The Australian Army Medical Corps In Egypt - free ebook by James W. (James William) Barrett

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The Australian Army Medical Corps In Egypt

James W. (James William) Barrett

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THE AUSTRALIAN ARMY MEDICAL CORPS IN EGYPT AN ILLUSTRATED AND DETAILED ACCOUNT OF THE EARLY ORGANISATION AND WORK OF THE AUSTRALIAN MEDICAL UNITS IN EGYPT IN 1914-1915

THE AUSTRALIAN ARMY MEDICAL CORPS IN EGYPT AN ILLUSTRATED AND DETAILED ACCOUNT OF THE EARLY ORGANISATION AND WORK OF THE AUSTRALIAN MEDICAL UNITS IN EGYPT IN 1914-1915

BY JAMES W. BARRETT K.B.E., C.M.G., M.D., M.S., F.R.C.S. ( Eng. ) TEMPORARY LIEUT.-COL. R.A.M.C. LATELY LIEUT.-COL. A.A.M.C. AND A.D.M.S. AUSTRALIAN FORCE IN EGYPT, CONSULTING OCULIST TO THE FORCE IN EGYPT AND REGISTRAR FIRST AUSTRALIAN GENERAL HOSPITAL; OPHTHALMOLOGIST TO THE MELBOURNE HOSPITAL, LECTURER ON THE PHYSIOLOGY OF THE SPECIAL SENSES IN THE UNIVERSITY OF MELBOURNE AND LIEUT. P. E. DEANE, A.A.M.C. QUARTERMASTER FIRST AUSTRALIAN GENERAL HOSPITAL, EGYPT H. K. LEWIS &amp; CO. LTD. 136

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INTRODUCTION

INTRODUCTION

The experience of the Australian Army Medical Service, since the outbreak of war, is probably unique in history. The hospitals sent out by the Australian Government were suddenly transferred from a position of anticipated idleness to a scene of intense activity, were expanded in capacity to an unprecedented extent, and probably saved the position of the entire medical service in Egypt. The disasters following the landing at Gallipoli are now well known, and the following pages will show how well

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CHAPTER I

CHAPTER I

THE AUSTRALIAN ARMY MEDICAL CORPS AT THE OUTBREAK OF WAR—THE CALL FOR HOSPITALS—APPEAL TO THE MEDICAL PROFESSION AND THE RESPONSE—RAISING THE UNITS. CHAPTER I Prior to the outbreak of war in August 1914, the Australian Army Medical Corps consisted of one whole-time medical officer, the Director-General of Medical Services, Surgeon-General Williams, C.B., a part-time principal medical officer in each of the six States (New South Wales, Victoria, and Queensland, South Australia, Western Australia,

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CHAPTER II

CHAPTER II

THE VOYAGE OF THE "KYARRA"—LACK OF ADEQUATE PREPARATION—DIFFICULTIES OF ORGANISATION—PTOMAINE POISONING. CHAPTER II The mode of conveyance of the hospitals to the front next engaged the attention of the authorities, and negotiations were entered into with various steamship companies. It was desirable that the hospitals should be conveyed under the protection of the regulations of the Geneva Convention. After some negotiation and the rejection of larger and more suitable steamers, a coastal steam

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Venereal and Infectious Diseases Camp

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 Canal. 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 meas

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Acquisition of Many Buildings

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. 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 t

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Preparation in Anticipation

Preparation in Anticipation

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,

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Methods Adopted in Organising Hospitals

Methods Adopted in Organising Hospitals

The methods adopted in organising these hospitals varied. In the first instance Lieut.-Col. Barrett was deputed by the D.M.S. Egypt to seek for the necessary buildings, and when these were approved to negotiate with the owners respecting the rent. This proceeding proved very tedious and difficult, and in pursuance of a General Army Order another and simpler plan was adopted by the appointment of an arbitration commission under the chairmanship of Sir Alexander Baird. To this commission the deter

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Chronology of the First Australian General Hospital

Chronology of the First Australian General Hospital

January 14.—Arrived at Alexandria. January 24.—Arrived at Heliopolis. February 7.—Established Aerodrome Camp. April 6.—Luna Park taken over. April 19.—Established Venereal Hospital, Abbassia. April 26.—The Casino taken over. April 29.—Arrival of wounded. May 1.—Prince Ibrahim Khalim's Palace taken over. May 5.—Al Hayat Hotel taken over. May 26.—The Atelier taken over. May 27.—Gordon House taken over. June 10.—Sporting Club taken over....

