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Minute sheets commenting on Report
DGAMS [Director General Administration Medical Services]
I have read this report through, and it is evident that the state of affairs in East Africa has, from a medical point of view, from the beginning been obviously unsatisfactory.
I shall be glad if you will have both the report and the enclosure very carefully examined, and all the points requiring action attended to at once.
The names of the Medical Officers [MO] who have failed in their duty should be brought out, and where possible those who are still there should be, if you consider necessary, relieved at once.
In the event of any of the above having been brought forward for recognition in despatches, I will bring the facts to the notice of the SoS [Secretary of State].
When you have considered the whole question it will be necessary to inform the Colonial Office [CO], as I understand that Colonial officials are to a certain extent responsible.
The further employment of Surgeon-General Hunter would seem to be inadvisable, except as a retired officer in a minor capacity.
When you have dealt with the Medical situation I shall require a report in order to deal with it from the point of view of the Staff.
It is very evident to me that the DA [Director Administration] and QMA [Quarter Master Administration] – Major General Ewart, was very greatly to blame, together with certain other combatant officers.
When you have completed your investigations, it would, I think, perhaps be well to talk it over before finally drafting your remarks.
AG [Adjutant General] GF 15/3/1918
AMD [Assistant Medical Directors] 1, 2 and 3: Spoke DG [Director General], Please prepare without delay a statement of action to be taken as directed in min[ute] 1.
QMG [Quartermaster General], DGMR [Director General Medical XXX], CM [Chief Medic],
Owing to reports which had reached the War Office as to the state of affairs as regards the Medical conditions in East Africa, Surgeon General WW Pike, accompanied by Lt Col A Balfour, RAMC [Royal Army Medical Corps], were ordered to proceed to East Africa under instructions set forth in the attached printed report.
General Pike’s report and itinerary are now enclosed and have been carefully examined by the DGAMS and myself.
I will endeavour to put the matter as concisely as possible:-
1. As regards the scientific and sanitary side of the Medical administration, there appears to have been a failure, to a considerable extent, to appreciate from the outset the necessity for an extensive organization to cope with the enormous and exceptional difficulties in disease prevention prevalent in East Africa.
It would appear, however, that the general medical and surgical work of the campaign has on the whole been well done (para 185).
These reports are in the hands of the present GOCinC [General Officer Commanding in Charge] East Africa and it is presumed that remedial measures have already been taken by him and his staff where possible.
All demands that have been made upon the War Office in the past in regard to material and scientific apparatus have been met, and if these were not sufficient, it is because application was not made for more.
2. The conditions prevailing in East Africa are quite different to those in other areas occupied by our Armies, and the scientific and sanitary organization required to investigate and fight against preventable disease will be met without delay.
It would seem from the Report that want of funds have seriously prevented adequate sanitary measures being carried out, and if the Colonial Government is unable to deal with the situation it would seem that the Military Authorities will have to do it.
3. There is no question but that very serious consequences to the strength of the Forces in East Africa have occurred owing to the omissions to safeguard the health of the Forces with adequate skilled bacteriologists, protozoologists, microscopes, malarial prophylaxis, chlorination of water etc, in the early stages of the campaign.
On page 16 of the printed Report, para 34, it is advised that an expert should be appointed at the War Office, but this has already been done in the person of Colonel Sir William Leishman, who has taken up these duties.
Representations will be made to the India Office that it is advisable that a similar officer should be appointed to advise as regards Indian troops.
QMG will no doubt enquire from India in regard to para 157. His Department appears interested also in paras 159 and 191. In para 150 a grave accusation is made of ignoring expert advice and not providing suitable food for carriers.
4. The names of various officers are brought to notice who in different degrees have undoubtedly failed in their duty.
Major General GD Hunter, DMS [Director Medical Services] of the Force, is now on his way to the United Kingdom. A summing-up of the Medical Administration will be found on pages 87 and 88.
Colonel CA Johnston, IMS [Indian Medical Service] who was DDMS [Deputy Director Medical Services] prior to the arrival of Maj Gen Hunter, and afterwards was DDMS Lines of Communication, appears to have been greatly lacking in the qualities which are to be expected from an officer of his rank and service. On page 26 it is stated that he apparently never fully appreciated his position, or took adequate steps to protect the troops under his medical charge, and further that when DDMS, LofC [Lines of Communication], he apparently did not acquit himself with any greater distinction than formerly, of which instances are given on page 88. This Officer is now on leave in this country.
On page 5 of the typewritten Report will be found a reference to Lt Col AL Scott, RAMC. His conduct in my opinion can be characterised as little less than disgraceful. He is now home on leave.
Lt Col CJ O’Gorman, DSO [Distinguished Service Order], ADMS, is still in East Africa, and I concur in the opinion expressed on page 5 of the typewritten Report, that he is greatly to blame for not having made himself acquainted with the way in which Lt Col Scott was carrying out his duties.
