The number of soldiers within easy distance of Heliopolis was not very great. Nevertheless patients, mostly medical cases, made their appearance in steadily increasing numbers, especially as Mena House was soon filled, and was limited in its accommodation.
With the arrival of the Second Australian Division in Egypt, and of subsequent reinforcements, the pressure on the First Australian General Hospital intensified, since these new arrivals went into camp at or near Heliopolis. The hotel rooms were filled with valuable furniture, including large carpets. From the outset it was arranged that neither carpets nor curtains were to be retained, and that the only hotel furniture which was to be used was beds and bedding for the officers and nurses. Everything else was stored away in various rooms. Up to this period the belief in official circles was that the First Australian General Hospital would soon be moved to France, and that it was consequently unwise to expand further, or to spend any considerable sum of money. The pressure, however, steadily continued, and when the Dardanelles campaign commenced, orders were given for the immediate expansion of the hospital to meet the ever-growing requirements of the troops. In order to effect this development the whole of the hotel furniture was moved into corridors of the building. Subsequently it was taken from the building and stored elsewhere, a difficult proceeding involving a great deal of labour.
[Ill.u.s.tration: THE MAIN HALL, HELIOPOLIS PALACE HOTEL.
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[Ill.u.s.tration: SURGICAL WARD, HELIOPOLIS PALACE HOTEL.
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VENEREAL AND INFECTIOUS DISEASES CAMP
On February 7 a New Zealand Field Ambulance which had taken charge of the venereal cases in camp, nearly 250 in number, was summarily ordered to the Suez Ca.n.a.l. Orders were given on that evening at 9 p.m. that the tent equipment of the First Australian General Hospital was to be erected at the Aerodrome Camp (about three-quarters of a mile distant), and that the hospital was to staff and equip a Venereal Diseases Camp by 2 p.m. the following day. By this time, too, large numbers of cases of measles had made their appearance, and it was quite clear that some provision must be made for these and other infectious cases. Accordingly another camp was pitched alongside the Venereal Camp for the accommodation of those suffering from infectious diseases. By direction of the D.M.S. Egypt, a senior surgeon was appointed to command the camp, and was given the services of two medical officers, one in connection with the venereal cases, and one in connection with the infectious cases. Definite orders were given that such cases were not to be admitted into the General Hospital.
The camp was no sooner pitched than it was filled, and the demand on the accommodation for venereal and other cases rose until upwards of 400 venereal cases, and 100 infectious cases--chiefly measles--were provided for. A good deal of difficulty was experienced in suitably providing for the serious measles cases in camp, and accordingly a limited number of tents were erected in the hospital grounds, and a small camp was formed in that position, and placed under the charge of a nursing sister. To this camp all serious cases of infectious disease, and all cases with complications, were immediately transferred. It may be said in pa.s.sing that the cases treated in this way did exceedingly well.
The number of venereal cases would have wholly out-stepped the accommodation had it not been for the policy adopted by the D.M.S.
Egypt. All venereal cases not likely to recover rapidly were sent back to Australia, or (on one occasion) to Malta.
ACQUISITION OF MANY BUILDINGS
The hospital, then, at this juncture consisted of the main building, in which the accommodation was being steadily extended by the utilisation of all the rooms, and of the venereal and infectious diseases camp.
[Ill.u.s.tration: HELIOPOLIS PALACE HOTEL: ISOLATION TENTS.
_To face page 26_]]
[Ill.u.s.tration: THE RINK, LUNA PARK, HELIOPOLIS.
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The first khamsin, however, which blew warned every one concerned that patients could not be treated satisfactorily in tents in midsummer. At the request of the medical officer in charge, two rooms in one wing of the main building were given over to bad infectious cases, and the camp in the grounds was abolished. The arrangement was unsatisfactory. The cases did not do as well as might have been desired, though this was attributed to an alteration in their type; and renewed efforts were made to devise a better arrangement. Finally a portion of the Abba.s.sia barracks was obtained, and converted into an excellent venereal diseases hospital to which the venereal cases were transferred.
The Mena camp had been struck, and the troops sent to the Dardanelles; the First and Second Stationary hospitals had moved to Mudros; and the First Casualty Clearing Station had been transferred to the Dardanelles.
Consequently the pressure fell almost entirely on the First General Hospital, and the Venereal Diseases Hospital thus became the only Venereal Diseases Hospital in Egypt.
Close to the Palace Hotel there was a large pleasure resort, known as the Luna Park, at one end of which was a large wooden skating-rink, enclosed by a balcony on four sides. This building was obtained, and was railed off from the rest of Luna Park by a fence 13 feet high. The infectious cases from the camp were then transferred to it. A camp kitchen was built, and an admirable open-air infectious diseases hospital was obtained. It became obvious, however, that the skating-rink, which with the balcony could accommodate, if necessary, 750 patients, might better serve as an overflow hospital in case of emergency, and accordingly efforts were made to obtain another infectious diseases hospital in the vicinity.
Eventually a fine building known as the Race Course Casino, a few hundred yards from the Heliopolis Palace, was obtained and converted into an infectious diseases hospital providing for the accommodation of about 200 patients. With its ample piazzas and excellent ventilation it formed an ideal hospital, and was reluctantly abandoned at a later date owing to the development of structural defects which threatened its stability.
