CONVALESCENT DEPOTS—EVACUATION OF CONVALESCENT SICK AND WOUNDED FROM CONGESTED HOSPITALS—KEEPING THE HOSPITALS FREE—LIBELS ON THE EGYPTIAN CLIMATE—DISCIPLINE.

CHAPTER V

It will be remembered that so far as the Australian troops were concerned, provision had been made for three convalescent hospitals or homes. The magnificent hotel of Al Hayat at Helouan was taken over on May 5, emptied of hotel furniture, fitted with palm beds and mattresses, and converted into a convalescent hospital. As there was no staff in Egypt available, it was placed under the direction of a military commandant and a principal medical officer who was a civilian practitioner resident at Helouan. A few non-commissioned officers and orderlies were transferred to it from the convalescent camp in the desert at Zeitoun, which was very properly terminated. The cooking was effected by arrangement with a professional caterer at a charge of 5s. a day for officers, and 3s. a day for men. These charges ultimately included the provision of cooking and eating utensils. This convalescent hospital both in its general character and with respect to the food supplied represents in all probability the most successful effort made in Egypt. In fact it has been suggested that the hospital was almost too attractive, and that there was consequently a good deal of disinclination to leave it. In favour of the principle involved in installing a military commandant to administer a convalescent hospital there is much to be said, as the administration is one man's work.

The Egyptian Climate

Those who know Helouan and the hotel will not be surprised at the success of the Hospital, but it may surprise even those who know Egypt to learn that Helouan is considerably cooler than Cairo, notwithstanding the fact that it is situated on the edge of the desert. Owing to dryness the Wet Bulb temperature is considerably lower than at Cairo in midsummer and the nights are always cool.

It must be remembered that the figures in the attached table give means only, and that any registration over 75°F. Wet Bulb is high, and that at 80°F. Wet Bulb work becomes difficult. At 90°F. Wet Bulb the danger point is reached, and all work must cease on pain of death from heat apoplexy.

It will be seen, then, that Egypt is not especially hot, even from May till October, and that Helouan is particularly cool. These conclusions coincide with the feelings of those who live there. Alexandria is pleasant by day, because of the sea breezes, but at night most people prefer Heliopolis, which is drier and where they are more likely to enjoy a breeze.

These observations apply to the weather after May. From March to May the khamsin may blow for several days. The temperature then is high, but the air very dry. Khamsins usually cease in May.

The normal progress, then, of a patient admitted to No. 1 General Hospital suffering from a serious wound or a serious disease of non-infectious character was removal to one of the auxiliary hospitals when he reached the semi-convalescent stage, and removal to one of the convalescent hospitals when he reached the convalescent stage. From these hospitals he was discharged to duty.

Now, Helouan is twenty miles from Cairo, and can be reached by railway or motor ambulance; and the railway station in Cairo for Helouan is eight miles from Heliopolis. As the patients were moved from Heliopolis to Helouan in scores or even hundreds at a time, some idea of the tax imposed on the motor ambulance corps can be imagined. During the crisis of May, June, and July, a visitor could witness an eternal procession of trains discharging wounded at Heliopolis, of trains discharging wounded at Cairo for other hospitals, of sick being moved to and from the different hospitals in Cairo, and convalescents from the various hospitals being sent to the Cairo station for Alexandria or to the Bab el Louk station for Helouan. Without an adequate supply of motor ambulances such an organisation would have been impossible.

It should be understood that the convalescent hospitals were available not only to all Australian sick and wounded from any hospital, but also to British or New Zealand sick and wounded. The adjustment of accounts between the separate Governments was a matter of discussion, and it was finally agreed that in the case of hospitals no charges should be made by reason of the section of the force to which the sick or wounded man belonged. It was desirable as far as practicable to send the Australians to Australian hospitals, but if the treatment of the sick and wounded necessitated it, no hard-and-fast distinction was to be observed. In the case, however, of convalescent hospitals, in which the matter could be dealt with in a more leisurely way, the respective Governments were charged the cost of maintenance of soldiers belonging to them.

Army Medical Administration

When the Kyarra arrived in Egypt the military medical arrangements in that country were on a very small scale, and under the administration of the D.M.S. they rapidly enlarged. But the unexpected rush on April 29 found the British Medical Force to a considerable extent, and justly, dependent on the Australian Force for hospitals, medical officers, nurses, transport, specialists, and Red Cross stores. As there is really only one service and one object in view, it is quite unnecessary to emphasise the satisfaction felt by Australians in being of substantial service at a critical time. Since then the development of the medical services has steadily proceeded, and the anxiety of May, June, and July is never likely to be experienced again.

