Now we have always understood that a large base hospital cannot be placed far from a great city. A city grows in a particular place for natural reasons--water supply, lighting, transit, etc. The hospital gets the benefit of all these agencies, whereas it was necessary at Lemnos to create them. The result was somewhat disastrous as regards supplies, and might have been foreseen.

"Grousers" should stay at home, and exercise their privileges there.

The difficulties of obtaining supplies by requisition were easily surmounted at Heliopolis because of the broad policy adopted by the Officer Commanding the Australian Intermediate Base, Colonel Sellheim, C.B.

[Ill.u.s.tration: N.C.O.S AND MEN, NO. 1 AUSTRALIAN GENERAL HOSPITAL.

_To face page 197_]]

Ordnance cannot supply the varied requirements of a group of expert medical officers during a great war, and delays cause untold annoyance to active men. On the other hand, it would never do to give the staff a free hand to purchase when and how it pleased.

The inst.i.tution of "local purchase orders" met the difficulty. The O.C.

of the hospital sent in a requisition for something which could not be obtained from Ordnance, marking it "urgently required." The A.D.M.S.

endorsed it, or, if it were an entirely new line, asked the D.M.S. to endorse it. The Ordnance officer then issued a local purchase order to the medical officer, who made the purchase. The method combined a measure of control with reasonable speed in execution.

We have no sympathy with the usual references to military red-tape. If the administration is competent, the military system is thoroughly sound from the business point of view, and from the standpoint of record difficult to improve on. It may be at times a little c.u.mbersome, but it is much easier to fall in with it than to attempt to effect alteration during war. We never had any real difficulty with requisitions, although supplies were sometimes withheld from us on grounds of policy not disclosed at the moment.

There is no doubt that the erratic changes of staff were injurious. Some medical officers preferred the front, others the base, and an attempt was made to effect an orderly system of periodical exchange. Orders, however, were continually arriving to send so many medical officers, so many nurses, and so many orderlies, here and there, with the result that at the end of ten months the original medical staff had disappeared, many of the nurses were new, and so were most of the orderlies.

Whenever there was a shortage of staff near the front, the base hospitals were depleted. These changes were inevitable in the circ.u.mstances, but they emphasised the value of the advice given by Colonel Manifold, that there cannot be too many unattached junior medical officers in a campaign.

The following report from Major Brown, Officer Commanding Luna Park No.

1 Auxiliary Hospital, shows what he experienced owing to these oscillations:

FIRST AUSTRALIAN GENERAL HOSPITAL, LUNA PARK

April 30 Opened with 296 patients May 2 790 patients Staff: 4 sisters, 4 orderlies, and myself. With Captains Bentley, McDonald, and White from Light Horse Regiments.

May 6 Sisters increased to 13.

May 14 1,171 patients 13 sisters, 4 medicos, and 40 orderlies (mostly untrained).

May 18 1,244 patients June 7 1,099 patients 41 sisters (new).

(also 65 Casino) June 9 1,370 patients " " "

(also 65 Casino) June 11 1,620 patients (also 65 Casino) " " "

June 16 1,520 patients Still 4 medical officers, Capt. Brown, Capt.

Single, Capt. Lovegrove, and Capt. Craig.

June 17 Medical officers now increased; sisters also increased.

[Ill.u.s.tration: PALACE OF PRINCE IBRAHIM KHALIM (NURSES' HOME).

_To face page 198_]]

With reference to orderlies, the work from May 3 has been done with 10 A.M.C. men and 30 men drawn from the patients.

On June 17, 40 reinforcement A.M.C. men were detailed for duty. Up to June 16 over 1,600 patients have been discharged. On May 23 the Operating Theatre was opened.

For the 1,600 patients we had six cooks with six natives to a.s.sist.

T. F. BROWN, _Captain_, _Officer in Charge, Luna Park_.

HELIOPOLIS, _June 17, 1915_.