Captain Duke, of the East African Medical Service [EAMS], has recently been tried by General Court Martial as the result of this Enquiry, and the result is not yet known. He is referred to in pages 3 and 4 of the Report.
On page 37 of the printed Report reference is made to Major W Penberthy, RAMC, and Captain DRH Tyrrell, IMS, both in charge of Hospital Ships. In neither case, especially in the case of Major Penberthy, was the condition of these ships at all as it should have been.
On page 42, reference is made to Col FE Gunter, ADMS at Kisiwani, and adverse remarks are made as regards sanitation and general cleanliness of the place.
On page 42, it is stated that Lt Col M Gillivary, IMS, in charge of No 1 African Stationary Hospital, was evidently neglectful of his duty and the unit he commanded.
I propose to have extracts made in each of the above cases, and where officers are serving at home, to ask them for any remarks they may have to make. On receipt of their replies to deal with their cases on the score of discipline or efficiency as the case may be. [A]
5. Extracts of this Report, or if further copies can be obtained, the whole Report, will be sent to the Colonial Office and extracts to the India Office [IO], especially those dealing with officers of the IMS.
6. It is impossible to read this Report without feeling that the Staff work of the East African Force from the very beginning has been lamentable from many points of view. The Report deals mainly with Medical matters, but throughout it runs a clear indication that the A and Q staffs from GHQ [General Headquarters] downwards, did not carry out their duties in a way which might have been expected, at all events after the first rush of the campaign was over. That the responsibility in the first place rests on the different General Officers who have commanded the Force in East Africa is self-evident, but they were undoubtedly let down by their staffs.
Appendix 2 on page 100 of the printed Report, down to the end of page 105, gives an extraordinary picture of the manner in which the staff and medical arrangements were carried out, to say nothing of the disciplinary action in the case.
The last two minutes on page 105 in the Appendix are, I hope, the only ones of the kind that have been written in any theatre of operations during the present war.
I notice that Major General RH Ewart, the DA and QMG of the Force, is mentioned in General Van Deventer’s despatches as worthy of recognition, but as the responsible officer for the shortcomings herein brought to notice, I am of opinion that he cannot be held to be in any way qualified for his present rank, so far as staff duties are concerned.
In the meantime I am cabling to the GOCinC, East Africa, asking what steps he has taken in regard to the Report, copies of which have been given to him, and what assistance, if any, he may require.
AG, GF… 22/4/1918
The lack of proper staff work in this campaign appears to have been attended with deplorable results.
The extent of the theatre of operations, and of the line of communication called for specially strong staffing, and great vigilance and activity in inspection, especially having regard to climatic conditions, but the Chief Staff Officer, a very hardworking, loyal, STC man, of poor health and physique, had no previous staff training whatever, and has been employed for years on government farms and dairies.
His office was a dual one, and as regards his ‘A’ duties, I believe that he has never been employed in any capacity where his work would have given him such experience.
The failure of medical provision is the result of the method of employment of IMS men, who rarely have any chance of keeping up their knowledge, unless they specialise, or go outside the regimental appointments.
The obvious desire to cover up the inevitable results was most reprehensible.
The failures reported by this Commission appear to have been the result of want of knowledge on the part of the staff, or perhaps it would be better to call it ignorance.
DGMR, John XXX 15/5/1918
These reports are very disquieting. We should at once take such action as you suggest at A in your minute and all ‘mentions’ and ‘decorations’ etc should be stopped.
SofS would like to see the report from GOCinC East Africa when it arrives.
AT Bess… 17/5/1918
This report indicates deficiency in the scientific and sanitary sides of medical administration – failure to a considerable extent to appreciate from the outset the necessity for an extensive organisation to cope with the enormous and exceptional difficulties in disease prevention prevalent in East Africa.
‘The general medical and surgical work of the campaign has on the whole been done well’ (para 185).
The recommendations of the Commission are, it is presumed, concurred in and are being actively carried out.
The necessity for more laboratories and microscopes is often emphasised.
This department is ready to supply all such demands as may be made. An efficient organisation for disease prevention and adequate machinery for the scientific investigation of tropical diseases on the spot are imperatively necessary.
The Commission refer to improvements already having taken place in the above direction. Doubtless further advances have since been made and are now in progress.
The GOCinC East Africa, and his DDMS it is assumed have had copies of the Report some time ago and are carrying out the recommendations of the Commission in so far as circumstances there permit – The conditions prevailing in East Africa are quite different to those in other areas occupied by our armies, and the scientific and sanitary organization required to investigate and fight against preventable diseases should, if not already dealt with, be considered and provided without delay.
From this typed Report on British East Africa it appears that want of funds have seriously prevented adequate sanitary measures being carried out. This condition doubtless still obtains. If the Colonial Government is unable to deal with the situation it would be advisable that the military authorities should tackle it – sympathetic co-operation between the Colonial and military sanitary organizations is, in the interests of efficiency, essential.
