When a War Goes Wrong

When a war goes wrong, a longstanding British political habit is to establish an official inquiry. They take many forms. Florence Nightingale used the Royal Commission on the Health of the Army (1858-62) to promulgate her views after Crimea. The Second Boer War engendered nearly as many fat volumes as Chilcot. Several covered ‘The Military Preparations … the supply of Men, Ammunition, Equipment and Transport … and Military Operations’, others ‘The Care and Treatment of the Sick and Wounded’. The Elgin Commission took evidence from the military commanders, and the secretary of state for war set up an expert commission to investigate dysentery and enteric fever.

Events before, during, and after Operation Telic (Iraq, 19 March 2003 to 22 May 2011) induced the same kind of investigatory response. Hutton (the death of Dr David Kelly) was followed by Butler (intelligence regarding WMDs). The National Audit Office published a general report in December 2003, a report on combat identification (preventing friendly fire) in February 2006, and one on treating injury and illness arising on military operations in February 2010. Chilcot is the latest. It has published an enormous body of evidence, but in essence not much that surprises.

Soldiers in the Boer War would have welcomed body armour and night vision equipment. But they would not have been surprised if they were in short supply when combat started, as happened at the beginning of Telic. Militarily, some things never seem to change. In 1899 there was a deficit of boots; so there was in 2003. Unlike the Boer commandos, Saddam’s army scuttled away when challenged. It isn’t surprising that British casualties were so limited. In South Africa, 7792 soldiers were killed or died of wounds. Two bad days accounted for 627 of them. On 11 December 1899, 244 were killed by enemy action at Magersfontein, and on 24 January 1900, 383 died on Spion Kop. During the eight years of Telic, 179 service personnel died, 136 in hostile circumstances. The biggest difference was that in South Africa, 13,250 soldiers died from disease. During the eight years of Telic, 43 died as a result of illness, accidents, friendly fire or suicide. Well before the battle of the Somme the British army had learned how to prevent typhoid, the most frequent killer of soldiers in the field.

Chilcot took evidence from Lieutenant General Louis Lillywhite, the director general of army medical services, when Telic began:

If you actually look at killed in action rates and died of wound rates, which you can actually follow from the 1500s in fact, the killed in action rate has remained quite constant over many centuries at about 25 per cent. We appear to have reduced that to 15 per cent in the later Iraq and Afghanistan conflicts. So for the first time in many centuries we have made a significant impact into the killed in action rate.

Chilcot received a medical post-operational tour report from the MOD:

It was determined from Op TELIC that the control of catastrophic bleeding in the first 10 minutes after led to a significant improvement in casualty morbidity and mortality rates.

The Combat Applied Tourniquet was introduced in 2005. It can be put on with one hand. It has a built in windlass system. Immediate application after injury has been shown to improve survival by nearly 25 per cent.

‘There were major improvements in the provision of medical care, mental healthcare and rehabilitation care available to service personnel,’ Chilcot concluded, ‘over the course of Operation Telic.’ Right, but a pity that the improvements were driven by IEDs.