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The Policy of Expansion

The Policy of Expansion

It has frequently been said in criticism of the Auxiliary Hospitals that it would have been better to have taken over Shepheard's Hotel, or the Savoy. Neither Shepheard's nor the Savoy (particularly the former) is very suitable for hospital purposes, since hotels containing a large number of small rooms involve much labour, and consequently a large staff, and the authorities were faced with the fact that there was no staff available. Surgeon-General Williams had cabled to Australia for reinforce

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Motor Ambulances

Motor Ambulances

When the Kyarra arrived in Egypt the British authorities did not possess any motor transport. There were some motor ambulances belonging to the New Zealand authorities and a few motor ambulances which accompanied the hospitals on the Kyarra , and which had been allotted to special units. It became obvious, however, that units might be placed in circumstances in which they did not require their ambulances, and others in circumstances in which they required more than their share; and accordingly S

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The Arrival of the Sick and Wounded from the Front

The Arrival of the Sick and Wounded from the Front

The end of April was reached. The bulk of the forces had disappeared from Egypt, and their position was only known by rumour; the hospital was gradually emptied of patients; Mena Camp had been abandoned, and Maadi Camp was reduced to small proportions. The weather was beautiful, and any one might have been easily lulled into a sense of false security. On April 28, however, a train-load of sick arrived. Its contents were not known until it arrived at the Heliopolis siding. The patients had come f

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The Auxiliary Hospitals

The Auxiliary Hospitals

As the patients became convalescent they were moved to one of the auxiliary hospitals, and from the auxiliary hospitals to one of the convalescent hospitals at Helouan or Alexandria, and thence either invalided or discharged to duty. As the patients during transference to the auxiliaries were conveyed in a motor ambulance, and when transferred to Helouan or Alexandria were motored to Cairo railway station under charge of a N.C.O., some idea of the work thrown on the motor ambulance corps and on

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The Conversion of the Auxiliary Hospitals into Independent Commands

The Conversion of the Auxiliary Hospitals into Independent Commands

Finally it became obvious that the mechanism was becoming too complicated, i.e. that the administration of all these hospitals from the Palace Hotel, and the keeping of the records at the Palace Hotel, had become impossible. It was accordingly decided to separate them and make them independent commands. This arrangement was completed about the middle of August, but it involved a fresh crop of difficulties. It was quite necessary that some one should meet the trains and allot the patients to the

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The Egyptian Climate

The Egyptian Climate

Those who know Helouan and the hotel will not be surprised at the success of the Hospital, but it may surprise even those who know Egypt to learn that Helouan is considerably cooler than Cairo, notwithstanding the fact that it is situated on the edge of the desert. Owing to dryness the Wet Bulb temperature is considerably lower than at Cairo in midsummer and the nights are always cool. It must be remembered that the figures in the attached table give means only, and that any registration over 75

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Convalescent Hospitals

Convalescent Hospitals

The Ras el Tin Convalescent Hospital at Alexandria was organised on similar principles to those adopted at Al Hayat, for those who required seaside change and sea bathing. At a later period half the accommodation in the Montazah Convalescent Hospital was rendered available to Australians. The Montazah Hospital will be described under the heading of Red Cross. By the use of these three convalescent hospitals, accommodation was provided for 1,500 patients, but in case of necessity at least another

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Army Medical Administration

Army Medical Administration

When the Kyarra arrived in Egypt the military medical arrangements in that country were on a very small scale, and under the administration of the D.M.S. they rapidly enlarged. But the unexpected rush on April 29 found the British Medical Force to a considerable extent, and justly, dependent on the Australian Force for hospitals, medical officers, nurses, transport, specialists, and Red Cross stores. As there is really only one service and one object in view, it is quite unnecessary to emphasise

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Discipline

Discipline

A word must be said on the subject of discipline and its influence on Australians. The bravery and resourcefulness of Australians in the field are sufficiently attested by those competent to judge. Of their splendid behaviour when desperately injured we have had ample evidence, which we furnish with proper respect to brave men. The convalescent Australian presents another problem, as also does the soldier waiting at the base. The lines in Dr. Watts's hymn come to mind. In these circumstances his

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MEDICAL REPORT ON AN INVALID

MEDICAL REPORT ON AN INVALID

Note. — The answers to the following questions are to be filled in by the officer in medical charge of the case. In answering them he will carefully discriminate between the man's unsupported statements and evidence recorded in his military and medical documents. He will also carefully distinguish cases entirely due to venereal disease. 9. Date of origin of disability. 10. Place of origin of disability. 11. Give concisely the essential facts of the history of the disability, noting entries on th

