 Preface to, with the Royal Army Medical Corps in Egypt. This is a LibriVox recording. All LibriVox recordings are in the public domain. For more information or to volunteer, please visit LibriVox.org. With the Royal Army Medical Corps in Egypt by Sergeant Major R.A.M.C. 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 preparation and publication have been undertaken with the full sanction and approval of the authorities I personally am entirely responsible for all statements made, facts recorded and opinions expressed therein. It is due to the reader, however, to say at once that, though the book may 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 Royal Army Medical Corps on the battlefield and in respect of the Corps's 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 the other facts dealt with in these pages he has been indebted to the official records in Egypt all of which have been placed unreservedly at his disposal and to the personal evidence of the Royal Army Medical Corps officers and men from the highest to the lowest which has been, in every instance, readily and frankly accorded him. Moreover, the whole work on its completion was submitted to one very highly placed in the Army Medical Service in Egypt and was by him carefully considered 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. Signed Sergeant Major R.A.M.C. Cairo, Egypt, 1917 End of Preface Section 1 of With the Royal Army Medical Corps in Egypt by Sergeant Major R.A.M.C. This LibriVox recording is in the public domain. Chapter 1 Retrospect The story of the work of the British Army Medical Service in Egypt begins 35 years back so long ago as the late summer of 1882 when Sir Garnet Wolsey 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 11 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 Corps as the medical branch of the service was then termed there was 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 Alexandria 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 Suadezon School of Medicine founded in the bad and brilliant maya met alley 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 cesspits 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 Marmoudi Canal which was the sole source of water for the town was virtually an open sewer every condition favourable to the development of epidemic disease was present not only in the great towns but 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 incidents 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 Mediterranean 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 overcrowded and the narrow streets indescribably filthy in addition to these normal conditions rendering the place at any time a veritable hotbed for disease the date of the outbreak of cholera coincided with the existence of special and extraordinary circumstances it was the time of the great annual fair when the 30,000 or so constituting the ordinary population of the already overcrowded town had been augmented by the influx of some 15,000 people from neighbouring districts these 45,000 human beings were subsisting on Fasec which is fish allowed to putrify 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 carcasses 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 infected areas and set in train a host of preventative 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 32 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 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 then was done by the handful of British medical men during those patient laborious years when they succeeded at last in creating something approaching to hygienic order out of a chaos that outrivaled 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 Saganat Wolsey over the mutinous Egyptian army under Arabi Pasha in 1882 Egypt proper settled down to a state of tranquility and peaceful progress it was far otherwise throughout the vast area of the Sudan where the Khadiva'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 befallen the native forces sent against the Madi General Gordon who had been dispatched to the Sudan on behalf of the Egyptian government to conduct the 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 Chroma 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 Madi the Nile expeditionary force consisting of some 11,000 men was therefore sent out under Lord Wolsey 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 circumstances of extreme difficulty they're followed in 1885 the Swakim expedition against the Dervishes under Osman Dignar in the East and 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 can try to perform its part in the singular devotion and energy the Nile expeditionary force which was organized 4 years later to assist the now rehabilitated Egyptian army to repel the threatened invasion of Egypt by the Dervishes did not actually take part in the operations except in regard to its cavalry the battle of Taski which terminated the campaign was fought in one 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 fought 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 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 succumbed moreover, among the British garrisons while the first epidemic produced 200 cases the present accounted for only 6 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 the campaign which in the autumn of 1896 ended with the occupation of Dongola was carried through mainly by the Egyptian army under it's Sardar Sahurbaq Kitchener the only British forces engaged numbering in all less than 1000 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 around the camps all united to create a situation fraught with great difficulty and anxiety for the medical authorities but though the cholera obtained a footing among our troops the number of cases reached only 24 of which however but three recovered 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 saw the final destruction of Madyism in the Sudan and the restoration of the Cadeva's authority so long set at nought in that unhappy province the Nile expedition of 1898 the successful conduct of which one 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 organization once more changed in name bearing at last the title with which we are all familiar today the Royal Army Medical Corps but the change was not only in name the science of the treatment of sick and wounded in war waged in tropic countries may be said at this time to have first emerged from the tentative experimental stage and to have blossomed out into a proved and practical system based not only on the experience gained in past Egyptian campaigns but specially devised to meet the exigencies 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 Nakila on the at-barra and of Onderman close to Khartoum and from first to last the arrangements made for the care and conveyance of sick and wounded almost without a hitch what this means can only be realized by a study of the conditions geographical and climatic under which the operations 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 Onderman which finally broke the power of Madyism 