The following document is the final report handed down by the Liverpool Military Camp Site Committee on 13 December 1915. The Committee was formed to overcome the problems associated with the camp and endeavoured to head off any potential problems. The results speak for themselves.
BRITISH MEDICAL ASSOCIATION NEW SOUTH WALES BRANCH
Liverpool Military Camp Site Committee. Appointed 5 October, 1915
Report, Conclusions, & Recommendations.
13 December, 1915.
The object of a Military Camp in time of war is to prepare men for the fighting line. The Camp will fail in its main object whenever men are lost to the forces, either temporarily or permanently, through ill-health or death. It will also fail if the conditions of camp life become so notorious as to discourage recruiting. By common repute both of these elements of failure were associated with Liverpool Camp, and, since the suitability of the Camp site was excluded from Mr. Justice Rich's Commission, public misgivings were not allayed.
These considerations prompted a number of medical men to approach the Council of the New South Wales Branch of the British Medical Association with the request that it would select a Committee of investigation which should offer its services to the Minister for Defence to report on the Liverpool Camp Site from a medical standpoint. That Committee, having been approved and accredited by the Minister, has personally inspected the Camp and the conditions of camp life at Liverpool, and has otherwise obtained official and first-hand information. It has now the honour to submit the following Report, Conclusions, and Recommendations.
The question of the suitability of the Liverpool Camp Site on medical grounds may be considered under three headings:-
1. The physical characteristics of the site.
2. The health of the encamped troops.
3. The relations of the site to its surroundings.
1. Physical Characteristics.
The Camp is situated on a level plain on the right or eastern bank of George's River just above the junction of the fresh water with the tidal river. The fresh water is separated from the tidal or salt water river by a weir, the position of which almost exactly coincides with the northern boundary of the Camp.
The site occupied by the Camp is about 1½ miles long with a breadth varying from ¼ mile to about ½ mile. It is roughly rectangular in shape with the longer axis lying parallel to the course of the river. The site is bounded on the west by George's River, on the north and east by a made road, and on the south by bush-covered land.
The surface of the site is about 21 to 23 feet above the existing level of the water in the river. Inquiries have been made by the Committee as to the likelihood of the site being affected by floods. We were unable to ascertain the existence of any official records bearing upon this point, but the result of inquiries made among persons who have known the district for long periods of time do not indicate the occurrence of floods sufficiently high to overflow the,, Camp site within recent years. The manager of a wool-washing plant, situated on the left bank of the river at a lower level than the Camp site, stated that, although he had known the district for many years, he had never known the river to rise high enough to flood the ground on which his works stand.
One important matter, to which attention was directed, concerned the likelihood of storm-water lodging upon the surface of the Camp and water logging the soil. There appears to be very little cause to fear this contingency. It is true that, although the surface of the site is, in the main, level, there are many shallow depressions in which water might lodge, and the western boundary of the Camp, where it overhangs he river bank, is actually slightly higher than the general surface. On the other hand the surface soil throughout the Came consists of a light sandy loam too porous to hold water so as to become waterlogged. Moreover, surface drains can very easily be cut so as to drain any localised depression into the river. As a matter of fact this has been done already for nearly all the lower areas of the Camp.
The light sandy surface soil referred to is very variable in its depth. An examination of the numerous drainage cute throughout the Camp led us to form the opinion that, on the greater part of the site, it averaged about 18 inches to 2 feet in depth. As it approaches the river it extends deeper, and in places is at least 10 feet in depth. The subsoil consists of clay, considerably admixed with sand as it approaches the surface; but attaining a stiff consistency at the lower level.
Two permanent or semi-permanent waterholes exist towards the southern extremity of the Camp. Both are deep, and probably lie wholly within and upon the clay subsoil which underlies the Camp site. In each case the surface of the water in these holes is considerably (5 feet or more) below the level of the general surface. This water appears to be derived entirely from rain-storms; a conclusion which is supported by its shrinkage during the recent dry weather. The only indication of the height of the subsoil water in the Camp is in a disused well attached to an old dwelling near the centre of the Camp on its western side. The level of the water in this well is about 20 feet from the surface.