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OPINION OF THE MEDICAL BOARD

OPINION OF THE MEDICAL BOARD

Notes .—( i ) Clear and decisive answers to the following questions are to be carefully filled in by the Board, as, in the event of the man being invalided, it is essential that the Commissioners of Chelsea Hospital should be in possession of the most reliable information to ENABLE THEM TO DECIDE UPON THE MAN'S CLAIM TO PENSION . (ii) Expressions such as "may," "might," "probably," etc., should be avoided. (iii) The rates of pension vary directly according to whether the disability is attributed

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The Following Draft was made the Basis of the Arrangement

The Following Draft was made the Basis of the Arrangement

1. Two medical officers are to be detached from other duties at Nos. 1 and 2 Australian General Hospitals respectively, in order to form a majority of a permanent invaliding board at each hospital. They will be known as the senior and junior invaliding officer respectively. 2. The duties of the Board at Nos. 1 and 2 Australian General Hospitals will be to form an Invaliding Board by meeting in each case the medical officer in charge of the case. 3. The Board proceedings when completed will be se

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Transport of Sick and Wounded by Sea

Transport of Sick and Wounded by Sea

As soon as it was decided to return patients to Australia in addition to those sent to England, Cyprus, or convalescent hospitals in Egypt, a system was developed in order to provide the necessary staffs and equipment on ships. Surgeon-General Williams had exerted himself to get hospital ships provided, but in the early stages they had not even been promised, and a service was perforce created by utilising empty transports and collecting the staff in Egypt. The first efforts may be described as

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Base Medical Store

Base Medical Store

These continual demands on personnel and on medical stores necessitated suitable arrangements, and messages were sent to Australia asking for reinforcements. In addition a large base medical store was established at Heliopolis, and made an independent unit. It became the business of the officer in charge of this store, Captain Johnson, to make up drugs and surgical instruments per 100 patients, and to receive the surplus stores from each of the incoming transports. Two hospital ships were ultima

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Transport of Sick and Wounded to Suez

Transport of Sick and Wounded to Suez

The arrangements for conveying the invalids from Cairo to Suez were interesting. They could not be conveyed to Alexandria or Port Said because one passenger placed on a ship at those ports enormously increased the charges made by the Suez Canal Company, and Suez was consequently fixed upon as the port of departure and the port of equipment. Patients to be conveyed to Suez were at Helouan, or at different hospitals in Cairo, and accordingly two trains were made up—one at Helouan and one at Palais

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First Australian General Hospital

First Australian General Hospital

(Report begins) "The following figures have been obtained from the office of the D.M.S. Egypt. Owing to the movement of troops out of Egypt, comparisons are apt to be a little difficult to institute with accuracy. Nevertheless the figures given substantially indicate the position. On February 15 there were 1,329 patients in hospital. The number of sick and off duty in the lines, but not in hospital, is not stated; but as it amounted to 423 on February 1, and to 644 on March 1, it may be assumed

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The Enlistment of the Unfit and its Consequences

The Enlistment of the Unfit and its Consequences

Prior to the arrival of the wounded the medical service was inconvenienced by another circumstance. Men were continually arriving with hernia, varix, and other ailments which they had suffered from before enlistment, and which had been overlooked during the preliminary examination in Australia. In one case a soldier suffering from aortic aneurism arrived in Egypt, and similar instances might be given. The examination of recruits in Australia had been conducted by practitioners in country towns a

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Ophthalmic and Aural Work

Ophthalmic and Aural Work

When one of us joined the hospital as oculist and aurist and registrar (Lieut.-Col. Barrett) he was informed that specialists were not required, but apparently those responsible had formed no conception of the excessive demands which would be made on the ophthalmic and aural departments. The first patient admitted to No. 1 General Hospital was an eye case, and an enormous clinic rapidly made its appearance. It was conducted somewhat differently from an ordinary ophthalmic and aural clinic, in th

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Other Diseases: Measles and its Complications; Food Infections

Other Diseases: Measles and its Complications; Food Infections

The danger run by an army from measles is very great indeed, and at an early stage the position was surveyed, and an attempt made to limit the trouble. A cable message was sent to Australia, asking that precautions should be taken against shipping measles cases or contacts. At Suez arrangements were made with the Government Infectious Diseases Hospital to admit any patients suffering from measles or infectious diseases who might land with the recruits. In such cases the clothing of the remaining

