At the turn of the 20th century, infected wounds and communicable diseases were the greatest scourge of armies, taking the lives of more soldiers than explosives or steel. In the American Civil War (1861–65) sickness claimed approximately two-thirds of the estimated 620,000 soldier deaths. Two-thirds of all British deaths in the Boer War (1899–1902) were attributed to disease. Across much of the planet during World War I, germs continued their deadly work. Seven times as many Turkish soldiers died of disease as from wounds, and in the protracted campaigns ranging across East Africa, disease was the major killer of Europeans, Indians, and Africans.
At the start of August 1915, the Indian force in East Africa numbered some 17,000 men. But disease had so ravaged the men that only 4,000 were fit for duty. One member of the British cabinet lamented at a meeting to discuss future operations in East Africa, “One Indian Regiment, the 13th Rajputs, is suffering to such an extent from malaria and debility that they will never be of any more use in the field.” The sudden onset of extreme temperatures also presented a very real danger to armies. During the Carpathian Winter Campaign, between January and April 1915, temperatures routinely hit minus 30 degrees Celsius (minus 22 degrees Fahrenheit). Entire Russian and Habsburg armies – hundreds of thousands of men – quite literally froze to death.
The Russo-Japanese War and the Western Front were the first major conflicts in world history in which soldiers had a better chance of being killed by high explosives and bullets than by disease and exposure to the elements. This is not to say that the soldiers in Belgium and France did not get sick. And this does not mean that they did not suffer from exposure to rain, wind, and snow. But owing to recent and remarkable advances in medicine, wounded and sick soldiers stood a decent chance of surviving and returning to active duty at the front where their commanders wanted them. From a medical standpoint, one of the great ironies of the war on the Western Front may very well have been the fact that the modern medicine soldiers accessed in France (when combined with the insatiable demand for manpower) contributed to innumerable cases of repeated bodily trauma.
Conditions were so bad in Mesopotamia in 1915 and early 1916 that IEFD’s operations became the topic of official inquiry and opprobrium. The secretary of state for India, Austen Chamberlain, had called some attention to conditions in the Middle East in 1915. In the wake of that year’s disastrous operations and an outcry in the British press in 1916, command of IEFD passed from the hands of the Government of India to the British government, and two commissions were appointed to investigate things – the VincentBingley Commission (created in March 1916) and the Mesopotamia Commission (created in July 1916). The publication of the findings of these investigations in 1916 and 1917 exposed the gross deficiencies Indian soldiers had long endured in the employ of the Government of India.
When World War I began in 1914, Indian soldiers still received medical care under what was called the “regimental system.” Regimental hospitals were based on the principle of bringing “the hospital to the patient rather than the patient to the hospital.” Under this system in South Asia, hospitals and equipment were transported with the regiment to which they were attached when that regiment moved. Surgical equipment and facilities were quite naturally subpar; comforts and amenities were otherwise absent. Patients generally provided their own bedding and clothing (contributing to the spread of contagion) and relied on healthy comrades to provide them with food and nursing. The shortcomings of the regimental system were too much for authorities to stomach when it came to treating British soldiers employed by the Indian Army. British soldiers in South Asia had enjoyed the perks of “station hospitals” since 1882.
But until 1914 military authorities had rejected any attempt at reforming the way Indian soldiers were treated. “The salient rationale behind the system,” historian Samiksha Sehrawat points out, “was the spirit of nonintervention in indigenous customs and the principle of managing sepoy health care as economically as possible.” We might put it this way. The Indian Army’s healthcare system was separate and unequal.
Since “economy” was the rule by which Indian Army Command made decisions affecting the health and welfare of the sepoys, cutting costs was the modus vivendi of its underlings. “Under a policy so rigorously defined,” read the Mesopotamia Commission, “it is not unnatural that military and medical officers thought that they were best discharging their duty to the Government by keeping down demands, by carrying on as best they could without incurring fresh expenditure, and by discouraging their subordinates from pressing new ideas or ideals which . . . would entail . . . additional expenditure.”
The life of an Indian soldier was cheap, in other words. Better to keep quiet and permit conditions to deteriorate for the men than stick one’s neck out and call attention to the inadequacies of a healthcare system the army had already deemed inadequate for its white soldiers. Witnesses interviewed by the Vincent-Bingley Commission testified that this “Indian system,” as they called it, did more than anything else contribute to the breakdown of the medical arrangements in the Mesopotamia campaign in 1915 and 1916. According to the Vincent-Bingley Commission’s witnesses, it was “a system which allows officers to think, whether rightly or wrongly,”
That there is more merit to be obtained by keeping quiet and not worrying the higher authorities than by asking for what is necessary;
That keeping down expenditure is more meritorious than efficiency;
That nothing new is likely to be sanctioned unless a corresponding saving in something else can be shown; and
That even in small matters anything asked for will be cut down by half . . . A system of this nature will possibly be good and economical in peacetime but is bound to break down in war.
It was no secret to the doctors and medical personnel employed by the Indian Medical Service (IMS) that they were not adequately supported by the government in the work they had to perform. “I doubt whether you gentlemen would consider that the Sepoys’ hospitals in peacetime in India are hospitals at all,” one officer with the IMS recalled. Havelock Charles called India’s peacetime medical hospitals “a disgrace to the Government of India.”
Another witness told the Mesopotamia Commission of the Indian Army’s peacetime hospitals: “They are so bad that I think it would be necessary to reform them ab initio.” Alfred Keogh, who would have a hand in overseeing the operation of Indian hospitals in France and England during the war in his role at the War Office as director-general, Army Medical Services, said in 1916 of India’s prewar military hospitals: “I have no hesitation whatever in saying that the medical arrangements connected with the Army in India have been for years and years most disgraceful. I say that with a full sense of responsibility. I have served many years in India. I have not been there for some time now, but in my opinion, things are not better than they were. Anything more disgraceful than the carelessness and want of attention with regard to the sick soldier in India it is impossible to imagine.”
This was the system to which Indian soldiers had long been subjected in the years prior to World War I.
Excerpted with permission from Indian Soldiers in World War I: Race and Representation in Britain’s Imperial War, Andrew T Jarboe, Speaking Tiger Books.
