29 April 2015

On 25 April 2015, NZMA Chair Dr Mark Peterson and AMA President Dr Brian Owler were guests of the Turkish Medical Association at an event to commemorate the centenary of the ANZAC landings at Gallipoli.

This is the joint presentation they gave at the event:

Dr Peterson:

Gallipoli is a word that resonates strongly with Australians and New Zealanders.lest

Each year on Anzac Day, New Zealanders and Australians mark the anniversary of the Gallipoli landings of 25 April 1915. On that day, thousands of young men, far from their homes, stormed the beaches on the Gallipoli Peninsula.

For eight long months, New Zealand and Australian troops, alongside those from Great Britain and Ireland, France, India, and Newfoundland battled harsh conditions and the Ottoman forces desperately fighting to protect their homeland.

By the time the campaign ended, more than 130,000 men had died. Of the 14,000 New Zealanders who fought on the Gallipoli peninsula, 5212 were injured and 2779 were killed over a period of 240 days. Australian fatalities totalled 8709 and more than 19,000 were injured.


Dr Owler:

anzac1The Gallipoli attack began on the morning of February 19, 1915, with a British and French naval bombardment. But there were problems from the start. Several ships were lost due to mines and the bombardment was ineffective.

Allied commanders were hesitant and at times incompetent. The British War Office refused to give all of the troops requested for the landings.

The land battle for Gallipoli started early in the morning of 25 April 1915. The landings occurred in the wrong locations. Instead of gentle slopes, there were steep cliffs and the ravines that would later bear the names of Australians and New Zealanders.

Casualties were heavy right from the start. In the first four days of the campaign 3300 wounded passed through the 1st Australian Casualty Clearing station. Reports in the New Zealand Medical Journal tell us that in the first five weeks of the campaign, over 20 thousand wounded were taken to Alexandria.

It became a stale mate and finally ended on January 9, 1916, with the Allies withdrawing from the Peninsula in defeat. The number of Allies killed or missing was 63,000, while for the Otttoman Empire the number was 68,000.  Over a quarter of a million men were wounded, killed or missing.


Dr Peterson:

The Medical Corps faced huge difficulties and medical arrangements came in for much criticism.anzac2-Maheno

A key difficulty was the lack of communication between the different elements of the medical service. Before the landings started, a draft plan to deal with casualties had been worked out. Tent subdivisions were to be set up on the beach. A medical officer was to triage the wounded, with the seriously wounded to be evacuated to vessels offshore—but only once all the troops had been landed—and the slightly wounded to ambulances. The MO would be notified when the ships were full and would move the wounded onto the next vessel.


Dr Owler:

anzac3-beachThe reality was very different. The final draft of the medical arrangements had not been received by the Australian and NZ divisions. Communication was poor.

The only means of communication between the different commands on the various vessels and with those on shore was by small boat in rough seas. Radio transmissions were not permitted. A signal telling the assistant director of medical services of the ships available to him took two days to cross one km of water.


Dr Peterson:

anzac4-bargeAt the landing on the 25th—100 years ago today—very little went well for the ANZAC troops. Heavy shelling came both from the heights overlooking the landing place, and from the ships, with shells falling among the transports. Strong currents meant the boats landed all along the shore and the men had to regroup on the shore under incessant fire.

By evening, the NZ divisions had many casualties. As each company landed it was rushed in to support the Australian troops.

With no way of contacting the ships, requests for more vessels for the wounded were not received. No triage took place on shore…the wounded were mixed up and were brought out to troopships that were still laden with troops.

Stretchers used to transport the wounded were not returned to shore, and the men and a barge that were sent out to the troopships to evacuate Australian and NZ wounded were diverted to other duties.

All the ships were filled with wounded by the end of the first night.

___________

Dr Owler:

anzac5-walkers-ridgeThose on shore faced bitter cold and intense sniper fire. Treatment for the wounded was basic. Morphia was given by mouth; splints were improvised with rifles and bayonets.

Stretcher bearers struggled up and down narrow tracks, most having removed their white markers to avoid being shot.

For those wounded on Gallipoli, the wait for treatment and evacuation was often long and agonising. The evacuation framework for casualties would be conducted at night. Poor planning and the sheer scale of casualties overwhelmed the available medical resources. 