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 great the at-barra the branch of the Nile near which the whole force was encamped for 18 days consisted at the time of no more than a series of pools from a single one of which the Mairami 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 was 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 at-barra and the Nile still some 200 miles from Khartoum everything had to be moved either by riverboat or on the backs of animals chiefly camels not only had the wounded and sick to be evacuated to the rear by these means the material and equipment of the RAMC units marching with the column were dependent on the same modes of conveyance naturally the fighting men had the first call on the transport facilities and the medical corps had often the greatest difficulty in securing the necessary boats and camels for their work thus after the battle of Omdaman the wounded had actually to be placed on board the barges while these were still loaded with ammunition and stores but the indomitable spirit and resource which then as now characterised the army medical staff were equal to this as to all other difficulties incidental to the campaign indeed the whole story of the part played by the RAMC in this final stage of the Sudan 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 incenitation was pursued by our medical men as unremittingly as ever and year by year they had the satisfaction of seeing their ideas taking deeper route and reforms long and vainly advocated at last becoming accomplished facts though now on a peace footing the British garrisons 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 establishments at Khartoum had no lack of patience nor was the tried and proved efficiency of the RMC contingent 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 laterally the medical unit for Egypt and Cyprus being 17 officers and 120 of other ranks year after year the men were systematically and regularly trained in their duties both as hospital orderlies and as workers in the field especially with regard to the conditions of 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 Menor 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 End of Section 1 Section 2 of With the Royal Army Medical Corps in Egypt by Sergeant Major R.A.M.C. This Libra Box recording is in the public domain Chapter 2 Egypt and the Great War Part 1 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 interesting 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 reassuring 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 Moreover, 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 Eastwards stretch the Sinai Desert which from time immemorial has presented a well-nigh insuprable barrier against an invading army To the 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 Chroma 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 reorganized and regenerated after more than 30 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 purpose 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 subsequent events were to prove when Egypt was well-nigh denuded of British arms our troops soon began to pour into the country whole fleets of transports packed with Lancashire Territorials Australians, New Zealanders and the power 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 realized 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 this opportunity for a popular rising passed by harmlessly must be reckoned as one more spray in the perennial laurel wreath of Chroma for it was his wisdom that had created a contented peasantry in Egypt this fact alone it was that now saved the day the fellowheen 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 NCOs and men remained 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 servicemen staffing the two military hospitals at the Citadel Cairo Razel Tin near Alexandria came first of all the three East Lancashire field ambulances 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 accompanied 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 complete units of the Australian Army Medical Corps fully equipped in the meantime revolution in quite other and much more happy guys 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 Mea Matali the first and the greatest of the cadavers had said England must someday 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 fulfillment 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 independent state under her own Sultan and straight way set about the task of fighting her battles for her in the old time British way that Egypt was now in for troubleous times was apparent to all capable of the necessary worldwide view of a war that was destined soon to take practically the whole earth for its arena it was clear that no enemy of Britain wishing to do the Empire great as time could fail to see that the destruction of the Suez Canal must constitute one of the most fatal blows that could be dealt as 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 transporting 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 affect 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 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 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 RMC 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 the new phase the war it seemed was to be carried into the enemy's country the Mediterranean expeditionary force under Sir Ian Hamilton arrived in Egypt established its base at Alexandria and in April set out for the Dardanelles then some would instead of dealing as hitherto with more or less disjointed happenings it becomes possible to present a fairly well connected narrative of the work of the Royal Army Medical Corps in this part of the near eastern area of war it is a story now of a great crisis triumphantly met and overcome it begins properly with the earliest days of all year 1915 when vast camps had to be established in various quarters to accommodate the British colonial and Indian troops which were flocking into Egypt for training in such enormous numbers camp life is safe and salutary enough albeit on the larger scale if certain elementary principles sanitation and disposal of waste products 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 to circumscribe space and remain there for a prolonged period the undeviating observance 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 in camped in Egypt is the equivalent of theoretical knowledge or ability on the part of the officers whose duty it was to safeguard local conditions 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 discipline 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 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 in camped a very large number of cases of infectious disease occurred these being mainly cases of measles mumps and intestinal disorders of mumps alone some 1200 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 2000 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 there was no 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 in Egypt consequent on the launching 