Of the 93 nurses belonging to the hospital, within a week of landing no fewer than 47 were taken away and dispatched to various parts of Egypt, viz.:

Port Said (Clearing Hospital) 21 Pont de Koubbeh (Egyptian Army H.) 9 The Citadel (British Hospital) 6 Alexandria 2 Transport duty 8 Returned to Australia (sick) 1 __ 47 __

No. 1 Australian General Hospital was much inspected by keen and curious, as well as sympathetic, eyes. His Highness the Sultan, Their Excellencies Sir Henry and Lady MacMahon, the General Officer Commanding-in-Chief, Egypt, the General Officer Commanding Australian and New Zealand Army Corps, and many other distinguished people honoured the hospital by an inspection.

The following letters were written by three distinguished visitors. Two Corps Orders are also attached.

"SHEPHEARD'S HOTEL, CAIRO, "_May 20, 1915_.

"DEAR COLONEL RAMSAY SMITH,

"Allow me to congratulate you upon the admirable medical arrangements at Heliopolis, and upon the excellent hospital you have established there.

One is at first disposed to say, 'How well the building adapts itself to a hospital!' until the true fact becomes revealed of the genius displayed in converting a decidedly refractory building into a place for the sick. You and your staff have done wonders and have once more shown that in the land of Egypt 'it is possible to make bricks without straw.'

"Australia may well be proud of the part she has played in this war, and I can pay no higher compliment than by saying that the medical arrangements of the Australian Army are as splendid as are the fighting qualities of its men.

"Above all I was impressed with the energy and enthusiasm with which the work at Heliopolis is being carried on, with the ingenuity and resource displayed at every turn, and with the thoroughness that was manifest in every department of the vast hospital.

"The generosity with which Australia has provided motor ambulances for the whole country and Red Cross stores for every one, British or French, who has been in want of same is beyond all words.

"I only hope that the people of Australia will come to know of the splendid manner in which their wounded have been cared for, and of the n.o.ble and generous work which the great colony has done under the banner of the Red Cross.

"Yours sincerely, "(Signed) FREDERICK TREVES."

[Ill.u.s.tration: GORDON HOUSE, HELIOPOLIS (NURSES' HOME).

To _face page 200_]]

"TURF CLUB, CAIRO, "_June 21, 1915_

"DEAR COLONEL RAMSAY SMITH,

"I am just off to the Dardanelles, and then back to Cairo, but I felt that I must write and thank you for your kindness in sending me those excellent and interesting photographs, which I shall treasure, and the memory of the interesting day I spent with you at your wonderful hospital. I also thank you for your report and for the copy of Sir F.

Treves's letter.

"You must feel proud of your work at Heliopolis, on which I heartily congratulate you. It is a monument of skill in administration and the surmounting of what would at first appear to be insurmountable difficulties.

"Hoping soon to see you again,

"Yours very sincerely, "(Signed) A. W. MAYO-ROBSON."

"ST. MARK'S BUILDINGS, ALEXANDRIA, "_June 5, 1915_.

"DEAR MAJOR BARRETT,

"I have been away at the front or I should have written to you sooner to thank you for the interesting visit which you enabled Sir Frederick Treves and myself to pay to your hospital and stores. I enclose an extract of a report which I made on May 25 to the Hon. Arthur Stanley, Chairman of the British Red Cross Society and Order of St. John in London.

"You may have noticed a minute published in the press with the approval of the G.O.C., Sir John Maxwell, in which it was laid down that all Red Cross work, except the Australian Red Cross work, should be under the control of the British Red Cross and Order of St. John. I hope you will not think that in drafting this minute in this way I wished to convey that we were not working in perfect harmony with your Red Cross, but I feel that we could hardly suggest to you that you should be in any way under our control. At the same time, I hope that when you either come here, or when I come back to Cairo, that we may have an opportunity of conferring together so that we may so co-ordinate as far as possible our mutual work.