There were some difficulties in transit. There was a most extensive outbreak of ptomaine poisoning on one ship, and measles, bronchitis, and pneumonia were much in evidence. The mortality was, however, small. The division on arrival settled down to hard training.
At once difficulties caused by the absence of Lines of Communication Medical Units became obvious. The amount of sickness surprised those who had not profited by previous experience. To meet the difficulty Mena House Hotel was improvised as a hospital and staffed by regimental and field ambulance officers.
At this stage, however, we can leave the division and return to the further development of medical necessities in Australia.
Steps were at once taken in Australia to raise a second division, and subsequently a third and other divisions in the same manner as the preceding. As time passed on, the unsuitability of some of the camps and the lack of medical military knowledge told their tale, and a number of serious outbreaks of disease took place. It is impossible to give accurate statistical evidence, but the Australian public seems to have been shocked that young, healthy, and well-fed men should in camp life have been so seriously damaged and destroyed. The causes as usual were measles, bronchitis, pneumonia, tonsillitis, and later on a serious outbreak of infective cerebro-spinal meningitis which was stamped out with difficulty and took toll (inter alia) in the shape of the lives of three medical men. The sanitation of the Broadmeadows Camp near Melbourne was not such as to provoke respect or admiration. The camp was ultimately regarded as unsuitable, and moved to Seymour, pending the necessary improvements.
It is instructive to note in passing that the Australian public received a shock when they were first informed of the amount of disease among the troops in Egypt. Yet it was apparently nothing like so great as that which existed in Australia, where the usual death-rate is so low. And yet, had the Service really profited by the lessons of the Russo-Japanese war, much of the trouble might have been avoided. The truth of course is that camp life, except under rigorous discipline as regards hygiene, and the loyal observance of that discipline by each soldier, is much more dangerous than the great majority of people seem to imagine. The benefit of the open-air life and of exercise is counteracted by the chances of infection due to crowding, defective tent ventilation, the absence of the toothbrush, and other causes.
In September, however, the Imperial Government notified the Australian Government that Lines of Communication Medical Units were required, and for the first time the majority of members of the Australian Army Medical Corps became aware of the nature of Lines of Communication Medical Units. The Government decided to equip and staff a Casualty Clearing Station, then called the Clearing Hospital, two Stationary Hospitals (200 beds each), and two Base Hospitals (each 520 beds). They were organised on the R.A.M.C. pattern, and the total staff required was approximately eighty medical officers. Even at this juncture the matter was not taken very seriously, and there was some doubt as to the nature of the response. The Director of Medical Services was anxious that the base hospitals should be commanded and staffed by men of weight and experience, and accordingly a number of the senior medical consultants in the Australian cities decided to volunteer. The example was infectious and there were over-applications for the positions.
The First Casualty Clearing Station was to a great extent raised and equipped in Tasmania. The First Stationary Hospital was raised and equipped in South Australia, the Second Stationary Hospital in Western Australia, and the Second General Hospital in New South Wales. An exception to this sound territorial arrangement was, however, made in the case of the First Australian General Hospital—an exception which proved unfortunate. The commanding officer, a senior lieutenant-colonel, was resident in South Australia. The hospital itself was recruited from Queensland, but as the Queensland medical profession was hardly strong enough to supply the whole of the medical personnel, most of the consultants, including all the lieutenant-colonels, were recruited in Victoria. Now Brisbane, the capital of Queensland, is some 1,200 miles by rail from Melbourne, and Melbourne about 400 miles by rail from Adelaide, the capital of South Australia. The result of these arrangements was that the captains and some of the majors were recruited in Queensland, together with the bulk of the rank and file and many of the nurses; whilst most of the senior medical officers, the matron, and a number of nurses were recruited in Melbourne, and the commanding officer (Lt.-Colonel Ramsay Smith) from South Australia. He brought with him some seven or eight clerks and orderlies. Furthermore a number of medical students and educated men joined in Melbourne. The bulk of the staff was, however, based in Queensland. This arrangement led to untold difficulties in the way of recruiting, and it is remarkable that the result should have been as satisfactory as it was. The equipment was provided partly from Melbourne, partly from Brisbane, and partly from South Australia. As the commanding officer was in South Australia, as the registrar and secretary was in Melbourne, and as the orderly officer was in Brisbane, some idea of the difficulties can well be imagined—particularly when it is remembered that with the exception of the commanding officer and a few officers, the members of the staff had no experience whatsoever of military matters. Nevertheless an earnest effort was made to secure the necessary equipment and personnel. In Melbourne great trouble was taken to secure as many medical students and educated men as could possibly be obtained.
On the whole the response to the call was more than satisfactory, and Australian people were of the opinion that a stronger staff could not have been secured.