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The Fly Pest

The Fly Pest

At the Island of Lemnos, however, which was not under fire, and where there was room, the conditions appear to have been nearly as bad, and it is somewhat difficult to know why the fly pest could not have been got under at Mudros. At Heliopolis at an early stage the fly problem was seriously tackled. A sanitary officer was appointed, and charged with the duty of dealing with this important matter. The following precautions were adopted. All refuse and soiled dressings were placed in covered bins

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The Egyptian Climate again

The Egyptian Climate again

Dealing with the surgical side of the matter, nothing was commoner at one time than to hear the statement made that owing to the hot weather septic infections were common, that wounds did not heal as they should in Egypt, and that it was not a suitable place to which wounded men should be sent. While quite agreeing with the critics that a cool climate is always preferable to a hot one, it may be remarked that in the first place summer in Egypt, apart from the khamsin, is not excessively hot. The

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Medical Organisation in Egypt

Medical Organisation in Egypt

When the Australian forces pass three miles from Australian shores they cease, at all events technically, to be under Australian control, and pass under the control of the Commander-in-Chief. On arrival in Egypt they passed under the control of General Sir John Maxwell, G.O.C.-in-Chief, Egypt. The medical section passed under the command of the Director of Medical Services, Surgeon-General Ford. The D.M.S. Australian Imperial Force, Surgeon-General Williams, arrived in Egypt in February and was

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The Risk of Cholera

The Risk of Cholera

In view of the risk of cholera, the following note by Dr. Armand Ruffer, C.M.G., President of the Sanitary, Maritime and Quarantine Council of Egypt, Alexandria, was issued and, later on, inoculation was practised on an extensive scale....

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Dr. Ruffer's Views on Cholera

Dr. Ruffer's Views on Cholera

(Report begins) "The first point is that although, in many epidemics, cholera has been a water-borne disease, yet a severe epidemic may occur without any general infection of the water supply. This was clearly the case in the last epidemic in Alexandria. Attention to the water supply, therefore, may not altogether prevent an epidemic. The second point is that the vibrio of cholera may be present in a virulent condition in people showing no, or very slight symptoms of cholera, e.g. people with sl

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Other Infectious Diseases

Other Infectious Diseases

The Infectious Diseases Hospitals were filled mostly with cases of measles and its complications, including severe otitis media. Cases of erysipelas, scarlatina, scabies, and diphtheria were met with in small numbers. In the autumn there was a severe epidemic of mumps. Through the summer and autumn many cases of diarrhœa and of both amœbic and bacillary dysentery made their appearance. There is good ground for believing that many so-called diarrhœal cases were dysenteric. There is little doubt s

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Moral Conditions in Cairo

Moral Conditions in Cairo

Something must be said, however, about the moral conditions in Cairo, about which exaggerated and perverse notions seem to be entertained. Cairo, like all large cities in the world, possesses its quota of prostitutes, who differ only from prostitutes elsewhere in that the quarters are dirtier and that the women are practically of all nationalities, except English. The quarter in which they live is evil-smelling, and is provided with narrow streets and objectionable places of entertainment. It co

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Prophylaxis

Prophylaxis

At the same time, when all these measures were weighed in the balance—plain speaking to the men on arrival, police surveillance, medical examination, etc.—it was felt that more might be done. A number of medical officers accordingly gave instruction to their men in the means of effecting prophylaxis and of preventing infection in the event of association with these women. The medical officers acted entirely on their own responsibility. They advised the men to avoid the risk, but as they knew a c

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Result of Prophylaxis

Result of Prophylaxis

In the case of our own unit, the First Australian General Hospital, trouble was taken to explain in detail the consequences of venereal diseases to the men, and to those with whom they would be associated in later life. They were asked to refrain from taking the risk, but for those who would not take the advice—and there was bound to be a percentage—the necessary directions and material were provided for preventing infection. The result was challenged by a medical officer, and an immediate exami

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Soldiers' Clubs

Soldiers' Clubs

But another and constructive side of the matter appealed forcibly to those concerned. Why not supply for the benefit of the men places of entertainment with music, refreshments, and the like, similar to and better than those which the prostitutes supplied, but minus the prostitute. In other words, why not give a healthy and reasonable alternative? After consultation with His Excellency Sir Henry MacMahon, with the G.O.C.-in-Chief, General Sir John Maxwell, and with the D.M.S. Egypt, General Ford

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The Duty of the Medical Officer

The Duty of the Medical Officer

We have never wavered from the conviction that any one suffering from venereal disease should be treated by a medical practitioner exactly like any other sick person. In military service, however, an added element makes its appearance in that the soldier by his act has rendered himself unfit, and consequently must suffer some pains and penalties. It is no answer to say that other men have exposed themselves and have not become infected. The fact remains that he has by a deliberate and avoidable

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Wassermann Tests

Wassermann Tests

The examination of the cases showed that gonorrhœa was far more common than syphilis, and a series of Wassermann determinations showed that the cases of soft sores did not give a syphilitic reaction in the early stages. Captain Watson of the First General Hospital made a number of determinations in order to try to settle this important point....

