El Arish & After

The advance across the Sinai Desert from Romani to El Arish called for a vast amount of work on the part of the Royal Army Medical Corps, distinct from its Field Ambulance and hospital duties.

Our Mobile Column had moved continuously ahead of the main body of our troops, and was often encamped many miles from the railhead, its supplies, including water, being carried to it by means of camels, no wheeled transport being possible in that terrain. The difficulty of maintaining an adequate supply of water in this way was enormous, owing to the large number of animals employed. Everything was done, therefore, to discover and develop such natural sources of water as might exist on the route chosen, in order to minimise the problem of transport from the base. 

With this object in view, water reconnaissance parties were organised and sent forward in advance of the column. These parties consisted of detachments of the Royal Engineers accompanied by their attached Medical Officers. They worked under an escort of mounted troops, and were often away from the base for weeks on end, pricking the ground in all likely spots by means of Norton ‘s Tubes, and, where water was found, marking the locality for the guidance of the well-sinking parties of infantry who would eventually follow. These water reconnaissance parties were entirely detached, and their task was not unattended by danger. They were frequently attacked by enemy aircraft, and had continual hairbreadth escapes. The Medical Officers accompanying the parties were provided with chemical boxes containing all requisites for testing the quality of the water located. The chief difficulty was to discover water of sufficiently low salinity as to be drinkable by troops. In many places near the sea-coast, though trial borings revealed the existence of water in fair quantity, it was often more than four times as salt as sea water.

The occupation in force of El Arish by our troops raised this question of water-supply into one of prime and very grave importance. The railhead was at some distance from the town. This intervening stretch of Desert proved almost entirely waterless, and our troops were dependent on camel-borne water, not only during their march thither, but for such time from the commencement of their occupation of the town as must elapse before the local supplies could be sufficiently developed. These required a large supply of potable water daily. It will be understood, therefore, what a strain was thrown on the resources of our camel transport service until the supply from wells sunk in the locality could be raised to the requisite point. Luckily, fresh water in abundance was obtainable in the vicinity of the Wady el Arish, a substratum of impervious clay existing beneath the sand, which latter acted as a natural filter for the surface water. All wells, however, had to be treated by chlorination, or other means, before they could be used by the troops, and this involved heavy and continuous work on the part of the Sanitary Sections of our Corps.

Our sanitary men had indeed a busy time during  the first weeks of our occupation of El Arish. The town had been in possession of the Turks for about two years previously, and its condition from a sanitary point of view, on our arrival, was well-nigh indescribable. 

El Arish lies in the midst of a wide plain of more or less cultivated land, interspersed with woods of date-palm. The town covers a considerable area; but, far from being the prosperous eastern caravan-city as represented by the newspapers at home, it proved, on our arrival, to be largely of the tumble-down, half-ruinous type, inhabited, or rather haunted, by some four thousand people – a thoroughly cowed, disheartened, poverty-sticken crew.

How much of this was due to the blessings of the Turkish occupation we had no means of judging, and little time to inquire. The Turks, on their departure, had not only carried off with them all men of military age, but had entirely denuded the town of foodstuffs. Those of the people who remained were practically starving, and to feed them was the first duty that confronted us on our entry. Our next was to cleanse the place. 

The situation which faced our R.A.M.C. sanitary men in this regard was little less than appalling. El Arish consisted of a wide-spreading jumble of houses and mud-huts, intersected by a labyrinth of narrow lanes, courtyards, and cul-de- sacs. Human excrement, filth and garbage of all kinds, were heaped in every corner, and met the eye and the nostrils at every turn. Turkish latrine-pits, full to the brim with the accumulation of months, were spread indiscriminately over the whole town-area, each adding its stench to the already overburdened air. There was a plague of flies in the place, and little wonder. The people were overrun with vermin. Smallpox was early discovered to be rife among them. Cholera was suspected. We came into the place literally with our lives in our hands. Moreover, the thousands of inhabitants remaining there continued to befoul the public ways with their excreta under our very eyes, and thus added every day to the perils and difficulties of the situation. 

The country immediately surrounding the town was in no better case. All the “hods” or plantations of trees, were thickly bestrewn with human fæces and the dumped refuse of ages ; while the trenches which had been dug for the defence of the place by the Turkish garrison were little better than open latrines. 

Well might the officer commanding our R.A.M.C. Sanitary Section have despaired at sight of the Augean stable, the work of whose cleansing confronted him on his entry into El Arish. But of course he did nothing of the kind. He and his men wasted no time in looking at the job; they just took off their coats and went at it. 