We consider the site to be fortunate in its soil, which is a healthy one, and of such a nature as to facilitate drainage and the rapid removal of waste products. The chief drawback is that it is so friable as to render the Camp very subject to dust storms. This drawback may be greatly reduced by such measures as re-making the roads which adjoin the Camp, forming permanent roads within the Camp, and treating the surface between the men's huts with "soluble tar" or other suitable dust-laying preparations. We further recommend that no drilling be done on the Camp site in order to avoid pulverising the surface
The objection has been put forward to the site that it is low-lying and subject to fogs. Both these allegations are true within limits. On the other hand the elevation of the site is higher than that of many healthy areas around Sydney, Melbourne, and other large cities. Fogs, unless they are associated with an excess of smoke or other products of human activities, as in great cities, are not in themselves known to be unhealthy, although they have a depressing effect on certain individuals.
The Camp site is almost destitute of trees; and so is lacking in shade and the other beneficial effects of vegetation. It is desirable that this defect should be remedied without delay by the systematic planting of trees.
We consider that the disadvantages mentioned furnish reasons for improving the local conditions rather than for changing the site.
2. Health of the Troops.
It has not been possible to obtain data for final adjudication concerning the health of the troops during their stay at Liverpool Camp, as the complete figures are not available at the present time. We have at our disposal, however, a record of the deaths which actually occurred in the Camp, as reported, in accordance with the law, to the Registrar of Births, Deaths, and Marriages at Liverpool, and of the deaths of soldiers from the Camp which occurred at various metropolitan hospitals, to which they had been removed for treatment. Whilst it cannot be claimed that the figures given are absolutely accurate (because it is possible that sick soldiers may have returned to their homes and there died, and correct information of such cases cannot be obtained), it is believed that there is no serious omission, and that the figures given are reasonably representative of the mortality.
We find from the sources mentioned that, between January and September 30, 1915, the total number of deaths was 53, assigned to various causes, as follows:
|Measles and Pneumonia||17|
| Pneumoniainal Meningitis||16|
| Acute colitis||1|
| Accident or violence||3|
For an ordinary mixed civilian population of the same magnitude as that of the Camp this number would give a very low mortality. But considering that the Military Service represents a picked male population, of which the units are at a period of life comparatively little liable to disease and death, a different and lees favourable aspect is put on the figures. It is to be noted, however, that sore than half the deaths were caused by epidemic diseases - measles, and cerebro-spinal meningitis - which were unusually prevalent amongst the general community, and exacted from it also their toll of death, during the same period. That such diseases should reach the Camp was inevitable, and, once introduced, their spread would be fostered by camp conditions. These conditions include close association of individuals in tents or huts, and the frequent re-introduction of infection from fresh drafts of recruits. Moreover, many of the individuals in the Camp had lived a rural life and had been but slightly exposed to the infections common in large cities. They had, therefore, not acquired the immunity which is found among persona who are frequently exposed to infection. Of the remaining causes of death the only one which possesses significance from the point of view of this deport is pneumonia. This has been serious enough to demand special consideration.
We do not know the precise extent to which pneumonia prevailed in the Camp; but, as a matter of observation, it is certain that respiratory troubles were extremely prevalent, ranging from simple colds to the severe pneumonias which revealed themselves in the fatality lists. We have no doubt that the chief factors in the dissemination of these respiratory diseases were the camp conditions to which we have already referred.
These conditions were aggravated by the overcrowding and defective ventilation of the sleeping quarters. Chills, consequent on exposure and neglect to change wet clothing, may have been operative by inducing a lowered resistance to disease. And, in this connection, we cannot ignore the injurious effect of alcohol. Not only does over-indulgence in alcohol predispose to pneumonia, but it materially reduces the chance of recovery from the disease; and, in all probability, it contributed to the fatality from pneumonia at, Liverpool.
