Gallipoli - Casualties and Non-Battle Casualties

[Guest]

Hi - I am looking into the Battle Casualty* and in particular Non-Battle Casualty (NBC) figures at Gallipoli and trying to understand the proportion of men who were invalided due to sickness rather than military action. I am also trying to understand the types of sickness and how they impacted the effective strength of Battalions. If anyone has any pointers as to decent sources and reliable stats I would be grateful. All my sources are for the 'British'. I recently received a copy of The Medical War - British Military Medicine in the First World War by Mark Harrison (Prof of Medical History at Oxford University) which has an insightful chapter on Gallipoli. I understand the Australian Army Medical Services by A G Butler (on order) is very detailed and "unparalleled among official accounts for the clarity and consistency.." according to Harrison. Prof Harrison also quotes from the History of the Great War - Medical Services : Casualties and Medical Statistics of the War by Mitchell and Smith which I have ordered. Six sets of (British) stats which he highlights make an interesting starting point:

1. In the Dardanelles (1915) 6.45% of battle casualties died after being admitted to (British) medical units v. 7.61% in France and Flanders (1914-1918).

This stuck me as being remarkably low.

2. In the Dardanelles (1915) 2.84% of men admitted with disease died v 0.91% in France and Flanders.

Ditto.

3. In the Dardanelles (1915) Battle Casualties were 587.9 per 1,000 v. 492.9 per 1,000 in France & Flanders (1914-1918) **

4. In the Dardanelles (1915) Non-Battle Casualties were 1,239.9 per 1,000 v 646.5 per 1,000 in France & Flanders (1914-1918)**.

This is not a typo. It means that (on average) every man in the Dardanelles was sick, and many were sick more than once and (on average) twice as likely to be sick than in France & Flanders.

5. In the Dardanelles (1915) the 145,154 Non-Battle Casualties outweighed the 68,826 Battle Casualties.

The ratio is 2.1 times. Note: applying the admission ratios from point 1. (above),

this implies 9,362 British deaths from Non-Battle Casualties (NBC). When compared to the 27,729 KIA and DOW and the 7,402 MIA, (source: OH Medical Services Vol IV) it brings into stark relief the impact of sickness. Assuming all MIA were KIA, this implies of the 44, 493 British deaths (KIA+DOW+MIA+NBC deaths) in the Dardanelles, fully 21% or one man in five were due to Non-Battle Casualties

. Edit: Mistake. The numbers 'imply' 4,122 British deaths from NBCs, implying 10.5% of all deaths were NBCs. Note this calc is still incorrect as not all NBCs were due to disease. MG]

6. In France & Flanders (1914-1918) the 3,528,486 Non-Battle Casualties outweighed the 2,690,054 Battle Casualties.

The ratio is 1.3 times. The same calculations as point 4. (above) implies 268,518 men died as NBCs. I don't have the equivalent data for KIA and DOW for France and Flanders, but intuitively the NBC ratio will be significantly lower than that of the Dardanelles.

I am mindful of "Lies, damned lies and statistics" and that average numbers can sometimes have no meaning. I am mindful too that it can be dangerous to draw too many conclusions from statistics without digging deeper. These are however Official figures and it would be virtually impossible to rebuild the data. The size of the samples are large enough to be statistically relevant. It is well understood that Non-Battle Casualties were a problem in Gallipoli. These stats help us start to understand the extent of that problem in absolute and relative terms. Simplistically one can state that proportionally more men died of sickness, but I am interested in digging much deeper than this.....

* I assume Battle Casualties mean and KIA and WIA and (implicitly) DOW and MIAs who were later declared KIA.

** The figures for Mesopotamia (outside the core subject here) are alarming. Men were 13 times more likely to be evacuated sick than become a Battle Casualty.

Most of my answers might be in "Casualties and Medical Statistics" but I am sure that GWF pals will have Bn case studies to illustrate the impact at unit level. I am particularly interested in any personal diaries (particularly MOs and RAMC) that can expand on this. I have Oskar Teichman and john Hargraves accounts, neither of which really address the impact of sickness in sufficient detail. I have the following sources too:

History of the Great War - Medical Services Vol IV by Maj-Gen Sir W G Macpherson.

It does not really analyse the diseases in the Dardanelles or give any breakdown

ADMS War Diaries and Fd Ambulance War Diaries (where available) for 10th, 11th, 29th Divs

. Tend to be rigid diaries counting their own casualties and the numbers passed through without detailing the ailments/injuries.

Drilling deeper, my interest in the area Non-battle Casualties (NBC) is to understand primarily the nature and impact (in numbers) of two particular ailments - dysentery (and related gastric illnesses) which seem to be the single largest debilitating factor and extreme fatigue which is mentioned by many MOs but is not really analysed in any history I have read so far. My understanding is that working the men continuously for weeks with dangerously low levels of sleep and recovery time severely diminished their resistance to other ailments. There are quite a few MOs recording acute heart conditions among the men as a result of this. The Bn level sickness stats do not usually reveal the underlying causes of sickness, but do show an exponential explosion in the sick lists after just a few weeks. Doubtless this is due to a complex combination of factors. I am attempting to unravel these factors. I am interested in how quickly fatigue began to have an impact. Looking at modern military studies of extreme exhaustion and chronic fatigue, I suspect this factor was not well understood by GHQ at the time. If anyone can expand on this or point me to the definitive study in these areas I would be grateful. I am posting this in the 'Others' section too as a signpost to this thread

Any mistake are mine.

Regards MG

[centurion]

I have seen anecdotal evidence that almost everyone in Gallipoli suffered from stomach problems at some time or other. This was put down to the unsuitability of standard army rations to the climatic conditions. After better food (including replacing tinned meat with frozen or even fresh) was supplied this seems to have reduced (but it might have also been due to better organised sanitation, improved cooking methods or even men becoming accustomed to the local intestinal flora).

[Guest]

I have seen anecdotal evidence that almost everyone in Gallipoli suffered from stomach problems at some time or other. This was put down to the unsuitability of standard army rations to the climatic conditions. After better food (including replacing tinned meat with frozen or even fresh) was supplied this seems to have reduced (but it might have also been due to better organised sanitation, improved cooking methods or even men becoming accustomed to the local intestinal flora).

