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APART from the factual recording of past incidents, there are two qualities essential in any history. Sufficient emphasis must be laid on errors of commission and omission to prevent their repetition in the future and the whole must be presented with enough interest that he who runs may read, not nod. In telling the story of the New Zealand Dental Corps it is impossible to avoid the use of technical terms, for dentistry is a scientific subject, so if some of the explanations seem empirical to the dental reader, his indulgence is craved. May he share with the lay reader some enjoyment of the successful struggle of the Corps for recognition by the Armed Forces, which should appeal to anyone who has read ‘Cinderella’.
There is little of the blood and thunder of war but enough fights, if only on paper, to satisfy even an Irishman. There is something from every theatre of war in which the New Zealand troops fought, for the Corps was responsible for the dental health of every man and woman of the Navy, Army and Air Force at all times. If there is some pride of achievement there is some justification, for New Zealand led the way in providing organised dental service for her armed forces; conceived the ideal of the establishment of complete dental fitness at all times, as distinct from the maintenance of a casualty service, not only at the Base but in the field; clung to this ideal with such fierce intensity that the New Zealand forces, handicapped by an initial grave burden of dental infirmity, enjoyed a standard of oral health second to none of their Allies.
It is a far cry from the experimental inclusion of two dental officers in the field ambulance that left New Zealand in
The thanks of the author are offered to many, too numerous to mention in detail, for willing assistance. It is desired to place on record, however, the names of some without whose help it would have been well-nigh impossible to complete the task: the late Colonel B. S. Finn, whose long and intimate association with the Corps shone a beacon of light through the fog of early research;
BEFORE the Great War of 1914–18, the connection between dental health and fighting efficiency was but faintly recognised. There was a grudging acknowledgment that a toothless recruit might cause embarrassment when confronted with standard rations and thus be a military misfit, but little thought had been given to adjusting his disabilities to the military machine. In most cases he was rejected with the lame, the halt and the blind. Even the layman could see the injustice and futility of this policy, as instanced by the indignant reply of the Scottish recruit in Punch when told that his lack of teeth disqualified him from army service, ‘Mon, I'm no wanting to bite the Germans.’
Napoleon emphasised the importance of good food to the soldier,
These arrangements were thought to be unnecessarily lavish at the time but were fully justified by the work of these officers in Egypt,
During the first nine months of the war, civilian dental practitioners were treating recruits both prior to mobilisation and after they had entered camp, either free of cost or at reduced fees borne by the recruit himself. In spite of this a large number of otherwise fit men were being rejected because of gross dental defects, and amongst those accepted there was still much treatment needed. Recognising this as a waste of manpower and seeing the difficulties in providing treatment for the Expeditionary Force, the
The Association was taking a realistic view of a situation which demanded urgent action. Instead of pressing for the formation of an army dental service which would take time to organise and develop, it immediately made available a practical service from civilian practitioners. The scheme had the added value of getting the treatment done before the recruit entered camp, thus saving interruption of training. This was an important consideration in view of the announcement by the Minister of Defence that the period of training was to be reduced at the request of the Imperial authorities. It was gladly accepted by the Government and for over two years assisted in making most of the men for the reinforcements dentally fit. Mr
The scheme, however, was put forward as an emergency measure only, intended to supply the need until an army dental service was formed. About this time,
In Gazette notice of the formation of the New Zealand Dental Corps appeared on
At this time the 9th and
The
Overseas, the autonomy of control of the Dental Corps was not so quickly achieved as in New Zealand, but this is readily understandable in view of the obstacles to be overcome in fitting a new service into an established organisation such as a fighting division. During the voyage of the Main Body of the Expeditionary Force from New Zealand to Egypt, the dental officers began, under the poorest conditions, the task of examining every soldier and carrying out as much urgent treatment as possible. Their examinations revealed a serious condition, fully justifying the foresight of the authorities in providing dental officers for the Expeditionary Force. What had appeared to the critics to be an unnecessary luxury was soon to be applauded as an important contribution to the ‘An army today is a self-contained community; it contains everything its members need for war, from bullets to blood banks. I will always remember Churchill's anger when he heard of several dentist's chairs being landed over the beaches in Assistant Director of Medical Services.The Memoirs of Field-Marshal Montgomery, p. 348.
When the Anzac forces went to
After some months, five more dental officers were sent to
New Zealand had certainly led the way in the provision of an adequate dental service for an Expeditionary Force and a dental hospital capable of carrying out any form of repair or mechanical work and the making of dentures, and provided with cylinders of nitrous oxide gas and dental engines, perched on a trenched hillside, cheek by jowl with a very noisy mountain battery, surely reaches the ‘limit’ in front line dentistry.
Following the evacuation from
One other administrative matter we must consider. The New Zealand Dental Service was now to be reorganised. Captain Finn, DSO,
NZMC , the dental officer whom we have seen evacuating wounded from the No. 3 Pier at Chailak Dere, for which good work he had a DSO, was now appointed as acting administrative dental officer, attached to NZEF Headquarters. The ideal of a compact dental service attached to a Division was not as yet fully attained. The opinion of the GOC, NZEF at this time was that the OC of a medical unit to which a dental section was attached should be able to undertake the administration of the section so that a separate Dental Corps Headquarters was unnecessary.
Dental sections were formed comprising one dental officer, two mechanics and one orderly. Two were attached to each of the three field ambulances, with nine panniers of equipment weighing 7½ cwt. Later this was reduced as it was considered to be too much for the ambulance transport. In all, eleven sections were allotted to various units, including two to the New Zealand Infantry Base Depot which was to accompany the Division and one to the
In Director of Medical Services.
They were soon missed in the field, and late in
Days of attendance were allotted to brigades and other formations. Sundays were also work days and were devoted to officers. The NZDC worked hard and well; in their first two months they treated
1702 cases and owing to the close proximity of the trenches—the front line was only 3¾ miles away—of a fully equipped dental establishment capable of executing any type of work required, a soldier could come down from the most advanced positions and have efficient treatment without being more than a few hours absent from his duties in the line.A very important work performed by the dental officers this winter was the prophylaxis and treatment of ‘Trench Mouth’ or ulcero-membranous gingivitis caused by Vincent's organisms, now very prevalent amongst the men and, in the opinion of some observers, the cause of secondary lung complications of a severe type.
Another quotation from the same source refers to the period of rest and reorganisation of the New Zealand Division in
The New Zealand dental sections had been remodelled and had now reached their perfected organisation. The dental section which had been formed in the
United Kingdom to accompany the Fourth Field Ambulance was a very mobile unit; all cumbersome equipment had been eliminated, with the result that two small panniers (one pack mule load) now contained sufficient instruments and material for all operations, surgical and prosthetic, and the actual space taken up in transport only half of a half limbered G.S. cart.The dental hospital had also been made mobile by allotting one threeton lorry to the purpose of its transport as required. General Service cart.
There was no difficulty in maintaining a constant supply of expendable material as, in accordance with a contract made between the
New Zealand Government and the War Office, all necessary dental equipment could be obtained from Advanced Supply Depots of Medical Stores. In this way all difficulties had been overcome by experience in the field and the New Zealand Dental Corps may justly claim to be the pioneers of a movement which resulted in an efficient and practical dental service for the front line troops.
Not only was dentistry establishing itself as a service to the troops; it was identifying itself as an essential component of the fighting machine, selling its wares with the utmost confidence to a cautious but rapidly appreciative market. These first steps in mobility are interesting as a prototype of the mobile dental unit in the next war, when the whole character of the war made fluidity of movement a primary essence for every unit in a military force.
From the beginning of
In
When the war ended in
This necessarily brief outline of the origin and development of the NZDC emphasises in particular the development of the Corps from a minor star in the medical firmament to a constellation of its own. Many authoritative references lead to the conclusion that New Zealand was well to the fore in providing dental services for its army, and particularly in establishing a Dental Corps as a separate entity from the Medical Corps. At this stage it is of little value to retrace the steps by which this independence was won. The important
IN
The only treatment left for the Corps was that of patients at the military hospital at
After the war, a Territorial Force was maintained in New Zealand on a compulsory basis, the training consisting of regular parades and annual camps. In the annual report for
It is not proposed to retain a permanent establishment of the Dental Corps, but experience has shown the need for an
Army to be dentally fit and the great influence sound teeth in a soldier have in reducing the rates of sickness and invaliding. It is proposed to maintain the Dental Corps as part of the New Zealand Territorial Force, utilising it in all future camps of training that force. A definite establishment will be laid down which will provide for peace requirements and for the expansion of the Corps for war purposes if necessary.
For the next decade, however, in spite of this statement of policy, the NZDC was not maintained as part of the Territorial Force, although there was retained a Director of Dental Services and a Reserve of Officers.
In
In Lt-Col Sir Charles Hercus, DSO, OBE, m.i.d.; Dunedin; born Dunedin,
In
This was not wholly acceptable, and the matter was temporarily held in abeyance. Something, however, was done. Captains
Due to Lieutenant-Colonel Finn's strong recommendation to the GOC, the NZDC was re-established in the Territorial Force in
Six dental sections, each consisting of one officer and two clerk orderlies. Two of these were to be attached to each of the three Territorial field ambulances.
The Dental Section of the Otago University Medical Company, which was recruited from dental students and officered by two NZDC officers.
With the appointment of officers already mentioned, this left a vacancy for five more officers for the sections attached to the field ambulances. These were filled by commissioning recent graduates from the Dental School instead of using reserve officers who had served in the last war. To complete the establishment, dental clerk orderlies were recruited, chiefly from the staffs of the dental trading companies. There were fourteen days of annual training, made up of weekend or whole-day parades and an annual camp of six days.
Although, on the establishment of the Territorial Force, each dental section was attached to a field ambulance, it went into camp attached to some other unit. In this way as many Territorial units as possible were provided with an emergency dental service and each dental officer gained experience in setting up a field dental section and fitting it and himself into the general military organisation. The emergency treatment for so short a time was not enough to interfere with general training but was greatly appreciated by the Force. In the first years the dental officers themselves provided all the equipment, but later, seven outfits of standard equipment were provided by the
Very soon two significant facts were noticed. Firstly, there were more applications for commissions in the NZDC than there were vacancies, and secondly, there were more requests from commanding officers of Territorial units for dental sections than there were sections available. The enthusiasm of the profession, and of the Territorial units, did not result in an increase in establishment. New Zealand, in common with other members of the British Commonwealth, had not as yet provided the funds for other than a peacetime army. This, however, did not deter the DDS from planning for war, and Lieutenant-Colonel Finn gave freely of his own time in preparing a basis of organisation and administration which would serve the NZDC in time of peace, and provide for its rapid expansion in time of war. His persistence was rewarded by the authorisation of various regulations from time to time dealing with:
The dental standard required and the procedure for the dental examination and charting of recruits:
For the Permanent Force.
For the Territorial Force.
For general mobilisation.
The standard of dental treatment for peace and war.
Equipment tables.
Accounting for stores.
Mobilisation regulations.
War establishments.
Dress regulations.
NZDC regulations and standing orders.
General and field notes for the examination of officers.
Prescriptions for examination for Certificates ‘A’ and ‘B’ (Dental) and for the promotion of officers, NZDC.
Instructions to dental officers, Territorial Force.
Syllabus for courses of instruction for officers, NZDC.