During the April landings and the August offensive, the advanced dressing stations in the gullies and the casualty clearing stations on the beach could not cope with the large numbers of wounded. The stations themselves often came under fire because of their exposed positions


Dr Peterson:

anzac8a-shipFrom the field ambulances and casualty clearing stations, wounded were evacuated by boat to hospital ships and ambulance transports waiting offshore. Poor coordination and mismanagement meant that many serious cases were left on the beach too long; once on board they found appalling conditions.

...There were no beds. Some were still on stretchers on which they had been carried down from the hills, some on the paillasses thrown down on the hard decks. The few Red Cross orderlies were terribly overworked. For 12 hours on end an orderly would be alone with 60 desperately wounded men in a hold dimly lit by one arc lamp. None of them had been washed and many were still in their torn and blood-stained uniforms. There were bandages that had not been touched for two or three days – and men who lay in an indescribable mess of blood and filth … Most of them were in great pain, many could get no ease or rest, and all were parched with thirst.


Dr Owler:

Anzac9a-stretcherWriting from the Dardanelles, a sergeant attached to the Medical Corps sent back graphic details about the treatment of Australian wounded:

"After the first fighting a ship came alongside, and at midnight the first batch of wounded were brought on board. Some had their legs off, others lad no arms or hands, some were without fingers or toes. A lot of the poor fellows had terrible head-wounds. Some had their ears blown off, and others their eyes shot out. Nearly all had to be operated on, and this was done by lamp light. We had no time to be squeamish. The very sight of the poor chaps made us feel that we wanted to do all we could for them, no matter what is cost us. One poor fellow died under chloroform. A shell had struck him on the thigh, absolutely shattered the lower part of his body. We worked all through the night.

“At 4.30 a.m. about a dozen large shells fell very close to us, exploding with an awful noise. The wounded are coming in continuously, and their groans are most unnerving. But they are heroes. They try to be as quiet as possible, and are eager to get back… They are all caked in mud and are ravenous. Some have had no sleep tor several days, and drop asleep the moment they sit down to wait their turn. Snipers are everywhere, dug in all over the hill. One sniper caught had a week's supply of food and thousands of rounds of ammunition.”


Dr Peterson:

anzac6-stretcherThe role of the ambulance men and stretcher bearers was crucial during the campaign. Writing for the Colonist magazine in 1915, a correspondent described the chaos they faced and the price they paid:

“Too high an eulogium cannot be pronounced on the ambulance department. Unable to take cover, and continually working in fire-swept zones, their casualties have been abnormally high. Dressing station staff are continually being renewed.

“In times of high tension, many wounded are dressed by men injured themselves.

“At the end of a day of gruelling fighting, bearers are thoroughly exhausted. Their stretchers blood soaked, and as often as not stained, from head to foot themselves, they stagger down to the beach hospital.

“The wounded play the ‘grin and bear it game’ with all the pluck they have. There are terrible cases which strain the nerves of the bystander. On the beach, the most competent surgeons untiringly employ the gifts with which nature has endowed them to relieve the suffering and heal the wounds.

“On being cleared from the shore the casualties are taken on board either a hospital ship or a transport for removal to Egypt.”


Dr Owler:

anzac7-simpsonOne bearer, in particular, has become a symbol of the heroism displayed by many: Jack Simpson Kirkpatrick. A contemporary newspaper account tells the story of the Donkey Man, a humble hero:

“Unremitting in their deeds of heroism, self-sacrificing to what appeared almost like madness, ever ready and anxious to rush forward to the aid of a fallen comrade, there they would kneel, under a withering fire, and tend some poor suffering soul; and carry him to a place of safety.

“Such acts as these were common amongst them... Many of them were shot down in the execution of their noble work. One case in particular is deserving of mention. A young fellow named Simpson (Simmy), a member of the West Australian Royal Army Medical Corps commandeered a small donkey, which he christened Barney, and all hours of the day or night, whenever there was any fighting going on, Simmy (with his little whip in his hand) and Barney were to be found right in the thick of it.