Thanks Centurion. Quick off the mark as ever.... I am attempting to unravel these factors and would really value your input on this as I have a limited understanding of France & Flanders and need to compare the Dardanelles data with F&F. I have seen various accounts of the impact of Maconochie Rations on the men - some hating it and other liking it -and the impact on health.

I have also seen references (in the books I mentioned too) that virtually everyone had gastric problems as you mention. In Gallipoli it is interesting to note that a few accounts suggest dysentery had already taken hold before the troops had landed, particularly those who had stopped off in Egypt. The Yeomanry in particular lamented their time in Egypt having spent nearly 4 months there prior to landing at Suvla. What interests me is how quickly it turned epidemic. The War diaries also strongly suggest that men were kept in the lines (and therefore not in the stats) for long periods of time before finally collapsing and MOs asking men to try and 'stick it out' when they should have been evacuated. I have also seen examples where large proportions (well over 75%) of men from evacuated units in Nov/Dec went straight into hospital - the point being that when on the peninsula they were 'effectives' and the day they were evacuated (as a unit) they became NBCs. Some of the data is quite shocking. Typhoid and cholera were large risks but thankfully did not occur....and we haven't even started talking about frostbite in Nov.....

One other area that piqued my interest is that anti-cholera injections seemed to be optional - i.e. the ORs could refuse them. This seemed more prevalent in the TF and New Armies. The whole of the (Regular) 29th Div was innoculated which seems to imply the Regulars had little or no choice but the TF and New Army men did,..... any thoughts on this anomaly? MG

[bob lembke]

Martin;

First of all, allow me to applaud your effort to come to grips with a thorny set of questions using quantitative means, which I feel is attempted far too infrequently in our field of study.

You saw my comments on the prevalence of disease in the German volunteer Pionier=Kompagnie at Gallipoli, the largest European contingent on the Central Powers side, on the prior thread. I wish I had more statistics for you, but of course the Prussian Archives were destroyed in 1945, and the German effort at Gallipoli was somewhat clandestine (My father's Militaer=Pass makes no mention of his service there; but I have other corroboration of his oral history about his service there.) so there probably were not that many records anyway. I can report that an authorative source (probably Liman von Sanders' memoirs; I could look it up.) stated that 80% of the men of the 200 man company were disabled almost immediately, almost entirely from disease, and only a few from wounds. Although I have the names of a few more enlisted men from the company, mostly from cable copies in the archives of the Foreign Office naming replacements being sent for the company. I only have information on two other company members, both officers, and one had to be sent back to Germany ill. (He later recovered; later, as a needed heavy artillery officer he was later in 1916 smuggled into German East Africa to serve with the forces there, again becoming seriously ill iunder the bad conditions.)

That is the only quantification I can provide from the Hunnish side of the picture of disease at the Dardanelles, aside from some information indicating that relatively few cases of malaria (which my father contracted there) occurred, dystenery being by far the most common ailment.

Bob Lembke

[centurion]

One other area that piqued my interest is that anti-cholera injections seemed to be optional - i.e. the ORs could refuse them. This seemed more prevalent in the TF and New Armies. The whole of the (Regular) 29th Div was innoculated which seems to imply the Regulars had little or no choice but the TF and New Army men did,..... any thoughts on this anomaly? MG

Before the war there was an anti vaccination movement for reasons that do not altogether appear rational (but we've had that in much more recent times too). Whilst some vaccinations were compulsory one could register a conscientious objection to them and this is sometimes noted on mens records (sometime causing confusion when some researcher finds a soldier with a conscientious objector tag). Possibly there were more COs amongst the New Army and TF men?

[Guest]

Before the war there was an anti vaccination movement for reasons that do not altogether appear rational (but we've had that in much more recent times too). Whilst some vaccinations were compulsory one could register a conscientious objection to them and this is sometimes noted on mens records (sometime causing confusion when some researcher finds a soldier with a conscientious objector tag). Possibly there were more COs amongst the New Army and TF men?

Very interesting indeed. I guess we saw the same with MMR in modern times. Statistically it seems odd that there was not a single objector in the 29th Div, unless the anecdotes of the 'entire' Div being vaccinated are just generalisations (quite possible)..... or maybe a case of moral suasion perhaps? Or "Answer 'D' - all of the above" ....The anecdotes strongly suggest that there was a big difference between the Regs and the TF/New Army and I wonder if the Regs effectively signed away their rights to refuse vaccination when signing on? MG

[Guest]

Martin;

First of all, allow me to applaud your effort to come to grips with a thorny set of questions using quantitative means, which I feel is attempted far too infrequently in our field of study.

You saw my comments on the prevalence of disease in the German volunteer Pionier=Kompagnie at Gallipoli, the largest European contingent on the Central Powers side, on the prior thread. I wish I had more statistics for you, but of course the Prussian Archives were destroyed in 1945, and the German effort at Gallipoli was somewhat clandestine (My father's Militaer=Pass makes no mention of his service there; but I have other corroboration of his oral history about his service there.) so there probably were not that many records anyway. I can report that an authorative source (probably Liman von Sanders' memoirs; I could look it up.) stated that 80% of the men of the 200 man company were disabled almost immediately, almost entirely from disease, and only a few from wounds. Although I have the names of a few more enlisted men from the company, mostly from cable copies in the archives of the Foreign Office naming replacements being sent for the company. I only have information on two other company members, both officers, and one had to be sent back to Germany ill. (He later recovered; later, as a needed heavy artillery officer he was later in 1916 smuggled into German East Africa to serve with the forces there, again becoming seriously ill iunder the bad conditions.)

That is the only quantification I can provide from the Hunnish side of the picture of disease at the Dardanelles, aside from some information indicating that relatively few cases of malaria (which my father contracted there) occurred, dystenery being by far the most common ailment.

Bob Lembke

Bob - Vielen dank. I really appreciate your post. I have done nothing on the German/Ottoman side (yet) as the language barrier seems to be a big hurdle. Ironically I was born in Germany (British Military Hospital Hannover) and lived there for 17 years (son of the Army) but my German is extremely rusty. Ich kann nur ein bischen Deutsch sprechen. ....I had to learn Gurkhali when I served and it became my best second language. Now when I try to speak German and forget a word, my brain automatically inserts the Gurkhali word. You can imagine the confusion. On that subject I read in Harrison's book accounts that the Gurkhas were amazed that the British did not kill their prisoners (sounds apocryphal to me), especially the wounded Germans and how they had to be separated from wounded Gurkhas at Gallipoli in case the Gurkhas had a go at them at night time. A British armed guard had to stand over them apparently.... Anyway, back to the thread.....