Organisation won the day. Maps of the town and its vicinity were immediately prepared, and the each section was ground divided into sections. placed under the charge of an R.A.M.C. man as inspector, with a staff of natives, hastily recruited in the town, to carry out his orders. Steadily, methodically, each street, cross-lane, corner, and blind alley was cleared of its filth. Old fæcal heaps were first treated with disinfectants, and then buried on the spot. Public latrines and public incinerators for the reception and destruction by burning of all refuse, were established in various convenient spots, and the compulsory use of them by the El Arish folk enjoined under pain of severe penalties. Then a house-to-house tour was organised, the local Egyptian doctor acting as interpreter; and each house was thoroughly cleansed, sprayed with germicide, its compound scavenged, and all garbage and rubbish consigned to the nearest incinerator. The native school was visited and plentifully dosed with disinfectants. Afterwards a system of daily scavenging of all public ways in the town was instituted and maintained, a permanent staff of natives under four permanent inspectors being detailed for the purpose. Also, to minimise in some degree the plague of flies-pending their disappearance following the removal of their breeding-grounds as above described – a liberal supply of fly-papers and tanglefoot was distributed among the inhabitants with very encouraging results. As a final sanitary measure, all moist places and stagnant pools round about the town received a surface-film of petroleum for the destruction of mosquito larvæ ; and the native sources of drinking-water were carefully chlorinated, in the same way as was done for our own troops. 

While all these dispositions were being carried into effect by the Sanitary Section, our Medical Staff was vigorously prosecuting its own side of the work. The town was systematically and thoroughly searched for cases of smallpox and other infectious diseases. When found, these were removed to an isolation hospital, the buildings where the ailments were identified undergoing drastic fumigation, and all clothing, etc., destroyed. People who had come into contiguity with these cases were also removed and placed under quarantine as “contacts” This, however, considerable as it was, formed relatively only a small part of the work of the R.A.M.C. Medical Staff at this critical period. Vaccination of the whole population of El Arish was decided upon as a precautionary measure, and there can, of course, be no question as to the wisdom, or rather the downright necessity, of the step. The puzzle, however, was how to carry out the edict effectively. As a matter of fact, over 3,000 were vaccinated by our M.O.’s out of a roughly computed population of 3,700, and there is little reason for doubt that by this prompt measure a severe epidemic was nipped in the bud.

It must be remembered that all these early sanitary and humanitarian operations were carried through long before the railway reached El Arish. Everything needed – disinfectants, medical supplies and the like – had to be brought up on the backs of camels, a tedious and lengthy process. 

In addition to the labours imposed on our R.A.M.C. men by the insanitary condition of the town itself, there occurred at this time among our troops a severe outbreak of scabies, popularly believed to be a kind of skin disease, but actually an irritant and inflammatory condition due to a parasite which burrows into the skin. It became necessary to treat large numbers of our men for this highly contagious affection, but personal treatment could be of little practical avail without the thorough disinfection of all clothing and bedding. The treatment of fabrics on so large a scale as now became necessary could be effected only by means of the Thresh high pressure steam disinfecting machines in common use in the army. But our Thresh machines were down at railhead, and there was no possibility of getting them brought up for some time to come. 

At this juncture we made an extremely lucky find. This was nothing less than a steam disinfector which had been left behind by the Turks on their evacuation of El Arish. It was discovered hidden away in an obscure corner, and proved to be in good going order. Our Sanitary Section soon had the machine in action, and by its means carried out the sterilisation necessary for the whole of the troops. 

Subsequently, this machine proved itself an invaluable addition to our medical resources. All agreed that it accomplished its work better and more quickly than the machines of British make officially supplied to the Section – a circumstance which will cause little wonder to engineers acquainted with the machinery market of pre-war times, when it is mentioned that though this appliance purported to be Turkish, and had, indeed, the Red Crescent and a Turkish motto glaringly displayed upon it, an inconspicuous tablet revealed the fact that it was made in “Wien”

The evacuation of El Arish by the enemy, and his pursuit and decisive defeat at Rafa at the hands of our troops, marked really the close of the Near East Campaign so far as Egypt was concerned. Here, therefore, our account of the doings of the Royal Army Medical Corps in Egypt in respect of the actual fighting naturally terminates. Rafa was the last stronghold of the Turks in Egyptian territory. Thenceforth the war was to be carried into the enemy’s own country, and how this latter task was accomplished is, or soon will be, known to all. 

That, however, is “another story”, the telling of which must be left to other pens.

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