The drinking habit must also be regarded as a powerful predisposing cause of venereal diseases. These diseases do not give rise to direct mortality and so do not show among the causes of death. But we are aware that the diseases have occurred to a considerable extent and that special measures have had to be taken to deal with them. We regard their existence among the troops as due largely to the loss of moral restraint induced by alcohol.
The complete absence of enteric fever, and the almost complete absence of other forms of enteritis, in remarkable.
It is a tribute to the efficiency of the sanitary administration of the Camp. Medical reports from armies in other parts of the world indicate the value of protective inoculation against enteric fever, so that it is likely that this measure has been of service to us here.
3. Relation of the Camp to its Surroundings.
From the point of view of this Committee considerations under this heading group themselves round the questions of water supply, the disposal of refuse, the prevalence of mosquitoes and other insect pests, and the very important matters of alcoholism among the troops, and defective ventilation of the sleeping quarters.
The first of these matters may be dismissed with the statement that, in this regard, the situation of the Camp is admirable, since it is within reach of an abundance of very pure water from the pipe mains which supply Sydney. Ample water, fit for sprinkling the open spaces of the Camp and for bathing purposes, can easily be obtained from the adjacent river, which is also available for the troops to swim in.
As regards refuse disposal the Camp is also well situated, since, within a distance of a mile from its southern boundary, there is an extensive area of very sandy soil forming a site, suitable in all respects for the burial of the excrete, of the Camp, should conservancy methods continue to be employed. On the other hand should it seem desirable to install a water carriage system of treating excreta, complete facilities exist for the construction of a septic tank and the disposal of the effluent there from in the tidal waters below the weir. Even without a septic tank all the sullage waters of the Camp could easily be diverted into the tidal river by the introduction of an intercepting drain and the erection of a pumping plants and this we recommend should be done.
Mosquitoes are said to be very numerous in the Camp in Summer. Their presence on land so near a river basin is probably inevitable; but their number may be greatly diminished by the employment of precautions such as the drainage of small water holes and the regular sprinkling of the larger bonds with petroleum. The provision of mosquito netting for the troops may be Necessary. The fly pest does not appear specially to affect the neighbourhood of Liverpool; and this also could be dealt with effectually by tie application of suitable measures.
Defective ventilation and overcrowding in the sleeping huts could be remedied in simple ways, namely:-
(a) by opening the roof along the whole length of the ridge;
(b) by taking out the whole of one side of the hut on its northern exposure; and
(c) by providing sleeping bunks, made of iron, arranged one above the other, the lower raised about 1 foot above the floor.
This would avoid the men being packed so closely together as they are now, and would prevent them from breathing into one another's faces, and thus transmitting infection. At present they lie on the floor in a layer of fetid air laden with dust and bacteria.
The convenience of access to the Camp by train from Sydney, and the proximity of the Camp to large areas of level land suitable for the manoeuvring and training of troops are circumstances, which, no doubt, were regarded as of high importance on military grounds in the selection of the site.
The situation of the Camp has an important bearing on the question of alcoholic indulgence with its attendant evil effects upon the health of the troops.
Partly from conversations with medical and other military officers connected with the Camp, and partly from the personal observations of many of our members, it has come to the knowledge of the Committee that there is a lamentable amount of alcoholic indulgence among the troops in the Camp. It is unnecessary to enlarge upon the disastrous consequences of this state of affairs especially in regard to young men in training for the hard life of a soldier. We have referred in previous sections of the Report to the influence of alcohol upon pneumonia and the venereal diseases.
The situation of the Camp, so near to the town of Liverpool with its hotels and temptations to promiscuous sexual indulgence, and so convenient of access to Sydney, has, in the opinion of the Committee, been responsible in no small measure for the extent to which alcoholism and venereal diseases have affected the troops. From this point of view the site of the Camp must be considered undesirable.