I assume because of the epidemic nature and proximity of troops, the diseases respected no borders and both sides felt the same. I have some Malaria stats from Salonika that will interest you, but I'll have to post them later as duty calls right now....

An aside - I read that at Suvla there was a (dismounted) Cavalry Regt in the vicinity of Hetman Chair. Ironic as they would have faced the British (dismounted) Yeomanry. It might explain the bid for a Cavalry Regt's scale of Medical supplies that you mentioned on the prev thread? MG

Bis spater.

MG

[bob lembke]

Bob - Vielen dank. I really appreciate your post. I have done nothing on the German/Ottoman side (yet) as the language barrier seems to be a big hurdle.

The Turks have rich archives (the German advisors at Gallipoli complained about the reporting burden on Ottoman officers; a Turkish source, an infantry captain at Gallipoli, reported that he had to fill out, on a regular basis, a set of 146 reports, and as the literacy rate was so low, a company commander would probably have no one to help him; in the German Army the Feldwebel would probably do 95% of the paperwork, only giving it to the OC for signature. But Ottoman Turkish is a nightmare. One of the only lasting accomplishments of the recent adventure in Iraq was burning a Turkish archive with 500 years of records of the occupation of Mesopotamia! Sigh!! And despite reports to the contrary, the serious researcher can access them; I was offered access (after formalities) by the commander of the Military Library attached to the wonderful Askeri Mueze (Military Museum) in Istanbul. But I have almost no Modern Turkish, let alone Ottoman Turkish. My wife and I both think that Modern Turkish may be, overall, the most difficult major language in the world. My wife looked at it for two days and moved on to Arabic.

Ironically I was born in Germany (British Military Hospital Hannover) and lived there for 17 years (son of the Army) but my German is extremely rusty. Ich kann nur ein bischen Deutsch sprechen. ....I had to learn Gurkhali when I served and it became my best second language. Now when I try to speak German and forget a word, my brain automatically inserts the Gurkhali word. You can imagine the confusion.

I immediately reported your German/Gurkhali "condition" to my wife, who was vastly amused, and sympathetic. (She works in about 80 languages {Let me state clearly, she does not speak 80 languages}, now walks about the house muttering the Basque she is teaching herself, but I do not know if she suffers such a cross-circuit. My mother and I were almost jammed in a camp in the US in 1943, so she was scared to death lest I be identified as a German-American, made sure that I did not learn German as a child, although it was spoken at home, I learned to speak it in Slovenija when 27, and taught myself to read it and the scripts after I found my father's and grand-father's letters from the front in 2000. Language follows life.

An aside - I read that at Suvla there was a (dismounted) Cavalry Regt in the vicinity of Hetman Chair. Ironic as they would have faced the British (dismounted) Yeomanry. It might explain the bid for a Cavalry Regt's scale of Medical supplies that you mentioned on the prev thread? MG

I don't know if you are implying that there was was a German dismounted cavalry regiment there. (I don't think that the Germans made much of an effort to supply mass medical care to the Turks at Gallipoli.) But the cable I received clearly states that the medical stores of a cavalry regiment were being requested for the needs of the Pionier=Kompagnie. I can dug it out and get it to you. Aside from advisors, the European forces at Gallipoli were the company of engineers; one or two volunteer Naval MG detachments of say 40 and 60 sailors formed at the beginning of the fighting from the crew of the Goeben and Brestlau, with MGs from the armories of the the ships, as the Turks had almost no MGs at first; I don't think they stayed long, but had heavy losses from fighting and being over-run; and very late two Austrian artillery batteries, one battery of the 24 cm Motor=Moerser (the little brother of the famous 30.5 cm Motor=Moerser), sent to ANZAC; and a battery of 15 cm howitzers sent to Helles. They got there in November or later. With the rail line through Serbija opening, the Germans were planning to send 20 heavy batteries, and train six of the better Turkish divisions as assault units, and finish the Gallipoli thing conclusively. So it just as well that the Allies pulled out.

Bis spater.

MG

Gruss aus Philadelphia

Bob

[Guest]

The Destruction of a Regiment. Here is a rather unique case study of the destruction of a Regiment. Total days on the peninsula: 75. Total Casualties: 88%

The original Yeomanry regiments in the 2nd Mtd Div did not receive reinforcements from landing until evacuation. One Yeomanry regiment kept meticulous medical records of each man who landed. Consequently it is possible to see the rapid destruction of a Regiment without the 'arithmetic of the frontier' it being masked by the reinforcements. The effects of a full frontal assault uphill against entrenched machine guns, followed by 2 months of trench warfare at the height of the Gallipolian summer when disease and fever took its toll is laid bare. I believe there is a strong case to argue that the Non-Battle Casualties part of this study could be scaled up to Bde and Div level due to the proximity of troops, the ubiquitous and epidemic nature of the diseases.

General. The regiment landed at Suvla with 359 All Ranks on 18th August 1915 and departed at the end of October. The stats below show that 18.7% were killed due to enemy action, with a further 30.4% wounded. Total Battle casualties 167, equating to 49% (not including POWs)of all those who landed.. Non-Battle Casualties represented 37.6% of the original numbers who landed, and accounted for 75.7% of all casualties (ex POWs). 40 walked out. This regiment did not record what happened on the day of evacuation, however if the experience of other regiments is a guide, most of the survivors (over 75%) would probably have gone straight into hospital. The other remarkable feature is that recovery from most of the NBC ailments was quite likely.

KIA: 58 (mostly in the attack on Scimitar Hill 21st August 1915)

MIA: 2 (presumed KIA)

DOW: 7

POW: 5 of which one died in captivity.

Died: 1 of pneumonia

WIA: 109 (mostly in the attack on Scimitar Hill 21st August 1915)

Invalided: 134 - see below for analysis

Survived: 40

Leave: 1 (!)

