Rupert Downes

Education and early life

Rupert Major Downes was born on 10 February 1885 in Mitcham, South Australia. He was the youngest of fifteen children of Colonel Major Francis Downes—a British Army officer—and his wife Helen Maria, née Chamberlin, only five of whom survived to adulthood. After service in the Crimean War, Colonel Francis Downes served as commandant of the Colonial forces of South Australia and Victoria and retired with the rank of major general in the Australian Army in 1902.

Rupert was educated at Haileybury in Melbourne as a boarding school student. In March 1901, at the age of 16, he joined the Victorian Horse Artillery (St Kilda Battery), a part-time volunteer militia unit, as a trumpeter. In May 1901 he served in this capacity at the opening of the inaugural Parliament of Australia by The Duke of Cornwall and York at the Royal Exhibition Building. He left the Army in 1903. That year he became a medical student at the University of Melbourne. A good result in his first year examinations earned him a residential scholarship to Ormond College, and he graduated with the double degree of Bachelor of Medicine and Bachelor of Surgery (MBBS) in 1907.

Soon after graduation, Downes re-enlisted in the Army. He was commissioned as a captain in the Australian Army Medical Corps on 1 July 1908 and promoted to major on 26 March 1913. He served his residency at Melbourne Hospital and became a general practitioner in Malvern, Victoria, but soon returned to the university to pursue a doctorate. His Doctor of Medicine (MD) thesis, entitled "The anatomical relations of the thymus, especially considered in regard to thymic death with an account of cases of abnormality", was accepted in 1911. He also did the coursework for a Master of Surgery (MS), and this degree was conferred in 1912.

Downes married Doris Mary Robb on 20 November 1913 at St John's Church, Toorak. They had three children, all given the same middle name as Rupert: Rosemary Major, born in 1914; Valerie Major, born in March 1918; and John Rupert Major, born in 1922.

First World War

Downes joined the Australian Imperial Force (AIF) on 2 October 1914, shortly after the outbreak of the First World War, assuming command of the 2nd Light Horse Field Ambulance with the rank of lieutenant colonel; this made him the youngest officer of that rank in the AIF at the time. Soon after his taking command, the unit was renamed the 3rd Light Horse Field Ambulance. After training at the Broadmeadows Army Camp near Melbourne, the unit embarked for Egypt on the transport SS Chilka on 2 February 1915.

After the early fighting in the Gallipoli campaign, the need for reinforcements became acute, and the commander of British Troops in Egypt, Lieutenant General Sir John Maxwell, decided to ship the light horse brigades to the Anzac Cove lodgement without their horses. The 3rd Light Horse Field Ambulance departed Alexandria for Anzac on 17 May 1915. It moved to Lemnos in June, where it operated a hospital, but returned to Anzac for the August offensive. Downes missed this operation, as he remained on Lemnos supervising the hospital until he returned to Anzac on 11 August. He remained with his unit until 13 November, when he departed for Lemnos and then Egypt.

After the evacuation of Gallipoli, Downes was appointed Assistant Director of Medical Services (ADMS) of the newly formed Anzac Mounted Division on 15 March 1916. He was given the temporary rank of colonel. Downes combined this post with that of ADMS AIF Egypt from 6 September. Downes therefore had to travel back and forth to Cairo. In November 1916, a Deputy ADMS was appointed to assist him.

Medically speaking, the health of the Anzac Mounted Division was remarkably good, but the Sinai Peninsula still had its challenges—especially for medical officers unfamiliar with conditions in the Middle East. The Battle of Romani revealed the importance of transportation in an area with few roads. A poorly organised casualty evacuation effort caused preventable hardship and suffering for the wounded, and resulted in several avoidable deaths. An inquiry into the matter was held after the battle, at which Downes was called to testify. The Commander in Chief of the Egyptian Expeditionary Force (EEF), General Sir Archibald Murray, declined to assign blame to any individual, but implemented the inquiry's recommendations for improving the casualty evacuation process.