“Simmy would lift the wounded man on to Barney's back, and, if he couldn't sit there he'd tie him on, and, with a "Gee, Barney," away they would go to the nearest dressing station. This went on day after day and night after night, and where you would see others running for their lives across dangerous spots, Simmy and Barney would walk calmly, on, as if they were going along some city thoroughfare in times of peace, instead of travelling through a tornado of shot and shell.

For 23 days this wonderful hero and his donkey performed many acts of self-sacrifice and gallantry, until, on May 18 or 19; poor Simmy came to his end by a sniper's bullet through the heart.”

There is debate amongst historians as to whether Simpson’s donkey existed but there is no doubt or debate as the heroics of the medics and stretcher bearers.


Dr Peterson:

anzac8Although acknowledging the bravery of those who cared for the wounded, other contemporary accounts strongly criticised the lack of planning that had gone into the medical arrangements:

“The point of the matter is that there was totally inadequate medical and nursing attention on several boats. How this came about it is hard to explain because several army corps proclamations warned the men to expect heavy casualties, so the slaughter on April 25th was not unexpected.

“How comes it then that, with no permanent hospital ashore, there were but three hospital ships detailed for the whole peninsular operations?

“Of course many of the transports went back laden with wounded, but these had in many cases just discharged troops a few hours before, and were quite unsuitable for the nature of work they were called upon to perform.

“A certain number of transports were instructed to be prepared to undertake hospital ship duties. Doctors and ambulance men went on board and put things in readiness for the patients’ arrival. On the other hand, various troopships were called into requisition without warning.

“Most of them had a few transport or artillery men on board looking after horses. In some cases they were called upon at dark to go ashore and assist in bringing the wounded from the beach—now one retreat ward where shrapnel struck the life out of the incapacitated as they lay on their stretchers.

“It was a task of the utmost difficulty in the misty night to carry the helpless out waist-deep in the water, and lay them in their boats. Getting them aboard was even worse.

“Those who could walk wore assisted up the gangways, others slung aboard by the winches. The scenes on some boats were pitiful in the extreme.

“One story will serve as an instance. There were 600 wounded on the Lutszow, and no doctor, nurses or A.M.C.

“A veterinary surgeon and transport drivers did the work and, although more used to breaking brumby horses than nursing, did all in their power to assuage the pain of the sufferers.

“Men said that the horsemen and ‘bullockies’ lifted them more gently than a woman could. But only the most seriously injured could receive attention. The greater part of the 600 never had their injuries dressed, their clothes removed, or the blood washed off them until they arrived in Egypt.”


Dr Owler:

anzac9-truceAlong with the inherent dangers of war, the threat of illness was never far off. Bodies piled up around the encampments attracted flies, and the stench was sickening. A lack of water for washing, and poor quality rations, with little or no fresh food or vegetables of any sort made it even more difficult for the troops to cope with the conditions they faced.

A truce was held on 24 May for both sides to bury their dead, but by June sickness rates were steadily rising, with 456 sick in early June, rising to over 800 by the end of the month.

Severe diarrhoea caused by amoebic dysentery and typhoid fever badly affected all those on shore. The conditions resulted in swarms of disease-carrying flies.

This could prove as much of a challenge as the enemy. The role of the flies was recognised and more strict public health regimen came to exist. Waste was disposed of by burning and care was taken not to leave rations that would attract flies.

Due to these measures deaths due to communicable disease was lower for the AIF in 1915 with around 600 deaths due to communicable disease compared to the South African Wars for the British where 2 troops died of communicable disease for every soldier lost in battle.


Dr Peterson:

anzac10-woundedFinally, perhaps the best way to understand what it was like for those who were here at that time, is to hear it in their own words. The following extracts are taken from correspondence to the Editor of the New Zealand Medical Journal from a medical officer:—

Gallipoli, 18th June, 1915.

“…For the last two months we have had a hell of a time. I cannot give you full details, but owing to the nature of the country here…we have had to be within half a mile of the firing line the whole time, and for the last two months we have done all our work under continuous fire.

“Rifle bullets and machine guns whistle over us, shrapnel and lyddite from field guns have played on us the whole time, and occasionally 10-inch and 12-inch melinite shells from the forts in the Dardanelles burst around us.

“Our operating tent is a most amusing sight; it is more like a sieve than a tent, and yesterday I had my sterilising orderly knocked over by a bullet while at work. I have made dug-outs for the patients that are fairly secure—only one of them has been killed, though several have been wounded.