Detached: 3

Total:359

Non-Battle Casualties (NBCs) Invalided Troop: 134 - Causes and Stats. Note all were evacuated unless stated otherwise. Also some men had more than one ailment which will explain why the numbers to not exactly tally. Dysentery accounted for nearly a quarter of all NBCs. This and related gastric ailments accounted for 43% of NBCs which is a surprisingly low figure given the anecdotal evidence of nearly everyone suffering. It is probably worth noting that these are only the cases that got as far as the Field Ambulance and were (mostly) evacuated. It will not include men who had ailments but were dealt with in the lines.

Dysentery: 32 (23.9% of NBC) of which only one returned to the regiment.

Diarrhoea: 16 (11.9%) of which 3 returned to the regiment.

Gastritis: 3

Gastro Enteritis 1

Enteritis:3

Enteric: 3

Total Dysentery/Gastric related: 58 (43% of NBC). It is small possibility that all of the above were in fact the same ailment and mis-diagnosed.

Unstated Causes: 15

Pyrexia (fever): 10

Fever NYD (Not Yet Diagnosed?): 3

Septic: 10 of which 6 returned to the regiment. Mostly septic hands

Debility (loss of strength): 7

Jaundice: 4 of which one returned to regiment

Other - (total 22)

Dyspepsia, Rheumatism, Dental Caries, Myalgia, Abcess - 2 cases of each.

Sunstroke, Synovitis, Impetigo, Nerves, Hernia, Blood Poisoning, Pleurisy, Colic, Phlebitis, Tonsilitis, Sprained ankle and my favourite - Flat Feet (Invalided) - one case each.,

This is the nearest that I can find to a 'clean' set of casualty data. Before I started this study I would have guessed a much higher proportion of NBCs from dysentery. I was surprised by the number of different ailments (29) and the lack of 'nerves', although some might be buried in the Unstated Causes. The main unquantified factor is the extent to which critically debilitating fatigue, lack of rest, limited water supply (in the early days) and a limited variety of rations and key vitamins was a root cause of some of these ailments. Any thoughts on the above would be very welcome.

Any mistakes are mine.

MG

[grantmal]

Martin,

This may be of interest -- a report on the health of troops in the Anzac sector, September 1915 (apologies for any crazy phrasing; I use voice recognition software):

"Sir James Purves Stewart,

94 Harley St

W1

September 18, 1915

To General Sir Ian Hamilton GCB etc

GOC Mediterranean Expeditionary Force,

Mudros

Sir,

In accordance with your instructions, I have the honour to submit a short resume of observations made by me within the last few days upon the Australian troops at present in Anzac.

I would particularly draw attention to the fact that these are not sick men, but men on active duty at the present time, examined at their posts in the firing trenches.

The condition of those of them who have been in the trenches, under continuous shellfire, for an average period of 18 weeks, is such that they can no longer be regarded as first-class troops. The high percentage of heart weakness (evidenced by feebleness and rapidity of the heart, together with shortness of breath on water fatigues etc) not only renders them unfit for anything like a forced march but, in the event of an epidemic disease such as pneumonia breaking out during the approaching rainy season, the mortality from such disease is likely to be abnormally high. Emaciation and marked pallor are further indications of their unfitness. Nevertheless their spirit and morale are unshaken. Not one man hinted at any desire to be relieved from trench duty.

Notes on the Effect of 4 1/2 Months Continuous Service upon the Health of Australian Troops.

By Purves Stewart M. D. FRCP Consulting Physician to the Forces

With the approval of the Commander in Chief General Sir Ian Hamilton, I duly visited all three positions, at Helles, Anzac and Suvla, in order to gain first-hand information as to the physique and general health of the troops. And in view of the conditions above referred to, I directed special attention to the Anzac troops, amongst whom the sickness reached the highest proportions.

...During my stay at Anzac from September 11 to September 13, with the approval of Gen. Birdwood, I carefully examined a number of men at their posts in the firing trenches. Old troops, from seven different battalions, were first examined, all along the lines, not picking out those who appeared specially healthy or otherwise, but selecting the men who happened to have been the longest in the trenches. By the courtesy of Col M.Howse VC CB acting DADMS at Anzac, who detailed Capt Fry of the Australian Medical Service to assist me, I was able to make careful notes of 104 such soldiers.

.....As a control, in order to show the original quality of these troops, I subsequently examined 50 fresh Australian troops from two battalions, one of which had landed eight days and the other four days previously.

The contrast between the old and fresh troops was striking. The newly arrived men were of splendid physique, in the pink of condition, active and alert. The old troops were emaciated in 77% of cases and nearly all of them showed well marked pallor of the face. There was no sponginess of the guns or other signs suggestive of scurvy. 64% of these men were suffering from indolent ulcers of the skin, chiefly of the hands and shins. This condition, locally known as "Barcoo Rot" is very similar to the 'veldt sores' of the South African campaign. A large proportion, 78%, had occasional diarrhoeal attacks but not enough to put them on the sick list. The probable causes of this diarrhoea are, I understand, the subject of a special report by the Commission on the Prevention of Epidemic Diseases.

Most striking of all was the rapidity and feebleness of the hearts action, tachycardia being observed in 50% of the old troops. The regularity of the cardiac rhythm was not observed in any case. The rapidity of the hearts action in these men could not be ascribed to sudden exertion, for each man was examined at his post, laying aside his rifle for a few minutes for purposes of medical investigation. Nor was it due to the emotional disturbances, for notwithstanding the frequent impact of bullets and shells on the adjacent sandbags, the pulse rate did not, even momentarily, become accelerated.

74% of these troops suffered from shortness of breath, a condition which was conspicuously absent in the fresh troops.

The spirit and morale of all these soldiers, whether of the old or newly arrived troops, were excellent. Not one man hinted at the slightest inclination to be relieved from trench duty.

....It is evident that the condition of those troops that have been in the trenches at Anzac for a prolonged period (the average time in 104 men being 18 weeks, 50 of these 104 having been on trench duty since the original landing 20 weeks ago) is such that they can no longer be regarded as first-class troops.

The high percentage of cardiac weakness, evidenced by feebleness and rapidity of the hearts action together with a marked dyspnoea on slight exertion, not only renders them unfit for anything like a forced march or a long uphill charge, but in the event of an epidemic disease such as pneumonia breaking out during the approaching rainy season, the mortality from such disease is likely to be abnormally high. Emaciation and marked pallor are further evidence of their unfitness.