A course of instruction at the
In
As a result of Lieutenant-Colonel Finn's initiative and perseverance and the ready response of members of the profession, the skeleton of an army dental service was built up prior to the outbreak of war in
THE outbreak of war in
It has already been mentioned in the previous chapter that Lieutenant-Colonel Finn had submitted certain proposals to Headquarters for action in the case of general mobilisation. This transition period is concerned chiefly with two aspects of these proposals:
The standard of dental fitness expected of the troops.
The methods by which dental fitness was established.
Certain standards were laid down for medical and dental fitness in Appendix XXIV of
The standards are given in detail in Appendix II, omitting the medical ones which are not relevant to this history. They were grouped under four headings:
Armed Forces for Home Defence.
Large Expeditionary Force.
Small Expeditionary Force for Garrison Duty Abroad.
Temporary Employment in New Zealand.
On examination the men were classified as:
‘F’ or dentally fit or capable of being made so in three working hours.
‘T’ or requiring treatment longer than three hours to be made fit.
‘U’ or dentally unfit, such as those requiring multiple extractions or suffering from a contagious oral disease.
For home defence nobody in categories ‘F’ or ‘T’ who was willing to receive treatment was to be rejected, but for small or large expeditionary forces only category ‘F’ men were to be accepted to begin with.
Standing Orders also gave instructions to dental examiners as a guide to assessment of standard, as well as defining their authority to make decisions and receive payment for their services. It is unnecessary to quote these details in full, but one curious anomaly is mentioned as an example of how confusion can be caused when regulations have to be built piecemeal to meet unknown contingencies. When these regulations were framed, the DDS did not know whether the dental treatment for the armed forces would be by civilians or a Dental Corps, and they reflect the uncertainty of the time, being built as a patchwork according to fluctuating circumstances. The anomaly concerned the standard expected of an artificial denture and probably arose from an attempt to ease the severity of the dental standards because of the urgent need for manpower, but the new patch was put in without taking out the old one. The two paragraphs, separated from their context, are:
Definition of a well fitting denture
A denture will not be considered as ‘well fitting’
unless six months have elapsedfrom the completion of the extraction of the replaced teeth; no further extractions must be required which will affect the stability of the denture or necessitate alterations. The denture must fit firmly, be without movement on mastication and complete all spaces where natural teeth are missing. The artificial teeth must correctly meet the corresponding teeth in the opposite jaw and afford a good masticating surface. The denture must be free from cracks and breaks. Author's italics.
[The dental examiner is wholly responsible for] … assessing approximately the time that may be involved in the treatment decided upon, taking into consideration from the information that will be made available to him whether arrangements have been made for a camp system of dental attention or by individual practitioners and, also, that where extensive extractions and the provision of artificial dentures is indicated, only the extractions should be completed and the provision of dentures deferred pending absorption.
Impressions for dentures, especially full dentures, will not be taken
within a period of four monthsfrom the date of the completed extractions and, in no case, will they be taken, even though four months may have elapsed, until the dental examiner is satisfied that absorption is sufficiently completed for permanent dentures to be inserted.
In regulations framed on the basis of a known policy such a discrepancy would be unlikely to occur. As it was, it did not inspire confidence in the efficiency of the
During the pre-war months of
A plan had also been prepared and authorised whereby civilian dentists would do the limited amount of treatment at a stated scale of fees.
On
The aim of the New Zealand Dental Corps was to send every overseas contingent away from New Zealand as nearly dentally fit as possible. This was stated in the 1914–18 War but was achieved only in the later stages of that war. In this war the plan of dental selection of recruits and their immediate treatment made it effective from the beginning. It was never more than a makeshift plan calculated to implement the NZDC policy and give the necessary breathing space for the mobilisation of the NZDC on a war basis. It was, however, a distinct advance on the position existing in
CIVILIAN dentists were examining and treating the volunteers for the
On
The attitude of inter alia:
It is recommended that a reasonable amount of dental treatment should be provided in order to make the men fully fit. If this recommendation is approved, consideration should be given to the two methods by which such treatment may be carried out.
Dental treatment after enlistment and concentration at mobilization camps.
Dental treatment after enlistment but prior to concentration at mobilization camps.
With regard to (
a), this will entail the provision of:
An extensive dental hospital at each of the four mobilization camps. This would involve heavy expenditure in buildings and after the initial pressure of work had been overcome, would be much greater than the normal requirement of the camp.
Equipment for such hospitals. A large quantity of equipment would be necessary at the outset and in this case also the amount would be far beyond normal requirements. In addition, the equipment required could only be obtained from dental supply houses and it is known that sufficient stocks are not held by these. Importation of equipment or commandeering from civil dentists is the only alternative if equipment is to be provided at mobilization camps.
Staffs of dentists, dental mechanics and orderlies for each hospital. These would have to be brought into camp on a temporary basis and naturally will involve heavy expenditure.
With reference to (
b), this course has none of the disadvantages outlined above. The treatment would be spread over the dental practitioners of the Dominion, thus making full use of existing facilities. The work could be carried out expeditiously and prior to the men going onto theArmy pay roll. The men would arrive in camp medically and dentally fit and therefore able to proceed with their training without interruption.It is therefore recommended that method (
b) should be adopted.
The memorandum then outlined the procedure to be adopted under paragraph (b) and was approved by the Minister of Finance on 9 September. This is a remarkable document and deserves the closest scrutiny, for it is difficult to imagine a more fertile field in which to examine the political and military thought of the time.
The Director of Dental Services was, by his appointment, adviser to the
The 1914–18 War had shown the large volume of dental work that could be expected among the troops and the tremendous struggle the New Zealand Dental Corps had to cope with it all. This was surely enough evidence to discourage any civilian scheme for dental treatment. Dentists were working hard and could not be expected to give priority to army patients, and it would have been impossible to force them to do so. Also, some of them would have to be brought into the
Expense was stressed in the memorandum on two occasions in connection with buildings and equipment, but no comparison was made with the expense of operating the civilian scheme nor was a premium put on the greater efficiency of an
The statement that equipment was not available from the supply houses was not correct as the Director of Dental Services had submitted lists of equipment and stocks (together with prices) which were held ready for the purpose. The Assistant Directors in the three Districts had made full inquiries as to suitable non-expendable equipment for purchase, hire or gift in addition to that held by the supply houses. There were also seven field surgical panniers equipped to mobilisation standard. Some equipment was therefore available to start the Corps, although the machinery for obtaining further supplies was not perhaps as facile as it might have been. It must also be remembered that under the civilian scheme additional stock would be needed under less economic conditions.
The assertion that large dental hospitals would be beyond the needs of the camps after the initial pressure of work had been overcome was a guess wide of the mark. It showed a disregard of experience and was directly opposed to the considered opinion of the Director of Dental Services. A bad guess can be forgiven on the score of ignorance, but there was no such excuse in this case as there was ample evidence on which to form an opinion without recourse to guessing. It is therefore difficult to understand how an appreciation of the position so unrelated to the actual situation could have been given.
The result of this uncooperative attitude was that there was a serious check to the formation of the Corps on a war basis. In spite of it, however, the DDS went ahead with his plans, but every request had to be fought for and many ventures had to be launched on his
Such was the position in
Establishment of dental officers to accompany New Zealand Special Force overseas.
When troops first leave New Zealand they will be dentally fit and the establishment of dental officers at this stage will be based on a requirement for maintenance purposes of
onedental officer for 2,000 men.When troops have been absent from New Zealand for six months it is estimated that their dental requirements will show a marked increase and the Dental Corps will require to be reinforced to the extent of providing
onedental officer for 1,000 men.When troops have been absent from New Zealand for a further six months, i.e., a total of twelve months, there will be a further increase in their dental requirements and it is considered that the ultimate strength of the Dental Corps should be based on a requirement of
onedental officer per 500 men.
The Dental Corps overseas was to be gradually reinforced by sending dental officers at regular intervals to bring the strength up to 32, or one officer to 500 men in a force of 16,000. This gave an opportunity for dentists to be brought in from civilian life in time to be trained as dental officers before being sent overseas. To continue with the notes of the DDS:
Establishment of Dental Officers in mobilization camps in New Zealand. The following factors must be taken into account in deciding upon the number of dental officers required in the mobilization camps:
The completion of initial dental treatment for recruits.
The maintenance of dental fitness for troops in training.
The training of dental officers for the supply of reinforcements to the NZDC overseas.
The completion of initial dental treatment for recruits.
First Echelon . The majority of the recruits will be dentally fit on entry into camp but there will be a fair proportion who require denture work to complete the restoration of their occlusion in accordance with the accepted standard of dental fitness.Second and Third Echelons and Reinforcement Drafts. A large number of these men, say 80%, will require some form of dental treatment before being passed as dentally fit. If the present system is continued and all surgical work (fillings and extractions) and repairs to dentures, up to a maximum of six hours' work, is undertaken by private practitioners, there will still remain an increasingly high proportion, say 40%, who will require denture work.
The maintenance of dental fitness for troops in training. This should be comparatively light for several months after the initial treatment is completed. Each man however will be examined on entry into camp. This is essential. It is also highly desirable that each man should be re-examined as far as possible at six monthly intervals.
The training of dental officers for the supply of reinforcements to the NZDC overseas. It is essential that dental officers going overseas should have at least three months' preliminary experience in New Zealand Dental Corps methods and organisation in a mobilization camp. During this period also it would be possible to gauge each officer's suitability for the work.
As already shown …, there will be a progressive increase in the number of dental officers required overseas and it is therefore necessary that the amount of initial treatment performed for recruits
in campshould be considered in the light of the necessity for drafting dental officers into mobilization camps and providing them with an adequate amount of work.It thus becomes obvious that an increasing amount of initial dental treatment will require to be performed in camp and a correspondingly decreasing proportion carried out by private practitioners before recruits enter camp.
Meanwhile, the civilian practitioner scheme as applied to the examination and treatment of the men of the
The medical boarding of the first draft from this area is practically completed now. I have attended every board as an assistant in the organisation under Dr Fergus. The boards, as you know, have been held in the dental school and I have had an excellent opportunity of discussing with all dental supervisors matters relating to the dental examinations. Further, some of the ‘F’ and ‘T’ men have been treated at the dental school, the latter at half hospital fees.
I feel now that the position calls for certain comments with regard to the system as it is operating at present. All these points are derived from first hand knowledge. I have concluded:
That the system of examination with mirror and probe cannot be accurate enough to ensure that, even if Form 362 is completed, the soldier would proceed to camp dentally fit on NZDC standards.
That a number of ‘F’ class men, either through lack of opportunity or other reasons, have failed to attend their dentist to have the treatment in Form 362 completed and thus have gone to camp with a large number of fillings and other work outstanding.
That the whole system offers far too great a variation in the standards of examination, classification and treatment, i.e., there is no common standard in these things that would be acceptable, for instance, to a Principal Dental Officer of a mobilization camp.
That the present system is not sound economically. Organised and disciplined treatment by Dental Corps personnel must inevitably serve the troops on the most economical basis possible.
It follows from these conclusions that, if a force is to proceed overseas using a dental standard accepted by the Dental Corps during the last war, the system must inevitably be that developed during that war from
1917 onwards. Ample evidence that history is repeating itself with regard to this matter may be obtained from a study of old files of the New Zealand Dental Journal—evidence moreover which can be corroborated by NZDC officers who had experience of mobilization camps of the last war.(signed)
R. B. Dodds,
Major NZDC
11 October 1939
Major Dodds was merely emphasising imperfections of the scheme which had been anticipated by the DDS and of which he had warned Headquarters with such little effect. There was, however, another factor which carried considerable weight. The public purse was being affected. A draft memorandum by the Adjutant-General, undated but probably written in November, sums up the position with suitable emphasis:
It was anticipated that when recruiting for the special force commenced, the response would be of such an extent that it would provide wide scope in the process of selection and, in consequence, the cost of dental treatment would be kept at a moderate level by selecting from those offering their services only those who were of the required dental standard or those who, by the repair of minor dental defects, involving not more than three hours' dental treatment, could be raised to the dental standard specified.
