While plans for the defence of the Suez Canal against an attack from the east were being carried into effect, as already narrated, the protection of Egypt on its western front had been by no means neglected.
The problem here in the west was very different from that confronting us in the Suez Canal area. Egypt has been very aptly described as a streak of mud drawn through a desert of sand. This streak, conterminous with the course of the Nile, stretches from Alexandria on the Mediterranean coast due southward to the Sudan, a distance of about 600 miles. Leaving out of account the wide and fertile Delta, this streak of deposited river mud, perhaps the richest soil in the world, has a breadth of from one mile to fifteen miles. There is also the coast-line, more or less cultivable on account of its appreciable rainfall, stretching westward from Alexandria for a distance of about 200 miles. Throughout the Desert, lying within and near the vast right-angle formed by these two streaks, there are numerous, though widely separated oases, inhabited by various Bedouin tribes. It was against these tribes that we were now called upon to protect the western frontier of Egypt – a frontier which, owing to the peculiar configuration here described, extended practically for 800 miles.
The question of the defence of this frontier did not seriously obtrude itself until the late autumn of 1915.
The semi-political religious sect of Bedouins, taking its name from that of a prominent and powerful Sheik, El Sennussi, was widely distributed along the hinterland of North Africa. This sect came seriously into collision with the Italians in the war of 1912 in Tripoli. The headquarters of the Sennussi were at Siwa, one of the most extensive, as well as most distant, of the western oases.
The Sheik, EI Sennussi, himself had hitherto always expressed a friendship for England, though he was bitterly opposed to the Italians ; but when Turkey entered the war against us, the Sheik came under the malign influence of some Germanised Turkish officers, particularly that of Nuri Bey, a brother of Enver Pasha, and he began to waver in his allegiance. For some time he did not openly declare himself against us, but about November, 1915, he gathered together a force of his followers, with the assistance of Turkish officers, and advanced against the coast of Northern Egypt.
The coast villages of Matruh, Barani and Sollum were at that time garrisoned by detachments of the Egyptian Coastguards. On the arrival of the Sennussi at Sollum and Barani, these Coastguards offered no resistance, and a considerable number of them deserted and joined the enemy. The local Bedouins and Arabs of the coast for the most part threw in their lot with the invaders. At this juncture our Western Frontier Force took the field. We reached Matruh in advance of the Sennussi, and occupied and held it. After some months of more or less defensive action, a bold push was made, the Sennussi were driven back, and eventually decisively defeated in two major engagements.
Thereafter operations consisted mainly in seizing and occupying the various oases and routing there-from the scattered remnants of the enemy. Most of these, together with the local Arabs, eventually gave in their submission and were disarmed. It became necessary, however, to garrison with British troops the oases and the most important places on the western fringe of Egypt, to overawe the population, among whom a certain amount of disaffection existed owing to a wide-spread sympathy with the tenets of the Sennussi sect.
The work of the R.A.M.C. on this frontier was peculiarly difficult and arduous, not only during the time of active operations, but throughout the tedious periods spent with the garrisons occupying so many remote and inaccessible spots. The climate of these western oases, as well as of the terrain lying immediately westward of the Nile, is such that, in the opinion freely expressed at the time by those best qualified to judge, our troops would not be able to withstand it unharmed during the summer heats. Malaria, plague, enteric fever, dysentery, smallpox, and typhus were said to be indigenous to the district, and this by no means exhausted the list of local disabilities. To be forewarned, however, is to be forearmed ; and our medical authorities laid their plans with commendable thoroughness and foresight. During the actual fighting period the main difficulty of dealing with the sick and wounded lay in the matter of transport, a peculiar condition of the country being the vast distances that often intervened between the scene of hostilities and the base. Luckily, however, we were not dependent to any great extent on camel transport for helpless men, which had been such a trying feature of the campaign in Sinai. The camel cacolet is at best a cruel means of conveyance for a seriously wounded man. Its motion, when the animal is on the march, may be likened to that of a small boat in a choppy sea. If the camel had never before earned its title of “The Ship of the Desert,” some British sufferer would now certainly have hit upon the simile, but probably from no access of poetic fervour, and assuredly with a more than generous garniture of adjectives. Fifteen or twenty miles in a camel cacolet with a fractured femur would vitiate the vocabulary of a saint.
Fortunately the sand of the western Desert, owing to the limestone substrata, was often so compact and smooth that the use of light motor ambulances with good axle-clearance was found quite feasible. This was generally the case within the coastal area of operations, and, in a less degree, on the tracks between some of the oases ; while throughout the country contiguous to the Nile, the motors were almost universally employed. Where, however, the motors could not penetrate, sand-carts drawn by four mules necessarily took their place.
