Part 54

Every moment news of another battle was expected; the experience of the first, with no better means as yet at hand, was a matter of great concern and worry to all present. Suggestions were made and discussed. Finally it was agreed to request more Red Cross aid by telegraph. A call for one hundred Sisters was suggested, and Mrs. Lesser was consulted in the matter. We had fifty trained nurses and assistants on our lists, also women to act as matrons to distribute nourishment; we promised to send for that number immediately, as we had sent for twenty-five already. That morning Miss Barton, with Mr. Kennan and several of her staff, had gone to the front, and before leaving, Miss Barton instructed her secretary, Mr. C.H.H. Cottrell, that, at our request, he should cable in her name for such persons and material as should be needed in the Hospital Department. We cabled for fifty nurses, ten assistants, a number of immune physicians, complete hospital equipment, and a quantity of surgical material, sufficient to make at least five hundred patients comfortable.

The work was performed almost without intermission, every surgeon employing all his energies. The feeling in the hospital among the members of the surgical staff was an excellent one.

The night of the third we expected to be able to rest a few hours, but during the day the fleet had fought its battle, and a number of Spanish wounded prisoners were taken off by the various ships. Dr. Lewis, chief surgeon of the "Harvard," who assisted in attending the wounded at the hospital at Siboney, invited Dr. Parker, myself and the Sisters to help him in attending the wounded Spaniards, to which we gladly responded and spent the night on the "Harvard."

The wounded continued to arrive for four days, many of them telling that they had been shot on the first day of the battle, July 1, and as yet had received no care except from some comrade who had with him the little emergency package.

Permit me to say here that I believe the little emergency package has saved many a man from death through bleeding.

Most notable and commendable was the desire of the surgical staff to save limbs when at all possible; and I have seen and often joined Drs. Fauntleroy, Nancrede, Ireland and Parker in the work, spending an hour for resection of the part in order to prevent amputation. Of course all endeavored to do the same, and out of the total number of 1415 wounded treated in the Siboney Hospital after the battle, there were but three amputations of the thigh, two of the leg and one of the forearm, that I observed in the camp. The death rate was also very small, as most of the shots made clean wounds, and only when they affected most vital parts did they cause death.

The dressing of wounds and the operating upon the wounded, however, were not all the service required by the injured. Shelter, comfortable cots and blankets were needed, very few of which had been landed. Still, as the wounded came, and the needs became greater, I saw Surgeon-Major La Garde, most ably assisted by Chaplain Gavitt, hunt about for canvas or anything that would act as cover for a tent, and have it put up along the tents and flies. Their work was unceasing. In those days every officer and member of the medical staff gave up his cot and tent that the wounded might find some kind of shelter and proper resting place; but in spite of that they were inadequate. The largest number of wounded lay on the ground, some on blankets, others on canvas, or if very severely wounded, on a litter.

The steamship "State of Texas" had a number of cots (I believe 350) which were originally meant for Cuban relief, many of which we used in the Red Cross Hospital at Siboney; when I informed Miss Barton of the condition of affairs, all cots that were in the ship were unloaded and sent to the hospital, and the most seriously wounded received comfortable resting places.

The gauze, particularly the iodoform gauze, and bandages soon gave out. The "State of Texas" carried a quantity of surgical dressings. All that was necessary was to ask Miss Barton for them, who immediately sent on land any article needed if in her possession.

Among our patients were several cases of gunshot wound through the skull and brain near the eyes; the eyes were inflamed, and ice had to be applied continuously to relieve excruciating pain. Dr. Fauntleroy suggested that the cases be sent to the Red Cross Hospital, we had there the only ice in the field at that time; it also came from the "State of Texas," from which we received a daily supply. The eye cases were carefully attended by Mrs. White, the wife of Dr. Trumbull White, of the Chicago _Record_, who deserves much praise for the constant attention which she gave them. It was necessary to make continuous application of ice every few minutes, which she did with constant and unceasing care. Mrs. White is not a trained nurse, but a gentle, wise woman. I agree with the remarks of Dr. Fauntleroy when he said that her attention and the ice relieved much suffering and saved quite a few from blindness. Captain Mills, who was one of the wounded in that manner, may tell of his own experience.