In view of the above, it was decided that the dental treatment then anticipated as requisite should be carried out by civilian dental practitioners prior to the men being concentrated at mobilization camps.
Actually, the number offering their services was not so great as anticipated and it also became evident that the general dental condition of the men offering their services was much below the standard expected. So much so that it was found necessary to increase the period of dental treatment required to six hours. Even with this added facility considerable difficulty was experienced by Districts in filling their quotas of men who were dentally
as well as medically fit. Consequently the initial estimate of costs of requisite dental treatment has been exceeded, and it is therefore considered desirable that the situation in regard to dental treatment should be reviewed with the object of ascertaining if a more economical method could be instituted. As far as can be gathered at the moment, of the number who have offered their services and have been accepted in the first echelon, not less than 85% have required dental treatment and, from the information at present available, it is estimated that the average cost per man of such initial treatment will be approximately £2 2s. 0d. The estimated cost for the first echelon is £11,780.
Other factors are, that of recruits entering mobilization camps whose dental treatment was carried out by civilian dentists, it has been found that 15% require further treatment. This is due to an inevitable amount of dental defects being missed by the dental member of the medical board and the ever-recurring denture remakes and repairs which are to be expected when approximately 25% are wearing some form of artificial denture. There will also be a percentage of those accepted for the special force who may have to be provided with partial dentures to remedy deficiencies that are considered detrimental to their general health.
It is anticipated that the general dental condition of the men enlisted in the second and third echelons of the special force will be lower than the standard of those enlisted with the first echelon. If the dental treatment of these two echelons is carried out in the same manner as that for the first echelon, it is estimated that the cost of such treatment will amount to approximately £17,417, giving for the three echelons a total estimated cost of £29,197.
It is estimated that the cost of the alternative method of rendering the special force dentally fit by carrying out all dental treatment in mobilization camps after the troops are concentrated will be £17,135.
In addition to this, trouble was arising out of the claims from the civilian dentists for payment for their services. There were cases when the work was not done satisfactorily, and even claims for work that had not been done. Men were being treated who did not appear in camp for one reason or another. Enlistments were sometimes cancelled after treatment had been completed; specialist fees were being claimed, and so on. The whole position became so confused that finally, on
The scheme collapsed under its own weight and on 15 December authority was given for all dental treatment, with the exception of extractions which would bring the recruit temporarily below a minimum standard of masticatory efficiency, to be carried out in camp by the NZDC. Even this exception was removed on
It must not be thought that while this fight for recognition was going on there was nothing happening in the Dental Corps outside Headquarters. Most of the recruits for the
Towards the end of October six more officers were mobilised and posted to the camps: Lieutenants J. G. W. Maj H. A'C. G. Fitzgerald; Hastings; born
Dental examination of all troops in the three camps was then undertaken. This, with completing treatment not finished by the civilian dentists, emergency work for the camp staff and maintenance for the 6600 men of the
Towards the end of November a new stage was reached. The dental services expanded and, from an administrative point of view, became consolidated to form camp dental hospital groups rather than multiple field dental sections. Papakura Mobilisation Camp, which was to replace
By the end of December the mobilised strength of the NZDC was 22 officers and about 50 other ranks. Buildings for dental hospitals at
When the troops of the
There were other troops in New Zealand than the echelons of
In December Government approval was given for dental examination and treatment of these troops to be undertaken by the NZDC. The policy was that the NZDC would be temporarily detached from the mobilisation camps whenever intervals in the treatment of overseas drafts made this possible. They were to operate as mobile field dental sections, taking fully equipped outfits from the mobilisation camps. The first of these intervals occurred when the
In staffing the Corps there were two important questions to answer:
How much treatment was needed to make the troops dentally fit and maintain them so?
How many dentists, mechanics and orderlies were required to do this?
The first question could not be answered with complete accuracy but the amount of treatment could be roughly assessed by analysing the results of the examination of the men who volunteered for the
The answer to the second question then appeared to be one of mathematics, provided the source of supply did not dry up. It was known approximately how much work a dental officer could do in
There was no difficulty at the beginning of the war in finding enough dentists to volunteer for service in the Corps; in fact, more applied than could be immediately accepted. But, even in these early times, the action of volunteering did not mean acceptance, as the DDS demanded a high standard for the Corps, quite apart from medical fitness to stand up to the work. The dentist had to have high professional ability and be of good ethical standing, fit to receive the King's Commission. The Dental Corps was not going to be a dumping ground for profession failures or playboys. The needs of the civilian population also had to be considered and dentists could not be drawn into the
The maintenance of a balance between civilian and military requirements was recognised as important by the Government, and in Col J. L1. Saunders, CBE, DSO, m.i.d.;
At the beginning of the war there were 697 dentists on the New Zealand register. Twenty-five of these were in Government employment, at the dental school or in the island dependencies, so in the
At this time all manpower for the fighting forces came from volunteers so the authority of the Organisation for National Security and its committees was limited. In the case of dentists the committee's main function was to see that the needs of the civilian population were not adversely affected by too many enlistments from the same quarter. To help it in deciding this, it asked the
On
The committee also recommended that those dental students who had completed one full year of professional study, i.e., who had completed the second year of their dental course, should not be withdrawn for military service but would be required to continue their professional studies.
The result of this was that the DDS was able to select those dentists he needed for the Corps with a reasonable chance of getting them, and still had a free hand in rejecting unsuitable applicants, with a knowledge that they would not be withdrawn from the general dental pool. That the DDS was careful in his choice is shown by the very small number who turned out to be misfits. That his standard was high can be seen by the instructions given on many occasions to officers leaving to take up a command overseas:
You will remember that your first duty is to look after the men you command, then to equip yourself with the necessary military and specialist knowledge to make your branch of the service the most efficient section of the military organisation. Everything has been done to give you rank and status in the Force and it rests with you to build up from this with your own initiative and personal application a branch of the service that will function under all conditions presenting. It is up to you to live up to the ideals of your profession apart from inculcating into the minds of other branches of the force, by practical demonstration and propaganda amongst all Units, the importance of our specialist service and the essential part that dental health contributes to the mental and bodily health of the soldier.
With the strictest observance of Service Regulations and Procedure and the continuance of the loyalty and co-operation you have shown, so will the ‘Esprit de Corps’ be built up and the traditions of the New Zealand Dental Corps and your profession be upheld. Nevertheless do not forget that commissioned rank in the professional services is easily gained and the soldier who presents to you for treatment, of whatever rank, is deserving of all the consideration that you, as a professional man, can offer him, and
he will get itand with good measure from the New Zealand Dental Corps.
The Corps owes a debt of gratitude to Colonel Finn for selecting his officers with such care and for constantly refreshing them with his own idealism. At one time in the war he was so desperate for dental officers that he was prepared to take them direct from graduation and train them at the camp dental hospitals. This was against his principles, and later when the supply improved he insisted that new graduates must have at least six, or preferably twelve, months' practical experience in the dental department of a public hospital. The wisdom of this is seen when troops are scattered over the country and dental officers have to work alone, supported only by their own initiative and professional experience.
Civilian requirements were assessed as one dentist to 2200, but in
The Germans apparently had the same difficulty in providing an adequate dental service for the civilian population. In Oral Hygiene:
With many of the country's dentists in military service, toothaches are becoming widespread in Koelnische Zeitung of
Further steps were taken in
The National Service Department did not recognise dental mechanics as belonging to the ‘Schedule of Important Occupations’ but it did concede that they should be subject to some direction. All those drawn in the ballots for overseas service were referred to the National Medical Committee as in the case of dentists. For those drawn in the ballots for Territorial training, postponement of calling up was dealt with by the Appeal Board on the individual merits of the case. A letter from the DDS to the Director of Mobilisation on
The New Zealand Dental Corps can absorb all dental mechanics or dental technicians available through Expeditionary Force ballots and the Director of National Service has notified Appeal Boards accordingly, also suggesting that, where these ballotees are released for military service it should be conditional upon service in their technical capacity and additionally that the appeals of grade II and III mechanics should be adjourned until their medical board papers have been perused at
Army Headquarters with a view to their being utilised in home service duties thereby releasing grade I mechanics for overseas.It should be explained that the classifications ‘Dental Mechanic’ and ‘Dental Technician’ are synonymous and appear indiscriminately in memoranda quoted in the text.
There was, however, a definite need to preserve the balance between military and civilian requirements, although perhaps not to such an extent as with dentists. It was therefore decided that if the dental sub-committee was satisfied that a mechanic was a competent tradesman and essential to civil requirements, an appeal from military service would be lodged on his behalf on the grounds of public interest. This was not entirely satisfactory as it entailed much unnecessary correspondence and delay. Also, in many cases, no sooner were appeals lodged and dealt with than the DDS would require the men urgently and could not get them until the appeals had been withdrawn. A simpler scheme was therefore evolved. After the issue of the Gazette the sub-committee made inquiries into the bona fides of each mechanic drawn in the ballot. This was a necessary precaution as in a number of cases boys who could barely lay claim to the proficiency of a ‘plaster boy’ had styled themselves dental mechanics. These were useless to the NZDC and to the civilian population except as trainees. After their bona fides had been established, the mechanics continued in their civil occupation until their services were asked for by the DDS. In other words, every dental mechanic was kept in his trade either in civilian or military practice. This exemption applied also to the National Military Reserve and the Home Guard, except of course in the event of full mobilisation of the latter in the defence of New Zealand's very existence, when dentists, mechanics, Toms, Dicks and Harrys would all be in it together.
In
These arrangements did not fully satisfy the demands of the NZDC for trained mechanics and already attempts had been made to train its own in the mobilisation camps. As will be seen in the chapter on this subject, this was not completely successful at first, but it led to the formation of training schools under capable teachers
That with the dental mechanics who are gradually being released to civilian occupation from the Armed Forces, together with those already serving as apprentices and employed as journeymen mechanics, or in business on their own account, the dental profession is reasonably served by dental mechanics under present conditions.
That in view of the increasing number of dental mechanics being released from the Armed Forces, the necessity no longer exists for dental mechanics who are, or have been, called in ballots to be retained in their civilian occupations or for their work to be regarded as a protected industry.
The removal of dental mechanics from an essential industry classification restored the balance which had been disturbed by the release of mechanics from the armed forces. Those who had been drawn in ballots were then called up either for general military service or for other essential industries in equal numbers to those released from time to time by the armed forces.
In selecting non-technical staff for the Corps, the policy was to look for keen men of a reasonable standard of education and personal cleanliness, fit to work in a hospital team. The choice was limited by the needs of the combatant units, for whereas dentists and mechanics naturally gravitated towards the Dental Corps whatever their medical grading, untrained men who were medically Grade I could not often be spared for a non-combatant unit such as the NZDC. There were, however, many men graded II for slight abnormalities sufficient to disqualify them for service in a combatant unit who were of a sufficient standard of physical fitness to make them valuable members of the NZDC. It was perhaps not fully appreciated at first to what extent the NZDC would be employed and the high standard of fitness required of those serving in a field ambulance or a mobile dental unit, but it was realised that there must be Grade I men to accompany the NZDC overseas. The result during the first ten months of the war, when all the men were voluntary enlistments, was that Grade II men welcomed the opportunity to serve with the NZDC but Grade I men were difficult to get, as the choice of orderlies for service overseas was limited by the large amount of work the NZDC had to do in New Zealand.
