Report on the medical arrangements in the South African war / by Surgeon-General Sir W. D. Wilson.
- Great Britain. Army Medical Services
- Date:
- 1904
Licence: Public Domain Mark
Credit: Report on the medical arrangements in the South African war / by Surgeon-General Sir W. D. Wilson. Source: Wellcome Collection.
332/490 page 278
![questions of general application frequently arise, and should be dealt with as far as possible on a uniform principle, leaving the details to be modified according to the actual local conditions. The most important feature, however, in having one central sanitary authority is, that the knowledge of what is being done throughout the whole field will frequently ensure that local objections to some proposal can be refuted, by showing that under similar conditions elsewhere the difficulties brought forward have been overcome. Further, a central authority, obtaining early information as to the incidence of disease, can note any unusual preva- lence in one district as compared with the cthers, and can therefore at once take steps to have the cause of this inquired into and remedied, Local authorities have not the information necessary to show how their district compares with others. D.— INFORMATION REQUIRED BY PrincipAL Meptcan OFFicER, ARMY, There seems to be little doubt that the main part of the statistical work should be carried out at the base. But the Principal Medical Officer and the Sanitary Officer of the army corps staff must have the earliest possible infomation that is obtainable of the numbers of sick and wounded, both for purely administrative purposes and for the protection of the health of the troops by sanitary precautions. From the end of 1900 the Principal Medical Officer, Army, received a weekly telegram from every hospital in South Africa giving the following particulars :— Total number of sick in hospital. Number of wounded. :, cases of enteric fever. 4 cheers simple continued fever. ne » dysentery. PS ,, malarial fevers. deaths. ,. In convalescent camps. In this way the Principal Medical Officer was kept informed of the local needs as regards accommodation and of the relative prevalence of disease, while the telegram also included a statement of the reason for any sudden increase in the numbers in hospital and the prevalence of any special disease. At the beginning of the campaign, while the whole arrangements are to all intents directly under the Principal Medical Officer of the force, a daily telegram from each hospital, giving total pumbers and the number of cases of infectious disease, is required to enable him to arrange the necessary accommedation. But as the campaign progresses, and the district arrange- ments become more complete, this information will be of more use to the Principal Medical Officers of districts or of the lines of communication, who should normally dispose the accommodation in their districts as re quired, while intermediate telegrams in the case of any emergency will enable the Principal Medical Officer of the force to take any action that may be necessary to enable the districts to meet the new conditions. This is al] the information that is immediately necessary for the purposes of administration or sanitation, and it adds very little to the work required from a hospital staff. The great point is that the information must be available as soon as possible. E.—PossIBiLity OF DECENTRALISATION. Effective decentralisation of duties is the key to smooth working of a service. But in the late campaign, the Medical Service (in the executive ranks) was very largely composed of untrained men who were not interchangeable with the regular service ; the result was that where, with a staff composed solely of trained men, the Principal Medical Officer of a district could have made all necessary arrangements to meet fresh necessities from the personnel serving under him, in this case a trained staff had to be collected from other districts for this purpose. This required the intervention of the Principal Medical Officer, Army, whose work was therefore very materially increased,](https://iiif.wellcomecollection.org/image/b32172874_0332.jp2/full/800%2C/0/default.jpg)