I would submit the following suggestions for your consideration: --

1. Troops which have been at Anzac continuously for four months or longer, should be withdrawn from the peninsular and sent elsewhere.

2. Physical and mental rest are essential, with abundant sleep and generous diet. The ordinary rest camp, with the usual games and other amusements, is unsuitable. Most of these men are too tired and feeble to play football, cricket, etc.

3. Life in a large city, like Alexandria or Cairo, is undesirable, not only from the unavoidable noise and restlessness, but from the liability of troops to become infected with venereal and other diseases.

4. A voyage to Australia and back, with a week or two on furlough in their own homes (as at present carried out in the French Army) with meet all medical requirements. Further, home furlough of this sort would probably produce a large influx of fresh recruits from Australia.

5. For those fresher troops who are at present physically fit, an important factor in maintaining their health would be the establishment of canteens, where the soldier might supplement his diet by minor luxuries of his own choosing. The present ration, however excellent in quality, tends to be monotonous and is only capable of variation, at present, by the substitution of one equivalent for another (eg. Jam instead of cheese, etc).

I have the honour to remain,

Sir,

Your obedient Servant,

Purves Stewart, Colonel AMS

September 20, 1915"

Grant

[Guest]

Grant - this is of great interest. Thank you for posting it and taking the time to go into so much detail. There are a few areas that are very consistent with the British experience at Suvla. The areas I thought that stood out were

1. The Medic took time to examine a control group of 50 'fresh troops' as a benchmark. Proper clinical trials in the field. Impressive. It reinforces his arguments and establishes a reference point.

2. Emaciation. Interesting he makes comments on their emaciation. He does not ascribe any particular cause - diet? dysentery? work load? I always assume that weight was a function of calories in v calories out. He seems to suggest that the diet was OK although monotonous, which implies they were either expending more calories than they took in, or the dysentery was purging them of more calories than they could ingest.

3. Heart weakness and tachycardia were also rife among the Suvla troops. He hints at rapid and fluctuation heart rates/pulses.

4. 18-20 weeks was longer than it took the British Yeomanry to be reduced by 80% and become ineffective. The ANZACs received reinforcements and therefore it is difficult to immediately see the impact on the original troops who landed, as their numbers are swelled and the visual impact is 'masked' by these reinforcements. It is interesting that the medics carefully selected men who had landed on day one for their study.

5. Rest . Interesting that they advocated the French system of rest and recuperation.

6. Canteens. The absence of cantees was a major issue for the British at Suvla too.

7. Sores. I can only image that the diet was insufficient in certain vitamins and trace elements.

Lots to ruminate over. Thank you for sharing this.

Regards MG

[michaeldr]

quote from Col Stewart (Grant's post 10 above) "The regularity of the cardiac rhythm was not observed in any case" This is quite remarkable

Generally speaking, there is some useful reading on food, sickness etc in 'Defeat at Gallipoli: The Dardanelles Commission Part II, 1915-16" [iSBN 0 11 702455 4]

Re Canteens see page 228; 'If canteens had been established at an earlier date, there would have been a reduction in sickness.'

The first request for canteens was made on 27 May, however Kitchener was 'disinclined' to send them to Gallipoli. After pressure from the Quartermaster-General Sir John Cowans, it was eventually agreed to spend ₤10,000 and this was later raised to ₤50,000. The final total seems to have been ₤90,000 with ten ships of canteen stores going out to Gallipoli between 16th July and 4th November 1915.

One point which is not clear is - How much of this actually reached the peninsula and how much stayed on the islands?

regards

Michael

[phil andrade]

Make no mistake....the British casualty figures for the Dardanelles, as compiled by Mitchell and Smith, indicate that for every man who died from disease, at least ten were killed in battle or died from wounds. In rough and ready terms, I think those tabulations give more than 38,000 killed, died from wounds and missing presumed dead, compared with fewer than 3,500 non battle dead, of whom some hundreds died not from disease but from "injuries".

I do possess the Medical History of the War, and will happily elaborate if required.

The astonishing thing is how few actually died from disease, considering the horrible conditions.

The mortality rate for the Turkish sick was vastly higher, both relatively and absolutely.

Phil (PJA)

[michaeldr]

These are the latest Turkish figures taken from 'Gallipoli The Ottoman Campaign' by Edward J Erickson, Pen & Sword Military, 2010, ISBN 978 1 84415 967 3 (See page 199)

and please note the dates

Is there a similar table available in respect of the Allies which we can share here?

edit to add: In the text Erickson quotes "28,009 men dies from disease in the Fifth Army hospitals in the calendar year 1915" Giving this figure he is quoting from Hikmet Özdemir, The Ottoman Army 1914-1918, Disease and Death on the Battlefield (Salt Lake City: University of Utah Press, 2008) p.127, Table 6.20

regards

Michael

Edited 15 May , 2011 by michaeldr

[phil andrade]

Thank you, Michael.

Those Turkish casualties are terrible, aren't they ?

Significantly heavier than those of the Allies, and the proportion of dead is markedly higher, too.

We hear so much about the advantage enjoyed by an entrenched defender, and yet here we behold a striking example which, in statistical terms, confounds the usual perception.

Counter attacks - prodigal and frenzied - were responsible to a degree; but it still comes as a surprise to see that, in terms of actual combat fatalities, the Turks suffered fifty per cent more than their adversaries.

This is especially so when we contemplate the skill dispalyed by the Turks who were able to inflict such slaughter with rifle fire alone on April 25, and also the desperate frontal assaults that were made by the Allied soldiers.

I'm tempted to suggest that these figures indicate a more "primitive" attitude to the lives of their soldiers in the command, and, I daresay, the culture of the Ottomans. Life was cheap. And the huge loss from disease stands as equal testimony to this, too.

I will attempt to compile a tabulation of Allied figures, using the Medical Statistics, and the Australian and NZ official sources. I fear that the French will prove the most elusive in this respect.

My hunch is that roughly 45,000 Allied soldiers were killed in battle, and five thousand died from disease and accident, compared with 66,000 Turkish combat deaths, and 21,000 or so from disease etc. The number of wounded ( non mortal) was about equal - one hundred thousand on each side, more or less.... it's quite clear, that, whether wounded or sick, Turkish soldiers who were admitted to hospital were far more likely to die than their enemies.