There were certain key men who should not be called nontechnical. Men with a knowledge of dental stock, such as employees of supply houses, were the natural choice for NCOs in charge of stores, but these were hard to get as they could ill be spared from
The general selection of orderlies in the early part of the war was excellent and to those who served in New Zealand and overseas in the NZDC can be attributed much of the success of the Corps in the war. There were difficulties at a later date when the Dental Corps, in common with other non-combatant units, had to absorb its share of pacifists and objectors, but the constitution of the Corps was then sufficiently strong to do this without serious indigestion.
The obvious course of employing women in the camp dental hospitals to release men for service overseas and in the mobile units in the field was delayed by prejudice from the more conservative of the military authorities, and it was nearly eighteen months after the declaration of war before serious consideration was given to this prolific source. Before this no facilities existed for women in camp except for nursing sisters, and even the welcome invasions by concert parties arrived under strong duennal escort. Appropriately it was the youngest service which made the first move to use women as dental orderlies, as selection of suitable girls to join the Women's Auxiliary
The number of dentists, mechanics and orderlies serving in the NZDC in the war varied considerably at different times, but the following figures are interesting. Taking 697 as the number of dentists on the register at the beginning of the war, and remembering that many of these, through age, health or location were debarred from service, the creditable number of 215 were mobilised in the NZDC for varying periods. Practically every experienced dental
On the whole the staffing system worked satisfactorily and the balance between military and civilian requirements was well maintained.
THERE are two main points to be considered in the organisation of any unit in the armed forces:
The relationship of the unit to the general organisation.
The internal organisation of the unit itself.
The relationship of the New Zealand Dental Corps to the general organisation of the
The General Officer Commanding a force is responsible for everything pertaining to that force, including the dental health of his troops, but being a layman, he appoints a dental expert to organise and carry out the necessary work on his behalf. The Director of Dental Services is therefore an administrative officer with dental qualifications. The terms of his appointment read that he is responsible to the Adjutant-General for the organisation, maintenance and efficient working of the New Zealand Dental Corps and to the Quartermaster-General for the provision and inspection of dental equipment and stores.
In addition to these administrative and supply duties he has another role, viz., operational. He has to deploy his units in accordance with the commander's plan and must issue his orders in exactly the same manner as does any other commanding officer, such as the Commander of the Royal Artillery or the Director-General of Medical Services. He must therefore have close liaison with the operational staff. The shorter the channels of communication between him and the heads of the other departments, the more expeditiously can his organisation function. Similarly, any interference with these channels of communication must affect the efficiency of his organisation. In the case of the Director of the New Zealand Dental Corps, there was interference with the channels of communication by the claim of the Director-General of Medical Services that the dental services were part of the medical and, as such, should be subject to his direction. The terms of the Director of Dental Services'
Apart from his army appointment, the DDS was made responsible to the Naval Board through the Naval Secretary, and the Air Board through the Air Member for Personnel, for the dental health of the men in their services. His official title was therefore Director of Dental Services,
The DDS was given the task of rendering all the armed forces dentally fit and maintaining them so. The responsibility was his and his alone. He had direct access to the heads of the services for his requirements, his immediate superior officer being the Adjutant-General or his counterparts in the
During the whole of the war the DDS was Colonel B. S. Finn, who received his army command in
In a previous chapter it has been stated that the Director of Dental Services had given considerable thought before the war to the organisation of the NZDC for war purposes and had made certain recommendations to Headquarters. It is now convenient to examine his recommendations regarding organisation in more detail and to see what notice was taken of them. The analysis will show how difficult it was to carry out his obligations in the face of the uncooperative attitude of the authorities. His recommendations were:
Some administrative staff at headquarters.
A quartermaster for Dental Services to negotiate and advise in the purchase of equipment and stores, to be responsible for the issue and maintenance of the same and the establishment of an
Army Dental Store in conjunction with the Ordnance Department.Three Assistant Directors of Dental Services to rank as Lieutenant-Colonels and act as staff officers for dental services attached to each military command headquarters. Their duties would be to co-ordinate between their respective command headquarters, the Principal Dental Officers of military districts and standing camps and the Director of Dental Services and to act for the latter in their districts. The Central Military District ADDS was in addition to assist the DDS at Headquarters.
Three district Principal Dental Officers whose duties were to be:
To assist the command ADDS.
Be dental officer in charge of any dental centre situated in command headquarters area and carry out the dental duties required for the personnel of the troops in that area including the dental examination of recruits, invalid soldiers and members of the Forces as might be required by the Commandant.
Give regular oral hygiene lectures to troops and hold classes of instruction for non-commissioned officers and other ranks of the NZDC in connection with their specialist duties.
Considerable correspondence passed between the Director of Dental Services and the Director-General of Medical Services, on the one hand, and the Adjutant-General on the other, with the following result:
Administrative Staff at Headquarters
No appointments were made, not even a typist.
Quartermaster
No appointment was made, with the result that all the stores organisation and administration, which was highly technical and could not be handled by the Ordnance Department without advice, fell on the already overburdened shoulders of the DDS himself. It was not until the war had been in progress for seven months that Major H. E. Suckling relinquished his appointment as ADDS of the Southern Military District and was appointed ADDS,
Three Assistant Directors of Dental Services
Three part-time majors only were appointed, one each to the Northern, Central and Southern districts. Each of these officers was responsible to the DDS for the dental fitness of all mobilised military personnel in his district. They supervised and controlled on behalf of the DDS all dental services required for the
This part-time service was to be not less than two and a half hours daily and the remuneration was £150 per annum. The duties took up much longer than two and a half hours a day, but even if this were not the case, each officer had to work at least fifteen hours a week at four shillings an hour. They were all running busy dental practices in which overhead expenses went on while they were on army duty, so that actually they were paying for the privilege of serving in the
It is hardly surprising that this part of the organisation did not last and that, in the middle of
Three District Principal Dental Officers
It was found that the district mobilisation camps were close enough to their district headquarters to dispense with these appointments and allow the Principal Dental Officers of the camps to act in the dual capacity.
As soon as the mobilisation camps were ready a Principal Dental Officer was appointed to each, i.e.,
Dental examination and condition of the troops, the class of operations performed and for all professional matters connected with his Corps.
The control of the dental centre and staff, being responsible to the Camp Commandant for the discipline of his unit.
Dental equipment and stores issued to him and the submission of requisitions for approval for all dental stores required by the unit.
Arranging regular lectures to all troops in the camp on oral hygiene, classes of instruction in specialist duties for non-commissioned officers and other ranks of the NZDC, and for grading mechanics.
Arranging special classes of instruction for dental officers in military routine and procedures.
General co-operation with the training staff in completing the dental treatment of the troops so as to interfere as little as possible with their training.
Furnishing all reports through Camp Headquarters on the dental treatment and any returns that might be required by the DDS.
Although the Principal Dental Officers were appointed as executive officers, it can be seen that their administrative duties were considerable, especially when they took over the additional duties of ADDS of the district. They therefore had little time available for the actual practice of dentistry. Nevertheless they were appointed for their professional knowledge as well as for their administrative ability and were nominally responsible for the standard of work of the dental officers and mechanics under their command.
This was the framework on which the future organisation was built:
The Director-General of Medical Services has been included in this diagram to show that he, like the Director of Dental Services, was responsible to the Adjutant-General and was in no way included in the dental organisation.
Organisation below the level of the Principal Dental Officers was dependent on general army policy so it is as well to outline briefly once again what that policy was. A special force of approximately 16,000 men was to be mobilised, initially trained and sent overseas in three echelons, to be followed by various reinforcement drafts. In addition, other troops were mobilised to man the coastal defence and anti-aircraft batteries, to act as camp and headquarters staff, guards of vital points such as hydro-electric stations and reservoirs, and later for a field force.
Three main mobilisation camps had been built, one at
Dental treatment for these different groups of troops had to be arranged according to the time available. The intention of the Corps to send every soldier overseas dentally fit meant that first priority must be given to the echelons and reinforcements. The first concentration of dental personnel must therefore be in the mobilisation camps and the size of the establishments was calculated by the DDS and submitted to
As an example of this, establishments to begin with were cut down to nearly two-thirds of those recommended by the DDS; they were accompanied by a grudging admission of their inadequacy, as shown by the following extract from a memorandum from the Adjutant-General dated
The DDS still retains the authority to move personnel to overtake necessary work, even to the limit of adding surplus to the Camp Hospital, but at all times drawing from another authorised establishment.
This was robbing Peter to pay Paul and took no notice of the fact that more or less equal work was needed in each centre at the same time. The privilege was therefore of little use. That the memorandum was accompanied by an enclosure of outdated establishments when new ones had been authorised on 23 February was but another indication of the confusion existing at the time.
Out of the confusion, however, came reasonable establishments to cope with the echelons and reinforcements, though little relief for the DDS from his administrative problems at headquarters and an inadequacy for the amount of work throughout the country.
Dental treatment for the mobilised troops in the coastal batteries, etc., was provided in
Later, when troops became dispersed and when more dental personnel became available, the organisation expanded accordingly. Other large hospitals were built, such as that at See p. 46.
This organisation, although authorised, was never fully used as it was found to be impossible to staff it at a time when every man and woman was needed to defend the country against the threat of Japanese invasion. Some appointments had to be abandoned and some had to be filled by those doing other duties. For example, the depot was staffed by mobilisation camp personnel and did not function as a separate entity, although it has since become the nucleus of the suggested peacetime organisation of the Corps and is an integral part of the framework on which the Corps can be built for a future war.
Certain sections and groups of the organisation were under the direct control of the DDS and the others were divided among the three military districts. These were under the command nominally of the Officer Commanding the District Depot, but actually of the Principal Dental Officer of the mobilisation camp, who combined these two appointments.
As in the study of biology we find the most complex structures can all be reduced to a cellular fundament, so can the operative organisation of the NZDC be considered in terms of its smallest unit, the dental section. The dental section is a self-contained unit capable of carrying out all classes of dental treatment other than specialties. It was designed to operate in areas, training depots, forts and camps, other than mobilisation camps, and consisted of one officer, one or two orderlies and one mechanic. From this minimum can be built all the other organisations required, but below this the unit cannot function.
It is now possible to analyse the full organisation of the NZDC in New Zealand. Before doing this it is interesting to note that history up to a point was repeated. Although the dental treatment in this war was begun in earnest much sooner than in the 1914–18 War, it was again three years before the organisation was at its peak. In the Great War it was
On
Director of Dental Services in the rank of colonel.
Assistant Director of Dental Services, stores and equipment, in the rank of lieutenant-colonel.
Assistant Director of Dental Services, administration, in the rank of major.
Staff Officer in the rank of captain (or subaltern). This officer was not a dentist and it is interesting to note that this appointment, together with that of the officer in charge of the dental store, was the first authorisation for commissioned rank in the NZDC for a non-professional. Although authorised in
Administrative Warrant Officer. There was authority for the rank of first class, but only second class was granted.
Four clerks for general duties. One of these was a staff-sergeant and the other three were WAACs, one of whom was a corporal.
One WAAC orderly.
Two civilian typists.
For transport a five-seater car was allotted.
