Medical
Because they had no official army, except for the Staats Artllerie which had its own Doctor, Lillpop, the Boers had nothing set up to handle military casualties and it was the Jameson Raid which brought home this deficiency. The Pretoria Ambulance corps was formed becoming the Het Transvaalsche Roode Kruis in 1896 when the Geneva Convention was signed. As late as August 1899 there were very few ambulance units and it was not until January 1900 that the Republic set up a commission to establish ambulance requirements for Commandos. At the commencement of the war there were field hospitals scattered about in places such as Newcastle, Standerton and others that were manned by local Doctors, all under the general administration of Dr. Liilpop of the TRK. Soon after the commencement of hostilities hospitals and ambulances began arriving from countries sympathetic to the Republic’s cause, Germany, Russia, Holland, Swiss Red Cross and even from SA medical students studying at Edinburgh University which caused quite a stir in Britain. There were three Ambulances (hospitals) with the Boers at Ladysmith, one behind Pepworth Hill, another behind Lombards Kop and the third north of Telegraph Ridge. The service offered by these Ambulances was on a par with the British Field hospitals except the lack of medicines and equipment must have hindered their work.
The majority of the medical staff in the British army came from the fairly new Royal Army Medical Corps and would be attached to either Field, or Stationary Hospitals. There were also volunteer units from Natal and Britain that played a valuable part. Each soldier was supplied with a field dressing, the first time this had happened in a war situation. One medical NCO and two stretcher bearers were attached to each company whose job it was to treat the very minor cases and to carry the more major ones to a Medical Officer at the battalion post. Head injuries and the more serious cases were transferred to the Stationary hospital back at the base or the main hospital at Pietermaritzburg. Once the patient had been transferred to a Stationary or Base hospital it was fairly certain that he would be sent home to Britain by ambulance train to Durban and placed on a specially equipped hospital ship.
Field hospital dynamo
In Ladysmith at the start of the siege there were quite a number of hospitals both Stationary and Field but early on it became obvious to General Sir George White that a safer situation was needed. Negotiations with the Boer General Piet Joubert resulted in a large hospital camp being set up outside the town, in no-mans-land at a place called Intombi Camp. It was here that several of the hospitals were transferred.
Ambulances in the field were pulled either by oxen or horses and over the bumpy veldt, the bearers quite often had to unload the stretchers and carry their patients across large dry river beds or dongas or dried up river beds whilst the ambulance wagon caught up. This was quite stressful for the injured. Both the Boer and British medical staff treated all wounded alike providing medical help, water and tobacco. The British wounded were collected by the “body snatchers” comprised of volunteers, among them the famous Dhoolie bearers, unarmed “angels of mercy” who often retrieved the wounded whilst under heavy fire.
British ambulance
The majority of the medical staff in the British army came from the fairly new Royal Army Medical Corps and would be attached to either Field, or Stationary Hospitals. There were also volunteer units from Natal and Britain that played a valuable part. Each soldier was supplied with a field dressing, the first time this had happened in a war situation. One medical NCO and two stretcher bearers were attached to each company whose job it was to treat the very minor cases and to carry the more major ones to a Medical Officer at the battalion post. Head injuries and the more serious cases were transferred to the Stationary hospital back at the base or the main hospital at Pietermaritzburg. Once the patient had been transferred to a Stationary or Base hospital it was fairly certain that he would be sent home to Britain by ambulance train to Durban and placed on a specially equipped hospital ship.
From the medical attendant on the battlefield the injured soldier would be taken to one of two hospitals, either a Field hospital or a Stationary unit. Field Hospitals were positioned in close proximity to the battle and were designed to handle 100 patients. Doctor Treves, however, in his book “The Tale of a Field Hospital” describes No. 4 Field Hospital as designed to accommodate 300, in sixty-six bell tents and ten marquees. The Stationary Hospital was invariably sited close to the main lines of communication with facilities for 100. The very seriously injured were sent to General hospitals in Pietermaritzburg and Durban.
