277
Mumps, outbreak of, amdng
Australian troops, 22
Murray, Sir Archibald, and the
Battle of Romani, in
confronted by a difficult situa-
tion, 70
in command of Mediterranean
E.F., 68
measures for defence of Suez
Canal, 84
Mustapha, convalescent depots
at, 28
Dental Annexe at, 206
the R.A.M.C. Reception
Station, 210 et seq.
NAKHEILA, Battle of, n
Nasrieh School becomes a
British military hospital,
27
New Zealand Imperial Force,
the, 1 8
motor ambulances of the medi-
cal unit, 39
nursing sisters, 37
Nile Expeditionary Force, the,
8, 10
Nile River, the, 4
Nuri Bey and El Sennussi, 102
Nurses, admirable work of, 35
an official appreciation of, 41
honours for, 305
Q.A.I.M.N.S., 35, 263 et seq.
OGHRATINA, a fight at, 96
the R.A.M.C. at, 120
Omdurman, Battle of, u
Oram, Miss S. E., ability and
genius of, 36, 41
Osman Digna and the Eastern
Sudan dervishes, 8
PALESTINE Expeditionary Force,
the, 126 et seq.
the R.A.M.C.'s multifarious
duties, 130, 138 et seq.
Plague, the, 103, 182
outbreaks of, and how they
were stamped out, 189
preventive measures against,
183
self-inoculation by man, 185
source of the outbreaks, 190
Pont de Koubbeh, Army hos-
pital at, 26
Port Said, convalescent depot
at, 28
sporadic cases of Plague at,
184
the Government Hospital, 26,
90
Port Tewfik, hospital at, 296
QUARTERMASTERS, 33, 50, 247
Queen Alexandra Imperial Mili-
tary Nursing Service, 35
a suggestion for, 267
honours awarded to, 305
Quenington, Lord, death of,
"3 "4
RAFA, Battle of, 129
cholera camp at, 296
stretcher-bearers, a tribute to,
133
Raffin, Corporal, awarded the
Military Medal, 100
Index
Raffin, Corporal, gallantry of,
98, 99
Ras-el-Tin, a seaside con-
valescent home at, 33
British hospital at, 26, 31, 231
Rats, destruction by poison for-
bidden, 188
Egyptian, ubiquity of, 187
necessity of extermination of,
191
their susceptibility to Plague,
185
Red Cross Society and Order of
St. John, author's tribute
to, 306
instal and furnish super-
numerary kitchens, 51
the V.A.D. contingent, 36
Relapsing fever, prevalence of,
among Egyptian troops,
282, 300
Rheumatism, bee-sting poison
and, 164
Ritchie, Private, 97, 98
Roberts, Captain, at Dueidar,
97
Romani, Battle of, in
an improvised hospital-train
service, 122
R.A.M.C.'s busy day,' 121
sanitary work of the R.A.M.C.,
162
Rontgen Rays, value of, 250
Royal Army Medical Corps :
a medical advisory com-
mittee appointed, 219
a specimen day in the routine
of an attached officer, 59
a stiff task at El Arish, 141
a wounded officer evacuated
by aeroplane, 131
and the battle of Romani, 112
and the destruction of ver-
min, 213
arduous work on the western
frontier, 103 et seq.
bivouacs and their construc-
tion, 93
campaign against malaria,
Casualty Clearing Station, 76
dental surgery in Egypt, 201
315
R.A.M.C. (continued)
Desert warfare training and
work, 14, 69, 88, 90, 149
discomforts on the march, 92
discover a German-made ster-
iliser in El Arish, 145
disinfecting stations, 299 (cf.
Steam)
dressing stations, 75
Egyptian hospital branch of,
284 et seq.
