From 1897 Malta and Crete were administered under one command known as the Malta Command. The average strength exclusive of colonial troops was 8023 men in Malta and Gozo, and 1152 men in Crete. There were 6397 admissions into hospital (797.3 admissions/1000 mean strength) with 64 deaths (7.97 deaths/1000) in Malta, and 1683 admissions into hospital (1460.9 admissions/1000 mean strength) with 24 deaths (20.83 deaths/1000) in Crete.
The Command had 269 officers, with 188 attacks of illness and 5 deaths. 13 officers were invalided home.
Admissions were for: simple continued fevers (69), Mediterranean fever (11), injuries (23), diarrhoea (9), influenza (6), synovitis (6) dysentery (5/1 death), enteric (4/2 deaths in Crete). Other deaths were from inflammation of the stomach and intestine.
A total of 258 men returned to England as invalids; 88 of whom were discharged from the service. The average number constantly non-effective through sickness (mean daily sick), excluding the RMA, was 443.10 men (55.23/1000 mean strength) for Malta and 44.41 men (38.55/1000 mean strength) for Crete. The average sick time to each soldier was 19.39 days; the average duration of each case was 22.02 days.
Fever accounted for 2575 admissions into hospital with 44 deaths. Admissions were for:
55 for nervous system diseases (2 deaths) 10 mental cases
There were 4 admissions for small pox, all of which occurred in Crete; 15 admissions for eruptive fevers (11 Scarlet fever, 2 measles, 1 rubella, 1 cow pox), 1 for influenza; 73 for enteric fever of which 34 admissions (15 death) were in Malta and 39 cases and 17 deaths in Crete. Of the 34 cases which occurred in Malta, 6 were admitted from Mtarfa, 5 from San Francesco de Paola and 2 from the transport Dunera.
There were 173 admissions for dysentery (9 deaths) of which 135 admissions and 9 deaths occurred in Crete; 158 for malarial fevers of which 156 were ague and 2 remittent fever, 80 of the former occurring in Crete.
There were 2482 admissions for simple continued fever (12 deaths). Most cases of simple continued fever were among young soldiers recently arrived in the Command or in men serving their first summer in Malta.
The medical officer in charge of the Cottonera Station Hospital observed two types of Simple Continued fevers. In the first type, soldiers presented with a high temperature for 2 or 3 days and made a rapid recovery. This type of fever was attributed to exposure to the sun; the second type consisted of a more prolonged fever continuing for 7 to 10 days with gradual recovery. This fever was blamed on insanitary barracks occupied by the soldier.
In 1897, the heading Mediterranean fever was introduced for the first time into the nomenclature as a distinct disease. It accounted for 422 of the cases and for all the deaths.
There were 422 wives, with 212 attacks of illness and 4 deaths. Admissions were for: simple continued fevers (47), Mediterranean fever (13/2 deaths), debility (39), diarrhoea (15), diseases peculiar to women (21).
There were 740 children with 491 cases of sickness and 26 deaths. Admissions were for: diarrhoea (78/4 deaths), bronchitis (74/2 deaths), 55 (measles, leading to the closure of the St Elmo's School in June), simple continued fever (53/1 deaths), Mediterranean fever (6/1 death), eczema (23), debility (23/3 deaths), dysentery (13/2 deaths).
Commissions Army Medical Staff
On 26 Jan 1897, the Governor Sir Arthur Lyon Fremantle submitted a recommendation to the War Office in favour of the annual grant of a commission to one of the most successful medical students of the university. Fremantle was aware that it was unlikely that the War Office would consent to his proposal, as this would be against the policy of admission by a competitive examination.
The Governor also thought it unlikely that Maltese medical officers could afford to travel to London to sit the competitive examination for a commission into the Medical Department of the Army.
In 1881, an Army Nursing Service was established at the Royal Victoria Hospital Netley.
In 1894, a proposal to form a Women's Volunteer Medical Staff Corps was rejected by the War Office and a civilian reserve corps of the Royal British Nurses Association was formed instead.