This objection to the site, is, however, not insuperable; inasmuch as it may be overcome, to a great extent, by suitable administrative measures, such as placing the town of Liverpool out of bounds to soldiers, and limiting ordinary leave to hours of daylight. Such measures would be particularly easy to enforce at the Liverpool Camp owing to the natural barrier which George's River interposes between the town of Liverpool and the Camp.
The Committee considers that the restrictions now in force on the sale of alcohol to the troops are, in one direction, too strict and, in another, too lax. It is a hardship to some men that they have not reasonable access to alcoholic beverages within the limits of the Camp; and this enforced postponement may lead to greater excess afterwards. The Committee is of opinion that the establishment of & .properly regulated wet canteen within the Camp would meet a want, and would lessen the tendency to drunkenness. The non-alcoholic beverages sold at the Canteen should be served attractively, and suitable entertainments of good quality provided. Whisky and other highly intoxicating liquors should be excluded.
On the other hand the sale of alcohol to soldiers should be absolutely prohibited, both inside and outside the Camp, after 8 p.m.. The Committee recognises that men may wish to take alcohol with their evening meal, and that, in most cases, the hurtful drinking is done after 8 p.m.. In this direction attention is directed to the still more stringent measures to this end which it has been found necessary to adopt in Great Britain.
The general conclusions reached by the Committee are:
1. That the site of Liverpool Camp, while not ideal, is, nevertheless, not inherently bad on medical grounds.
2. That certain circumstances, more or less independent of the site, have been responsible for such of the disease and disability, and, probably, for some of the deaths at the Camp.
3. That the conditions of camp life have been improved recently, and may be still further improved by appropriate administrative and constructional measures.
The Committee makes the following recommendations, namely:
1. That a complete system of road intersection be determined for the whole land after being laid out according to the purposes for which the respective portions thereof are required; the roads to be properly constructed for heavy or light traffic, as the case may be, and completed with guttering, kerbing, and footpaths.
2. That immediate steps be taken to !sears that the public roads, which run alongside and through the Camp and in its neighbourhood, be properly constructed for bearing traffic without the creation of any dust nuisances.
3. That the drill ground, if there is to be a drill ground within the Camp area, be permanently constructed with a surface of asphalt or other suitable material, or with the natural surface so treated as to avoid the production of duet; and that, until this is done, a drill ground be found outside the Camp, the dusk from which will not affect the area occupied by the huts or tents where the men sleep.
4. That all water holes be filled up and depressions levelled, and the surface drained, so that all rainwater may flow away without sinking into the ground to any injurious extent.
5. That trees, shrubs, and grass be planted, and gardens plaid out, wherever practicable.
6. That fences be erected or hedges grown, where suitable, to break the force of the wind, and to intercept the dust.
7. That the sleeping quarters be constructed with a view to adequate ventilation, which would be best obtained (a) by having an opening in the roof of the hut extending along the whole length of the ridge; (b) by leaving the north side of the hut open; and (a) by providing sleeping bunks, preferably made of iron, arranged in two rows, one above the other, the lower being at least one fort from the floor.
8. That for the disposal of sullage waters from the baths, laundries, and kitchens, which at the present time finds its way by gravitation into the river, or into the so called billabong, a special drain, either open or covered, running parallel with the river, be constructed, and the overflow there from be delivered, by pumping or otherwise, into the tidal waters of the river at a sufficient distance below the weir; also that the billabong itself be drained.
9. That the town of Liverpool be placed out of bounds between 8 p.m. and 8 a.m..
10. That a wet canteen, as described in the Report, be established at the Camp.
11. That the sale or delivery of alcoholic beverages to soldiers, both inside and outside the Camp, after 8 p.m. be prohibited.
12. That evening entertainments, such as lectures, concerts, bands, moving pictures, and theatricals, be systematically organised at the Camp by the Camp authorities.
13. That every man found intoxicated in, or on returning to, the Camp be sent to isolation quarters for medical observation and treatment until he is fully recovered.
14. That systematic attention be paid to personal cleanliness and that each recruit be supplied with a copy of Sir Thomas Anderson Stuart's Lecture "How to keep fit".
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