The Australian Army Medical Corps in Egypt

At the end of the ten days referred to, the position was as follows:

Heliopolis Palace Hotel had expanded to 1,000 beds, Luna Park accommodated 1,650 patients, the Casino would accommodate 250, the Convalescent Hospital, Al Hayat, Helouan, was accommodating 700, and if need be could accommodate 1,500 patients, and the Venereal Diseases Hospital could receive 500 patients.

In the meantime No. 2 General Hospital had been transferred to Ghezira Palace Hotel, which was rapidly equipped, and at a later date became capable of receiving as many as 900 patients. Mena House remained an overflow hospital, bearing the same relation to No. 2 General Hospital as the Auxiliary Hospitals at Heliopolis bore to No. 1 General Hospital.

It was quite evident, however, that the accommodation was still insufficient, and a further search was made for other buildings. At this juncture a building opposite Luna Park known as the Atelier was offered by a Belgian firm for the use of the sick and wounded. It consisted of a very large brick building, with a stone floor and a lofty roof, which had been used as a joinery factory. At first the idea was entertained of creating a purely medical hospital, and of keeping the Heliopolis Palace for heavy surgery, with the auxiliaries for lighter cases. This policy was found to be impracticable, and the Atelier was converted into a 400-bed auxiliary hospital similar in character to Luna Park.

It was open for the reception of patients on June 10, and on the 11th was practically full of wounded.

As it was evident that the accommodation was still insufficient, a further search was made, and the Sporting Club pavilion, a building in the vicinity of the Heliopolis Palace, was taken over, and converted into a hospital of 250 beds. It was at first intended to use it as an infectious diseases hospital. As, however, it possessed great possibilities of expansion if suitable hutting could be erected, another infectious diseases hospital was sought elsewhere, and wooden shelters were erected. The accommodation of the Sporting Club was raised by this means to 1,250 beds.

The heat of summer was coming on, and the necessity for providing seaside accommodation for the convalescents from Cairo became obvious. Consequently the Ras el Tin school at Alexandria was taken by No. 1 General Hospital, and turned into an excellent convalescent hospital for 500 patients. It consisted of a very large courtyard, surrounded by (mostly) one-story buildings, and was about 400 yards from the sea. In the courtyard a Recreation Tent, provided by the British Red Cross Australian Branch, was erected by the Y.M.C.A. The whole formed an admirable seaside convalescent hospital.

But even now the accommodation was not sufficient, and by direction the Grand Hotel, Helouan, was acquired, and converted into an additional convalescent hospital for 500 patients. This institution, however, was shortly afterwards transferred to the Imperial authorities and used for British troops.

The structural defects in the Casino or Infectious Diseases Hospital, and the undesirability of using the Sporting Club for this purpose, necessitated the erection of an Infectious Diseases Hospital elsewhere. A beautifully constructed private hospital, the Austrian Hospital at Choubra, was commandeered and staffed by the First Australian General Hospital, and provided 250 beds. This hospital also was, however, soon transferred to the Imperial authorities, and administered as a British hospital.

As the demand for accommodation for infectious cases increased, the artillery barracks at Abbassia were taken over by the Australian authorities, and converted into an Infectious Diseases Hospital which ultimately accommodated 1,250 patients.

The needs continuing to press, the Montazah Palace at Alexandria was offered by His Highness the Sultan to Lady Graham as a convalescent hospital. The offer was gratefully accepted by the combined British and Australian Branches of the Red Cross Society. It is the only hospital in Egypt in the administration of which the Australian Red Cross takes part.

In addition to these major activities, there were many other minor changes. The introduction of cholera from Gallipoli was feared, and in the grounds of the Casino a cholera hospital was erected in anticipated need, under the direction of the Board of Public Health, Egypt. Fortunately it was never required, but it was ready for use, and would have been staffed by the First Australian General Hospital.

The final result, then, of all these expansions was as follows. The 520-bed hospital which landed in Egypt on January 25 had expanded into:

Almost the whole of this work was undertaken by the staff originally intended to manage a 520-bed hospital, at all events until the latest developments. Reinforcements did not arrive until June 15, and even then they were not long available.