Most of the cases of gunshot wounds gave very little work to the surgeons, as the bullet entered at one place and made its exit at another, thus leaving a clean wound. Even through vital parts of the body, such as the brain and abdomen, bullets passed without apparently giving the patient any great distress. The simple cases did not need much attention; cleanliness and a cushioned dressing well protected was all they usually required. In fact, many of the smaller wounds came to us bandaged with a little emergency pad, progressing in healing. These were always shots from the Mauser bullet. Many of the men that I saw were shot in the shoulder, the bullets making exits through the back. Some gunshot wounds had two places of exit and entrance in their course. For instance, I had cases in which the bullet had gone into the upper and lateral part of the cranium, come out behind the ear, went into the shoulder and came out behind and below the shoulder blade; or had made its course through the left arm, again entering the right chest and coming out at the back. It would perhaps be out of place to enumerate or describe in this report the many courses which the bullets have taken, but as stated, most of them required little attention. There were, however, some serious wounds, such as compound comminuted fractures, in the treatment of which great skill was shown by the various surgeons in the hospital. Those were the cases which in former years would have resulted in amputation, but drainage and cleanliness, plainly speaking, have given the patients the advantage of keeping their limbs.

In the simple cases one could work alone, with the assistance of a Sister or a hospital steward, but in the more difficult cases good surgical skill was required, and it was often a source of great gratification to see two eminent surgeons, of equally good reputation, assisting each other in a difficult case; one advising, the other acting; thus the greatest harmony existed among the members of the staff. The Sisters being required in the operating tents as also the stewards there were no nurses in the tents to care for the wounded.

No food had been prepared for the large number of wounded lying on the cots or on the ground on blankets or canvas; a great many of them were too helpless even to turn. Surgeon-Major La Garde did me the honor of consulting me in regard to the nursing, and I suggested that some of the Sisters leave the operating tables, which were by that time supplied with other assistants.

The major then sent for Mrs. Lesser, who suggested that the worst cases be brought into one or two rows of tents, as the small staff of Sisters brought into Cuba was not sufficient to take charge of all and do them justice. The rows of tents were then placed in her charge, and she portioned the work of caring for them among the Sisters assisted by hospital corps men. The soldiers were nearly famished; some had not received a morsel of food for two days. Oatmeal gruel, coffee and quantities of prune juice and other articles of relish were at once prepared at the Red Cross Hospital in big cans which had come from the "State of Texas," and with the assistance of the ever active indefatigable Chaplain Gavitt, and several newspaper correspondents, the wounded soldiers received such food as their conditions allowed.

Unfortunately the surgeons lost track of the greater number of their cases. The patient marked for redressing was placed on any table, and the surgeon in charge of that table redressed the wound; thus it was hard to say what result one or the other had obtained, with the exception of a few cases, which by special request one was allowed to continue to observe. Some of the patients came down with their wounds dressed in some hospital at the front, and I may here mention that I saw excellent work coming from the hospital in command of Dr. Woods.

When the rush was over, I was called to the camp where the Spanish prisoners were located. I prescribed for their ailments, while the Sisters supplied their food. In addition, I answered the calls which came from Cuban families in Siboney. Some Spanish prisoners were wounded and others suffered from fevers. Those who were wounded had their wounds dressed at the scene of battle, and although some of the dressings were temporary, they feared to have any person touch them, until assured that they would be treated as gently as possible. The patients had now all been operated upon and attended; only some of the wounds needed redressing. They were taken to the transport hospital ships as soon as their condition permitted. It was about that time the hospital ship Relief arrived, bringing more food for invalids and more equipped cots.

Dr. Guiteras, who visited all the hospitals daily, informed me one afternoon that he had found a case of yellow fever in camp (not in our hospital), developed in a place near Siboney. There were two or more suspicious cases which he had watched, and he believed that yellow fever would develop very rapidly. I called the Sisters together, presented the situation to them, that they might decide whether to stay in the field or return to the "State of Texas." Their unanimous decision to stay and face the consequences made them continue their work without any hesitation. The Red Cross Hospital building became crowded, one room was set aside for doubtful cases, while the other rooms were occupied with typhoid patients. The porch in front of the house, shaded with canvas, and a little isolated room to the right, sheltered the wounded.

My work at the Red Cross Hospital became continuous, as a large number of patients came from the various camps to receive attention, and still a larger number from our camp came for consultation and treatment. The number of such consultations I discontinued to write down after three hundred were attended, Americans, Spanish and Cubans together.

Every case of typhoid fever and other disease which was placed in our charge from the day we opened the hospital, has recovered. The last of them were brought home well on the "Concho;" those that came later were on the way to recovery when I left for the fever hospital. Among our patients were two who had measles, complicated with pneumonia, and there was a large number of patient suffering with Cuban malarial fever. I also wish to state that not one patient in our hospital became infected with yellow fever; the cases that had it came there with the disease, but were closely observed, and as soon as the first positive sign was noticed, they were isolated and brought to the fever hospital. The total number of sick permanent and transient thus attended was 234. Most of the medicines we had brought with us, but received some from army stores.