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 hydro-headed significance this achievement of the army medical service in Egypt in dealing with the sudden enormous influx of sick and wounded from Gallipoli in the spring of 1915 will, it is safe to prophesy stand out well in the for-rank of all that British energy and ingenuity have accomplished from first to last human foresight based on whatever past experience of warfare could scarcely have computed a right the medical needs of an expedition such as that which was hurled against the Turks on the Gallipoli 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 be times 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 Menor 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 government was again applied to for all possible aid meanwhile additional hospitals were on their way out from home in general hospital with its equipment stores and personnel reached Alexandria on March 15 and by April 1 had taken possession of the building ordinarily occupied by the Abbasia secondary schools with 1040 beds ready for the reception of sick and wounded a second complete hospital number 17 general arrived shortly after and was located in Victoria College Alexandria 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 indeed how little the authorities at home had preestimated the true nature of the coming campaign may be judged from the fact that the two general hospitals numbers 15 and 17 had been sent out without feminine personnel it being intended that these base units should land and be established on the peninsula this shortage of nurses in Egypt however could it appeared on an emergency be made up by temporarily making use of local help while detachments of trained army nurses were being sent from home it seemed therefore that all probable demands 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 enuded 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 barely conceive of war but as something infinitely remote and incredible and then with hardly a rumoured word of warning the storm broke on the 25th and 26th of April the first fateful landing on the Gallipoli peninsula took place and within a 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 10 days no fewer than 16,000 cases were landed and distributed among the hospitals ashore in Alexandria all available 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 delay the expansion of existing hospitals was taken in hand and other establishments created either in permanent buildings requisition for the purpose or in little townships of canvass pitched in carefully chosen spots in Alexandria number 15 general hospital was expanded to 1500 beds number 17 was increased to the same number and eventually the accommodation at this hospital was raised to a total of 2460 beds a German hospital in Alexandria the Deaconesses which had recently been commandeered for our troops was also pressed into the service additional buildings acquired and the military number 19 general which soon arrived on the scene installed in the premises another British hospital number 21 living about the same time was located in the Egyptian army barracks and was rapidly opened out to a capacity of more than 1000 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 government hospitals in Alexandria Port Said, Suez and in six of the large provincial towns immediately prepared to receive British wounded and sick meanwhile in Cairo still more extensive developments 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 number one Australian general hospital had been established in the Heliopolis palace hotel on January the 25th with 200 beds and had since been increasing steadily was now swiftly expanded to 1000 as the influx of sick and wounded steadily augmented additional buildings in the neighbourhood were pressed into the hospital service and the beds were available in this quarter alone the Egyptian government lent it's civilian hospitals in Casarail, Iney and the army hospital at Ponte de Cuba the Sadiah 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 200 beds which rapidly increased to 650 the Anglo-American hospital immediately placed its wards at the disposal of the British army medical service later a hospital was opened at Chobra for infectious cases number five Canadian stationery hospital was established at the Cavalry barracks in Abbasia and the fine building of the Egyptian government primary school known as Nazaria school became a British military hospital with 584 beds in addition to all these arrangements affected 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 number five Indian general hospital at Alexandria which was rapidly expanded to 950 beds and by number eight 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 and efficient but for the 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 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 available for critical cases from overseas thus at Heliopolis during the first week of May when the wounded were pouring into number one Australian general hospital pasteurally equipped auxiliaries at the rate of 400 or 500 a day the conversion of the large L Hyatt Hotel Helwan 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 Alexandria one specially for enteric cases in some buildings near Port Said lent by the Suez Canal Company others in the Palace Hotel at Bulak El-Dakraw in the group of mansions at Montazar lent by the Sultan of Egypt in the Grand Hotel at Helwan and at what was called the Rest Camp at Abbasia which alone developed an accommodation of 2,300 beds while a convalescent hospital which received offices only was established in the Sardar's House at Cairo the Red Cross Hospital at Giza, Cairo obtained the loan of the Walder Palace from the Sultan and thither dispatched its own convalescence 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 depot was organised all the hotels at that place, 6 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 Army Medical Corps leaving out of account the mental strain arising 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 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 progress thousands upon thousands of desperately wounded or diseased 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 a shelter a decent bed the best of medical, surgical and nursing skill food and sick room comforts without stint clothing were needed easy transit from place to place by road or rail and a cheerful comfortable home in one of Egypt's famous health resorts were in to grow strong and fit again for the Empire's service if that might be or in the case of permanent incapacitation from duty birth 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 circumstance 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 immediately be made of the premises on any considerable 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 numbers 15 and 17 general hospitals were installed possessed it is true well appointed kitchens but these had to be enlarged at once and additional latrine accommodation provided the old Egyptian army barracks at Razal Tin when number 