Phil (PJA)

[michaeldr]

and please note the dates

Is there a similar table available in respect of the Allies which we can share here?

Phil,

You mention having access to "the Medical History of the War, and will happily elaborate if required." I feel that it would be helpful to see that, if you can oblige

regards

Michael

[phil andrade]

Yes, of course I will, Michael.

Here I confess to profound IT ignorance, and lack the training to do tabs and scan tables, so I will have to make a painstaking effort .

The information is comprehensive, and I reckon it's worth airing, so I'm going to give it a go.

Taking grandchildren out this afternoon, but will engage with the stats on return.

Another comment : there is something analagous to the Crimean War in the Gallipoli epic....a huge fuss was made about the ordeal of the British soldiers in the ordeal of the 1854-55 affair, just as there was to be about their grandsons sixty years later in a theatre of war in much the same area of the world. But, in the Crimea, while French and British soldiers died in tens of thousands, the Russians perished in hundreds of thousands. It's the scale of Turkish mortality at Gallipoli that seems shocking. Again, life was cheap. whether you were a conscripted serf or a subject of the Ottoman.

Edit : How could I forget ? The Turks were fighting on "our" side in the Crimea !

Phil (PJA)

[michaeldr]

A further thought on the Turkish statistics from Erickson's book:

Note the high figure for 'Weather Related'

This tends to back-up Erickson's point that the incidence of sickness in the Turkish army at Gallipoli started low and climbed steeply when the bad weather arrived at the end of the campaign.

For the opening period "25 April through 1 July 1915 the ratio of wounded to sick men in the Ottoman hospital system was 24:1 (only 2,358 for the period April, May and June 1915). It is unclear why the ratio of wounded to sick was so lopsided, except to note that the Turks had abundant supplies of water, adequate food and rest camps well behind the lines out of enemy artillery firing range. However, over the course of the campaign as the peninsula became very crowded, sanitary conditions deteriorated and the Turks ran short of imported medicines. The cold and wet winter accelerated the rates of men going sick."

[b3rn]

Official History of the Australian Army Medical Services, 1914–1918 is available in digital form from the AWM - see Volume 3, Chapter XVII - Statistics of the War

http://www.awm.gov.au/histories/first_world_war/volume.asp?levelID=67900

Just in case you weren't aware it was there ...

and there are a couple of articles in the Aust. Medical Journal by doctors from the Lemnos hospitals relating to pathology; will dig them up ...

also see Chapter XXI – Some Special Diseases: Pathology: Surgery of Volume 1 of the Official Medical History ... http://www.awm.gov.au/histories/first_world_war/volume.asp?levelID=67898 ... maybe that is useful

[Guest]

Make no mistake....the British casualty figures for the Dardanelles, as compiled by Mitchell and Smith, indicate that for every man who died from disease, at least ten were killed in battle or died from wounds. In rough and ready terms, I think those tabulations give more than 38,000 killed, died from wounds and missing presumed dead, compared with fewer than 3,500 non battle dead, of whom some hundreds died not from disease but from "injuries". I do possess the Medical History of the War, and will happily elaborate if required. The astonishing thing is how few actually died from disease, considering the horrible conditions. The mortality rate for the Turkish sick was vastly higher, both relatively and absolutely. Phil (PJA)

Phil, thanks for sharing your thoughts...

1. Casualties v KIA. While you rightly point out that more men were KIA than died of disease, from a commander's point of view it does not make much difference. A casualty whether KIA, MIA, DOW, WIA or NBC still takes the man out of the front line. My particular interest as stated in the original pots is the Non-Battle Casualties. Despite the fact that so many NBCs actually survived, they still had an enormous impact on the tactical and strategic operations. Hamilton could not fight for long with chronically sick men - although he tried to. There is a strong case that better medical care might have made a significant difference.

2. Stats. Your comment that "the British casualty figures for the Dardanelles, as compiled by Mitchell and Smith, indicate that for every man who died from disease, at least ten were killed in battle or died from wounds .............fewer than 3,500 non battle dead" raises an interesting conflict with stats from the same publication - see my original post (point 5). In the Dardanells (British figures);

a. T

here were 145,154 Non-Battle Casualties (source: Mitchell and Smith)

b.

2.84% of men admitted with disease died

(source: Mitchell and Smith)

Taking a. and b. above this implies 9,362 British deaths from Non-Battle Casualties (NBC) [Calc 145,154 x 2.84% = 9,362] compared to the 27,729 KIA and DOW and the 7,402 MIA, [source: OH Medical Services Vol IV].

Assuming all MIA were KIA, this implies of the 44,493 British total deaths (KIA & DOW (27,729) +MIA (7,402) +NBC (9,362) = 44,493) in the Dardanelles, fully 21% or one man in five were due to Non-Battle Casualties [Calc: 9,362 / 44,493 x 100 = 21.04%]. This would imply that 3.75 men died in action or the causes of action (KIA, DOW and MIA) for every Non Battle Casualty [Calc (44,493 - 9,362) / 9,362 = 3.75] somewhat off the 10:1 ratio. [Edit - PJA rightly points out this calc is wrong. Calc 145,154 x 2.84% = 4,122, not 9,362 see subsequent posts]

From the War Diaries etc it seems clear that the vast majority (well over 95%) of Non-Battle Casualties had illnesses that would be classed as disease. The (admittedly small) example in Post No.9 would bear this out. The only way to resolve the 1:10 to 1:3.75 is that 'admitted with disease' much is a significantly smaller subset of Non-battle Casualties and there is nothing to support this in the Bn, Bde, Div, ADMS, RAMC Fd Amb War Diaries. For these figure to tally, there would have to be 4,045 Non-Battle Casualty deaths or 5,317 fewer than the calculation from a. and b. above implies. Put another way, it would imply that diseased men were only 43% of Non-Battle Casualties, for which there is no evidence.

The conflict might be due to different definitions. It would be useful to see the exact quote from Mitchell and Smith about the 1:10 ratio. My copy of Casualties and Medical Statistics arrives tomorrow (I hope).