The organisation had grown to such an extent that even this seemingly generous allocation was not enough and should be regarded as the minimum rather than a satisfactory precedent to follow. Asked to comment on it at the time, the DDS wrote in characteristic fashion:
Officers—No argument. Four is the irreducible minimum. Even this involves them in long and arduous hours to the point of real risk to health.
His detailed comments in the same report on the duties of noncommissioned officers and other ranks show that there were no drones in the headquarters hive.
Reference to the diagram will show that the following were under the direct command of this headquarters:
Base Dental Store
No. 2 NZDC Depot
Trentham Camp Dental Hospital
Waiouru Camp Dental Hospital
Northern, Central and Southern Military Districts
This store was administered by the ADDS and had, up to
Quartermaster in the rank of captain (or subaltern). As mentioned above, this officer was not a dentist and thus did not receive the professional pay allowance granted to dental officers in New Zealand and overseas.
Accountant in the rank of Warrant Officer first class.
Head storeman in the rank of Warrant Officer second class.
Three ledger clerks who were WAACs, one being a sergeant, one a corporal and one a private.
Four storeman-packers (male). One was a sergeant and one a corporal.
One civilian typist.
This gave the store a staff of eleven, an increase of five on the previous figure.
This was a decentralisation of command on lines similar to the original appointment of an Assistant Director of Dental Services in each Military District headquarters. The Assistant Directors' positions could still be filled if required, but it was not intended to do this except on direct instructions from The Mikado, for by a strict observance of the correct channels of communication there were occasions when he carried on a correspondence with himself.
Each depot was responsible for the staffing and maintenance of camp dental hospitals, maxillo-facial injury sections, static and mobile sections, and for the dental health of the army troops, divisional troops, area troops and fortress troops in the district. The establishment was eight:
Officer Commanding in the rank of major.
Adjutant, a captain or subaltern, who was not a dental officer.
Regimental Sergeant-Major in the rank of Warrant Officer first class. His duties were to take charge of general military training for the Corps.
Staff-sergeant in charge of the district store.
Three clerks. One a sergeant and one a corporal.
An orderly, general duties, who would act also as a batman.
A five-seater car was allotted to the depot, with the exception of Depot No. 2 which shared that provided for Dental Headquarters and had none of its own.
The Adjutant and the Regimental Sergeant-Major were not appointed owing to the difficulty in procuring suitable men at a time when this type of officer could not be spared from duty with combatant units.
This group must not be confused with the mobile dental sections operating in the three districts. It was a group of twelve caravan trailer sections under the direct control of the DDS. Each section consisted of four, a dental officer in the rank of captain, a sergeant mechanic, and a sergeant and private clerk orderly. The trailer was fully equipped and was drawn by a 2-ton truck fitted with a special draw bar. One of the orderlies was the driver and was in charge of the vehicles.
This group enabled the DDS to send dental reinforcements quickly to any district. The section would then come under the temporary command of the Officer Commanding the Depot. There was an allocation of these sections to each depot but this was not used in the form of rigid attachment, the former method being found more satisfactory under the fluid conditions of troop deployment existing at the time. The origin of these trailer caravans is interesting. As the troops were scattered all over the country they could not attend the established dental hospitals, nor was it possible, or
This gesture by the
The provision of these caravan trailers did not do away with the necessity of providing some huts but it did allow scattered units of the
That they were a success is undoubted. To quote one report from Lieutenant P. B. Sutcliffe, NZDC,
Dental caravans are absolutely necessary. There is no comparison between working in a tent and working in a caravan. In the north, where there is a lot of rain, a caravan makes it possible to carry on with good work in all weather and at all hours. The hygienic appearance of the caravan creates a good impression on officers and men alike. The whole outfit has the appearance of good dentistry, not a makeshift.
This part of the organisation is only mentioned because it was responsible for the dental treatment of
These were army camps as distinct from district camps. That is to say, they were controlled by the DDS from
Most of the district organisation is easily understood by examining the diagram on page 46. The areas mentioned are geographical military divisions, and it will be noticed that all areas did not have a dental section attached to them. In such cases an area was serviced by a conveniently situated
In
From what has been said of the dental condition of the recruits for the Expeditionary Force, it can be understood that at least an emergency dental service had to be provided for the Territorial troops if they were to be under continuous training for three months. The treatment was limited to the relief of pain and to other dental operations which would retain the soldier on duty and enable him to carry on during his period of training. It included the extraction of teeth for the relief of pain or a septic condition, the insertion of dressings to relieve pain when extraction was unnecessary, the repair of broken artificial dentures and the treatment of diseases or neglected conditions of the gums by the removal of accumulated calculus and by other prophylactic measures. In addition to this treatment, a further duty of the dental officers was to educate all ranks in the importance of oral hygiene and care of the teeth by individual instruction where necessary, by short lectures on the subject, and by arranging with commanding officers to draw attention to the matter in standing and routine orders. A complete dental examination of all troops in camp was to be carried out and this was to be recorded on the usual dental history chart, NZ361, which was then to be attached to the personal file of the soldier concerned. The object of the examination and charting was to find out the amount of treatment required should the soldier be called for general service requiring dental fitness.
The method of providing this limited service was by field dental sections at the various camps and a permanent dental section at
Up to the end of
In spite of these arrangements it was soon apparent that members of the Territorial Force were being sent to private practitioners in nearby towns for treatment. This was no doubt due to the fact that sections were not permanently attached and, owing to the limited scope of treatment, emergencies were bound to occur in their absence. It was the obvious course to take when the NZDC had not the staff to cope fully with the situation, but this was not the view taken by the authorities. In
In
Under the original plan it had been intended to examine and chart all Territorial troops under training, retaining the forms for future reference. In
Further information about the dental condition of the young men of New Zealand was obtained in
During the last three months of
Another group was also mobilised at the end of
The first undertaking was to remedy septic conditions by the removal of roots or irreparable teeth and to treat any oral lesion so as to place the oral cavity in a reasonably healthy condition, being careful not to reduce the masticatory efficiency below a workable minimum. No organised attempt, however, was to be made to achieve complete dental fitness. Prosthetic work was limited to the repair of existing dentures. To quote the DDS in a memorandum to PDOs and OsC dental sections dated
It is to be remembered by all concerned that, if a man who has been mobilized from civil life and is thus otherwise medically fit, presents with a hopeless carious condition of teeth or is fully or even partially edentulous, and claims that he does not possess artificial dentures or is wearing dentures and requests remodelling, he will have to carry on as he did before mobilization. He obviously managed to assimilate three meals a day, maintained his working efficiency in that state and was physically fit, so he can continue to carry out his military duties until the situation is stabilized, especially when one considers that the daily rations are similar, if not in some cases better, than those to which he is accustomed.
On
As the troops were even more scattered over the country than in
The original method of carrying out dental treatment for the Territorial Force in New Zealand was by attaching a dental section to each field ambulance. With the troops scattered all over the country and with the amount of work to be done, this was impracticable and some method had to be devised to provide a more extensive and elastic organisation. It was quite impossible for the troops to attend the existing dental hospitals and equally impossible to provide enough new hospitals to cover the vast area over which they were spread. The answer was obvious. If the troops could not come to the NZDC, the NZDC must go to the troops and, like the snail, take its house with it. The Mobile Field Dental Section therefore became an important part of the NZDC organisation. At the same time, the necessity for attaching a dental section to the field ambulance disappeared under the conditions existing in New Zealand in early
On
The sub-section became attached to a unit and was rationed, quartered and paid by that unit. The sub-sections were fully equipped and capable of carrying out all classes of treatment.
The general organisation of the section was elastic enough to allow the officer in charge wide scope for variation in the employment of his men. For instance, by omitting the prosthetic pannier and substituting an orderly for the mechanic, a sub-section could be sent out as a surgical unit and the prosthetic cases could be sent by motor-cycle transport to the Field Prosthetic Laboratory for
With the attachment of the mobile dental section to a brigade group or Area, the officer commanding the section became responsible to the DDS for the dental health of the troops and acted as adviser to the Brigade or Area Commander on dental matters. All movements or arrangements for treatment were made through the headquarters of the formation to which he was attached, but he could communicate direct with the DDS on technical subjects. He was expected to co-operate closely with the Senior Medical Officer in matters affecting the general health of the troops. In other words, he was to the officer commanding the formation what the DDS was to the GOC.
The personnel of a mobile dental section numbered 43. There were 8 officers, 1 warrant officer, 2 staff-sergeants, 6 sergeants, and 13 rank and file of the NZDC, and 1 sergeant and 12 rank and file of the
Headquarters Section consisted of:
Each of the six sub-sections consisted of:
There were thirteen motor vehicles allotted to each section. Each sub-section had a 30-cwt truck to carry personnel and equipment.
At headquarters there were:
The prosthetic laboratory on the 3-ton truck was fitted with benches so fixed that they could be easily removed and re-erected in a hut, building or tent. Water was in an 8-gallon tank. Lighting was by two six-volt batteries with two in reserve. There were windows for natural lighting. The canopy of the truck was raised to give a minimum clearance of 5 ft 9 in. Access was from the back by steps and the whole truck could be locked up when not in use. Bottled gas A natural rock gas from
The equipment for the section was carried in panniers. Each subsection had a surgical, prosthetic and stores pannier, an emergency haversack, canvas chair case and two Indian pattern tents, one for operating and one for prosthetics. A tarpaulin 18 feet by 12 feet was also included. Sub-sections did not carry bottled gas but worked with primuses. The headquarters section, however, had a pannier for bottled gas and two each of the surgical, prosthetic and stores panniers, two haversacks, three tents and two tarpaulins. With this equipment the section and sub-sections could work under all conditions and were independent of building accommodation, although huts or houses were always used if available in preference to tents. The tent is difficult to camouflage and is easily visible from the air so was an unwelcome addition to a fighting unit. At one time it was thought that a ‘Hubbard hut’, named after the designer, would solve the problem but they proved to be unsatisfactory, being too low in the stud, unable to be kept open in wet weather and too difficult to keep clean in fine weather. Their only use was as sleeping accommodation.
Ten pistols, £455 or £38 inch, with 180 rounds and thirteen £303 rifles with 1300 rounds were issued to each section. The dental officers carried pistols, but the rifles were issued to the
Some confusion seems to exist as to our position in relation to the British Red Cross. Some orderlies have Form NZ 630 (Certificate of Identity) as well as rifles. Four of us have not been issued with the above forms. This causes us no particular concern but we feel that there should be some uniformity in this matter one way or the other. We understand that both American and Australian Dental Corps travel under the
Red Cross .
It is to be noted that NZDC personnel are not permitted to carry rifles. Please take steps immediately to withdraw any rifles that have already been issued. With reference to the
Red Cross , this emblem is not used by the NZDC on any vehicles, buildings, panniers etc.
This was in line with a decision already given in
The
This was at Burwood, near
At Linton, near
If one dental hospital had been built as in a mobilisation camp, the men would have had to travel some distance for their treatment, with the loss of valuable time. It was therefore decided to build a small dental hospital for two chairs in each block and control them from a headquarters in much the same way as was done in the
It consisted of a headquarters and six sections, but as each hospital was designed for two officers, the usual proviso regarding temporary increase in personnel applied to cover excessive demands on their services. The establishment was as follows:
Group Dental Officer in the rank of major.
Seven dental officers, captains or subalterns.
Administrative Warrant Officer second class.
Staff-sergeant as storeman.
Fifteen clerk orderlies, seven of them corporals.
Seven mechanics. A staff-sergeant at Headquarters and six sergeants.
An orderly as driver in charge of a 15-cwt truck.