To house the reinforcements of nurses two other buildings were taken at Heliopolis: Gordon House, opposite Luna Park, and the Palace of Prince Ibrahim Khalim, on the outskirts of Heliopolis.

It will be noted that the greater part of the expansion took place in the immediate vicinity of the Palace Hotel. This step was alike deliberate and necessary, for reasons that will be explained hereafter.

Methods Adopted in Organising Hospitals

The methods adopted in organising these hospitals varied. In the first instance Lieut. – Col. Barrett was deputed by the D.M.S. Egypt to seek for the necessary buildings, and when these were approved to negotiate with the owners respecting the rent. This proceeding proved very tedious and difficult, and in pursuance of a General Army Order another and simpler plan was adopted by the appointment of an arbitration commission under the chairmanship of Sir Alexander Baird. To this commission the determination of rent and compensation was referred when the acquisition of the buildings received the sanction of the Commander-in-Chief. It need hardly be said that a good deal of tact was necessary in these proceedings, and every attempt was made to meet the wishes of owners with regard to the buildings commandeered.

Up till June 15 the number of nurses available was small, and it became quite obvious that, owing to the rush of sick and wounded, and the hot weather, some of the nurses would experience a breakdown. Lieut. – Col. Barrett accordingly visited Alexandria, and arranged with the Australian and Egyptian branches of the British Red Cross Society to take over and equip two buildings as Rest Homes. These houses had been generously offered for this purpose to Her Excellency Lady MacMahon, wife of the High Commissioner for Egypt. One of these buildings was a large house belonging to a distinguished Egyptian and was situated in Ramleh, not very far from the beach, and the other was about eight miles from Alexandria at Aboukir Bay, the site of Nelson's victory. The latter consisted of a large seaside bungalow owned by Mr. Alderson, with an excellently fitted house-boat anchored some little distance from the shore.

The Australian Government undertook to pay for the maintenance of the nurses in these homes, which were placed under the management of a joint committee of the two branches of the Red Cross Society, under the presidency of Lady MacMahon. Nurses were then sent to these homes for a week at a time, and derived great benefit from the sea-bathing. These vacations formed a welcome and healthy break in work of excessive severity.

The following table indicates the dates of the principal changes which took place in the First Australian General Hospital.

Chronology of the First Australian General Hospital

January 14. – Arrived at Alexandria.

January 24. – Arrived at Heliopolis.

February 7. – Established Aerodrome Camp.

April 6. – Luna Park taken over.

April 19. – Established Venereal Hospital, Abbassia.

April 26. – The Casino taken over.

April 29. – Arrival of wounded.

May 1. – Prince Ibrahim Khalim's Palace taken over.

May 5. – Al Hayat Hotel taken over.

May 26. – The Atelier taken over.

May 27. – Gordon House taken over.

June 10. – Sporting Club taken over.

The Policy of Expansion

It has frequently been said in criticism of the Auxiliary Hospitals that it would have been better to have taken over Shepheard's Hotel, or the Savoy. Neither Shepheard's nor the Savoy (particularly the former) is very suitable for hospital purposes, since hotels containing a large number of small rooms involve much labour, and consequently a large staff, and the authorities were faced with the fact that there was no staff available. Surgeon-General Williams had cabled to Australia for reinforcements long before the crisis, but the reinforcements did not arrive until the middle of June. Clearly the sound policy was to obtain buildings as close to Heliopolis as possible, to administer them with a small staff, and to use them as overflow hospitals. Shepheard's or the Savoy would have required a very large staff, and it was not existent. Even at Helouan the employment of civilians as officers was necessary in order to carry on. Arab servants were extensively employed by reason of the shortage of staff. They acted as menservants, sweepers, and the like.