ADG, McClennan? 11/4/1918
Short of re-writing most of the chapters on preventable and infection diseases, and sanitation generally, with comments on the omissions to safeguard the health of the forces with adequate skills bacteriologists, protozoologists, microscopes, malarial prophysaxis, chlorination of water etc in the early stages of the East African campaign, one can only say that these omissions have occurred with very serious consequences to the strength of the force. A few special recommendations can be considered here, but as the GOC has had a copy of the Report I think that the procedures should be to cable and ask him what action he has taken in remedying the conditions described in the Report, and in order to carry out the recommendations, what assistance does he require from us here. He should also be asked to cable the numbers of the main paragraphs which he cannot, for local or other reasons, deal with as recommended by General Pike.
Of the special recommendations which we should deal with here, the following call for immediate attention if agreed to:-
1) On page 8 the suggestions 1,3 and 5 should be cabled to OC [Officer Commanding] Transports (?SR1a).These pamphlets are in existence, and supplies have already been sent to GOC East Africa, for distribution to troops on arrival.
2) It is for decision how much of this report should be sent to the Colonial Office. Probably Appendix 1 and Appendix 5. (typewritten copy)
3) On page 16 of the main (Blue Book) report, paragraph 34, it is advised that an expert should be appointed to the War Office. Colonel Sir William Leishman has recently been recalled, and will carry out these duties.
India should be told that a similar officer is recommended to advise as regards Indian troops.
4) Section IX, para 157, QMG should see and ask India about para 157. See also page 89, para 191. QMG should also deal with para 159 in which a very grave accusation of ignoring expert advice and also not providing suitable food for carriers, is made.
ADG, A Webb, 9/4/1918
The names of officers adversely commented on in Major-General Pike’s report on East Africa have been extracted and in accordance with AG’s instructions, it is for consideration what action is to be taken. Several of them are already at Home, and one has been moved to the Mediterranean and is still in charge of a Hospital Ship. The following remarks are taken from the Report:
(Page 16) a) The DDMS prior to the arrival of Surgeon-General Hunter was COLONEL CA JOHNSTON, Indian Medical Service. The report states – ‘this officer apparently never fully appreciated the position or took adequate steps to protect the troops under his medical charge.’ The report further states – ‘When the present DMS assumed his duties at the end of January, 1916, his predecessor (Col Johnston) continued to act as DDMS, LofC, an important and responsible position, in which so far as we can see he did not acquit himself with any greater distinction than formerly’ and they give instances on page 88. This officer is now on leave in this country.
b) MAJOR GENERAL DG HUNTER, DMS is now on the way to the United Kingdom. A summing up of the Medical Administration is made on pages 87 and 88.
(page 5) c) LT COLONEL AL SCOTT, RAMC. The supplementary report on British East Africa states regarding this officer that ‘KIJABE Sanatorium has been much neglected by this officer who was OC No 3 British General Hospital and who was placed in charge of the Sanatorium for administrative purposes in January, 1916, and has never since visited it. He has left it to be entirely run by Miss Donkin without even an orderly or a nursing orderly of any sort since August. Lt Col Scott apparently took no interest whatever in KIJABE and we consider it was shamefully neglected by him.’ This officer is now at Home.’
(Page 5) d) Lit Col CJ O’GORMAN, DSO, ADMS is still in East Africa. This same report states that ‘we regret that we consider the ADMNS to blame in not having ascertained that Lt Col Scott never went near the hospital and in not ordering him to inspect regularly.’
e) CAPTAIN DUKE in charge of the Infectious Hospital at Bombo was tried by Court Martial, the result of which is not known. He is still in East Africa. This officer belongs to the East Africa Medical Service. The report deals with him in pages 3 and 4.
(Page 37) f) MAJOR W PENBERTHY, RAMC is still OC of the Wandilla and is in the Mediterranean. The report says that his Ship was extremely dirty.
g) … DRH TYRRELL, Indian Medical Service was in charge of the Dongola, ‘generally fair but not so clean as other hospital ships.’
(Page 42) h) COLONEL FE GUNTER was ADMS at KISIWANI and adverse remarks are made by te Commission regarding the sanitation and general cleanliness of this place.
(Page 43) i) LT COL M GILLIVARY, Indian Medical Service is still in East Africa so far as is known. He was in charge of No 1 African Stationary Hospital and the report states that this was not a good unit.
E Watkins, AMG 25/3/1918
The Secretary, War Office (AMD 1), London, SW1, England
Msa/1/18, Mombasa, 18 January 1918
We have the honour to forward herewith Copy No 1 of our Report on German East Africa. We will forward Copy No 2, without maps, by another mail with a book of photographs illustrating some of the subjects mentioned.
Copy No 3 is being handed to the General Officer Commanding East African Expeditionary Force.
A short Report on British East Africa will shortly be sent.
We have the honour to be,
Your obedient servants,
Signed Pike, Surgeon General, AMS
AB, Lieut-Colonel, RAMC
Note: The Secretary, War Office,
Copy No 2 and book of photographs forwarded herewith in continuation of above.
Surgeon General, AMS