Dysentry in Mesopotamia

[ddycher]

Whilst researching on officer who served on the staff on the 6th Division (see seperate thread) who was evacuated from the front prior to Kut with dysentry I have been staggered by the number of similar cases that I have come across. This got me wondering how big a killer disease (and in particular dysentry) was in this theatre where the war diaries show simply masses of troops out sick or being invalided.

Trying to patch together this particular officers experience I have come across some truly horrific references for the inadequacy of the medical services supporting the troops particularly following the retreat from Ctesiphon and it would seem that the medical services were simply overwhelmed particularly through 1915/16. In general terms I am trying to undertstand how was this treated and what were the survival rates. Given that it was such a problem what did the british forces do to try to curb or contain this ?

If as in this case the suffer actually survived does anybody know what was the typical period of convalescence for troops recovering from dysentry was in Mesopotamia. I am assuming that those suffering would have been invalided to India typically but does anybody have any points of reference for time to recover and coming back on active service?

Hospital ships running between Basra and India would appear to have headed predominantly for Bombay - would this have been the typical route to hospital in India ? Has anybody got any recommended references for the Hospital infrastructure in India during this time ?

Lots of questions and very little real points of reference. Can anybody give further insight ?

Regards

Dave

[ph1418]

Although I do not have the figures specifically for dysentry - I can provide the causalty stats :

•By 1918 – 411,000 serving in the campaign – although the effective fighting strength was 112,000 •There were 905,000 casualties during the campaign –11,000 killed in action –7,500 Died of wounds or were missing –16,700 Died of disease –66,000 Wounded in action –803,000 sick –1 battlefield casualty to every 9.6 non battlefield

There was a public outcry in Britain which lead to the Mesopotamia Commission which found widespread poor provision for the causalties

• The Failures were : –Command Structure To the point of Obstruction – Criticism of CinC india & Viceroy –Infrastructure – Shortage of river transport –Medical 1.Lack of Hospital Steamers 2.Lack of Medical Personnel 3.Lack of River Transport 4.Lack of Land Transport

Lack of Medical supplies

The Commissions outcome was :

•[/size]“An Offensive movement based on political and military miscalculation and attempted with tired Forces and inadequate preparation”

Paul

ps The Campaign Commission report & the Official Histories are available - Depending on where you are in the country the Army Medcial Museum in Surrey has reference copies

[ddycher]

Thanks Paul.

The sick numbers are staggering - I'm surprised there is not more avilable detail on this. Maybe just looking in the wrong place.

Regars

Dave

[PhilB]

One of the biggest fears of soldiers out there sems to have been that of being left behind. I spoke to L/Cpl J Snaylham, ex-11th East Lancs. On recovering from 1/7/16 wounds, he`d been sent to the 6th Bn and got evacuated to India with dysentry. He said that, when a unit was moving up, any man who couldn`t keep up because of dysentry was left behind with a rifle and ammo in the hope that some following unit could provide transport if his own unit couldn`t. The fear was that a lone soldier would be murdered by the local tribesmen.

[swatt9r]

Dave

Here is an excerpt from 'Surgeons in the Field' by John Laffin (Chapter 20, 1970, J M Dent & Sons)....'The scourges of earlier campaigns - enteric, plague, smallpox, cholera, typhus - were no great problem during WW 1, except in a few isolated areas. But dysentry and diarrhoea caused a lot of trouble, notably in the Near East. On Gallipoli,1915, almost every soldier was attacked, so that the RAMC dealt with over 85,000 cases of disease in addition to the 115,000 battle casualties. In Lower Mesopotamia heat and insanitary camps led to much dysentry, malaria and heat stroke. During the siege of Kut, 1915-16, the average daily number of men under treatment - in a force of only 14,500 - was 1,351. The Turkish enemy suffered as much. In Macedonia, British, French, Serbian and Greek troops suffered from malaria. The British had 6,000,000 cases of sickness, the French 5,000,000, the Germand 7,000,000 and the Russians a roughly estimated 11,000,000. The great difference from earlier wars was that, comparativley, so few men died of illness.'

Stewart

[ddycher]

Silly question then gents but why were troops evacuated to India ? Weren't the same problems there ? Was this just a case of inadequate hospital space ? Whilst researching the same Bn I have number of cases where members of the Bn died whilst on garrison duty in India before the Bn moved to the Near East.

Regards

Dave

[centurion]

1] 'British' included Indian Army - they would be happier treated at home.

2] India was closer

3] Indian hospitals would have experience of treating the disease

4] Dysentery was usually caught through drinking water from a contaminated source or eating fruit that had been irrigated with contaminated water. Military hospitals and barracks in India at that time would have secure uncontaminated water supplies.

Incidentally the proportions catching the disease in Mespot seem to have been much the same as in the South African war (where one of my Grt Uncles had to be evacuated home as a result). This was often because troops were careful about sourcing their water but much less scrupulous about eating fruit, mistakingly believing that if it were fresh picked and washed it was safe whereas the fruit itself was often contaminated from the water taken up by the plant.

[ph1418]

The Internet archive has the following link http://www.archive.org/details/ABriefOutli...potamia19141918

Book printed in 1930 to provide details of the capaign

Paul

[ddycher]

Paul

Thanks for this - had not seen this one before.

Regards

Dave

[mikemeso]

Dave,

Managed to track down some stuff about Dysentery recovery rates from the Medical Service Official Histories:

Incidences of Acute Dysentery 1916 1839 cases = 50.94 per 1000 personnel

1917 4960 cases = 60.34 per 1000 personnel

1918 5445 cases = 51.12 per 1000 personnel

The admission rate at one time in 1916 ran at 7900 per 100000.