Other than the truck, transport consisted of one bicycle.
This group did not actually function as by the time the dental hospitals were completed, the camp was not needed. It appears, however, that it was the correct organisation for the purpose. The
This was the basic organisation of the NZDC in New Zealand. The bare bones that had rattled in the pre-war Territorial camps were unrecognisable in the vital body that sought the troops wherever they might be. It was a Corps organisation, able to concentrate its forces quickly where the need was greatest. For example, the main mobilisation camps needed one officer and one orderly for every 200 men of
As a contrast to the ease with which emergencies were met under the completed organisation, two examples of what happened in the early days of the war are given.
On
The second example occurred while the treatment of the
Confirming the telephone message of the Director of Dental Services of even date would you please arrange that instructions are issued to the Principal Dental Officer,
Papakura , to establish a Dental Hospital atNgaruawahia immediately with himself in charge, leaving a skeleton staff only atPapakura to attend to any urgent dental treatment presenting.All work on the 3rd Echelon at
Papakura and Fortress Troops atNarrow Neck is to be suspended for this period and all equipment and stores necessary transferred.Whilst the Dental Hospital is being installed the Dental Officers should be given every facility to have the respective units examined and charted on form NZ 361.
Would you also issue instructions that full co-operation is to be given by Unit Commanders to enable the Dental staff to render as many men dentally fit as possible prior to embarkation.
Following the telephone message, the movement and the preparations for a temporary hospital at
Eight hundred and seventy-eight were examined, of whom 557 required treatment. One thousand four hundred and forty-four fillings, 552 extractions and 101 dentures were done and, apart from one or two cases, the work was completed by 9 July. One officer and two other ranks were left to mop up and deal with emergencies and the rest returned to
These two examples show that even when the Corps was far from adequately staffed, the organisation was developing along the right lines, forecasting the mobility of the future and refusing to be defeated by the shibboleths of the past. The fight for recognition was over; the NZDC was accepted as essential to the army organisation. The organisation attracted interest in
BEFORE
At this time there were two
In October he arranged for all airmen then serving, approximately 1400 of them, to be examined by civilian dentists in the same way as the men for the
By this time the strength of the
The result of the meeting was that a scheme was approved by Cabinet on
Almost immediately it was realised that the scheme was based on a miscalculation of the rate of growth of the
To appreciate the NZDC problem it is necessary to know something of how the Later transferred to
From Levin the air gunners and observers, after a course of from four to eight weeks, left for
Similarly, those who went to Harewood Ground Training School received courses of various lengths and then went to such stations as
When considering the ultimate goal of dental fitness for the
It can be seen that each station had its own problems, but the general dental organisation was co-ordinated so that at some stage of his career every man was rendered dentally fit. Owing to the delay in authorising a service for the
Establishments varied on the different stations according to their size and function from time to time. Dental sections or multiples of these were therefore moved from station to station according to the needs of the moment. All control was from the DDS at Headquarters through the
With this reorganisation in
The service to the
It will be appreciated that certain RNZAF Units rely on
Army dental sections for their dental treatment as being the most economical method, due either to their location or small establishment. Likewise there are instances where army and navy personnel are reliant upon theRNZAF dental services.
To summarise:
Because of its division into groups or stations, the
The staffing of the
The dental problems of the three services were identical and could only be controlled by one DDS, unhampered by service jealousies, and using his dental forces with the one aim of establishing and maintaining dental fitness in all the armed forces all the time.
All overseas personnel were made dentally fit before embarkation, and the happy relationship between the
THE dental service for the Royal New Zealand
The only dental examination of candidates for entry into the New Zealand Division of the Royal
Candidates under the age of seventeen should have twenty one teeth present either sound or capable of efficient repair, and those over seventeen should have twenty two. They should have some molars and incisors in good and efficient occlusion on both sides of the mouth. Where teeth are only capable of efficient repair and the candidate does not intend to have the defects made good prior to final examination, acceptance for entry will be subject to his undertaking to have the necessary treatment effected at his own expense.
This was meaningless and it is difficult to understand on what grounds the arbitrary assessment of the number of teeth was based.
In
I am directed to request that the standard of dental fitness required of candidates for entry in the New Zealand Division of the Royal
Navy and the routine for the examination of candidates may be reviewed, and a report furnished as to the suitability or otherwise of the present arrangements.It is desired to maintain as high a standard as practicable and consideration of requirements in ‘Instructions for Surgeons and Agents’ section 11 paragraph 12 (c) should be directed towards determining whether they are fair and reasonable from the point of view of the general standard of dental fitness in New Zealand.
The opinion of the Director of Dental Services, Lieutenant-Colonel B. S. Finn, DSO, should prove of value.
Apart from the excellent suggestion that expert advice be sought from the DDS, there was also a suggestion that the regulations be brought more in line with those dealing with entry into the Royal
The New Zealand Division consisted of ships on loan to the Government from the Royal
This was an important decision. It recognised the need of the New Zealand Division for a dental service but bowed in conciliation to the traditional organisation of the Royal Naval Dental Service, which was hopelessly inadequate to cope with New Zealand conditions. As Surgeon-Lieutenant (D) the officer came under the control of the Royal Naval Medical Service, but while serving with the New Zealand Division he was subject to direction from the Director of Dental Services of the New Zealand Forces. Lieutenant-Colonel Finn was not fully appointed as DDS until
To return to the decision to commission a New Zealand graduate in the Royal Surg Cdr (D) A. C. Horne, RN (retd); Achilles and
This was a decided improvement on past arrangements and worked reasonably well under peace conditions, when the movements of the flagship could be foretold with some accuracy, but there were drawbacks. A dental officer permanently attached to a cruiser was restricted in his activities with other ships or shore establishments. This was recognised by the DDS, as can be seen by his letter to the Royal New Zealand
Personally I do not favour the establishment of the dental officer on a cruiser permanently for obvious reasons, but circumstances prohibited the installation of a shore dental clinic at the base where the dental officer would normally be stationed, transferring periodically to either of the cruisers for duty. Provision is made in the plans of the new base sick quarters for a modern dental clinic to cope with all classes of dental work and, when erected, it is hoped that perhaps an increase of staff on the station may be effected which will allow all naval personnel to be catered for, having their own prosthetic laboratory and dental mechanic, X-ray plant and facilities for major surgical operations etc. Treatment at the public expense by civilian dental surgeons will be confined to an occasional extraction or repair.
The naval base was situated at Philomel, an obsolete vessel moored there for use as accommodation and training. The dental clinic in the sick quarters did not materialise but, some time later, a dental department was established in the entrance hall of the squash courts. The Squadron Dental Officer came ashore in
This was the position at the outbreak of war. It was in conformity with the policy of the Royal Tamaki, on Motuihi Island in the
A serious problem then arose in the two cruisers employed on detached duty far from their base. They were dependent on casual dental attention in such ports as they might visit for fuel. Such visits were of short duration and only the more urgent cases could be treated, with a complete lack of continuity of treatment. A report from HMNZS Leander in
The routine under which the cruiser in New Zealand waters now operates is not known but presumably facilities for dental treatment ashore are less frequent than in peace time. Even when lying in a naval base, the presence on board of a dental officer would result in an appreciable reduction in the time lost from training and important ship work. The possibility of the ship being ordered abroad at short notice is a further factor in favour of the proposal, while a dental officer possesses qualifications which would be of real value in action. The necessary accommodation can be made available provided that the ship is not carrying a flag.
In other words, the Admiral's sea cabin could be used.
The general dissatisfaction was crystallised into action by the emphasis of this report, and on
With reference to the dental condition of the sea-going personnel I have to report that present arrangements are not efficient nor are they economical.
There is virtually no provision for the dental treatment of the ships' companies of either of the above excepting that which may be provided during their brief visits to the naval base and ports other than
Auckland , with the result that the dental condition of the personnel—of HMS ‘Achilles’ especially—is deteriorating.
A considerable amount of money is being paid to Naval Dental Surgeon Agents for dental treatment of ratings from minesweepers, trawlers and shore establishments at
Wellington ,Christchurch and Dunedin and for denture work carried out by the agent atAuckland .
The result was a complete reorganisation aimed at bringing the service into line with those operating for the
At HMS Philomel new quarters were designed and authorised, and a dental section was seconded from the Philomel or Tamaki. The oral surgery specialist stationed at Monowai, an armed merchant cruiser, was to have a dental section when she was ready to go to sea at the end of
The result was a compromise. HMNZS Achilles took the Squadron Dental Officer, Surgeon-Lieutenant (D) D. M. Page, RN,
Even this compromise was not effected without considerable opposition from
The Director of Dental Services' estimate was as follows:
At £1000 capital outlay and £900 per year, the New Zealand
All opposition quickly faded when the great value of the service became apparent. The service provided by the
Army Dental Department proved thoroughly successful throughout the remainder of the war. Not only did it provide for the needs of the New Zealand personnel but it rendered extensive service to ships of theBritish Pacific Fleet . One feature in particular which excited the envy and admiration of the RoyalNavy was the provision afloat of competent technicians and equipment for prosthetic work.
The provision of prosthetic facilities was a sine qua non in the NZDC wherever it operated, at the base or in the field, so without detracting from the sincerity of the tribute from the Director of Naval Medical Services, it cannot be regarded as anything remarkable. It can only be regarded as a further reason why the NZDC organisation for the three services was so much more efficient than that existing in the Royal
From the end of
Apart from the disadvantages already mentioned, there were individual disadvantages. The rate of promotion in the
As ratings serving in cruisers are only called upon to act in the capacity of dental mechanics on occasions, the institution of the rating DM is not justified, notwithstanding the fact that the ratings borne for dental duties may be qualified for higher duty. It is not in accordance with the Naval Board's policy to allow in complements ratings of a higher grade than those necessitated by Service requirements.
The reasoning was unsound. The ratings had to be fully qualified even to act as mechanics on occasions. The
Despite these difficulties, the dental health of the
New Zealand.
The Pacific.
The cruisers.
Demobilisation.
Just as there were three military districts in New Zealand, there were three naval ones, although the boundaries were not the same. The dividing lines ran east and west, one at Philomel, the Central HMNZS Cook, and the Southern HMNZS
Philomel was situated at the naval base in Tamaki on Motuihi Island, where there was a separate dental section. Cook was at
This was the nearest that the
The Corps system of treatment was adopted in the Viti was the seagoing ship and the shore personnel belonged to HMS Venture. Full treatment for the Europeans and partial treatment for the natives was easily given by existing
In the Arabis, Arbutus, Matai, Tui and Kiwi. The base was situated in the Kabu. Operating in the area was the No. 1 Kabu. Again the
The surgeon-lieutenant is entitled to his views as to the capabilities of Sick Berth Attendants to carry out dental work but showed surprising disregard for service procedures. He submitted his scheme to the DDS through the Director of Naval Medical Services, implying that the latter had a right to be an intermediary in such correspondence, whereas his only right was in permitting his Sick Berth Attendants to be used in any other capacity than that in which they were trained. It was not his province to arrange for dental treatment of the flotilla without consultation with the DDS, and the surgeonlieutenant should have known that what he was suggesting was a danger to the men of the ships. Colonel Finn's reply was emphatic and unequivocal:
I have to inform you that the well-intentioned and prepared instructions and charts for the purpose of enabling Sick Berth Attendants to render urgent dental treatment to
RNZN personnel cannot be approved.It is pointed out to you that such procedure on the part of the rating would render him liable to prosecution for committing a breach of the ‘Dental Act’
1937 which prohibits, as do service regulations, anyone other than a registered dental practitioner (or medical practitioner where the services of a dental practitioner are not available) from performing any dental operations in the oral cavity.All Naval Officers in charge and Ships' Commanding Officers concerned are being notified that Number 1 RNZAF
Mobile Dental Section NZDC is responsible for the dental treatment ofRNZN personnel in the South West Pacific area, and that dental sub-sections are located throughout theNew Hebrides ,Solomons and Admiralty Islands, and have instructions to give every facility for dental treatment toRNZN personnel.You are to take immediate steps to withdraw the instructions, dental instruments and authority for Sick Berth Attendants to undertake urgent dental treatment.
