The British Interned in Switzerland

by Henry Philip Picot

It was a matter of interest to me to learn from Colonel Hauser that, as in the case of the French and Belgian Interned, his officers were already being criticized as a result of this cautious attitude, and that the criticism amounted to a suspicion of neglect. This suspicion may have been aggravated to some extent by a feeling amongst certain of the officers that reasonable facilities were not being granted them for treatment by private Specialists. The regulations affecting this question gave the officer the right of consultation with, and treatment by, a Specialist, but with the proviso that the charges incurred should be debited to the Sanitary Department only, when the necessity for calling in the Specialist had been allowed by the responsible camp doctor. In the case of his non-approval, the charge had to be met from the private purse of the officer. The D.M.Os. took the point of view that, in the majority of cases, treatment could be as well conducted in the camp by the regular Medical Staff as by the Specialist, and as trustees for the proper expenditure of the funds placed at their disposal by our Government, they did not feel themselves justified in employing the Specialist in other than exceptional cases. The charges involved by this latter procedure would, of course, have proved heavier than in the former, and though they did not attach undue importance to the financial side of the question, they did not feel inclined to ignore it altogether. On the one hand, the medical officers complained of the capricious nature of the demands made by our officers for specialized treatment, when the ordinary camp treatment would have amply sufficed, and held the opinion that the latter had no regard whatever for the financial interests of our Government. On the other hand, our officers cast doubts on the quality of the professional skill available in the camp, and criticized the cheese-paring policy of the medical officers.

The one view was directly opposed to the other, and it looked as though it would be difficult to arrive at an understanding on the question. The conclusion which, after conversations with both sides, I personally came to was, that the camp doctors (I am only speaking of Château d'Oex, for the same difficulty was not experienced elsewhere) were disposed to adhere too closely to the letter of their instructions, and were not sufficiently flexible in their dealings with either officers or men. They were too inclined to treat our soldiers as they would their own Swiss compatriots; a great mistake, as, in doing so, they made no allowance for the weaknesses and suspicions of men who had been subjected to hardships of a trying nature during a period of long confinement, and whose nerves were vibrating and sensitive to a degree. Moreover, the mentalities of the Swiss and British soldier were very different, and to judge of one soldier by the other could only lead to error and misunderstanding.

I discussed this question with Colonel Hauser, who spoke to me on the subject with the utmost frankness. It was apparently all the more easy for him to do so, as he had already been through the same phase of doubt and dissatisfaction with the Interned of our Allies, and had succeeded in proving to their satisfaction that all was well with their medical treatment. He pointed out that the conditions under which our men were being treated were, when compared with those of the Swiss soldier, exceptionally favourable, and this I believe to have been the case. It was true, he said, that in respect of food, nursing, etc., no comparison could be drawn, as either the circumstances differed, or the system adopted varied in our respective countries in a greater or less degree, but we could not expect the Swiss Government to adapt itself to the idiosyncracies of the soldiers of any one nationality; we must be prepared to judge by results. He could only deplore the lack of confidence displayed towards his Staff at Château d'Oex, and thought that our officers were over critical.

I, in reply, stated that I was at a disadvantage in having no qualified British doctor to assist me, and suggested that a visit of inspection by a distinguished British surgeon would, in all probability, serve to allay suspicion on the part of the Interned, and bring about a better feeling between his Staff and our men. He met the suggestion with enthusiasm, and said that both he and his Staff would welcome such a visit. Any officer nominated by the War Office for the purpose would be warmly received, and be given every facility to make himself acquainted with the conditions which determine the care and treatment of our Interned, and the attitude of the Swiss Sanitary Service towards them. He would be more especially pleased to see a medical expert of international reputation, as his doctors would have much to gain from an expert of wide experience.

Thereupon, I lost no time in making the situation clear to the Authorities at home, and asked that a surgeon of standing should be sent to inspect and report on the medical treatment, and to advise me as to the sufficiency or otherwise of the care bestowed upon our officers and men. Some delay took place before the right man could be found, but at last Lieut.-Colonel Robert Jones, R.A.M.C. (now Sir Robert Jones), the distinguished inspector of Military Orthopædics in Great Britain, was nominated for the purpose by Sir Alfred Keogh, K.C.B., Director-General A.M.S., and arrived in Berne on December 22, 1916.

He commenced his inspection at once, and in due course visited the camps at Mürren, Château d'Oex, Leysin, and the hospitals affiliated to these camps at Interlaken, Berne, and Lucerne. Shortly before his arrival, a contingent of Ps. of W. had reached Switzerland from Germany, and he therefore had an opportunity in each of the camps of comparing the conditions of these newly-arrived men with those who had been in residence in Switzerland for some time, a matter, to my mind, of great importance, as Colonel Hauser had contended that the true test of the efficiency of his Sanitary Service could best be demonstrated by results, the methods by which those results were achieved being of secondary importance. In principle, I agreed with this view, and looked upon it as a very happy circumstance that the arrival of this contingent had coincided with that of Colonel Jones, who would be able to apply this test when making his examinations.

As regards the medicine and surgery practised in the camps, Colonel Jones found the doctors to be well-informed young practitioners, who had undergone a sound modern training. Assisting at an emergency operation, conducted by Captain Dr. Brüstlein, at Château d'Oex, he writes:

The technique was good, and the theatre staff compared quite favourably with many more ambitious theatres at home. This experience gave me confidence with regard to the conduct of emergency operations in this camp. Neither at Mürren nor at Leysin is there an operating theatre in the camp. This is as it should be, as at neither place is there a surgeon qualified for serious surgical emergencies. Should such emergencies arise, an operating surgeon would be telephoned for from Interlaken or from Montreux. The character of the cases is very similar to those which we find in the ordinary British Military Hospital….

I was much pleased to find that the Swiss doctors were conservative, and did not show an undue haste to operate. They were beginning to learn of the dangers of recrudescent purulent outbreaks in those instances where operations were performed too early. This delay, in one of the camps, has given rise to suspicion of neglect, a suspicion which I took pains to dissipate….

The treatment of the Swiss doctors was quite equal to that which we find in a well-conducted auxiliary hospital at home, and the facilities offered the men to consult specialists were even greater than we often find to be the case at home.