In Ladysmith at the start of the siege there were quite a number of hospitals both Stationary and Field but early on it became obvious to General Sir George White that a safer situation was needed. Negotiations with the Boer General Piet Joubert resulted in a large hospital camp being set up outside the town, in no-mans-land at a place called Intombi Camp. It was here that several of the hospitals were transferred
Attached to the Relief force was No. 4 Field Hospital under Colonel Gallway CB. His team comprised Major Baird and Captain Begbie along with 88 NCO’s and men, three army and nine civilian surgeons, two sisters, two nurses and a hundred native attendants. This hospital arrived at Frere Camp on the evening of 11th December 1899. Two days later it was moved to Chieveley in readiness for the battle of Colenso.
No.1 Stationary Hospital in Ladysmith was originally established at the Town Hall but after it came under fire it was moved to Intombi Camp. The hospital staff included Major Minnice, Lieutenant Weld and sisters Dowse, Noble, Bond (in charge of the operating theatre) Hoadley and Hill. Many of these nurses were awarded Red Cross medals for service aIntombi Camp. The largest number of patients in the Stationary Hospital was recorded at 800.
The Natal Volunteer Medical Corps served with the Siege and Relief forces. Although initially the Corps hospital was in the town it was eventually moved to Intombi Camp under the Principal Medical Officer Major Hyslop. Other medical staff consisted of Captain Currie, Doctor Fernandez, Captains Buntie and Bowhew, Lieutenants Hornabrook and Campbell, Doctors Balfour, Marton, Harwarden, Whitehead, Salmond, Kay, Henter, Cream and Nix. The Matron was Yeatman with sisters Mrs Ludlow, Ross, Lees, Shapiro and Miss’s Charleson, Patterson, Keighly and Stow. The number of cases treated by the Volunteer Hospital was 843, 99 of whom died. The largest number of cases accommodated at one time was 345. Those nurses who preferred to remain in town remained with the Volunteer Hospital, They were often helped by civilians such as Miss Craw, Nurse Deane and Miss Webber.
Doctor Bruce was to investigate the outbreak of enteric fever among British troops in South Africa during the Boer war. Mary Elizabeth accompanied him and they both played a prominent role in the siege of Ladysmith, where he directed a hospital and performed successful surgery. They returned home in October 1901. Mary Bruce received the Royal Red Cross Medal for devoted work with the wounded, particularly as nursing sister in her husband’s operating theatre. Colonel Bruce was promoted and received a medal with seven clasps. Article donated by Basil Grogono
So Grateful were the Natal Mounted Rifles for the splendid work of the volunteer nurses that the regiment presented silver shields to many of them as tokens “of remembrance of untiring care and unceasing devotion”.
No. 2 Field Hospital was sited just off the road on the outskirts of town.
No. 11 Field Hospital arrived 14th October 1899 with Carter, Pope and Martin in charge. It was situated at Market Square adjacent to Town Hall. It was later moved to the ravine at the foot of Leicester Post on 11th December 1899.
No. 12 Field Hospital with 100 beds and under Major Love Royal Army Medical Corps and Doctor Exton, was situated at the Station and was subsequently moved to Intombi Camp.
No. 18 Field Hospital, initially at Dundee, was moved to Ladysmith and sited around Market Square.
No. 24 Field Hospital from India, arrived on 8th October 1899 and was also sited near Market Square. It was later situated between Black Rock and Red Hill near Range Post. It was a massive affair, constructed of turf, with a roof of pipes and rocks and big enough to hold 20 patients who were reached through a winding passage. Major Donegan took charge and was assisted by Majors Martin, Porter and Holt together with Lieutenant Martin.
No. 26 Field Hospital, with 50 beds, was the Indian Field Hospital and was initially sited near Market Square but subsequently moved to Intombi Camp under Major M.W.Kevin.
No. 69 was a native Field Hospital under Major W.H.W. Elliot, assisted by Indian Medical staff.
Additional hospital space was set aside in the church buildings.
