The New Zealand Medical Service in the Great War 1914-1918
[introduction]
The military forces now assembled at Mudros consisted of one French and four British Divisions: the 29th Division, Regulars; the Royal Naval Division, a recently formed unit consisting of volunteers; the first Australian Division; the New Zealand and Australian Division, lacking one Brigade of Infantry; and the French Division of mixed Territorials and Senegalese troops under General d'Amade. The M.E.F., comprising some 75,000 officers and men, was about to embark upon the most intricate and hazardous operation in amphibious warfare: a landing against determined opposition. An operation likely to be attended by heavy casualties and one in which the problems of the evacuation of wounded by sea presented difficulties as yet not explored, nor elucidated by previous experience. It is of interest, then, to consider momentarily the medical arrangements made prior to the landing at Gallipoli, which have been the subject of much controversy and ill-informed criticism both in England and in the Dominions. If there is just blame attachable to the medical staff by reason of the partial failure of these arrangements, the N.Z.M.C. surely must be held in part responsible, at least as far as Anzac is concerned, as certain of our officers were in medical charge of the ambulance transports, and our chief medical officer—the A.D.M.S.—was for a time, at least, directly associated with the adoption of the scheme of evacuations. What follows, therefore, is an attempt to set out quite plainly the sequence of events which led up to the formulation of the scheme drafted by the D.M.S., M.E.F., Surgeon-General Birrell, and the Administrative Staff of Sir Ian Hamilton, in collaboration with Sir Roger Keyes, Director of Communications in chief, for the evacuation of wounded of the M.E.F. engaged in the operations at Anzac in April, 1915.
On the 4th of April General Sir Ian Hamilton with the General Staff finally sailed for Lemnos on the Arcadian. With the party was Lt.-Col. Keble, R.A.M.G, A.D.M.S to the D.M.S.; Surgeon-General Birrell had remained behind with the D.A.G., Bgr.-Gen. Woodward, making arrangements for the base hospitals in Egypt. In the absence of the administrative staff, Lt.-Col. Keble, representing the D.M.S, drafted a scheme of evacuation of wounded for the 29th Division, probably in collaboration with the Director of Naval Communications, Sir Roger Keyes of Admiral de Roebeck's staff. In a combined operation of the naval and military forces such as a landing of troops against opposition, it was an accepted principle that the naval commander should be responsible for and direct all movements at sea, consequently the evacuation of the wounded by sea transport was a matter for naval consideration and direction. Roughly, the Navy was in sole charge up to high water mark in amphibious warfare.
Col. Howse, V.O., A.D.M.S. to the 1st Australian Division arrived in Mudros on the 12th April, and in an interview with Col. Keble, on the 15th, was shown a copy of the medical arrangements for the 29th Division which included: provision of one hospital ship, the Sicilia then at Mudros, and one ambulance transport, the B2 Caledonia. Col. Howse was advised that he would be required to provide a ship for slightly wounded cases, and medical personnel to the extent of three officers, 20 O.R., from the medical field units under his command, for the purpose of manning the ambulance transport allotted to his division. At this interview it was made clear that, at that time, no medical officer had been appointed D.D.M.S. to the Australian and New Zealand Army Corps. To the Headquarters of each of the two corps of infantry which formed part of the B.E.F. in 1914, a senior medical officer was appointed as deputy director of medical services, his duties being to co-ordinate the medical work of the two divisions which then formed an army corps. So far no similar appointment had been made for the Australian and New Zealand Corps; General Carruthers, who was A.A. and Q.M.G. of the corps, consulted Col. Howse and asked him to draft a scheme of wounded evacuation for the corps. Col. Howse, following the general lines of Lt.-Col. Keble's draft for the 29th Division, submitted a tentative plan on the 16th. This scheme selected a transport (not named) to be manned by medical personnel drawn from field ambulances and equipped with medical and surgical stores supplied by the First Australian Casualty Clearing Station: but Col. Howse considered that such an arrangement was not the most satisfactory. He held that it would be preferable to use the Osmanieh—-the Constantinople ferry boat—and that personnel should be provided by the 2nd [Australian Stationary Hospital then at Mena. He had strong Objections to the use of troopships in that they all had horses aboard, and he considered it impossible that they could be adequately cleansed in the interval between the time of disembarkation of troops and the reception of wounded. The transport Clan McGillivray was ultimately allotted to the First Australian Division.