Motor Ambulances

When the Kyarra arrived in Egypt the British authorities did not possess any motor transport. There were some motor ambulances belonging to the New Zealand authorities and a few motor ambulances which accompanied the hospitals on the Kyarra, and which had been allotted to special units. It became obvious, however, that units might be placed in circumstances in which they did not require their ambulances, and others in circumstances in which they required more than their share; and accordingly Surgeon-General Williams decided to park the whole of these motor ambulances in two garages, a major one at Heliopolis and a smaller one at Ghezira, near No. 2 General Hospital. The garage at Heliopolis held at least thirty motor ambulances. It belonged to the Heliopolis Palace Hotel, and was equipped and furnished with a repairing plant at the expense of the Australian branch of the British Red Cross. The Ghezira garage was dealt with in like manner, and in addition the rent was paid in the first instance by the Australian branch of the British Red Cross. The organisation of these garages involved considerable difficulty. The drivers employed were not recruited by the Commonwealth Government as belonging to the motor transport, since there was not any motor ambulance establishment, and they consequently only received the ordinary private's pay. Furthermore promotions were very difficult to effect. Nevertheless they saved the position. For a long while Egypt was absolutely dependent on these motor fleets for the removal of the sick and wounded, British or Australian. The work was excessive but the drivers responded splendidly. Difficulties arose through different units endeavouring to commandeer motor ambulances for their own use. This was met by a decision of the D.M.S. Egypt that ambulances were to be kept in the garages, and telephoned for when necessary. From the outset, the lack of runabout motors was severely felt, and ambulances were frequently employed for purposes which would have been better effected by runabouts.

The Arrival of the Sick and Wounded from the Front

The end of April was reached. The bulk of the forces had disappeared from Egypt, and their position was only known by rumour; the hospital was gradually emptied of patients; Mena Camp had been abandoned, and Maadi Camp was reduced to small proportions. The weather was beautiful, and any one might have been easily lulled into a sense of false security. On April 28, however, a train-load of sick arrived. Its contents were not known until it arrived at the Heliopolis siding. The patients had come from Mudros, and numbered over 200 sick, including some 60 venereal cases, a matter of some interest in the light of subsequent events.

On the following day, however, without notice or warning of any description, wounded began to arrive in appalling numbers. On April 30 and May 1 and 2 no less than 1,352 cases were admitted at Heliopolis.

The expansion already indicated at Luna Park was at once effected, and some relief was obtained by transferring the lighter cases to Mena House – some seventeen miles distant. The last train-load of wounded arrived in the early morning of May 2, and deserves special notice, as many of the men were very seriously injured. There were about 100 cases; the train arrived at midnight, and was emptied by 4 o'clock in the morning. The bearing of the men badly injured was past praise. At 4 a.m. the main operating-room of the hospital bore eloquent testimony to the gravity of the work, which had been going on for many hours, and the exhausted condition of the staff further demonstrated what had occurred. The staff at the hospital was quite inadequate to cope with the rush, notwithstanding the willingness of every one concerned, and accordingly volunteers from some of the Field Ambulances, and from the Light Horse units which were still in Egypt, were called for and readily obtained. With the aid of the volunteers and by dint of universal devotion to duty the work was done, and on the whole done well.

The following table shows the staff available from April 2 to August 18, and the work required of it:

Staff, etc., of No. 1 General Hospital at Heliopolis, Including Auxiliary Hospitals

1 Including Luna Park.

2 20 Reinforcements.

3 38 Reinforcements.

4 195 Reinforcements.

5 Auxiliaries separated and made independent.

The proceeding adopted on arrival of the train was as follows: Two officers were on duty on the platform in control of guard and stretcher squad. The officer in charge of the train handed in a list of the number of wounded on the train, classified into lying-down and sitting-up cases, those of gravity being specially marked. The train was then emptied carriage by carriage of the sitting-up patients, who walked to the hospital or were driven by the motor ambulances as the case might be, tally being kept at the door of the carriage. As soon as the train had been emptied of the sitting-up cases, the cot patients were removed by the stretcher squad to the motor ambulances, each of which carried a load of two patients. In serious cases an officer was sent with the patient, and as the distance was less than a quarter of a mile, the transfer was fairly rapid.