“I have lost five killed and 15 wounded of my own men. The first day of the landing here all the bearers were sent ashore … and the tent divisions were on the transports to attend to the wounded, who were brought off in barges. The men did wonderfully, and were the talk of the beach. We had all the wounded who could be got at evacuated to the ships by midnight the first day. I will never forget the beach when I arrived on it—dead men lying everywhere in heaps, just as they had fallen. The shrapnel and fire were terrific, and it is marvellous how our men hung on at all.

“I am afraid the casualty list will be a big shock in New Zealand. We are now acting as a clearing station on the beach, where we do all necessary operations. We have done scores of trephinings and laparotomies with suturing and resections of gut. No abdominal wounds survive if not operated on. There are always multiple perforations, and very often the gut is torn completely across. … All carriage of wounded is by hand, and it is very hard work for the bearers. We managed to capture a dozen little donkeys... and most leg wounds come down riding the donkeys. They often ride right on alongside the operating table.

“We have advanced dressing stations along each flank, but it is usually impossible to bring the wounded in till dark, as the country is full of snipers. I recommended one of the bearers for the D.C.M., and he got it for bringing a man in from in front of the trenches. I have been very lucky myself, and though I have been hit twice—once by shrapnel and once by the fuse of a shell—I have only been bruised.

“I had men killed all round here, and it is very curious the way they spin round and round before they fall, just like rabbits. Well, as I write this—which, I fear, is rather disconnected, being interrupted by the crack of bursting shrapnel and the roar of our own guns—I am in a dug-out looking out over the Aegean Sea. It is calm as a lake and very blue. Just in front is the island of Imbros and to the right Samothrace. Beyond over the horizon we can see Mount Athos and the mountains of Bulgaria.

“The beach is a wild confusion of swearing men, bucking mules, and falling biscuit boxes. Pinnaces from the warships (which are in hiding somewhere) bustle round bringing in barges of supplies and taking of wounded to the hospital ship in the offing. All water has to be brought ashore and carried up the hills. Since we have been here we have seen all varieties of warfare concentrated on a very small area. We have had greater naval bombardments than the world has ever seen; we have seen a big battleship sunk before our eyes; we have seen an enemy submarine sunk; we have seen aeroplanes (both enemy and our own) drop bombs and fight in the air.

“We have fought with shell, shrapnel of all sizes, rifles, machine guns, howitzers, hand grenades, saps and mines. We have sprung mines under the Turks, and have had their mines sprung under us—and all in an area of a few square miles.

Published in NZMJ 1915;12(45):187–188.


Dr Owler:

anzac11-buglerIn the wider story of the First World War, the number of dead from the Gallipoli campaign, although horrific, pales in comparison with the death toll in France and Belgium. For New Zealand and Australia, however, the Gallipoli campaign is often seen to have played an important part in fostering a sense of national identity.

When Britain declared war on Germany, Australia and New Zealand were automatically at war with Germany too. The ANZAC troops were initially sent to Egypt for further training and then expected to go to Europe. They did not come to fight the Turk.

Turkey had decided to align with Germany for self preservation as much as anything else. So we had ANZACs and Turks fighting not because of antipathy between our nations but purely because of the actions and decisions of other nations. A mystery of human behaviour – but perhaps also another reason for empathy and respect between soldiers in the field.

Those at home were proud of how their men had performed on the world stage, establishing a reputation for fighting hard in difficult conditions. Like many soldiers they ended up fighting for each other. In Australia, this is what we describe as mateship. It is loyalty and dedication to a friend that goes with the love of friendship. Mateship became part of the Australian persona that owes much of its origin to the bond that formed between the ANZACs on these fatal shores.

For Australia and New Zealand, there was a realisation of their unique identities. They were egalitarian. The British class system was an enigma to them. They had not been served well by their British leaders, something that would continue.

As young nations, the deeds of the ANZACs, their bravery, their loss, and their tragedies, have played an important part in determining our identities as nations and our pride in our nations.

Anzac Day grew out of this pride. First observed on 25 April 1916, the date of the landing has now become a crucial part of the fabric of national life—a time for remembering not only those who died at Gallipoli, but all who have served their country in times of war and peace.