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 orgy and stable and its transformation into a thoroughly good hospital in record time was one of the most notable feats performed by the men of the RMC 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 around 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 airdrome site about three quarters of a mile away and subsequent developments 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 possession 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 Hyatt at Helwan this was furnished at once and lent itself to expansion at a pinch at the same time number two Australian General Hospital which had opened at Menor House near the pyramids in the early part of the year was installed in the Jazeera Palace Hotel Cairo and was rapidly equipped at Menor being retained as an overflow as time went on and the rush of wounded continued 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 Heliopolis Sporting Club Pavilion was also commandeered and converted into a hospital which was rapidly enlarged subsequently, hospital for infectious diseases were opened at Chobra and in the artillery barracks at Habesia in addition to all this the outlet for convalescent cases from this Australian group of hospitals was hidden by the establishment in the Razel Tin School at Alexandria of a seaside convalescent home also in the palace or rather group of mansions at Montazar 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 the extended band of doctors and orderlies of the Australian Army Medical Corps can be chosen then by giving an extract from the quartermaster's diary at the time it deals with only 48 hours of a long enduring crisis June 8th to 9th during the 24 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 of the 9th we worked until 3.30 am the ambulance train did not arrive till 2.00 am prior to the arrival of 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 24 hours rations for these men assembling for work about 6.30 am on the 9th 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 the day we received orders to convert a machinery workshop the artelia into a hospital to supply linen, blankets, stove hospital and cooking utensils to erect a kitchen and to make special sewage and ventilation arrangements the beds were ready for occupation within 24 hours while this work was in progress at the clubhouse of a local golf club had been commandeered and beds were to be erected immediately at 3.30 pm on the 9th I had a lime juice at the bar in the clubhouse and the people had then no idea of our intended occupation at 6.30 pm the first mattresses and beds were delivered and the hospital was enhanced tonight, the 10th, the hospital is fully equipped and ready for occupation the hospital completed yesterday is to be occupied tonight it is extremely doubtful if any quartermasters department in the army medical corps has ever been called upon to accomplish so much in 48 hours when it is remembered that our staff is here for an establishment of 1 7th 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 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 organize 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 affected and perhaps the most difficult if not the most important of all how the problem of feeding the multitude was solved end of section 2 section 3 of with the Royal Army Medical Corps in Egypt by Sergeant Major R.A.M.C this LibriVox recording is in the public domain chapter 2 Egypt and the Great War part 2 female nursing service in reviewing the part played by the members of the Queen Alexandra Imperial Military Nursing Service and of the colonial nursing organizations 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 Gallipoli campaign there was no more than a handful of trained sisters and nurses at the base in Egypt and these were already fully employed 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 Queen Alexandra's Imperial Military Nursing Service and of the Australian and New Zealand contingents though at one time strained did not in fact break but magnificently stood the strain must be set down to two factors in the first place to the admirable system of training in the Alexandra organization which rather it must be admitted to the astonishment of the merely masculine part of the army medical service succeeds in developing among men apart from technical knowledge the qualities of hard endurance instant resource and unflinching readiness to accept responsibility to a high degree and in the second place it must be ascribed to the ability and genius for organization of the matron in chief for Egypt Miss S. E. Orem 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 pouring into Alexandra it is not easy to understand how temporarily at least a condition 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 shellswept 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 later regard especially as indeed in all other departments of the nursing service in Egypt during the war attachment or VAD for short contingent of the Red Cross Society and Order of St 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 reinforcements of nurses were already out from home and immediately the authorities became aware of the true nature of the campaign further detachments 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 difficulty 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 Cairo 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 number 15 general hospital which it will be remembered came to Egypt without female nursing staff was at first entirely supplied from local resources these being gradually replaced by army nurses augmented by the VAD 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 number 17 general which like number 15 had been originally provided with male personnel alone April 29th 1915 two nurses were locally engaged April 30th 1915 four Australian nurses lent from Mina House arrived May 2nd 1915 to Queen Alexandra's Imperial Military Nursing Service reserve nurses arrived from Cairo May 4th 1915 six Australian nurses arrived for permanent staff 10 dispensary nurses arrived from different parts of Egypt for temporary duty here May 11th 1915 10 Australians arrived lent from Mina House May 14th 1915 for Queen Alexandra's Imperial Military Nursing Service reserve from England May 26th 1915 10 nurses of Lady Carnarvans arrived here June 15th 1915 13 Australian nurses arrived for duty here June 21st 1915 10 Australian nurses arrived July 1st 1915 10 Queen Alexandra's Imperial Military Nursing Service reserve arrived from England July 2nd 1915 15 New Zealand nurses arrived here 15 New Zealand nurses arrived here The 10 nurses who joined the hospital on May 26th were part of a detachment of 50 which the Countess of Carnarvans 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 The 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 entailed The motor ambulances available belonged almost entirely to the Australian and New Zealand medical units 30 fine cars the gift of the Australian Red Cross Society having been brought to Egypt in the Cairo early in the year and 20 