Egyptian Labour Corps, and
the medical side of its
organisation, 277
examples of everyday life of
a ship's contingent, 42
experiences of one unit in a
Desert campaign, 113
extracts from an orderly's
diary, 234 et seq.
facts as to casualties, 303
field- ambulance work under
Desert conditions, 20, 75
field and base laboratories in
Egypt, 193 et seq.
functions of, in war-time, 73
honours list of, 100, 304
hospital commissariat arrange-
ments, 49 et seq.
its debt to expert medical and
surgical aid, 217 et seq.
medical equipment and mate-
rial, 45 et seq.
methods adopted with recruits
for E.L.C., 297 et seq.
motto of, 302
Reception Station, Mustapha,
210
Regimental Aid Post, 60
Sanitary Section, 108, 140 et
seq., 149 et seq., 190, 299
the camel difficulty, 81, 91
(see also Camels)
"the Lucky Ambulance," 116
the M.O., and his duties, 74
the sine qud non of an am-
bulance man, 55
transport difficulties, 12, 39,
77, 104, 144
use of unskilled labour, 277
work on the Gallipoli Penin-
sula, 53
Index
SAIDIEH Government School
becomes a hospital, 26
St. Aldwyn, Lord, death of his
only son, 114
Sand-carts, 79, 90, 104, 117, 131
-sleighs, 78
-storms, 10, u, 88, 128, 157,
245, 246
Sanitation and conservancy, 21,
73, 108, 141, 142, 149, 158,
187, 224, 297
(Cf. Camp life and sanitation)
Scabies, outbreaks of, 144, 163
Segregation camps, 178, 179,
189, 295, 296, 301
Sennussi, Sheik El, 102
Serbians, deplorable condition
of, 43
Sheik Nuran, 296
Sheik Zuwaid, 131
Sinai Desert, the, 15, 70
a hospital-train in, 135, 137
an engineering exploit in, 126
caravan routes of, 86
climaticconditions, 127, 128, 150
sandstorms in, 128, 157
Sinai Desert Campaign, the, 109
field laboratories in, 197
Smallpox, 103, 175
inoculation against, 175
Sohag, hospital at, 105
Sollum, hospital at, 281
the Sennussi -at, 102
Splints, a factory for, in Alex-
andria, 251
Steam, disinfection by, 144, 163,
170, 171, 297, 299
Suakin Expedition of 1885, the,
8
Sudan, the, reconquest of, 9
work of R.A.M.C. in, 10
Suez Canal, 69, 70, 83 [86
Turkish attacks on, 19, 20, 71,
Suez Government Hospital, 26
sporadic cases of Plague at,
184
Sweet Water Canal, the, 84, 126,
Syria, cholera epidemic in, 174
TASKI, battle of, 9
| Teeth, the, as cause of illness
and disease, 202
Thompson, Sir Courtauld, 307
Turkey joins the enemy, 18
question of neutrality of, 15
Turkish aeroplanes iboonb ambu-
lance camps, 115, 118, 120
Turks, a medical unit cap-
tured, 117, 119
attack Canal, 19, 20, 71, 86
danger of disease- infection
from, 173, 179, 181
dislodged from Bir-el^Abd, 94
Typhus, 103
VACCINATION, wholesale, at El
Arish, 143
Venereal diseases, punishment
for concealment of, 215
treatment of, 252
Vermin, body, 44, 168, 185
railway disinfection, 170, 71,
299
Voluntary Aid Detachment, the,
36
author's tribute to, 306
WADY el Arish, 140
Wady Urn Muksheib, 85
Water, bacteriological examina-
tion of, 153, 195
contamination of, 108, 181,
182, 229, 230
fantasses, 79, 153, 154
pipes 1 laid in the Desert, 84,
126, 136, 153, 280
problem of, 4, n, 12, 73, 85,
86 > 93> 95> 107, 114, 121,
138, 139, 182
purification and sterilisation
of, 140, 152, 175, 227
reconnaissance parties for,
138 et seq.
Wolseley, Lord, commands Nile
Expeditionary Force, 8
Egyptian campaign of, 3, 7
Wood, Private, 98, 99
Wright, Private, 98
X-HAYS, an operation under, 261
their value to the surgeon, 250
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