When the "State of Texas" left for Jamaica to get ice, in order to save time we took a dwelling in one of the houses at Siboney, which was believed by experts not to be infected. The family living in it was very clean, and it appeared that the house would serve as well, and perhaps better than any other. Our tents, in which we should have preferred to live, had not arrived, nor did we have any cots, all having been given to the sick and wounded.

When the houses at Siboney were ordered to be burned down, we left for the yellow fever camp. Before leaving I requested Dr. Senn to operate upon two Spanish prisoners whom I had not seen for several days.

On the seventh day after our arrival at the camp we were able to return to Siboney. Our ailments, although not prevented, had been made light by prophylactic methods, and our recovery was consequently rapid. After our return to Siboney I again offered to serve.

In the meantime word from Assistant Surgeon-General Greenleaf was received at Siboney, stating that forty-five Red Cross nurses, surgeons and other assistants, had arrived at Guantanamo, waiting to come to us, and as we returned the same day from the fever camp, Surgeon-Major La Garde telegraphed and telephoned repeatedly for them to come, but he received no reply.

Feeling that under the existing circumstances and exhausted from work and illness we could not continue to work without more assistance, I applied for our return. Surgeon-Major La Garde upon this placed me in charge of the steamship "Concho" which left for the North on July 23, of which voyage a special report has been presented.

Before my departure from Siboney, Surgeon-Major La Garde handed me a document, a copy of which I herewith present:

RESERVE DIVISIONAL HOSPITAL, FIFTH CORPS, SIBONEY, CUBA, _July 23, 1898_.

This is to certify that Dr. A. Monae Lesser, surgeon-in-chief of the American National Red Cross, offered his services to the Medical Department of the army on the twenty-ninth day of June. From the latter date to the present day Dr. Lesser has been connected with this hospital as a surgeon and patient. When the wounded commenced to arrive on July 1, and during the rush of work which lasted four days in the care of the wounded, Dr. Lesser was assigned one of the six tables in the operating room. His work was skillful and most continuous. His suggestions to me on more than one occasion, concerning administration details, were of the highest value. After the rush of work in the operating room Dr. Lesser continued to take charge of a hospital, a building which was pronounced free from infection, in which he treated wounded and sick soldiers. His work was the admiration of every one who had the good fortune to be under the watchful care of himself and the Sisters under him. Unfortunately the building--in which they lived--soon showed signs of yellow fever infection. Dr. Lesser, his wife and four of the Sisters--his entire staff--were taken one by one with the fever. They were removed to our yellow fever hospital. They are now convalescing, though weak; they leave us for the North to-day for a much needed rest. I have no words at my command which could in any way express my appreciation of the work of Dr. Lesser and his heroic staff. Had it not been for their assistance and the quantities of supplies furnished by the "State of Texas," the sufferings of the hundreds of wounded would have been magnified more than I can now venture to express.

In commenting on our lack of supplies, attendants, etc., I desire to state that our unprepared condition to meet the rush of work which came with such surprising rapidity was due to those military conditions which often transpire in war when blood, suffering and death seem to be inevitable, or beyond the scope of man to anticipate.

May God's blessing be with him and his.

LOUIS A. LA GARDE, _Major and Surgeon, U.S.A., Commanding Hospital._

RELIEF WORK IN CUBA.

REPORT OF C.H.H. COTTRELL, FINANCIAL SECRETARY.

Early in February, 1898, after the President of the United States had called Clara Barton to several conferences on the question of relieving the sufferings of the Cuban reconcentrados; and the Central Cuban Relief Committee had been formed to take charge of the funds and supplies which it was known that the generous American people were anxious to donate for this purpose, it was decided that Miss Barton should go to Cuba at once to assist in the prompt and efficient distribution of the succor which was so near at hand. It is her habit to act quickly when her plans have been matured, and not a moment's time was lost in preparing for her journey to Havana.

On her arrival at Havana Miss Barton communicated with the American Consul General, the Spanish officials, and some of the best known and benevolently disposed citizens; and after freely conferring with them, and learning the existing conditions, the city was divided into distribution districts, and a committee of citizens, who were fully acquainted with the people and their wants, was appointed to take charge of each district. Abundant space in a very large warehouse had already been secured by the Consul General, which was, with the use of its employes, given free of charge to the Red Cross.

Several of the villages near Havana and as far east as Matanzas were then visited and arrangements similar to those made in Havana were perfected for the distribution of food and clothing; and these communities were supplied as quickly as possible.

Shortly after Miss Barton's arrival in Havana the deplorable "Maine" disaster occured, killing, drowning and injuring so many of our brave sailors and marines. As soon as she heard of this awful calamity she visited the hospital where the victims who were not killed outright were lying, and arranged to have them provided with every possible attention, and the best of everything needed that money and sympathy could procure.