There was also the heat, and the problem of supplying adequate quantities of potable water. Diseases included cholera, typhus and bilharzia. To combat these, Downes obtained the services of Lieutenant Colonel Charles James Martin, and created the Anzac Field Laboratory to investigate these diseases. As a result of aggressively tackling the problem, Downes reduced rates of disease among Australian and New Zealand troops well below those of British troops serving alongside them. Martin advanced the notion that heat exhaustion and heat stroke were not the result of defective evaporation, as had previously been believed, but simply a matter of failing to drink enough water. He in turn converted Downes to the belief that "provided water is available in adequate amount the heat mechanism of the body can defy all ordinary climatic ranges of temperature even under conditions of hard work."

Interwar years

Returning to Australia, Downes was discharged from the AIF, but remained in the Army as a reservist. He became an honorary consulting surgeon at the Royal Children's Hospital, Melbourne, and Royal Victorian Eye and Ear Hospital, and honorary surgeon at Prince Henry's Hospital. He was a founding fellow of the College of Surgeons of Australasia in 1927, and became president of the Victorian branch of the British Medical Association in 1935. He established a reputation as one of Melbourne's leading paediatric surgeons, but found himself in disagreement with certain medical practices then in vogue. In a 1922 paper published in the Medical Journal of Australia, he examined 100 cases of tonsillectomy in children, and concluded that the majority of them were unnecessary. It would be another four decades before the medical profession in Australia accepted this. He lectured on medical ethics at the University of Melbourne from the late 1930s until his death in 1945, and wrote a course textbook on the subject, entitled Medical Ethics, which was published in 1942.

Along with his medical writings, Downes wrote a book-length section on the Sinai and Palestine campaign for Volume I of the Official History of the Australian Army Medical Services in the War of 1914–1918, in the late 1920s under the direction of Medical Series editor Graham Butler. The two men had discussed writing a medical history of the campaign during a visit Butler made to Egypt in 1918 to inspect the medical records of the AIF, and again in France in 1919. Downes published an article in the Journal of the British Army Medical Corps entitled "The Tactical Employment of the Medical Services in a Cavalry Corps" in 1926, which he expanded into one of the chapters of the Official History. His manuscript proved too long for the proposed book, and was extensively edited by Butler before it was published in 1930. Downes was instrumental in supporting Butler's Medical Series and helped obtain the funding necessary to complete the project.

Downes was chairman of the Masseurs' Registration Board, a councillor of the Victorian division of the Australian Red Cross, and chairman of the Red Cross National Council. He was Victorian State Commissioner of the St. John Ambulance Brigade for 25 years. He was also president of the St John Ambulance Association for eight years, and chairman of the Victorian Civil Ambulance Service from 1937 to 1938. In 1930, he was appointed a Commander of the Venerable Order of Saint John, and became a Knight of Grace of the order in 1937. At the same time, Doris became an Officer of the Order of Saint John, in recognition of her fundraising efforts for the Victorian branch. She later served as a member of its council from 1942 to 1953. Downes was instrumental in persuading the state branches to come together as a national organisation, arguing that without a national body, the organisation would be eclipsed by the Red Cross.

Second World War

Downes, in his role as DGMS, pressed for the construction of major military hospitals in the state capital cities. He argued that, after the war, they should be handed over to the Repatriation Department for the care of sick and disabled ex-service personnel. Despite strong opposition on the grounds of cost, Downes won his case in October 1940. The major military hospitals in the state capital cities, the Concord Repatriation General Hospital in Sydney, the Austin Hospital in Melbourne and Greenslopes Private Hospital in Brisbane remain part of his legacy.

In late 1940, medical units in the Middle East were experiencing "precarious and at times acute" shortages of medicals stores. Units were sent to the Middle East as fully equipped as was possible, with the expectation that the British Army would make up the difference, but British policy was that all possible sources had to be exploited before any demands could be made on the United Kingdom's sources. General Sir Thomas Blamey, the Commander in Chief of the AIF, recognised this as something that had to be negotiated between the two governments, but medical officers in the Middle East blamed the Medical Services in Australia—and therefore Downes—for the situation. The Minister for the Army, Percy Spender decided to pay a visit to the Middle East to see the situation for himself but before he did so, he resolved that Downes should become Director of Medical Services, AIF (Middle East). On arrival in the Middle East with the Chief of the General Staff, Lieutenant General Vernon Sturdee, Spender found that Blamey had already appointed Major General Samuel Burston to that post. This came as a surprise to them as they had not realised that Blamey had the authority to make such an appointment; but on seeing the situation for himself, Spender confirmed Burston's appointment.