HMNZS Achilles: Before
Dentistry in a cruiser was often interrupted. Heavy calibre shoots meant that all breakable equipment had to be dismantled, while rough weather and high speed made operation impossible. In action the dental officer had to work with the medical officer in the care of wounded and, in any case, all his equipment was dismantled, as instance the report from the dental officer in
January 5 (A.M.), the ship was hit by a bomb resulting in casualties. January 5 to 9 inclusive no dentistry was attempted. Sterilizer badly damaged and engine foot-control soaked in water and repaired by ship's staff.
The Achilles went to England in early
Surg Lt (D) A. De Berry;
There is no doubt that at sea there was only a possibility of maintaining dental comfort and the standard of dental fitness had to deteriorate, but there were other factors which influenced the position and accentuated the difference between the naval dental service and that of the other services. The question is, whether as much was done under this system as would have been done under the organisation already proving so successful in other theatres of war.
In the Achilles from 1 July 1944 to 28 February 1945, 1160 fillings were found on examination to be required but only 702 were done. Likewise, 539 men needed treatment but only 272 were made dentally fit. The ship's complement was 850, which with one dental officer ashore would be well within his capabilities. Taking fillings as a reasonable basis for comparison of the rate of work afloat and ashore, it was 22 a week as against 63 for a similar period. Having due regard for the handicaps of bad weather and gunnery, the discrepancy was too much. The reason was that the naval assessment of the value of dental fitness was below that of the New Zealand Dental Corps. The dental officer was too often used for duties outside his profession. One dental officer in the
HMNZS Leander: As already described, the report from the commanding officer about the unsatisfactory dental service precipitated the reorganisation of the service to the Achilles. When she was damaged in action in Achilles when the
HMNZS Gambia: On
I have to inform you that telegraphic advice has been received from the High Commissioner for New Zealand that a Surgeon-Lieutenant (D) RN has been appointed to HMS ‘Gambia’, on loan to the Royal New Zealand
Navy .The Naval Board concur in a proposal that a New Zealand Dental Officer be sent to join HMS ‘Gambia’ in order to relieve the Royal Naval Dental Officer, and I have to ask you to nominate an officer for this appointment from the dental officers at present seconded to the Royal New Zealand
Navy . The officer selected will be required to take passage approximately mid-October next.
Captain H. C. B. Wycherley, NZDC, Achilles, transferred to the
During Stephenson's appointment certain interesting changes in the equipment and design of the surgery took place. The first concerned lighting. During a 6-inch-gun shoot the lamps vibrated more than was considered safe and were suspended from the bulkhead in a manner that made it difficult to remove them quickly. After removing the inner lining, two iron staples were welded to the deckhead itself, a piece of five-ply wood was fastened to the staples by rubber shock-absorbers and to this were attached the three ‘Controlens’ panel lamps, each having two shock-absorbers. The bulbs could then be removed when there was a shoot and damage to the rest of the system was unlikely. The second concerned the water supply to the unit. The cruiser was expected to spend long periods at sea and fresh water was therefore strictly rationed.
Experience in the Hospital Ship Maunganui showed that the unit could function with salt water with only some tarnishing of the bowl, which meant periodical replacement at small cost. The saliva ejector could operate at a pressure of 30 pounds but the circulating system could only provide a pressure of 25 pounds. The answer was to instal a small booster pump, bringing the water to the unit by means of a half-inch pipe. The pump was actually made, but there was trouble in getting a suitable 230-volt DC motor to work it and before the ship went in to refit, hostilities had ceased and the necessity had gone.
Towards the end of the war the NZDC in the New Zealand cruisers had to bow further to the system operating in the Royal
HMNZS Monowai: In this ship, an armed merchant cruiser, was a modern dental surgery in addition to all facilities for prosthetic work. Much of her work was done at the base, Philomel, when she was in
When the time came for men to be discharged from the
Members of the Royal New Zealand
Navy will be made ‘dentally fit’ before release but where a member, on being discharged, has been certified dentally fit within a maximum of six months prior to discharge, this certificate will be accepted for the purpose of dental clearance. No extractions necessitating the provision of artificial dentures will be performed for any member due or liable for discharge at short notice unless the member signs a witnessed declaration that he or she requests extractions and agrees to the insertion of immediate dentures and that the cost of any remake will not be sought from public funds.Where it is possible to anticipate discharge, endeavours will be made to render the officer or rating dentally fit at an early date in order that ultimate discharge will not be unnecessarily delayed.
As far as the
AT the end of the 1914–18 War all dental stores and equipment were disposed of by tender, with the result that for several years the Defence Department held no stocks at all. This was the position when the Dental Corps was reorganised in
The Department has no dental equipment or stores and Dental Officers will bring their own equipment to the camps they attend. The cost of any expendable stores (Drugs, filling materials and so forth) expended in the camp will be met by the Department. … As soon as the Department is in a position to do so, dental equipment will be provided as part of the war equipment necessary on mobilization. The equipment necessary for work in peacetime camps will then be provided. In view however of the extensive deficiencies that have to be made good in the war equipment of combatant units, the provision of dental equipment must be relegated to a low priority and will not be possible in the ordinary course of events for some time.
In the face of this rebuff, the DDS decided to approach the Director of the Division of Dental Hygiene of the Department of Health, who controlled the Government dental clinics for the treatment of school children by dental nurses. The Department's store only carried stocks applicable to this limited scope of treatment but had exceptional purchasing facilities in which the Corps hoped to share. The result was that enough materials were obtained to enable six dental sections to carry out urgent treatment at the Territorial camps and six metal panniers in which to pack them. The dental officers continued to provide their own instruments, but chairs were lent by private practitioners, dental trading houses and the Otago University Dental School.
In
Seven travelling dental engines.
Seven dental students' cabinets.
Seven folding wooden chairs.
Seven spirit sterilisers with stands.
With the exception of the chairs, which were made to order by the Public Works Department, this was all got from the Health Department.
Approval was then obtained to manufacture seven field dental surgical panniers and seven field dental prosthetic panniers. These were made at the Ordnance Workshops at
The pannier is a container for equipment and stock. To facilitate transport, it is of a standard size, standard weight both full and empty and has distinctive markings. The Government Dental Department used metal panniers and these were quite satisfactory where civilian transport was used and weight was a secondary consideration. In the field, however, ease of movement and identification were important so the new ones were made of 3-ply (later 5-ply) wood, covered with canvas for protection and were suitably painted and branded. The prosthetic pannier was a plain box, but the surgical one was ingeniously partitioned to hold a portable dental engine, student's cabinet, and other stores and equipment of specified quantity and weight.
The chair was carried in a canvas case along with miscellaneous articles such as a folding table, hurricane lamp, canvas basin and blankets.
Until
Early in
And so, after four years of great effort, the nucleus of a dental store was built up. But this was for peace requirements and the dove of peace was rapidly moulting. bona fides. The next step was to prepare a list of stores that would be required in the event of mobilisation for war. This was submitted to
At the outbreak of war the only stores held by the Corps were the seven peacetime outfits described above, and this was the case for over two months. Until stores came to hand, the early volunteers brought their own instruments into camp, and even supplied most of the stock from their own practices. Later this stock was refunded from army supplies.
The first big requisition, for electric units, chairs and sterilisers to the value of £2409, was placed on
In
One store for the
To obviate raising separate purchase requisitions and consequent competition on an already diminishing market.
To provide more favourable buying.
To promote a more equitable and convenient distribution of stores.
To enable the DDS to exercise complete control over their custody, proper use and accounting.
It is unfortunate that he did not mention the disadvantages of having different accounting systems in the two services at that time, as the anomaly might have been removed instead of existing for another three years. The Quartermaster-General and the Air Secretary agreed to the amalgamation. Premises were found in Lambton Quay,
By this time Major H. E. Suckling was Assistant Director of Dental Services at headquarters, in charge of stores and equipment. He personally supervised the transfer of the stores held at
In August the
The original staff of the store consisted of a Warrant Officer second class as accountant and two storemen packers.
The Dental Corps was expanding quickly and by the end of
The camp dental hospitals at
The first year of the war was a race against time to get enough stores and equipment to make every man dentally fit before embarkation for overseas. The race was won, the task completed, and much of the credit must go to those who overcame a very real problem in producing supplies continuously in the face of a host of difficulties.
In Tamaki, the naval training station on Motuihi Island,
During this year the three services grew to such an extent that the problem of supply assumed great importance. Prior to Philomel, in the two cruisers Achilles and
For some time the army camp quartermasters had been having difficulty in accounting for dental stores because of unfamiliarity with technical nomenclature and usage. They had been asked to take the responsibility for a large amount of expensive stock and equipment which they could not check without expert advice. They had no knowledge of what constituted a reasonable rate at which expendable material should be consumed and, without some idea of the nature of the stock, no method of judging with any certainty whether it was expendable or non-expendable. Who but a dentist for instance would know that, while the handle of a mouth mirror is obviously non-expendable stock, the mirror which screws into
During this year nine mobile dental sections were established. As these consisted of a headquarters section and six sub-sections, each commanded by a dental officer, the senior dental officer became the accounting officer and distributed the stores to his sub-sections.
With the mobile sections, static sections, mobilisation camps, naval and
As a comparison with the previous year, 22 dental establishments besides the mobile sections were supplied, 1055 issues were made and stores to the value of £17,280 were received. Requisitions were placed overseas amounting to £19,000, made up of £18,740 from the
During this year there was continued expansion of the armed forces with more and more dental sections to supply. For instance, the twelve caravan trailers had to be equipped and stocked both surgically and prosthetically. Further
The increasing danger of enemy action made it inadvisable to have all the stores concentrated in the same building. Bulk stores were therefore established in Rutland Street,
During
This year saw the beginning of retrenchment of the armed forces as the threat of enemy action diminished. Consequently, many of the dental sections were disbanded. The effect of this on the store was an embarras de richesses. The equipment and stock held by the disbanded sections were returned to the store. At the same time the influx of stores already ordered from overseas gathered momentum and seriously taxed the accommodation available. As a last straw, stores began to arrive from the
Two important changes in the administration and distribution of the dental stores for the
In
In
In
The organisation continued in this form until the end of the war and for two years afterwards, when the store moved to
THERE were two types of training required in the Dental Corps, technical and general. The officers and mechanics already had the technical training but, apart from the few who had served in the Territorial Dental Corps before the war, none of them knew anything about military matters, nor was it possible, because of the amount of dental treatment demanding attention, to give them all an immediate and comprehensive course of general training. In the very early days of the war, therefore, much had to be learned by individual observation and inquiry. This was inevitable in a young Corps with its meagre administrative facilities, but it was not intended to allow this haphazard method to continue and definite steps were taken to standardise the work and make every officer and man familiar with his technical and general duties.