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The Policy to be Adopted

The Policy to be Adopted

In spite of all that was done, 1,344 men were returned to Australia disabled, and 450 were sent to Malta. If a calculation be made of the cost of sending these men to Egypt and back, and of their pay before they were infected, some idea may be formed of the enormous sum of money the Australian Commonwealth wasted on men who were a drag and hindrance to the army machine. The Government should, on the raising and equipping of a volunteer army, treat it as older countries treat a standing army by i

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Venereal Diseases Conference

Venereal Diseases Conference

The following are brief notes of a Conference of senior medical officers convened by Surgeon-General Williams. Reference was made to the gravity of the problem with which the force was faced. It was estimated that about 1,000 men of the First and Second Australian Divisions are suffering from venereal disease on any one day, and of these a large number are incapacitated from work. The proportions seemed to be much greater than those of other forces, such as the Territorials, in Egypt. The displa

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The Red Cross Policy: Wanted, a Definition

The Red Cross Policy: Wanted, a Definition

Before leaving consideration of the details of the Red Cross question, attention should be directed to the numerous changes in the policy adopted by the British Red Cross Society, Australian Branch. No less than three different types of administration were rapidly adopted. It was first placed in the hands of Surgeon-General Williams and the High Commissioner for Australia, in London; then it was placed under a committee in Egypt formed by the High Commissioner for Egypt, Sir Henry MacMahon, and

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CHAPTER X

CHAPTER X

SUGGESTED REFORMS—DEFECTS WHICH BECAME OBVIOUS IN WAR-TIME—RECOMMENDATIONS TO PROMOTE EFFICIENCY—DANGERS TO BE AVOIDED—CONCLUSION. CHAPTER X The experience gained in connection with the establishment and extension of the First Australian General Hospital suggests modifications which should immensely increase efficiency. A base hospital modelled on the R.A.M.C. pattern may work exceedingly well in times of peace, or when staffed by R.A.M.C. or I.M.S. officers who have devoted their whole lives to

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The Fly Campaign

The Fly Campaign

Very active steps were taken during 1916 in the direction of a campaign for the destruction of flies. The only addition that need be made to previous remarks is reference to the ingenious fly traps which have been devised. A large one was designed by Lt.-Col. Andrew Balfour, C.M.G., and is described in the journal of the Army Medical Corps of July 1916. A modified form of this trap, furnished by the British Red Cross in Egypt, costs about 16 s. , and was most effective. These traps have been kno

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The Venereal-Disease Problem

The Venereal-Disease Problem

The venereal-disease problem in the early part of 1916 gave very great concern, and active measures were taken to deal with it. In spite of all the ameliorating influences the problem reached its most serious phase in March and April 1916, as questions put in the House of Commons show ( vide Lancet , April 8, 1916). I think I express the conviction of certainly 90 per cent. of medical men in stating that nothing but education and educated prophylaxis will ever enable us to get rid of this source

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Y.M.C.A. and Red Cross

Y.M.C.A. and Red Cross

The Soldiers' Club in the Ezbekieh Garden grew in favour and was extended in area and staff. In the autumn of 1915 some ladies became available, and did splendid service in the superintendence of the catering for the men in the Club, and by their presence there did much to help. A more extended experience of the work of the Y.M.C.A. and of the Red Cross has given much cause for thought. The Y.M.C.A. organisation appears to me to be excellent, since it is the organisation which caters for the soc

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Prevention of Disease

Prevention of Disease

Surveying the whole campaign, the fundamental fault of the Australian Army Medical Service was the insufficient attention given to, and stress laid on, the prevention of disease. Is it not obvious that there should be a staff of medical officers and orderlies, detached altogether from any association with the treatment of disease, who should devote themselves entirely to the problem of prevention? This staff should be presided over by a Surgeon-General who should be second only in rank to the Di

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Conditions of Recruits on Arrival

Conditions of Recruits on Arrival

Captain Lovegrove, A.A.M.C., was appointed Australian Embarkation Officer at Suez whilst I was in charge. He has contributed the following article to The Australian Medical Journal relative to the work he did during his ten months' stay. "During ten months' tenure of the unique appointment of Australian Embarkation Medical Officer, I have had peculiar opportunities of observing the condition of our soldiers arriving in Egypt. "The physique of our men has always excited the admiration of the Brit