Mortality in Mes rarely exceeded 2.7 %. The OH to paraphrase states 'True importance is not death rate but amount on invalidism it causes; individuals recovering from a severe attack may be so damaged as to render them unfit for further service.'

In France figures showed that patients oftern required 30 days in hospital prior to being suitable (fit enough) for convalescence. Figures from France, Egypt and Salonika showed that average days away from the front including convalescence was some 141.

Water supplies have been mentioned in this thread however the rate at the front for Amoebic Dysentery only ran to 20% of cases, the vast quantity of cases being Bacillary Dysentery caught from flies ingesting human faeces. Strangly there was higher incidence of Amoebic in the base areas.

It wasn't just down to how clean your own camp was. Research in the war in Egypt showed that flies capable of passing on Dysentery were found up to 17 miles from the nearest camp!

Mike

[ddycher]

Mike

This helps alot - first indication I have had as to when this particular officer may have been back fit for service.

Thanks again.

Regards

Dave

[ddycher]

Mike

Dont know if you have this or not but came a cross a copy of "In Mesopotamia" by Martin Swayne. It tells of his service with a TBD hospital there and gives a good overview of the conditions and problems the medical services had. Am working my way through it now. It can be downloaded from :

www.archive.org

Regards

Dave

[mikemeso]

Dave,

Thanks, I have Swayne. You may be interested in a book called 'Surgery on Trestles' by R Campbell Begg. He was an Australian surgeon with the 7th Division and the book recounts his experiences in Mes. some of action is worthy of a MASH episode.

There are usually quite a few copies available at ABEBOOKS for very reasonable prices.

Mike

[per ardua per mare per terram]

1] 'British' included Indian Army - they would be happier treated at home.

2] India was closer

3] Indian hospitals would have experience of treating the disease

4] Dysentery was usually caught through drinking water from a contaminated source or eating fruit that had been irrigated with contaminated water. Military hospitals and barracks in India at that time would have secure uncontaminated water supplies.

1) This was a campaign largely fought by the Indian Army. The concept that men would go to somewhere convenient for the families was a novel one. Why not India in comparison with say Malta?

2) The route was also safer, less of a threat from enemy attack especially Uboats. The supply lines and logistics were based in India.

3) Also the Indian hospitals were not inundated with war casualties.

[per ardua per mare per terram]

It is often forgotten that WWI was the first major war where more died from enemy action than died from disease.

[ddycher]

I'd never heard that before but thinking about it I guess it makes sense. still finding it difficult to trace the evacution route though - any ideas ?

Regards

Dave

[phil andrade]

It is often forgotten that WWI was the first major war where more died from enemy action than died from disease.

Yes...from a total of 709,000 British Empire deaths on the Western Front 1914-1918, only 32,000 were attributable to non battle causes, and many of these were from accident rather than from disease. In the French, British and German armies very close to 90% of all deaths were from enemy action, and that figure allows for deaths away from the front lines.

Phil.

[per ardua per mare per terram]

The more |I think about this the more impressive it is. So many men in close proximity in previous campaigns had previously resulted in typhoid, cholera etc. Another testimony to the engineers and the trench systems they dug, the medical services and the logistical support.

[phil andrade]

The more |I think about this the more impressive it is. So many men in close proximity in previous campaigns had previously resulted in typhoid, cholera etc. Another testimony to the engineers and the trench systems they dug, the medical services and the logistical support.

Yes, there was a vast diminution in fatal sickness, due mainly to control of water borne enteric diseases. In the Boer War, sixty per cent of all British military deaths were from disease. On the Western Front 1914-1918, the figure was well under five per cent.

A more cynical interpretation might be that this reflects the horrendous killing power of the weaponry and the determination to use it to full effect as much as it does the improvement of medical knowledge and practice. Also, it's apparent that the modern state has never been more solicitous of the physical health of its young men than when marshalling them for mass slaughter.

Phil.

[phil andrade]

Just taking a look through my Official History of the Medical Services, I find an elaborate tabular account of all the diseases that afflicted the troops in Mesopatamia, along with the number of admissions and the number of deaths, broken down into British and Indian columns to allow comparison. Dysentery was a huge scourge, and many died from it. What I notice is that cholera, while not causing nearly so many admissions into hospital, was especially lethal, and, in relation to numbers afflicted, was much more fatal than dysentery. I'll get my calculator and add up some figures, and post my findings.

back in a few minutes,

Phil.

[phil andrade]

Here we are:

Dysentery British 18050 admissions, 247 deaths (1.37%)

Dysentery Indian 24945 admissions 375 deaths (1.5%)

Cholera British 308 admissions 125 deaths (40.6%)

Cholera Indian 2269 admissions 485 deaths (21.38%)

Much more fatal was cerebro-spinal fever, which afflicted 46 British troops and killed 20 of them, compared with 760 and 438 respectively.

There are a myriad of other diseases tabulated here, from enteric fevers to VD. The problem is that, in total , they amount to a total that is nowhere near the officially recorded figure of 16,712 deaths from disease or injury. Deaths from enemy action were 18,631. In addition, 3,384 POWs died in Turkish hands. The total is over 38,000 - a costly campaign and an extremely unpleasant one.

Phil.

[Guest borneo78]

In order to shed a little light on the lack of medicare in mespot. my father who was with the 1/4th Dorsets, told me that there was about one doctor per thousand men, but this could aire on the negative side because of troop movements and illness amongst the medics.

[Michael Johnson]

I can't say for sure, but I would suspect that both Palestine and Mesopotamian casualties were evacuated to Egypt, and thence by the Suez Canal to India, probably to Bombay.