On returning to Australia, Spender appointed Major General Frederick Maguire as DGMS and Downes was appointed to the newly created post of Inspector General of Medical Services (IGMS). As IGMS, Downes toured extensively—he visited all the Australian states and overseas locations where Australian troops had been sent, including Papua and New Guinea, Malaya, the Middle East and North Africa, as well as the Netherlands East Indies (Indonesia), India and East Africa. When Blamey reorganised the Army on his return to Australia in 1942, he appointed Burston as Director General of Medical Services. Downes became the DMS of the Second Army on 6 April 1942. He joined the Second AIF as a major general on 27 June 1942, receiving the AIF serial number VX57673.

Death and legacy

Downes was the DMS of the Second Army until 22 August 1944. Due to the run-down of the Army in the latter stages of the war, the Second Army, always mainly a paper organisation, increasingly had less to do. Now nearly sixty, Downes accepted an invitation to write the medical history series of the Official History of Australia in the War of 1939–1945. As part of this, in March 1945, he decided to accompany Major General George Alan Vasey to New Guinea, where Vasey's 6th Division had encountered an atabrine-resistant strain of malaria in the Aitape-Wewak campaign.

On 5 March 1945, the RAAF Lockheed Hudson aircraft they were travelling in crashed into the sea about 400 yards (370 m) off Machans Beach, just north of the mouth of the Barron River near Cairns in Queensland. Downes and Vasey were killed along with all nine other Australian service personnel on board. Downes became the third most senior Australian officer to die in the Second World War, after General Sir Brudenell White, who died in the Canberra air disaster in 1940, and Lieutenant General Henry Wynter, who died from natural causes on 7 February 1945. The bodies were recovered and buried in the Cairns War Cemetery with full military honours. A memorial service was held at St Paul's Cathedral, Melbourne, on 9 March 1945.

Gavin Long, the editor in chief of the Official History of Australia in the War of 1939–1945, prevailed on Allan S. Walker to write the medical series volumes. Walker discarded Downes's plans to have specialists write different sections, and ultimately wrote three volumes himself, starting with Clinical Problems of War (1952). He was working on the fourth and final volume, on the Medical Services of the RAN and RAAF, when he was compelled to quit in November 1956 due to ill-health, and he died in January 1958. The final volume was finished by others and appeared in 1961. Downes's papers are in the Australian War Memorial. The Royal Australasian College of Surgeons established the triennial Rupert Downes Memorial Lecture in his honour. The subject of the lecture is "related to some aspect or aspects of military surgery, medical equipment (military and civil), the surgery of children, neurosurgery, general surgery, medical ethics or medical history; these being subjects in which Downes was particularly interested".

Rupert Downes Memorial Lectures

1950 Major General Samuel Burston Some Medical Aspects of Atomic Warfare

1954 A.S. Walker The Following Wind of History

1957 Major General Frank Kingsley Norris Be Strong and of Good Courage

1961 Sir Albert Coates The Doctor in the Services

1965 D. Waterson Œsophageal Replacement in Pædiatric Surgery

1970 J.H. Louw The Scientific Method in Surgery

1972 H.E. Beardmore Pædiatric Surgery – Yesterday, Today, and Tomorrow, and Tomorrow, and Tomorrow

1976 P.P. Rickham Nephroblastoma – a New Look at an Old Problem

1978 C.M. Gurner Military Medical Preparedness

1980 D.G. Hamilton One Hundred Years of Pædiatric Surgery in Sydney

1983 G.B. Ong The Trifacetted Nature of Surgery in Hong Kong

1988 B.A. Smithurst Distinguished Australian Military Surgeons

1990 Patricia K. Donahoe The Development of Tumour Inhibitors

1994 General Sir Phillip Bennett Medical Aspects of Australia's Defence

1996 Professor Averil Mansfield Arterio-Venous Malformations and their Treatment