In Mar 1897, the War Office formed the Army Nursing Reserve, called the Princess Christian's Army Nursing Service, so as to exert control on the military nursing reserves. It was this reserve which provided a large number of additional nurses for the Boer War in 1899.
In Mar 1902, the Queen Alexandra Imperial Military Nursing Service replaced the Army Nursing Service. Nurses, however, did not gain equivalent rank until 1926, and did not receive commissions until 1941.
Royal Naval Hospital Bighi
A report dated 13 May 1897 pointed out that the Royal Naval Hospital Bighi did not have enough beds to cover future hostilities. On 14 July 1897, the naval authorities accepted Deputy Inspector General James Hamilton Martin's plan to increase capacity by erecting a third wing on the vacant ground in the North East, adjoining the East Wing. The basement of the new wing was to be used as a living place for the Sick Berth Attendants, and as additional store rooms.
The DIG proposed to amalgamate the Auxiliary Hospital with the General Ward, and to treat infectious cases under canvas. He planned to increase the number of beds from 280 to 500, accordingly: 100 beds in the corridors (summer option), 100 beds under corrugated iron, or under a temporary shelter in the ditch and north front of the hospital (winter option), 72 beds in the New Wing, 112 beds in the Auxiliary Hospital, 216 beds in the General Ward.
To accommodate the additional medical staff, Martin intended to appoint unmarried officers only. There would allow ample space in the surgeons' quarters which had an anteroom, mess room, and bedroom for four doctors. The entrance to the old wash house, which served as a carpenter's shop, was to be adapted into a dormitory for the Sick Berth Attendants employed in the corridors or iron huts.
On 25 July 1897, a portion of land in the South West Corner was chosen for a new Zymotic block of 24 beds. The foundations were laid down on 19 January 1899. Tenders were invited for the construction of a new block for 150 beds on the east side of the hospital, and the Auxiliary Hospital was converted into quarters for sick berth attendants.
Cretan International Force
British troops formed part of the Cretan International Force and were encamped in Crete from 24 Mar 1897 onwards.
The first detachments were 1 Coy 1st/Seaforth Highlanders at Canae and HQ and 5 Coys at Kandia. The remaining companies of the 1st/Seaforth Highlanders and HQ and 4 coys of the 2nd/Royal Welch Fusiliers joined on 8 April. A Coy of the Seaforth Highlanders disembarked at Canae, and the rest of the reinforcements were at Kandia. ,/p>
On 26 April, No 4 Mountain Bty RA arrived at Crete, and was joined in early Aug by the rest of the Royal Welch Fusiliers. In Nov 1897, 4 Mountain Bty RA and the Seaforth Highlanders returned to Malta.
Army Medical Department
On 10 May 1897, Dr Thomas Smith warned prospective candidates seeking commissions in the AMD, that the life of an army medical officer was a succession of worry, petty annoyances, refusals of leave, sickness, expensive journeys, and social and official snubs.
In 1897, about seventy vacancies in the AMD had not been filled, placing an undue demand on those who had not already left on a pension. Under manning, alleged Smith meant overwork, sickness, inability to get leave, and a rapid decline in health, with the consequent invaliding from the service with a ruined constitution.
Smith also commented on the social snubbing facing medical officers. These are of two kinds, social and
official said Smith. Ladies connected with the army and also civilians have often told me that the doctors in the army are not considered officers at all; and as for the officials, medical officers are pushed as far in the background as possible.
Smith alleged that the General Officer Commanding a district in the south of England asked nearly every subaltern in the garrison to dine with him, but only invited his Principal Medical Officer twelve months after he had arrived in the station. Another slight was when Lord Wolseley while inspecting the troops returning in the hospital ship from the Ashanti expedition, spoke to everyone, and shook hands with most, but intentionally omitted to notice or shake hands with, or commend Surgeon General Taylor and the officers of the Army Medical Staff. This was more marked, as the senior regimental officer present was only a captain, and if there was any expedition where medical officers did good work worthy of all praise, it was the Ashanti campaign.