Regards MG

[phil andrade]

As promised ....Gallipoli casualties :

UK : 20,108 killed in action; 5,946 died from wounds; 49,758 wounded; 306 prisoners. Total battle casualties, 76,118, of which fatalities = 26,054 (34.2%). Non battle casualties : 145,154 ( 128,708 sick; 16,446 injured), of whom 1,881 died from disease(1.46%) and 227 from injury (1.38%). These non battle casualties do not include those of the Royal Naval Division, which might be estimated at ten per cent of the above viz. c.15,000.

Australian : 5,833 killed in action; 1,985 died from wounds; 19,441 wounded; 70 prisoners. Total battle casualties, 27,239, of which fatalites = 7,818 (28.7%). Non battle deaths : disease, 569, accident etc. 31, a total of 600.

New Zealand : 1,909 killed in action; 606 died from wounds; 4,852 wounded; 18 prisoners. Total battle casualties,7,385, of which fatalities = 2,515 (34%). Non battle deaths : disease, 200, accident etc. 6, a total of 206.

Indian : 1,285 killed in action; 397 died from wounds; 3,761 wounded; 101 prisoners. Total battle casualties, 5,544, of which fatalities = 1,682 (30.3%). No figures for non battle deaths.

Newfoundland : 18 killed in action; 13 died from wounds; 93 wounded. total battle casualties, 124, of which fatalities= 31 (25%).

No figures for non battle deaths.

Total British Empire battle casualties :

Killed in action : 29,153

Died from wounds : 8,947

Wounded : 77,905

Prisoners : 495

Total : 116,500, of which fatalities = 38,100 (32.7%)

Non battle deaths : disease; 2,650. Other causes : 264. Plus unknown number from the RND, Indian and Newfoundland contingent, probably amounting to a few hundred. Suggest overall non battle deaths fewer than 3,500 ?

In addition, naval personel who were killed or died in the campaign need to be considered. I have no figures for them.

For the French, the only figure I have is 27,000 battle casualties and 20,000 evacuated sick. If we allow the same fatality rate among their casualties as we have for the British, then it's reasonable to assume about 7,000 killed in action and 2,000 died from wounds, and 18,000 wounded...but that's just supposition on my part.

The aggregate battle deaths for the Allies comes to about 47,000, then, with perhaps ten per cent of that number dying from disease.

It's apparent that at least ten per cent of the wounded who were admitted to hospital died, and fewer than two per cent of the sick.

Edit MG...I see that you've beaten me to it with your response. Thanks for your input. The Mitchell and Smith tabulation for sick is definitive for the UK contingent, excluding the RND, and there is no way that it implies nine thousand non battle deaths. Forgive me if I sound obdurate....the Kiwi and Aussie official histories bear me out here. Actual deaths from disease are astonishingly few in number, aren't they ? Especially in view of those horrific conditions. Take your point, of course...men evacuated with illness of that severity were as lost to the army as men struck down in combat.

Phil (PJA)

[phil andrade]

a. T

here were 145,154 Non-Battle Casualties (source: Mitchell and Smith)

b.

2.84% of men admitted with disease died

(source: Mitchell and Smith)

Taking a. and b. above this implies 9,362 British deaths from Non-Battle Casualties (NBC) [Calc 145,154 x 2.84% = 9,362]

Martin,

You appear to have made an arithmetical error.

145,154 x 2.84% = 4,122......not 9,362

Mitchell and Smith actually tabulate the deaths from disease as 1.30% ( page 201). On page 205, however, they cite a figure of 1.46%....a contradiction, but nothing to challenge the contention that the number was remarkably low. You will find all the figures you need regarding the various illnesses, and how they impinged on the strength of the MEF. Dysentery was the preponderant killer, accounting for 811 deaths from a total of 29,728 admitted ( British troops only, excluding RND). Enteric fever came next, with 330 dying from 9,423 admitted : a slighly higher death rate than that from dysentery. Under the "Injuries" section of the non battle casualties, 6,602 British soldiers were admitted with frost bite, of whom 68 died; trench foot afflicted 1,380, and killed 10. In all, they tabulate 2,108 non battle deaths from the 145,154 admissions : just under one and a half per cent. If you find any evidence of this being virtually doubled to 2.84%, please let me know.

Phil (PJA)

.

[bob lembke]

One factor to consider if you attempt to compare various types of casualties between the Allies and the Central Power forces was the state of the Turkish artillery ammunition. Although Romania actually entered the war as a combatant later in 1915, they to a large extent (only mitigated by their famous corruption) effectively blockaded Turkey from shipments from Germany and the A-H Empire of men, weapons, and ammunition. While men could be gotten through in civilian garb and with false papers, it was very difficult with Materiel, and there are accounts of MGs being cast into blocks of concrete marked for the Berlin-Bahgdad railroad, or artillery shells being concealed in barrels supposingly containing beer.

The critical factor was the provision of artillery ammunition. As large-scale shipments were impossible (a plan to send the later Admiral Horthy dashing thru the Allied blockade with a very fast light cruiser loaded with artillery shells was considered, as were schemes to send artillery shells to Turkey with Zeppelins)a large number of German military and civilian experts and craftmen, probably over 1500, were sent to reform the very limited domestic armaments industry. While they were able to produce plentiful amounts of satisfactory small-arms ammunition, the artillery ammunition was not satisfactory. Eventually it was possible to manufacture shells up to about 15 cm for the large variety of guns in the Turkish inventory (a lot of it bought about 1875), it was not possible to make shells for the larger coastal defense guns, whose supply was very limited even in the first days of the Allied attack.

Creitically, while the German-assisted industry were able to make shells that fired, seemingly they were not likely to explode at the other end, as they were not able to make satisfactory fuzes. General Liman von Sanders estimated a 95% dud rate. I have read probably 20 personal memoirs from Allied soldiers, with this in mind, and while the dud rate was generally not discussed, I noted many mentions of a shell near miss without injury, and of soldiers killed when actually physically hit by a shell. There were attempts to fly small quantities of German fuzes in by aircraft, although the Turks/Germans only had a few aircraft in theatre.

Finally, I understand that the Turks/Germans were only able to make shells with cast iron bodies, not steel. While the latter, when exploding, produced many "razor-sharp" steel splinters that caused wicked wounds, the cast iron shells, when they did explode, produced sand-like grains that either did not wound or produced minor wounds.