As the situation developed and the needs of the country became known, it was found to be necessary to largely increase the working force of the Red Cross, and arrangements were accordingly made to have some of the oldest and most experienced workers of that organization, with some new recruits, come to Havana. A large house for their accommodation was secured in the suburb of Cerro, about three miles from the business centre of the city, where they were pleasantly and comfortably established. The party when completed consisted of the following named ladies and gentlemen:

Miss Clara Barton, Mr. J.K. Elwell, Dr. J.B. Hubbell, Dr. E. Winfield Egan, Dr. A. Monae Lesser, Mrs. A. Monae Lesser, known as "Sister Bettina," Misses Annie McCue, Minnie Rogall, Blanche McCorresten and Isabelle Olm, Red Cross nurses or "sisters;" Mr. J. A. McDowell and Mr. C.H.H. Cottrell.

Many of the best citizens of Havana, ladies and gentlemen, Spaniards and Cubans, gave us a most hearty welcome and every encouragement, many of them volunteering their services in any capacity in which they could be made useful, and we were thus enabled to secure a number of doctors and nurses, who gave excellent service, and who received the well-deserved thanks of the Red Cross.

RELIEF DISTRIBUTION FROM THE SAN JOSÉ WAREHOUSE.

Mr. Elwell was put in charge of the warehouse with an able corps of assistants, and his work there was all that could be desired, as it was something that he was perfectly familiar with from long experience; he had the great advantage of knowing the Spanish language and the character of the people with whom he was dealing. Many hundred tons of the finest supplies, including everything that a generous and sympathetic public could think of that would be suitable for a famishing people, were given out as fast as orders were issued for them; but in every instance the utmost care was exercised that nothing should go out that might reach the hands of irresponsible persons; and every possible safeguard of check and receipt was adopted and successfully used.

OPENING A HOSPITAL AND ORPHANAGE.

The large number of orphan children that had been left unprovided for appealed to the sympathies of some worthy people for whom Consul-General Lee was the spokesman, and Miss Barton was asked by them to provide a hospital and home for these waifs. She therefore rented and furnished a large private residence on Tulipan street in Cerro, near the Red Cross residence, which was opened and named the "Lee Orphanage." The house was completely arranged and had a capacity for seventy-five inmates, besides the attendants, and it was soon filled. Dr. and Mrs. Lesser were placed in charge of the orphanage, assisted by several Cuban doctors and nurses. The greater part of the children who were brought there were in an extreme state of exhaustion from lack of nourishment, many being unable to sit up, and the greatest care and watchfulness had to be observed to save their lives. A few of them died after they reached the hospital; but by careful and unremitting attention the larger part of them were gradually brought back to health, and it is to be hoped that some of them will eventually find homes in good families.

LOS FOSOS, THE HORRIBLE!

An old ramshackle building long before abandoned as unsafe and undesirable was owned by the city and known as Los Fosos. Being worthless and unwatched, it had become the lodging place of a horde of beggars and tramps, and when the unfortunate reconcentrados were driven into the city from their homes in the country hundreds of them flocked to this miserable place. Miss Barton found there men, women and children crowded together in a most pitiable and disgusting mass; and suffering from disease and exhaustion and in such a state of filth that her party was unable to endure the stench and had to get out after a very short stay. These poor victims of cruel war were lying on the bare floor in their dirty rags, and entirely helpless except for such poor aid as they could render each other. Many of them died daily and their corpses would lie for hours before being removed. Altogether it was one of the most horrible pictures imaginable.

Permission was obtained by the Red Cross to repair the building and make a hospital of it, and carpenters were put to work to strengthen the swaying floors and batten up the sides and make the roof rainproof. Three rooms were partitioned off for a dispensary, store room and kitchen. Scrub women were put to work and a plentiful supply of soap, water and disinfectants soon made a great change for the better. When the place had been cleansed, new cots were brought in and clean bedding put on them. Up to the time of their forced departure those devoted nurses worked faithfully from early morn till late in the day to keep the place decently clean and instill habits of neatness into those miserable beings. Deprived of the pride and care of those trained women, it is easy to believe that within a week after they left, Los Fosos had resumed its former reputation as the most unsavory spot in all Havana.

During the time that Los Fosos was under the care of the Red Cross the best medical skill obtainable was given to the inmates, and the untiring care and attention of as faithful a body of trained nurses as the world has ever known was freely given them, and the best of nourishing food and delicacies were abundantly supplied; and if fate had willed that this body of self-sacrificing men and women should remain, there is no doubt that, in the course of time, this old pesthouse would have become a famous hospital with a reputation second to none.

RELIEF WORK DISCONTINUED.