Col. Manders, A.M.S., A.D.M.S. to the New Zealand and Australian Division arrived in the Lutzow on the 15th, and had an interview with Col. Keble, at which it was settled that Col. Manders, being senior, should act as D.D.M.S. to the corps—an appointment which our A.D.M.S. accepted with considerable reluctance. In his capacity as D.D.M.S., he visited General Birdwood and as a result of the conference the corps issued in their operation orders (No. 1) instructions to the effect that:—The hospital ship Gascon, for serious cases, was allotted to the corps with two ambulance transports, the Clan McGillivray, and the Seeang Chun for slight cases; making provision for 200 lying down eases and 1200 sitting up—about 5½ per cent. of the full strength of both divisions. The necessary steps were taken by both A.Ds.M.S. to supply the troopships selected with personnel and stores. The transport selected for the New Zealand and Australian Division, the Seeang Chun, had on board the headquarters of the 4th Australian Brigade, Brigadier-General Monash, and the 14th Australian Infantry Battalion. She was a well found ship with a sick bay aft giving accommodation for 30 cot cases; she carried no horses. Three N.Z.M.C. officers and 20 O.R., medical personnel were detailed for duty with this ship, intended only for lightly wounded and a short voyage, of say three days, to Alexandria. Col. Manders issued a very important instruction to the A.D.M.S Australian Division which made provision for a senior medical officer to be appointed, who would act with the naval beach masters at the landing places in supervising the embarkation of casualties; he was to see that wounded were duly classified and that serious cases were sent to hospital ship, the slight cases to ambulance transport, and was above all, to notify General Birdwood's Headquarters on the Queen when a transport had embarked her full complement of wounded.
On the 18th Surgeon-General Birrell arrived in Mudros with the Administrative Staff, whose presence Sir Ian Hamilton so much required. The Deputy Adjutant-General, Brigadier-General Woodward, whose duty it was to supervise these medical matters after consultation with Lt.-Col. Keble, and the D.M.S., and scrutiny of the draft of medical arrangements for the evacuation of wounded, expressed dissatisfaction with the scheme on the grounds of inadequancy. He put forward fresh proposals wherein it was specified that five ambulance transports were to be put at the disposal of the Australian and New Zealand corps, and made other useful suggestions which included improved facilities for embarkations at the beaches and the provision of stationary hospital personnel and equipment in lieu of details and stores drawn from the field units. With these suggestions the D. of C. I.C. the C.G.S., Braithwaite, and the Q.M.G., Winter, were in agreement. The D.A.G. considered the matter to be one of great urgency and that without some such arrangement it would be impossible, from a medical point of view, to commence serious operations. Sir Ian Hamilton, in his Gallipoli diary, vividly describes the anxieties of his D.A.G. "Woodward, though he has only been here one night, is on barbed wires; his cabin is next the signallers, and he could not get to sleep, he wants some medical detachments sent up post haste from Alexandria, I have agreed to cable for them; and now he is more calm." The landing was to have taken place on the 21st, as originally planned, hence the anxiety of the Administrative Staff.
On the 19th the D.M.S. cabled to Egypt for the extra medical personnel, and ordered the following units to report at Mudros:—The 16th Stationary Hospital; the 2nd Australian Stationary Hospital, and No. 5 Advanced Supply Depot of Medical Stores.
Of these alterations in the medical plans, both A.D.'sM.S., Manders and Howse, had some verbal notification; they were at present acting in accord with the original operation orders of the Australian and New Zealand corps, but they were now informed that the field units would be relieved from duty on the ambulance transports and that their stores would be replaced on arrival of the stationary hospitals. Col. Manders took the necessary steps to supply the Seeang Chun with N.Z.M.C. officers, personnel, and one and three quarter tons of medical stores from the N.Z.M.C. reinforcements and reserve medical stores on board the Seeang Bee as he strongly objected to depleting his field units. He had been informed that an additional number of transports would be selected for serious and slight cases after the hospital ships had been loaded but he made it clear, in his diary, that he was not satisfied with the arrangements and that there was a want of harmony between the office of the D.M.S. and his own, owing wholly to lack of adequate communication, as the ships Arcadian, General Ian Hamilton's Headquarters, and the Lutzow, it must be remembered, were half a mile apart and the only means of communication was by pulling boats on a wind-swept harbour, at times so rough as to temporarily interrupt all communication.
