Venereal Diseases Conference
The following are brief notes of a Conference of senior medical officers convened by Surgeon-General Williams.
Reference was made to the gravity of the problem with which the force was faced. It was estimated that about 1,000 men of the First and Second Australian Divisions are suffering from venereal disease on any one day, and of these a large number are incapacitated from work. The proportions seemed to be much greater than those of other forces, such as the Territorials, in Egypt. The displacement of so large a proportion of men and the ultimate consequence of numerous infections, rendered it necessary to take a comprehensive view of the position, and to endeavour to take some action to minimise the damage done. It was proposed to ask each officer present to furnish the secretary with a general statement of the number of cases treated under their command, specifying them under three headings—syphilis, soft chancre, and gonorrhœa. The information so obtained would form the basis of a report to headquarters. The problem was considered under five headings:
1. Military assistance.
2. Use of prophylaxis.
3. Treatment—general and special.
4. Establishment of convalescent depots—accommodation and position.
5. Ultimate destination of affected men.
1. In what way can the military authorities give assistance?—There are three ways in which they can approach the problem:
(a) They may decide that all areas known to contain brothels are out of bounds.
(b) They can provide adequate military control by military police organised under a competent officer, with one or more junior medical officers to assist him.
(c) That punishment can be inflicted on those men who break bounds and expose themselves to the risk of venereal infection. It might be desirable to reduce the pay of men found in those areas whether suffering from venereal disease or not.
2. Prophylaxis.—Officers were invited to discuss the question whether it would not be advisable to establish prophylactic depots in various parts of Cairo. Men to report immediately after exposing themselves to infection, and by cleanliness and the use of medicaments prevent infection. Circulars couched in plain and sensible language might be issued to the troops, conveying to them a knowledge of the risk they run, and the fact that if infected they will take back to Australia a disease which would reduce their value as citizens.
3. General and Special Treatment.—Suggestions from officers present were invited.
4. Convalescent Depots.—Was it right that the hospital should be crowded out with venereal cases, which demanded very much time and attention from the staffs? If the hospital was placed near the scene of military action the wounded might suffer from the amount of attention required for venereal cases. Most venereal cases required rest in the main, and this could be obtained in convalescent depots.
5. The ultimate destination of the affected men.—Two courses are open: The men may be treated in Egypt, or sent back to Australia.
(a) If they are kept in Egypt and the Australian Expeditionary Force is moved to the front its medical services would be depleted, and medical men of great ability and experience would be left behind to take charge of venereal cases when their services were required at the front.
(b) If on the other hand the Australian and Imperial Government could utilise some ships for the accommodation of these men, those who were cured could be sent to the front, and those who could not be cured could be sent back to Australia at once. But such ships would require special staffing so that the existing units should not be depleted in order to provide staffs.
In the discussion which ensued it was represented that there was a difficulty in placing areas out of bounds, as the brothels would be moved to other areas. Prophylaxis was regarded as most important. Isolation tents could be set apart in the regimental lines where men could be treated on return from leave. Cases of syphilis should be sent to Australia.
The reduction of pay is forbidden by King's Regulations, and although the Minister for Defence in the Commonwealth of Australia authorised such reduction, it is only for such period as the troops are in Egypt.
It was agreed that cases of syphilis should be returned to Australia, as there is no chance in Egypt of treating them efficiently, and even if such treatment were available the men would not be fit for duty for from four to six months.
It was pointed out that at least 100 men left Australia with the First Division suffering from venereal disease.
The chief difficulty seemed to be what venereal cases would ultimately be of service to a fighting line, and to properly arrange for them during convalescence; in other words, when and how men considered unfit for further service should be returned to Australia. Officers were asked to recollect that the future of these soldiers was to be considered and the part they would play in civil life. In the American Navy unbounded shore leave had been given, and had some effect in checking the disease. In the British Navy it was an offence not to report "exposure."
The Soldiers' Clubs are fully described in the chapter on the Red Cross. They were rendered possible by an alliance between the Y.M.C.A. and the Australian Branch British Red Cross. To the Y.M.C.A., who managed them, the best thanks of Australia should be given, for Australians will never fully know what they owe to Mr. Jessop and his assistants. Unfortunately, the Australian Branch British Red Cross subsequently decided that help should be given only to sick and wounded. Although convalescents frequent these clubs, the view was taken—we think wrongly—that Red Cross funds could not be used for their support. We feel sure that when Australians fully understand the matter the decision will be reversed.