Surgical Experiences in South Africa, 1899-1900. George Henry Makins
from. The loaded stretcher and wheeled carriage can be readily handled by one man on good roads, and by two men in rough country. The springs prevent any jar being felt by the patient on the stretcher.
(b) For the longer journeys to the Field or Stationary hospitals, the service wagon and other transport vehicles came into use, particularly the South African ox-wagon.
The service wagon (fig. 7) is a heavy four-wheeled vehicle, drawn by ten mules. The good construction of the wagon was amply proved by the manner in which it stood the hard wear and tear of the present campaign. It is, however, very heavy, and in comparison with its size affords very small accommodation. Two lying-down patients and six sitting is its entire capacity. Some modified patterns were in use, notably those with the Irish and Imperial Yeomanry Field Hospitals, capable of carrying four lying-down cases, the men being arranged in two tiers. Major Hale, R.A.M.C., made a very successful trek from Rhenoster to Kroonstadt with some of these, carrying twice the regulation number of lying-down cases in his wagons. Some modification in the mode of fixation is, however, necessary to increase the security of the stretchers of the upper series.
A really satisfactory wagon, combining both strength and comfort, still remains to be devised.
During the later stages of the campaign, a very large number of patients were transported by the South African ox- or mule- (buck) wagons. Although not of prepossessing appearance, and unprovided with any sort of springs, these vehicles were far from unsatisfactory. The ox-wagon consists of a long simple platform, 19 ft. 2 in. in length, 4 ft. 6 in. in width, from the sides of which a slanting board rises over the wheels for the posterior two-thirds. These bulwarks increase the actual width to 6 ft. 6 in., which corresponds with the gross width occupied by the wheels. One third is covered by a small hood 5 ft. 6 in. in height erected on wooden stave hoops. The latter was often absent in transport wagons. The two hind wheels are large, the fore somewhat smaller. They are attached to very heavy wooden cross-beams bearing the axles, and the two beams are connected by a longitudinal bar, continuous with the düssel boom or pole. This latter bar is in two sections, the connection of which allows considerable play in the long axis and serves to break the jolts occurring when either pair of wheels passes over uneven spots on the ground. When some sacks of oats or hay were spread over the floor the wounded men travelled comparatively comfortably in these wagons, the great distance between the fore and hind wheels tending to minimise the jolting. The principal objection to them was the slow pace of the oxen, and the fact that to obtain the greatest amount of work from these animals a major part of the journey must be performed during the night. The ox-wagon carries, with comfort, four lying-down cases on stretchers, or six without stretchers; or twenty sitting-up cases.
The mule- or buck-wagon, which is of the same class but smaller, can only accommodate two stretchers, four lying-down men without stretchers, or 12–14 sitting-up cases. As a rule, the wagons were loaded with recumbent cases in the centre, while more slightly wounded men sat around, and were able to give help to those lying down when needed. The wagons can be covered with canvas throughout.
The steady even pace of the oxen is a great advantage, and I was often surprised to see how well men bore transport in these wagons, who seemed utterly unfit to be moved had it not been an absolute necessity. A very large number of the wounded from Paardeberg Drift were transported to Modder River in them.
One other advantage of these wagons, the possibility of converting them into an excellent laager, is not to be underrated. Any one who saw the comfortable encampment which a naval contingent on the march made by massing the wagons with intervals covered by macintosh sheets, could at once appreciate their capabilities for a long trek.
Traction engines were, as far as I know, never employed as a means of transporting the sick. The tendency of these heavy machines to stick in the mud and to break down bridges is so well known that it hardly needs mention. Putting these disadvantages on one side, with a supply of fuel ensured, and such roads as are afforded by a civilised country, a great future is probably before this means of transport for the wounded. A large number of patients might be carried at an even pace, and the camps would be saved all the trouble and worry of the transport animals.
Trains.—In many cases in Natal, and in a few instances on the western side, the wounded men were able to be transferred from the first dressing station directly into the trains. Space will not allow me to describe any of those in use, but the accompanying illustration shows the general arrangement of the beds in Nos. 2 and 3 trains (fig. 9). The carriages were converted from ordinary bogie wagons of the Cape Government Railway stock under the supervision of Colonel Supple, R.A.M.C., P.M.O. of the Base at Cape Town. Each train was provided with accommodation for two medical officers, two nursing Sisters, orderlies, a kitchen, and a dispensary, and each carried some 120 patients. The trains were under the charge of Major Russell, R.A.M.C., and Dr. Boswell (and later other civilian medical officers) and of Captain Fleming, R.A.M.C., D.S.O., and Mr. Waters, and carried many thousand patients from all parts of the country to the Base and Station hospitals. They were most admirably worked, and seemed to offer little scope for improvement except in minor details. To them much of the success in the treatment of the wounded who had to traverse the immense distances incident to South Africa must be attributed. I made many pleasant journeys in each of them. Later, two additional trains, Nos. 4 and 5, of a similar nature, were added. Two trains, No. 1, and the Princess Christian train, which I was not fortunate enough to see, performed similar duties for Natal.
Hospital Ships.—These were numerous and some especially well arranged. Fig. 10 is of the 'Simla,' a P. & O. vessel which was admirably adapted to the requirements of a hospital ship. On her main deck some 250 patients were accommodated in a series of wards all on the same level, which much lightened the difficulties of service usually experienced. During the present campaign the abundance of transport vessels rendered the transhipment of patients to England a matter of comparative ease, and good vessels were always available. Considering the constant transhipment of invalids from India and our other colonial possessions, it would seem advisable that, in place of having to hurriedly improvise hospital ships, the Government should possess two or three hospital ships of the 'Simla' type. It is true this would deprive our naval transport officers of a duty which in this war was performed with extraordinary celerity and success; thus the 'Simla' was fitted in seven days, and sailed with a cargo of invalids ten days after her arrival at Durban; but on the other hand it would ensure that really suitable vessels were always provided.
To give some idea of the amount of work contingent on the transport of wounded men from an army of some 15,000, fighting its way against continued opposition, I will quote the approximate number of men moved during Lord Methuen's advance from Orange River to Magersfontein. (The number of men actually present at each battle is shown in Table I., p. 12.)
Belmont, the first battle, was fought on November 23.
November 24.—No. 2 hospital train removed 152 cases to the Stationary Field hospitals at Orange River, then returned and loaded up with 130 more. Some of the most severe cases in the latter were detrained at Orange River, and the remainder were taken direct to Wynberg (591½ miles).
The division marched, and the battle of Graspan was