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Hospital Organisation

Hospital Organisation

With extended experience the views of the writer on the subject of the organisation of military hospitals have crystallised. There is no doubt that the commander of a hospital must be a medical practitioner, and there is no doubt that in all matters relating to his hospital his authority must be final. In the last resort he must decide whether a patient is to leave the hospital or to stay; who should be admitted, and what the treatment should be. In a good organisation he will probably be very r

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Assistance of Anglo-Egyptians

Assistance of Anglo-Egyptians

Surveying the work of the Australian Army Medical Corps in Egypt, it does seem to me that sufficient acknowledgment has not been made of the services rendered and the help given to the Australian sick and wounded by the British residents in Egypt, who, from their Excellencies Sir Henry and Lady MacMahon downwards, spared no effort to help wherever assistance was possible. Very many of the officials employed in the Egyptian Government service came to the hospitals when the day's work was over and

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CHAPTER I

CHAPTER I

Officers and soldiers, and other persons officially attached to armies, shall be respected and taken care of when wounded or sick by the belligerent in whose power they may be, without distinction of nationality. Nevertheless, a belligerent who is compelled to abandon sick or wounded to the enemy shall, as far as military exigencies permit, leave with them a portion of his medical personnel and material to contribute to the care of them. Except as regards the treatment to be provided for them in

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CHAPTER II

CHAPTER II

Mobile medical units (that is to say, those which are intended to accompany armies into the field) and the fixed establishments of the medical service shall be respected and protected by the belligerents. The protection to which medical units and establishments are entitled ceases if they are made use of to commit acts harmful to the enemy. The following facts are not considered to be of a nature to deprive a medical unit or establishment of the protection guaranteed by Article 6:— 1. That the p

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CHAPTER III

CHAPTER III

The personnel engaged exclusively in the collection, transport, and treatment of the wounded and the sick, as well as in the administration of medical units and establishments, and the Chaplains attached to armies, shall be respected and protected under all circumstances. If they fall into the hands of the enemy they shall not be treated as prisoners of war. These provisions apply to the guard of medical units and establishments under the circumstances indicated in Article 8 (2). The personnel o

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CHAPTER IV

CHAPTER IV

If mobile medical units fall into the hands of the enemy they shall retain their material, including their teams, irrespectively of the means of transport and the drivers employed. Nevertheless, the competent military authority shall be free to use the material for the treatment of the wounded and sick. It shall be restored under the conditions laid down for the medical personnel , and so far as possible at the same time. The buildings and material of fixed establishments remain subject to the l

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CHAPTER V

CHAPTER V

Convoys of evacuation shall be treated like mobile medical units subject to the following special provisions:— 1. A belligerent intercepting a convoy may break it up if military exigencies demand, provided he takes charge of the sick and wounded who are in it. 2. In this case, the obligation to send back the medical personnel , provided for in Article 12, shall be extended to the whole of the military personnel detailed for the transport or the protection of the convoy, and furnished with an aut

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CHAPTER VI

CHAPTER VI

As a compliment to Switzerland, the heraldic emblem of the red cross on a white ground, formed by reversing the Federal colours, is retained as the emblem and distinctive sign of the medical service of armies. With the permission of the competent military authority, this emblem shall be shown on the flags and armlets ( brassards ), as well as on all the material belonging to the Medical Service. The personnel protected in pursuance of Articles 9 (paragraph 1), 10, and 11 shall wear, fixed to the

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CHAPTER VII

CHAPTER VII

The provisions of the present Convention are only binding upon the Contracting Powers in the case of war between two or more of them. These provisions shall cease to be binding from the moment when one of the belligerent Powers is not a party to the Convention. The Commanders-in-chief of belligerent armies shall arrange the details for carrying out the preceding articles, as well as for cases not provided for, in accordance with the instructions of their respective Governments, and in conformity

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CHAPTER VIII

CHAPTER VIII

The Signatory Governments, in countries the legislation of which is not at present adequate for the purpose, undertake to adopt or to propose to their legislative bodies such measures as may be necessary to prevent at all times the employment of the emblem or the name of Red Cross or Geneva Cross by private individuals or by societies other than those which are entitled to do so under the present Convention, and in particular for commercial purposes as a trade-mark or trading mark. The prohibiti

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Article 1

Article 1

Military hospital-ships, that is to say, ships constructed or adapted by States for the particular and sole purpose of aiding the sick, wounded, and shipwrecked, the names of which have been communicated to the belligerent Powers at the commencement or during the course of hostilities, and in any case before they are employed, shall be respected, and may not be captured while hostilities last. Such ships, moreover, are not on the same footing as war-ships as regards their stay in a neutral port.

