Transport of Sick and Wounded by Sea
As soon as it was decided to return patients to Australia in addition to those sent to England, Cyprus, or convalescent hospitals in Egypt, a system was developed in order to provide the necessary staffs and equipment on ships. Surgeon-General Williams had exerted himself to get hospital ships provided, but in the early stages they had not even been promised, and a service was perforce created by utilising empty transports and collecting the staff in Egypt. The first efforts may be described as almost maddening. It was impossible to get adequate notice when a ship was likely to leave for Australia. It had probably been to the Dardanelles and unloaded soldiers and munitions of war. It had returned to Alexandria packed with wounded. It might then be drafted to Australia, at a few days' notice. It was necessary to clean and refit it, to place hammocks, blankets, beds on board, to provide drugs and surgical appliances and Red Cross stores, and to provide a staff in Egypt.
In looking back on the efforts made, the wonder is not that minor defects occurred in the early stages, but that the work was done anything like as well as it was. The difficulties were almost insuperable, and nothing but the devotion of a number of medical officers to the service rendered any decent result possible.
The first ship to leave with wounded on board was the Kyarra on June 7, but previously a number of ships had left containing invalids, venereal cases, undesirables, and oddments. In every case there was a scramble at the last moment to get things ready. The staff for the ships was provided by detailing officers, nurses, and orderlies from the scanty staffs of Nos. 1 and 2 General Hospitals. The Australian Government, under request, then began to provide transport staffs who came with the troopships and returned at later intervals when the troopships went back again as "hospital carriers." Of hospital ships proper there were none. Each ship was inspected in order to ascertain the number of patients she could carry, and to determine the staff requisite—consequently a routine procedure was adopted. Cot cases were seldom taken, as it was thought better where possible to keep cot cases in Egypt. A minimum of two medical officers was allowed for 300 patients, and an additional medical officer for every 150 patients. One trained nurse was allowed for every 50 patients, and one orderly for every 25 patients. These numbers were arbitrary and approximate, but served as a working basis. The supply was probably in excess of real requirements, but it was necessary to contemplate the possibility of an epidemic outbreak in the tropics and the grave results which might ensue. The equipment of drugs and instruments was liberal, and was arranged on a fixed plan worked out by the officer in charge of the base medical store at Heliopolis. The Red Cross stores were supplied in the same way, and the commanding officer was given a sum of money, sometimes as much as £150 to £200, to spend on comforts for the men. A canteen was placed on board in addition. The ship was not allowed to leave the wharf until the commander had given a certificate that he had on board all the medical comforts required by the Admiralty regulations, and until the principal medical officer had given a certificate that he had all that he required in the way of staff, drugs, surgical and medical equipment, and Red Cross stores.
There is no more dangerous branch of medical service than the transport of sick and wounded over the ocean, since there are so many possibilities of disaster.