The position, then, at this stage was that the First Australian General Hospital consisted of (1) the Palace Hotel, ever increasing in its accommodation as the furniture was steadily removed and s.p.a.ce economised, its magnificent piazzas utilised, and tents erected in the grounds for the accommodation of the staff; of (2) the rink at Luna Park, which was now empty and ready for the reception of light cases overflowing from the Palace; of (3) the Casino next door to Luna Park, which had now become an infectious diseases hospital; and of (4) the Venereal Diseases Hospital at Abba.s.sia, which soon became an independent command though still staffed from No. 1 General Hospital.
[Ill.u.s.tration: THE CASINO, HELIOPOLIS: INFECTIOUS DISEASES HOSPITAL.
_To face page 29_]]
PREPARATION IN ANTIc.i.p.aTION
At or shortly before this period, however, the authorities had become aware that wounded might be received from the Dardanelles at some future date in considerable numbers, which could not, however, be accurately estimated. Accordingly a consultation was held between Surgeon-General Ford and Surgeon-General Williams (who arrived in Egypt in February), Colonel Sellheim, who was the officer commanding the newly formed Australian Intermediate Base, the O.C. of the First Australian General Hospital, Lieut.-Col. Ramsay Smith, and Lieut.-Col. Barrett. It was decided to authorise the expenditure of a considerable sum of money in making the necessary preparation, on the ground that if the wounded did not arrive the Australian Government would justify this action, and that if the wounded did arrive a reasonable attempt would have been made to meet the difficulty. Instructions were accordingly given to buy up beds, bedding, and equipment, which would _inter alia_ provide at least another 150 beds in the Infectious Diseases Hospital and 750 in the rink. At first iron beds were purchased, but it was impossible to obtain deliveries of iron beds at a rate exceeding 120 a week, and there were (practically) none ready made in Egypt. It was during this period of expansion that the donation of 130 beds made to Lieut.-Col. Ramsay Smith in Adelaide proved to be so useful.
It was, therefore, quite certain that full provision could not be made in time if iron beds were to be used, and accordingly large purchases of palm beds were made. These are very strong, stoutly constructed beds, made of palm wood. They are quite comfortable and last for several months. The drawback is that they are liable ultimately to become vermin-infected and that their sharp projecting struts are very apt to catch the dresses of those who pa.s.s by. We were able, however, to obtain them with mattresses at a rate exceeding 100 a day. They were ordered in practically unlimited numbers, so that shortly there was accommodation for the 900 patients referred to. In addition a large reserve of beds and mattresses had been created so that they could be placed in the corridors if it became necessary.
At an earlier date the project of taking the whole of Luna Park and using the upper portion of it, the Pavilion, as well as the lower portion, the Rink, had been under contemplation, but had been rejected on the ground of expense. The rental demanded was high, owing to the fact that the park must perforce be closed as a pleasure resort if used as a hospital.
The conveyance of sick and wounded from Cairo to Heliopolis next engaged attention, and on April 26 it was found possible to run trains from Cairo on the tram-lines to Heliopolis Palace Hotel. A trial run was made about midnight on the 27th. The first train containing sick from Mudros arrived on the evening of the 28th, and on the 29th and 30th without warning the wounded poured into Heliopolis.
As soon as the nature of the engagement at the Dardanelles became known, the D.M.S. Egypt ordered that the whole of Luna Park be taken over and immediately equipped. The pavilion was made ready for the reception of the wounded within a very few hours, and in a few days Luna Park was so equipped with baths, latrines, beds, bedding, etc., that it could accommodate 1,650 patients.
[Ill.u.s.tration: THE PAVILION, LUNA PARK, HELIOPOLIS.
_To face page 30_]]
Never before in history were precautions better justified. Had the expenditure not been incurred, had the representative of the Australian Government held up the execution of the policy of preparation by waiting for instructions, a disaster would have occurred, and many wounded would have been treated in tents in the sand of the desert. Yet so strangely const.i.tuted is a minor section of humanity that instead of satisfaction being expressed that the best possible had been done, some criticism was levelled at the undertaking on the ground that it was not at the outset technically perfect, and that it showed the initial defects inseparable from rapid improvisation. The Australian people should be profoundly grateful to Surgeon-General Williams and Colonel Sellheim, whose decisive prompt.i.tude enabled the position to be saved.
CHAPTER IV
THE RUSH OF WOUNDED AND RAPID EXPANSION OF HOSPITALS--SAVING THE SITUATION--PERIOD OF IMPROVISATION--SHORTAGE OF STAFF AND EQUIPMENT--HOW THE EXPANSION WAS EFFECTED--THE NUMBER OF SICK AND WOUNDED.
CHAPTER IV
During the first ten days of the crisis approximately 16,000 wounded men entered Egypt, of whom the greater number were sent to Cairo, and during those ten days an acute compet.i.tion ensued between the supply of beds and the influx of patients. Fortunately the supply kept ahead of the demand, the pressure being eased by the immediate provision at Al Hayat, Helouan, of a convalescent hospital capable of accommodating 1,000 and in an emergency even 1,500 patients.
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.
[Ill.u.s.tration: THE ATELIER, HELIOPOLIS.
_To face page 37_]]
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 inst.i.tution, 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.