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Article 2

Article 2

Hospital-ships, equipped wholly or in part at the expense of private individuals or officially recognised relief societies, shall likewise be respected and exempt from capture, if the belligerent Power to which they belong has given them an official commission and has notified their names to the hostile Power at the commencement of or during hostilities, and in any case before they are employed. Such ships shall be provided with a certificate from the proper authorities declaring that the vessel

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Article 3

Article 3

Hospital-ships, equipped wholly or in part at the expense of private individuals or officially recognised societies of neutral countries, shall be respected and exempt from capture, on condition that they are placed under the orders of one of the belligerents, with the previous consent of their own Government and with the authorisation of the belligerent himself, and on condition also that the latter has notified their name to his adversary at the commencement of or during hostilities, and in an

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Article 4

Article 4

The ships mentioned in Articles 1, 2, and 3 shall afford relief and assistance to the wounded, sick, and shipwrecked of the belligerents without distinction of nationality. The Governments undertake not to use these ships for any military purpose. Such vessels must in no wise hamper the movements of the combatants. During and after an engagement they will act at their own risk and peril. The belligerents shall have the right to control and search them; they may refuse to help them, order them of

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Article 5

Article 5

Military hospital-ships shall be distinguished by being painted white outside with a horizontal band of green about a metre and a half in breadth. The ships mentioned in Articles 2 and 3 shall be distinguished by being painted white outside with a horizontal band of red about a metre and a half in breadth. The boats of the said ships, as also small craft which may be used for hospital work, shall be distinguished by similar painting. All hospital-ships shall make themselves known by hoisting, wi

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Article 6

Article 6

The distinguishing signs referred to in Article 5 shall only be used, whether in peace or war, for protecting or indicating the ships therein mentioned....

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Article 7

Article 7

In the case of a fight on board a war-ship, the sick-bays shall be respected and spared as far as possible. The said sick-bays and the matériel belonging to them remain subject to the laws of war; they cannot, however, be used for any purpose other than that for which they were originally intended, so long as they are required for the sick and wounded. The commander into whose power they have fallen may, however, if the military situation requires it, apply them to other purposes, after seeing t

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Article 8

Article 8

Hospital-ships and sick-bays of vessels are no longer entitled to protection if they are employed for the purpose of injuring the enemy. The fact of the staff of the said ships and sick-bays being armed for maintaining order and for defending the sick and wounded, and the presence of wireless telegraphy apparatus on board, are not sufficient reasons for withdrawing protection....

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Article 9

Article 9

Belligerents may appeal to the charity of the commanders of neutral merchant-ships, yachts, or boats to take the sick and wounded on board and tend them. Vessels responding to this appeal, and also vessels which may have of their own accord rescued sick, wounded, or shipwrecked men, shall enjoy special protection and certain immunities. In no case may they be captured for the sole reason of having such persons on board; but, subject to any undertaking that may have been given to them, they remai

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Article 10

Article 10

The religious, medical, and hospital staff of any captured ship is inviolable, and its members may not be made prisoners of war. On leaving the ship they are entitled to remove their own private belongings and surgical instruments. They shall continue to discharge their duties so far as necessary, and can afterwards leave, when the Commander-in-Chief considers it permissible. Belligerents must guarantee to the said staff, while in their hands, the same allowances and pay as are given to the staf

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Article 11

Article 11

Sick or wounded sailors, soldiers on board, or other persons officially attached to fleets or armies, whatever their nationality, shall be respected and tended by the captors....

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Article 12

Article 12

Any war-ship belonging to a belligerent may demand the surrender of sick, wounded, or shipwrecked men on board military hospital-ships, hospital-ships belonging to relief societies or to private individuals, merchant-ships, yachts, or boats, whatever the nationality of such vessels....

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Article 13

Article 13

If sick, wounded, or shipwrecked persons are taken on board a neutral war-ship, precaution must be taken, so far as possible, that they do not again take part in the operations of the war....

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Article 14

Article 14

The sick, wounded, or shipwrecked of one of the belligerents who fall into the power of the other belligerent are prisoners of war. The captor must decide, according to circumstances, whether to keep them, send them to a port of his own country, to a neutral port, or even to an enemy port. In this last case, prisoners thus repatriated may not serve again while the war lasts....