Central Power sources have stated that in some actions at Gallipoli the Turkish artillery fired barrages only for the morale effect, so that the Turkish infantry did not think that they had no fire support. I have not been able to quantify this problem, aside from Liman von Sanders' estimate, but rather collect a good number of anecdotes about this problem. So should this factor be included when comparing casualties?

As the Serbs retreated thru their country in mid-1915 they very thoroughly destroyed their railroads, and the first train that actually ran from Berlin to Istanbul ran in February or March 1916. But as the rails were restored in 1915 it became easier to ship weapons and good ammunition from Central Europe to Turkey, even if some sections of the transport still had to be by road or barge means; these supplies and weapons starting to appear at Gallipoli at about November 1915.

Again, hard to quantify this precisely, but this factor certainly affected the classes of casualty statistics from the front at Gallipoli.

Bob

[Guest]

Martin,

You appear to have made an arithmetical error.

145,154 x 2.84% = 4,122......not 9,362

Mitchell and Smith actually tabulate the deaths from disease as 1.30% ( page 201). On page 205, however, they cite a figure of 1.46%....a contradiction, but nothing to challenge the contention that the number was remarkably low. You will find all the figures you need regarding the various illnesses, and how they impinged on the strength of the MEF. Dysentery was the preponderant killer, accounting for 811 deaths from a total of 29,728 admitted ( British troops only, excluding RND). Enteric fever came next, with 330 dying from 9,423 admitted : a slighly higher death rate than that from dysentery. Under the "Injuries" section of the non battle casualties, 6,602 British soldiers were admitted with frost bite, of whom 68 died; trench foot afflicted 1,380, and killed 10. In all, they tabulate 2,108 non battle deaths from the 145,154 admissions : just under one and a half per cent. If you find any evidence of this being virtually doubled to 2.84%, please let me know.

Phil (PJA)

.

Phil... you are absolutely right. My mistake. Not sure how that happened ??....getting word blind! - Apologies for the confusion...I will go back and edit the original.... Also the 2.84% was quoting Harrison quoting Mitchell and Smith"percentage of deaths due to disease" - page 16 or table 16?. Thank you for posting the detailed stats. It also (I think) clarifies the differences between cases of illness (disease) and non-battle casualty injury. The stats suggest 88% of NBC cases were due to sickness. It is very useful. My copy should arrive today so I will be able to go through them with a fine-toothed comb. What I am hoping to do is to get a detailed split of the types of disease that impacted the MEF and it sounds as if Mitchell and Smith have this...

Quoting the same source, Non-Battle Casualties were (allegedly) 1,239.9 per 1,000, indicating many men were NBCs more than once, which again might distort the numbers slightly. What interests me mostly is the number of individuals who were sick, not necessarily the number of cases of sickness. The former will measure the impact on effective strength and the latter will measure the impact on the medical system. I believe the aggregate number 145,154 NBCs measures the numbers of cases rather the number of individuals (i.e. includes men counted for each time he was sick). If this is the case then the theoretical aggregate number of individual NBCs (i.e people not cases) would be 145, 154 / 1.2399 = 117, 069 which would give a death rate of 1.6% using your 1,881 figure. Either way one slices and dices the stats, I absolutely agree that the death rates from sickness are remarkably low - a point made on bullet No.1 on the original post.

I wonder how much of the illness could have been prevented. The conditions sounded horrendous and I wonder if any of it could have been prevented. The sanitary conditions seemed way beyond the control of the medics - bodies in no-man's land and the millions of flies. The low number of armistices for burials will be a factor but also the inability to dispose of animal carcasses effectively will be another factor. There seemed to be optimal conditions for plagues of flies to breed. I also understand that some troops (especially those who had stopped in Egypt) had dysentery before the landed. At Suvla, Battalions typically left behind 12% - 21% of men as a reserve when they deployed. One would assume any mild sick cases would have been left with the reserve. This might also have implications for the state of effectiveness of the reserve troops when they were eventually deployed.

Thanks again for the stats. I usually sign off "any mistakes are mine", QED.

Regards MG

[phil andrade]

Martin,

It's a pleasure to help you. With all these figures whizzing around, it's all too easy to get fatigued and take your eye off the ball.

I hope that you find your Medical Statistics answers the questions.

One feature I found singularly noteworthy in their tabulation for Gallipoli : on page 201 there is an analysis of British casualties ( again, it must be emphasised that these are for UK troops only, and do not include the 7,292 RND casualties) which breaks down the battle casualties into the usual categories, but with one significant addition..... Died of wounds, injury or exposure before admission to hospital . This is the only compilation I have seen which differentiates between died of wounds before evacuation and died of wounds in hospital....all the other tabulations that I have seen have lumped them together as "died of wounds". In this case, the died of wounds before admission amount to 2,264, and the died of wounds in hospital number 3,082. I suspect that the lower died of wounds figure for Gallipoli that you cited in your first post might be attributable to this. If the two categories are added together, then the mortality rate among the wounded aggregates nearly 10.7%; if only those who died in hospital are counted, the ratio drops to approx 6.5%.

I find the dual categorising system for the mortally wounded at Gallipoli is significant testimony to zealous and effective casualty evacuation : it suggests an immediacy of care, and a speed of counting and assessment....a consolation, I suppose, for the narrowness of the battlefield, and the proximity of the front line to the hospital. A nightmare on the one hand, and an assistance on the other. The aggregate per centage of deaths among the wounded is a good deal higher than that of the Western Front, which, ironically, suggests that recovery of wounded was more effective in the Dardanelles....a function, again, of the awful concentration of the field as the Allies were confined to small areas of coastal lodgements. A lower mortality rate, in all too many cases, indicates not better medical care, but a situation in which wounded men died before they could be brought in.

By any reckoning, though, the Gallipoli fighting was extremely deadly, with the proportion of killed running at a higher per centage rate than most battles on the Western Front - both in terms of its ratio to the numbers engaged, and as a proportion of the casualties incurred.

Bob : Thank you, too, for explaining why the Turkish deficiencies in the quantity and quality of artillery and ammunition account for the disproportionately heavy casualties suffered by the Turks at Gallipoli. That was informative and helpful.

Phil (PJA)