On the 21st, the day originally planned for the landing, it was blowing hard and the sea was so rough that transport from ship to ship was not available; the transfer of medical personnel could not 3 be completed. The landing was postponed pending improved weather conditions. On that day General Godley, with staff, the Brigadiers and the A.D.M.S. of the New Zealand and Australian Division attended a conference on board the Minnewaska (Corps headquarters) General Birdwood's ship, where Admiral Thirsby outlined the full scheme of operations intended to be carried out on Gallipoli, which, as far as our Intelligence showed, would not be without severe opposition. Amongst other subjects the estimates of probable casualties at the landing were discussed. Col. Howse dissented stoutly from the original estimate of 5½ per cent. casualties and also expressed his dissatisfaction with the corps medical arrangements. Col. Manders informed General Carruthers, that: "there seems to be the same mix up as far as the hospital ships are concerned," but the A.D.M.S. was not as yet in possession of the fully drafted scheme of medical arrangements. By "hospital ships" in the above fragment from his private diary, he means ambulance transports for lightly wounded, not hospital ships. He consequently had a long interview with the D.M.S. on the same matter without satisfactory results, as far as he was concerned. Part of the misunderstanding was due to the fact that, owing to the rough weather, correspondence dated the 20th and emanating from the D.M.S. office, did not reach Col. Manders until the 22nd, having passed through "A" branch of Corps where it was delivered at 4.30 p.m. on the 21st. This important document was to advise Col. Manders, acting as D.D.M.S. that the 2nd Australian stationary hospital was at his disposal—on arrival from Egypt—for duty on the Lutzow the Ionian or other ships he might select for the use of the Australian and New Zealand Army Corps, and that No. 5 advanced Supply Depot of medical stores, due to arrive on the Himithus, was placed at his disposal. This message which, had the units referred to been in Mudros harbour, would have relieved Col. Manders in his real anxiety took two days to cover a sea distance of half a mile. This incident demonstrates one of the multiple difficulties of amphibious warfare: variable and often insufficient means of intercommunication. The only question Col. Manders could now ask was: where were the medical units concerned?
Col. Howse with Col. Carruthers visited the D.M.S. in the forenoon in regard to the medical arrangements, and were informed that Col. Manders acting as D.D.M.S. had been communicated with and that he had received full instructions and that the second Australian Stationary Hospital had been cabled for Col. Howse was still dissatisfied and later reported to Corps that only one transport, the Clan McGillivray had been provided for the Australian Division. At the time of this interview, Col. Manders was as much in the dark as Col. Howse, as he did not have the instructions referred to by the D.M.S. until 1 p.m. that afternoon, that is after the visit of Col. Howse to the D.M.S.
On the receipt of these belated instructions Col. Manders as D.D.M.S. of the Corps, with General Carruthers the A.A.Q.M.G., again visited Surgeon-General Birrell. During the course of the interview Col. Manders exploded a bombshell by showing to the D.M.S. a letter from General Birdwood, the Corps Commander, representing that he, Col. Manders, would be unable to fulfil the duties of D.D.M.S. Australian and New Zealand Army Corps in addition to those of A.D.M.S. New Zealand and Australian Division. Col. Manders was personally thankful to be relieved of all responsibility as regards Corps medical arrangements and had at heart the satisfaction of thinking that two transports, the Clan McGillivray and the Seeang Chun were complete with medical stores and personnel. But as a matter of fact the Seeang Bee had not yet despatched the medical officers, men and stores to the Seeang Chung owing to rough weather and lack of transport.
The 23rd saw the end of the storm, it was a beautiful day; the Admiral-in-Chief issued instructions that landing operations would take place on the 25th, the transports started to move out of the inner harbour. There was a conference on board the Lutzow at which were present amongst other commanding officerss, the A.D.M.S. and D.A.D.M.S., Lt.-Col. Begg of the New Zealand Field Ambulance and Lt.-Col. Beeston, V.D., of the Australian 4th Field Ambulance. The nature of the operation assigned to the New Zealand and Australian Division was outlined: the Division was to form part of the forces landing between Fisherman's Hut and Kaba Tepe with the object of seizing the ridge over which the Gallipoli-Maidos and Boghali-Kojadere roads run, including Sari Bair. The intention was to cut off the retreat of the Turkish forces on Kilid Bahr Plateau and prevent reinforcements from reaching them. The method to be adopted was to land the first Australian Division under a covering party to seize Sari Bair and its main spurs and to put the New Zealand and Australian Division "through them" to capture the second objective namely Mal Tepe, the fall of which would lead to the surrender of Kilid Bahr and the domination of the forts at Maidos. It was anticipated that the landing would meet with a determined resistance.