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Article 15

Article 15

The sick, wounded, or shipwrecked, who are landed at a neutral port with the consent of the local authorities, must, in default of arrangement to the contrary between the neutral State and the belligerent States, be guarded by the neutral States so as to prevent them from again taking part in the operations of the war. The expenses of tending them in hospital and interning them shall be borne by the State to which the shipwrecked, sick, or wounded persons belong....

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Article 16

Article 16

After every engagement, the two belligerents shall, so far as military interests permit, take steps to look for the sick, wounded, and shipwrecked, and to protect them, as well as the dead, against pillage and improper treatment. They shall see that the burial, whether by land or sea, or cremation of the dead shall be preceded by a careful examination of the corpse....

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Article 17

Article 17

Each belligerent shall send, as early as possible, the military marks or documents of identity found on the dead and a list of the names of the sick and wounded picked up by him to the authorities of their country, navy, or army. The belligerents shall keep each other informed as to internments and transfers as well as to the admissions into hospital and deaths which have occurred among the sick and wounded in their hands. They shall collect all the objects of personal use, valuables, letters, e

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Article 18

Article 18

The provisions of the present Convention do not apply except between Contracting Powers, and then only if all the belligerents are parties to the Convention....

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Article 19

Article 19

The Commander-in-Chief of the belligerent fleets shall give detailed directions for carrying out the preceding Articles and for meeting cases not therein provided for, in accordance with the instructions of their respective Governments and in conformity with the general principles of the present Convention....

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Article 20

Article 20

The Signatory Powers shall take the necessary steps in order to bring the provisions of the present Convention to the knowledge of their naval forces, and especially of the members entitled thereunder to immunity, and to make them known to the public....

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Article 21

Article 21

The Signatory Powers likewise undertake to enact or to propose to their Legislatures, if their criminal laws are inadequate, the measures necessary for checking in time of war individual acts of pillage and ill-treatment in respect to the sick and wounded in the fleet, as well as for punishing as an unjustifiable adoption of naval or military marks, the unauthorised use of the distinctive marks mentioned in Article 5, by vessels not protected by the present Convention. They shall communicate to

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Article 22

Article 22

In the case of operations of war between the land and sea forces of belligerents, the provisions of the present Convention are only applicable to the forces on board ship....

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Article 23

Article 23

The present Convention shall be ratified as soon as possible. The ratifications shall be deposited at The Hague. The first deposit of ratifications shall be recorded in a Protocol signed by the Representatives of the Powers which take part therein and by the Netherland Minister for Foreign Affairs. The subsequent deposits of ratifications shall be made by means of a written notification, addressed to the Netherland Government and accompanied by the instrument of ratification. A duly certified co

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Article 24

Article 24

Non-Signatory Powers which have accepted the Geneva Convention of July 6, 1906, may accede to the present Convention. A Power which desires to accede notifies its intention in writing to the Netherland Government, forwarding to it the act of accession, which shall be deposited in the archives of the said Government. The said Government shall immediately forward to all the other Powers a duly certified copy of the notification, as well as of the act of accession, mentioning the date on which it r

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Article 25

Article 25

The present Convention, duly ratified, shall replace, as between Contracting Powers, the Convention of July 29, 1899, for the adaptation to naval warfare of the principles of the Geneva Convention. The Convention of 1899 remains in force as between the Powers which signed it but which do not also ratify the present Convention....

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Article 26

Article 26

The present Convention shall take effect, in the case of the Powers which were parties to the first deposit of ratifications, sixty days after the date of the Protocol recording such deposit, and, in the case of the Powers which shall ratify subsequently or which shall accede, sixty days after the notification of their ratification or of their accession has been received by the Netherland Government....

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Article 27

Article 27

In the event of one of the Contracting Powers wishing to denounce the present Convention, the denunciation shall be notified in writing to the Netherland Government, which shall immediately communicate a duly certified copy of the notification to all the other Powers, informing them of the date on which it was received. The denunciation shall only operate in respect of the denouncing Power, and only on the expiry of one year after the notification has reached the Netherland Government....

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Article 28

Article 28

A register kept by the Netherland Ministry for Foreign Affairs shall record the date of the deposit of ratifications effected in virtue of Article 23, paragraphs 3 and 4, as well as the date on which the notifications of accession (Article 24, paragraph 2) or of denunciation (Article 27, paragraph 1) have been received. Each Contracting Power is entitled to have access to this register and to be supplied with duly certified extracts from it. In faith whereof the Plenipotentiaries have appended t

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