Discipline

A word must be said on the subject of discipline and its influence on Australians. The bravery and resourcefulness of Australians in the field are sufficiently attested by those competent to judge. Of their splendid behaviour when desperately injured we have had ample evidence, which we furnish with proper respect to brave men.

The convalescent Australian presents another problem, as also does the soldier waiting at the base. The lines in Dr. Watts's hymn come to mind. In these circumstances his very fine qualities cause him to give trouble. His ingenuity in breaking bounds is worthy of a better cause.

For example, there were complaints from the military police that sick men were roaming about Cairo at night. The roll was called at No. 1 General Hospital several times, and no one was absent. Not quite satisfied, we called the roll in the Ophthalmic Ward one evening at 8 p.m. Only one man was absent. Still suspicious, we called it again at 8.40 p.m. the same evening, and twenty-one men had gone. Some had rolled up coats or blankets and so placed them that it seemed that the men were still in bed. Subsequently uniforms that should have been in the pack store were discovered under their mattresses.

These and similar difficulties were aggravated by the fact that even a moderate disciplinarian did not always receive the support of the nurses or even the medical officers.

To illustrate: An endeavour was made to limit smoking in the wards to reasonable hours, as it has become an unfortunate tradition that a sick soldier may smoke cigarettes all day long, when in bed, without injury.

One of us (J. W. B.) entered a small ward which was filled with smoke, and was just in time to see a sick man practically blowing smoke into a nurse's face; needless to say the cigarette vanished with astonishing rapidity. Looking through the murky atmosphere, I asked the nurse whether she had seen any one smoking, to which she unblushingly replied, "No, sir."

If nurses and a section of officers throw their weight against enforcement of discipline, because they don't think it necessary or right, the difficulties become considerable.

Again, the sentries were often in collusion with the men. Two instances suffice: A soldier got out of the hospital through a hole in the fence. On returning he determined to test the sentry with an eye to future escapades. Walking up to the gate, he said, "I want to visit a friend." "Have you got a pass?" said the sentry. "No," replied the sick man. A discussion followed, and finally the sentry said, "Go in and out by the hole in the fence; it will save me a lot of trouble."

Yet another amusing incident. Sitting on the great Piazza at Heliopolis were a number of men convalescent from serious illness, pneumonia and the like.

A short distance away on the outside of the iron railing fence, the Arabs were conducting illicit and prohibited trade with the men inside, and a sentry appointed to prevent it was walking up and down studying astronomy.

The Commanding Officer witnessed the occurrence, visited the happy scene, interrogated the sentry, and asked him what his duties were. The sentry answered, "To walk up and down here with me gun to prevent them prisoners" (the unfortunate convalescents) "coming down them steps, and to prevent them niggers jumping the fence!"

The hardest part of military work is waiting. The soldier who has the magnificent fundamental qualities of the Australian, and who can wait and obey, would be the greatest soldier on earth. We are hopeful that the experience gained will render the Australian the claimant for this coveted position. All thoughtful Australian officers we know tell the same story: "Give us discipline, and again and again discipline."

There is much to be said for the soldier. He will obey if he knows why an order is given, or if he trusts his officer and knows why it is given. But if he is uncertain on these points he pleases himself. Discipline cannot be enforced in general, except by properly trained professional officers.

Again, there was more drunkenness than there should have been from the same cause. One evening visitors passed liquor into hospital, and a hideous din arose. On seeking the cause, I discovered it to proceed from a ward containing three patients, of whom one had a broken leg and another a broken arm.

These two men were uproariously drunk, and were sitting up in bed making Australian political speeches. On my entry he of the broken leg demanded in broken tones to be at once paraded before the orderly officer.

On another occasion a particularly nuggety patient had broken the rules, and becoming troublesome was ordered back to his ward. Refusing to go, the guard was sent for, and a fight of a desperate character ensued before he was overpowered; yet we found accidentally that later on this man was made a N.C.O. and apparently gave satisfaction.

In other armies such an offence might have been punished with death.

On reading the account of the life of Stonewall Jackson it is clear that similar difficulties were experienced with the Confederate soldiers, and that Jackson against his inclination was compelled to enforce grave penalties at times to prevent still graver trouble.

It takes several men on the lines of communication and at the base to keep one man at the front, and only loyal obedience to orders during the wearisome and exacting day's work on the lines of communication will make the machine run smoothly, and do justice to the man in the line of battle who is risking his life.

Yet it seems to us there is much to be done by attention to the soldiers' social wants. The work of the Y.M.C.A. and the provision of soldiers' clubs were powerful influences in favour of good order and conduct.