Col. Manders explained the medical arrangements which were somewhat as follows:—A Casualty Clearing Station would land early on the beach and establish a dressing station at the northern most point of the beach in the vicinity of the landing place. The duty of the C.C.S. was to concentrate and tend the wounded until the tent subdivisions of the ambulances came ashore. It was not considered possible that the wounded could be evacuated by the naval barges and cutters until the fighting troops had been landed. The bearer subdivisions of the two ambulances would land as soon as possible: the New Zealand bearers to the left, the Australians to the right. An officer of field rank would be appointed to command each party. They would take with them medical companions, surgical haversacks and extra dressings. They would group the wounded and remove them to the C.C.S. at dark. Each bearer subdivision was to be strengthened by two tent subdivision officers. One sanitary officer was to land at the first opportunity and report to the Officer Commanding Royal Engineers for water control—he was to carry a water testing case and other apparatus for the purpose; any springs or wells found were to be carefully guarded; the water was to be tested before issue; a party of field engineers was to be landed with well-sinking appliances. Naval arrangements had been made to land as much water as possible by pumping from barges into receptacles on the beach and the divisions were to arrange for their own receptacles for carrying water to the firing line. The evacuations of wounded would be: serious cases to hospital ship Gascon; light cases to the Clan McGillivray and Seeang Chun; transport from shore to ship by navy launches equipped as hospital boats. The old maps, 1.40,000, printed in Egypt were issued to the medical officers and all necessary verbal instructions given. Lt.-Col. Begg returned to his ship, the Gosler, and made all matters as clear as he could to his officers. Major E. O'Neil, N.Z.M.C was to command the landing party of New Zealand bearers, about 120 strong, with Captains Tewsley, Boxer, H. Short, A. V. Short and Mitchell: three bearer subdivision captains, plus two tent subdivision officers as required by the A.D.M.S.'s orders.
As it had been very rough in the harbour it had not been possible to practice disembarkation from boats, which was a feature of the preparation of other units, but on this day the bearers went through the manoeuvre of embarking in rowing boats satisfactorily. Captain Walton, N.Z.M.C was detailed for temporary duty on the Seeang Chun, with one other medical officer. Lt.-Col. Beeston, O.C 4th Australian Field Ambulance, had similar orders and made similar dispositions except that he was not obliged to detach ambulance personnel to man the Clan McGillivray.
On the 24th the final draft of medical arrangements prepared by the Administrative Staff and signed by Surgeon-General Birrell, D.M.S., M.E.F., was issued to "A" branch and the General Staff on board the Arcadian. No copies were sent to the A.D.'sM.S. Australian Division or New Zealand Division. Some interesting points are revealed in this document. The C.C.S. personnel was to be landed at 2 p.m. with as much surgical and medical equipment as could be man-handled; the remainder of the equipment of the C.C.S. was to follow later. Two hospital ships were available: one for Helles, the Sicilia. 400 cot cases, and the Gascon for the A.N.Z.A. Corps, accommodation, 500 cot cases. Two more hospital ships were to be available on the 27th. The Beach Master, a naval officer, would start at 2 p.m. to evacuate wounded from the shore by means of launches each capable of holding 12 cots—three were allotted to the corps—they were to be towed to the hospital ships. Four ambulance transports were provided: Lutzow, 200 serious, 1,000 slight cases; Ionian, 100 serious, 1,000 slight; Clan McGillivray, 100 serious, 600 slight; Seeang Chun, 100 serious, 600 slight. This list, if we include the hospital ship, made provision for transporting 500 cot eases and 1600 slight cases from each division, on an estimated basis of over 16 per cent. casualties for the operation. The Lutzow and the Ionian were to be supplied later with personnel and stores by the 2nd Australian Stationary Hospital. No. 1 Australian Hospital at Mudros was to be used to receive sick only. It was proposed to evacuate wounded to Alexandria and Malta direct.
No. 2 Australian Stationary Hospital, cabled for on the 19th, arrived this day in the Hindu, but was unable to report to the D.M.S. who remained in ignorance of the disposition of this unit. Three R.A.M.C officers and 20 O.K. R.A.M.C., from the 16th Stationary Hospital boarded the Seeang Chun on which they found three N.Z.M.C officers; 20 O.R. N.Z.M.C; and extra medical stores. On the arrival of this party Captain Abbott, N.Z.M.C withdrew with his men as he had been previously instructed that he would be relieved by stationary hospital personnel; but two N.Z.M.C. officers were obliged to remain on the transport on account of lack of boats and rough weather. All sick were put ashore; the transports moved off just after midnight.
On the 25th the O.C 2nd Australian Stationary Hospital received his orders that he was to provide stores and men for the ambulance carriers. He was unable to comply as the transports had sailed; he was instructed to stand fast; but the naval authorities ordered the Hindu to sail at 7 p.m. for Helles. He should have supplied three officers, 20 O.R. to the Lutzow and the same to the Ionian; one officer and 16 O.R. to the Clan McGillivray; and 15 O.R. to the Seeang Chun—the latter the only part of the order he was able to comply with as this transport had not yet left Lemnos.