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 Jazeera 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 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 Railway and the service admirably maintained through the periods of crisis there were six separate trains for the service these being kept at Gabbari 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 Egypt at this critical time from a very few regularly appointed hospital ships supplemented by hastily improvised carriers and troop ships which constituted the service at the beginning of the peninsular operations the number of these vessels was steadily and swiftly augmented until over 60 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 doctors, orderlies and nurses of the Army Medical Service the following quotation from an official report of the time will be of interest I 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 establishments 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 and to notice in a very special manner the work performed by the nursing services under Miss S.E. Auram R.R.C. the matron in chief whether belonging to the regular territorial or overseas services the untiring devotion displayed by these ladies in the very trying conditions on board ship at the front the collection 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 invalidated as a result of hard work and privation the dangers, difficulties and hardships to be met with on these sea-going hospitals are indeed scarcely realised by the public at home apart from the risk from enemy torpedoes and mines, witnessed the fate of the Breymar Castle, Britannic Marquette, where nine of the nurses were drowned, the Gloucester Castle and many others the days work on a hospital ship continuously passing from port to port with the most exacting and portentious cargo that vessel could possibly carry is as much as, sometimes more then human energy and hardy-hood can support here is a very terse disjointed series of extracts on board one ship alone the Dunlouce Castle which fairly represents the sort of life a ship's staff of the R.A.M.C. lives as a matter of every single day throughout summer of 1915 up to time of evacuation 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 Volona and carried Serbians to Berserta Banner and Algiers she then carried patients from Egypt to Sicily for transshipment to Britannic then from Egypt to England with full cargo of sick and wounded then back to Egypt again with equipment and personnel of a stationery hospital for Mesopotamia then to Salonica to fetch wounded then to and fro between Salonica and Malta up to October 1916 with many wounded also large numbers of dysentery and malarial cases on one voyage alone out of the total patients two thirds were cases of malaria in October ran between Malta and Mudrose also one trip home to fetch number 41 General Hospital for Serbians then Egypt to England carrying a number of mental cases after disembarking at Southampton went immediately on the same day to Havera and brought over cases including 136 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 dysentery 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 larkonic phrase went to Volona and carried Serbians to Berserta on the afternoon of February 10th, 1916 the Dunlust 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 early days of the war 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 Berserta at daybreak by that time however in spite of the closest attention 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 marasmas of Daria and many were in the typhoid state the odour in the wards and throughout the ship was indescribable and disfectance 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 15 in the first 24 hours an angloserve vocabulary of about 50 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 working in the wards Berserta was reached during the morning of Sunday, February 13 by which date the death roll had reached a total of 39 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 and it was a pleasure to serve after disembarkation the ship was fumigated throughout and kept in strict quarantine for a period of 5 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 to be brought by sea over about 3000 perilous miles a journey that never occupied less than 3 weeks and might take 8 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 sphere with good lines of communication but the task was far otherwise in Egypt the armies first at the Dardanelles and then at Salonica 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 stationery 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 depots 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 mechs peninsula and the seaboard 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 these 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 in drugs, dressings etc in Egypt how was it done? organization is very simple and can be stated in half a dozen words organization, 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 a saleable 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 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 appartenances 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 surplicages that the main medical store depot the 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 successfully 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 depot 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 shed at the docks Alexandria in April the depot was opened and almost immediately it was working under high pressure heavy demands being made on it at an early stage especially for dressings for the Gallipoli peninsula it soon outgrew its original premises and took over several of the large chowners or cotton warehouses adjoining the depot eventually comprised a floor space of 85,000 square 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 remota 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 the maintenance of the usefulness of the depot it may be mentioned that a complete electroplating 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 medical use and reissued to the medical units thus an important economy was affected 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 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 to 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 that the kitchen organization of each hospital and convalescent camp should keep pace with the swiftly expanding wards 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 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 against a whistling hurricane of bullets throwing away life as they would a spent matchstalk 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 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 install and furnish supernumerary kitchens at nearly all the hospitals where the lighter and more delicate articles of sick war diet could be prepared at a time when the regular staffs of the main hospital cookhouses would 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 the adolescent 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 section 3