In the subsequent treatment of sick and wounded on this frontier, in view of the great distances between the posts held by the troops and the inadvisability of evacuating all the cases to the General Hospitals at the Base of the Force in Cairo, an ingenious arrangement was effected. Along the course of the Nile facing the Desert there are certain small towns at widely separated intervals, and in each of these towns there is a more or less well-appointed native hospital. Such places are Fayoum, Beni Suef, Minia, Assiut, Sohag, Kena, Esna, and Assuan. Negotiations were concluded with the Egyptian Public Health Department – itself under the direction of a British R.A.M.C. officer – for an allotment of space in the hospitals at all these places, to be used for British patients and be exclusively under the care of an R.A.M.C. personnel, M.O.’s and orderlies, as well as a Q.A.I.M.N.S. Matron and the necessary staff of nurses. The male medical staff for these hospitals was wholly drawn from the various Field Ambulances acting with the Force; and the arrangement was specially useful in that it gave the R.A.M.C. ambulance men the privilege of learning to work under Nursing Sisters a faculty in which some otherwise capable orderlies are sorely lacking while, it also proved a good opportunity for gaining experience in nursing duties and general hospital routine.
In addition to the partial use of these Egyptian State Hospitals, Field Ambulance Camp Hospitals, for the treatment of less serious cases, were established in all the more important camps. The patients were in almost every instance accommodated in the very convenient E.P.I.P. tents, though reed huts were provided at certain places, and existing local buildings were occasionally used. Either the regulation iron bedsteads, or the native angerib – like an oblong basket made of palm staves and turned upside down – were provided in all the camp hospitals, and a special schedule of equipment was added to the Field Ambulance Establishments to bring them up to the standard of Casualty Clearing Stations.
Cases requiring special or prolonged treatment were sent to the Cairo General Hospitals, and during the hot weather it was found advisable to send a considerable number of men to convalescent hospitals in Cairo before returning them to duty. In the cooler months of the year, however, very few convalescents were sent away from the area, most of the cases being re-drafted to their units direct from the West Force hospitals.
But the treatment and care of the sick and wounded formed only part, and not the larger part, of the work of the R.A.M.C. on the western Desert. Under the trying climate and soil conditions, the maintenance of the health of the troops by rigid sanitary surveillance of the camps and the adoption of preventive measures against disease became all-important.
It was realised from the first that the health of the British troops in such an environment, especially during the trying heats of summer, could only be ensured by giving the men in the permanent camps a high standard of bodily comfort, not neglecting also the psychological aspect of the question.
It was stipulated that all troops should be housed in double-skin tents, the well tried and proved E.P.I.P. tent where available, but failing this, the bell tent with double top. Meals were not to be taken in the sleeping-quarters. Mess-huts, made of light wooden framework, covered with grass matting, were to be provided and these huts were also to serve as resting-places during the hottest time of the day. Fly-proof larders for storage of food, and properly sheltered cook-houses, were installed ; shelters were also erected for stables, so that the men would not have to groom in the sun. Personal cleanliness among the troops was encouraged in all possible ways, ablution-places, and – wherever the water- supply would allow it – shower-baths, were provided on a liberal scale. Lastly, and not least important, all camps were established, when anyhow practicable, well out on the clean Desert sand, experience having proved that the proximity of cultivated land always meant the presence in the air of a disagreeable and highly infective dust which could not prove otherwise than a source of danger.
The provision of water, good alike in quality and quantity, was an ever-urgent problem. It was not merely a question of providing drinking-water – that prime necessity of Desert life – which should be free from taint of disease. That used for washing and bathing had also to be safeguarded: Our R.A.M .C. bacteriologists had firmly established the fact that the germs of a distressing and incurable ailment called bilharziosis, largely prevalent among the native population, lurked in nearly all natural sources of water in Egypt, not excluding the Nile itself ; and mere skin-contact with the infected water was quite enough to communicate the disease to British troops. Fortunately the problem of dealing with water in large quantities so as to render it safe for use was simplified in this case by the fact that mere straining, and storing for 48 hours, would serve to eliminate the danger. It needed, however, in addition, constant vigilance to prevent the contraction of the disease by men surreptitiously bathing in the river or any of the canals, or the water-holes of the oases, all of which were probably swarming with the bilharzia organism. This, indeed, has been an ever-present danger to our troops quartered in any part of Egypt and the Sudan, and has from the first received the closest attention from the medical authorities.
In addition to the work of rendering the Army water-supply free from disease-producing organisms, the duties of camp sanitation and conservancy – the disposal of waste products- – have closely occupied the attention of the R.A.M.C. Sanitary Sections on both Fronts. These are questions, always of prime importance in warfare, which assume still graver proportions when hostilities are being carried out by European troops in a tropical or sub-tropical country.