Colonel Exham was Principal Medical Officer in charge of all medical facilities within the town, a very controversial man by all accounts.
There was a civilian hospital within the town called “The Ladysmith Borough Hospital” managed by the Mayor and his deputy. Patients were referred by their medical practitioner and paid their way at 2 pounds 2 shillings per week for nursing, accommodation, bedding and medicine.
Outside the town other Hospitals took the form of trains and ships. Both were fully equipped and highly regarded. The first train to re-enter Ladysmith following the relief was a Hospital Train. Ten Hospital ships were existed, the most famous being the “Maine”, under the direction of Lady Randolf Churchill.
Throughout the Siege a total of 10 673 cases were handled by the Hospitals. Of the 583 soldiers who died, 382 were the result of Enteric fever and 109 of Dysentery.
Blood Transfusions and saline Drips were unheard of, the X-Ray machine was very much in its infancy and Ambulances were covered wagons pulled by oxen or horses. In a very primitive form it was used during the War when ever
y available machine was sent to South Africa. Rontgen had discovered the x-ray only three years earlier.
Disease
Injuries were not the only cause of incapacitation to the British soldier, deaths from diseases were very high on the list and at the end of the 19th century very little was known about treating patients for them. Deaths from disease were higher than from a Boer bullet.
The Boers had cut the fresh water supply quite early in the siege and the only water available was from the Klip River which, as the siege progressed, became increasingly contaminated and was the cause of the high incidence of deaths from diseases such as Enteric, Malaria and Dysentery. The first two cases of Enteric occurred on 11th November 1899 and there would eventually be over 1700 and the records would also list 1900 cases of Dysentery
Dysentery is infectious, causing inflammation of the intestine accompanied by abdominal pain and diarrhoea. The disease can range from a mild attack that is soon over to a severe attack ending in death through dehydration and poisoning. The symptoms occur after about six days and take the form of a fever and frequent stools containing water and blood which is soon followed by dehydration. In severe cases the symptoms also show themselves as ulceration of the large intestine. The transmission of the disease occurs by ingesting food or water that have been contaminated by human faeces. Dysentery is common in areas where people are crowded together.
Enteric or Typhoid Fever is an acute infectious disease caused by the bacteria Salmonella Typhi. It enters the body through ingestion of contaminated food or water. Within twenty-four hours it enters the bloodstream causing blood poisoning. After twelve days or so the symptoms appear as headaches, tiredness, general aches and fever followed by loss of appetite, nosebleeds, cough and either diarrhoea or constipation. During the second week a rash of small, red spots appears on the trunk lasting for approximately four days. By the third week the patient is emaciated and their abdominal symptoms are marked. If untreated, typhoid proves fatal in up to 25 percent of all cases. The prevention of Typhoid Fever depends mainly on proper sewage treatment and the provision of pure drinking water, both of which were almost impossible to provide during the latter part of the siege. Volunteers with the Relief Force were inoculated against the disease via a hypodermic injection of dead typhoid germs. Winston Churchill when offered the treatment, declined saying that he would “remain unconvinced and resolved to trust to health and the laws of health-an inoculation against bullet wounds he would have accepted”
Treatment during the siege was supportive and symptomatic whereas today vaccination and drugs are all that is required.
Malaria is one of the oldest infections known, being mentioned in the 5th century BC and is a serious, relapsing infection in humans. Transmitted by the female mosquito, it is characterised by attacks of shivering and fevers which can often be fatal. The connection between the mosquito and the malarial parasite were only discovered in the early 20th century. Malaria occurs throughout the tropical and subtropical regions of the world and is the most common of all serious infectious diseases. A malarial attack normally alternates between sweating, chills and severe headaches with temperature swings from very low to dangerously high. Attacks to begin with are almost a daily occurrence but soon begin appearing at regular intervals of forty-eight hours. Before the advent of modern drugs during World War 2, the accepted treatment for Malaria was Quinine.
Buriel at sea
Major Buntine Major Hyslop
Lt. Currie Major Currie