When the men of the
As soon as time permitted the DDS issued a book of ‘Instructions to Officers NZDC’, a copy of which was given to every officer in the Corps in New Zealand. This contained all the information an
It is extremely difficult in wartime to find time to train dental officers without interfering with their primary function, which is treatment of the troops. This is an added argument in favour of having a trained nucleus in peacetime ready to occupy key appointments on mobilisation for war. For example, it would be useless and dangerous to detach a sub-section from a mobile dental section in charge of a dental officer with no knowledge of map-reading, in a part of the country where all road signs had been removed. Serious attempts were made by the DDS to give each officer as much general training as possible by arranging with the staff officers at the mobilisation camps to give them drill and instruction whenever they could be spared from their dental duties, but these occasions were infrequent.
In
To exercise commanders, staffs and leaders in functions of command and duties in the field.
To practise all ranks in field exercises in co-operation with other units, arms and services.
The NZDC took part in these exercises with both these objects as well as a third, which was to provide urgent treatment to the troops in the field. The exercises occupied fourteen days and, in each district, the number of troops involved was in the vicinity of 6000, nearly all belonging to the Territorial Force and therefore not dentally fit.
The Principal Dental Officer of each camp dental hospital group was appointed ADDS for the respective field force. Although NZDC war establishments were taken as a basis, he had to make his own appreciation after conferring with the General Staff of the field
While recognising the excellent reputation of most of the mechanics employed in the Corps, it cannot be denied that there were some disappointments. There was no qualifying examination in civilian life to guarantee a standard of efficiency and nothing to prevent the half-trained man from claiming the status of expert. As an example, the large advertising dental firms made so many artificial dentures that some of them adopted the chain system in their laboratories, i.e., a man would be trained in one process of the work and might be retained in only that process for some time. This man could claim in all good faith that he had had years of experience in a dental laboratory, whereas in fact he was not capable of constructing an artificial denture in all its phases. Without further training he was useless to the NZDC.
A large number of mechanics were required in the Corps, not only for the large amount of work to be done in New Zealand but to accompany the troops overseas. First-class mechanics were difficult to get and, before the National Service Department took action to prevent it, several were lost to the Corps by having volunteered for service in combatant units. The result was that the Corps in the early part of the war was always short of mechanics. It therefore decided to augment the supply by training some of its own. A few men who were mechanically minded and keen to be trained were selected and classified as dental mechanic's orderlies to work in the prosthetic laboratories of the mobilisation camp dental hospitals.
A course of lectures and demonstrations has been arranged starting tomorrow, 10 September, for mechanic's orderlies. The four at
Papakura are showing considerable aptitude for the work and I feel confident that with extra tuition it will not be long before at least two of them will be in a position to be used as junior mechanics.
In six months two of them were so appointed. They were not by any manner of means dental mechanics, but they had a working knowledge of all branches of denture construction as carried out in the army prosthetic laboratories and the opportunity to learn more. Of those trained in this way some fell by the wayside, but others served as dental mechanics in New Zealand and overseas.
This method of training was somewhat haphazard as it was not always possible to get dental officers and senior mechanics willing, or even competent, to act as satisfactory teachers. In
Men and women were given a course of approximately twelve months and then sat an examination. An exception was made for trainees with previous experience who were allowed, on the recommendation of the officer commanding the school, to sit the trade test without completing the syllabus.
The candidate had to get 70 per cent marks in the technical syllabus and produce a certificate from the officer commanding the school as to his readiness for examination before being allowed to sit the test. Those not recommended were either deferred for six months or transferred to other duties as unsuitable and unlikely to qualify. There were two examiners, one being the PDO of the camp dental hospital to which the school was attached and the other was appointed by the DDS.
On passing, the successful candidates were given provisional standing as ‘B’ grade dental mechanics, NZDC, and were sent to other camp dental hospitals for a further three to six months' training. At the end of this probationary period they were given the full status of ‘B’ grade dental mechanics, NZDC, without further examination, providing the report of the officer commanding the prosthetic school was satisfactory.
There was one danger in the scheme of which the DDS was fully aware. After the 1914–18 War, dental mechanics who had served
A statement to the press from the annual conference of the
The construction of dentures for the replacement of the natural teeth demands an intricate knowledge of many basic medical and dental subjects other than technical procedures and we wish to correct any public misunderstanding which may exist regarding the capability of anyone other than a fully-qualified dental surgeon to undertake the work.
The scheme of training appeared to be satisfactory, but unfortunately it was started so late in the war that by the time the first trainees gained their full status as ‘B’ grade mechanics, there were signs of a general retrenchment and the fledglings were never tested in full flight. Judging by the comprehensive nature of the course and the interest shown in it, the scheme was of sufficient value to recommend its adoption early in a future war. Even with the advances made and being made in preventive dentistry, it is difficult to visualise a force of New Zealand troops with less than half wearing artificial dentures of some kind.
The men and women engaged as dental orderlies were selected more for their intelligence and general suitability than for their previous knowledge of dental work. Their training as dental assistants was primarily in the hands of the officers of the Corps, who varied in their capabilities as teachers and, in the very early part of the war, were in military knowledge little more than a page ahead of their pupils. With the advent of the officer's vade-mecum
It was not until
Surgical duties.
Clerical duties and accounting for stores.
There was a written paper of one hour's duration and a quarter-hour oral examination in each subject. General capabilities were the subject of a report from the officer commanding the section to the DDS, and this was considered with the examination results. Examinations were conducted from Air Headquarters,
Group IV: WA2—Written and oral, 50 per cent in each subject.
Group IV: WA1—Written and oral, 60 per cent in each subject.
This reclassification carried an increase in pay as ‘Qualified Personnel’. This produced more highly trained assistants than the haphazard methods of the past had done.
The RNZAF was the only service to adopt this trade testing for dental orderlies, and judging by its success, it is reasonable to suggest its adoption by the other services. The tuition can be given without interfering with normal routine and should take little organisation to set it in motion. It entails extra hours of work, but the officer is repaid by more efficient orderlies and the orderly has the incentive of more pay and added interest in the subject. A sine qua non is a nucleus of officers capable of teaching and this, to begin with, would have to come from those holding commissions in the Regular Forces or the Territorial Force.
WHEN the New Zealand Dental Corps assumed the responsibility for treatment of the armed forces in the Dominion and overseas, one of the first considerations was the provision of suitable accommodation. The use of tents or converted huts was only excusable under field conditions or when time precluded the building of permanent hospitals. Costly, delicate and complicated equipment is used in the practice of dentistry, and this has to be suitably housed and readily available if treatment is to be of the high standard the forces have a right to expect. In addition to this, there is a considerable strain on an operator working long hours in an exacting profession which demands the best conditions to produce the best results. Suitable hospitals, however, cost money, and enough has been said of the official reluctance at the beginning of the war to recognise the value of the Dental Corps in the general scheme of things, to show that getting authority for the necessary expenditure was not easy. Eventually, good hospitals were built in every permanent camp or station.
An example of tented accommodation in the early part of the war was when the
The dental staff comprised the Principal Dental Officer and four other dental officers, one administrative sergeant, four dental orderlies, three mechanics and one mechanic's orderly. I found the dental quarters to comprise one large marquee and one bell tent.
The marquee was approximately 15' × 30' and here the mechanical work, office work and surgical work were carried out…. There was a duck-board flooring in the mechanical portion but in the surgical part there was no flooring at all…. Conditions were not altogether favourable in wet and rough weather. There was an electric light above each chair and also in the mechanical room and the lighting conditions generally were as satisfactory as could be expected under the circumstances. Electric power was used for an electric vulcaniser and for electric engines. Primuses were used for other heating requirements.
On questioning the PDO I found that the dental plant, including the electric plant, stood up to the weather very well.
Drainage was … by means of a septic tank. Water was laid on and facilities for washing were provided by means of canvas basins. I might also state that space was provided in the marquee for sleeping one member of the staff to act as caretaker.
The bell tent accommodated one officer and one orderly. I found here a close wooden flooring with no provision for lighting or drainage. As this was only a make-shift tent it answered the purpose for which it was intended….
It must have been difficult to maintain reasonable asepsis under these conditions, and even more difficult to impress the patients that the standard of service received was not in some measure commensurate with the surroundings.
Dental hospitals, whether large as in a mobilisation camp where up to nineteen officers were operating, or small as for a single section, have certain essential requirements, and all are constructed on the same principles. A study of these essentials will give some idea of the general layout of all dental hospitals without the need for describing the details of the many different designs, although it must not be forgotten that the numerous designs were the result of much thought and effort by Dental Headquarters and the Public Works Department.
In general, the building had to be so situated as to be easily accessible to the patients. It had to be orientated to provide the best operating light, big enough to accommodate staff and patients, yet small enough to allow hospital cleanliness to be observed. It had to have water, electricity, sewerage, gas, compressed air and heating, as well as having specialised apparatus installed and suitable fittings designed and constructed. There had to be a surgery, office, workroom, waiting room and lavatory. In the case of the larger hospitals, a store, X-ray room, darkroom, and a room for extractions and oral surgery had to be provided.
The centrepiece of the surgery was the chair. While in some cases hydraulic pump chairs were provided, most of them were of the folding type made of wood with adjustable headpiece and back. They were reasonably adequate, though lacking in strength and range of movement in comparison with the pump chairs. On the left of the chair was a unit complete with spittoon, saliva ejector, bracket, electric engine and compressed air atomiser. They were made in New Zealand and proved to be very satisfactory. On the right of the chair was a cabinet for instruments and drugs, with its top designed for use as a writing desk.
The chair, unit and cabinet required a width of 7 ft 6 in. to 8 ft and at least 12 ft from the window to the back wall. When a series of chairs were placed alongside each other as in the larger hospitals,
There is an age-old controversy among dentists about the most suitable daylight for operating. In the southern hemisphere the majority, as revealed by a poll taken among the dental officers, favoured the southern light, some almost to the point of fanaticism, while the minority with equal vehemence swore by the northern. As there were some hospitals in long narrow army huts where the chairs were placed back to back, it is hoped that officers of appropriate schools of thought were employed. There was one point, however, of universal agreement, that direct sunlight must be avoided at all costs because of eye strain from glare. This made the eastern and western aspects unsuitable. Some form of artificial light was necessary for dull days and evening work, but this was discouraged whenever adequate daylight was available. All the hospitals were equipped with a rise and fall light fitted with a suitable reflector above each chair. In addition, a battery operated light which could be worn on the forehead was a standard issue to each section.
It is reasonable to presume that, with the development of the fluorescent tube, this will be the lighting of the future, but its first trial in Cook in
Every surgery was provided with hot and cold water. It was found necessary to filter the cold water to prevent blocking the saliva ejector system, and for this purpose a strainer was fitted outside the hospital. Some hospitals had their own electric hot-water system, some were connected with the camp supply, some used the ‘Zip’ type heater and one, at least, had a coke boiler. A steriliser bench, a plaster bench covered with battleship linoleum and a wash-hand basin completed the furnishing of the surgery.
The walls, ceiling and joinery were painted and enamelled, usually in a light green colour which was very restful for the eyes. The floor was either covered with linoleum or left bare, in which case the wood was highly polished. In Papakura,
Heating in winter was in most cases of the tubular electric type although some of the smaller hospitals had a coke heater standing on a concrete block. Adequate heat is essential in a dental hospital as without it the work must suffer. The occasion of the treatment of the Railway Construction companies in
Compressed air for the unit was provided by an electric motor and tank situated in the workroom with a pipe through to the surgery.
The hospitals in the mobilisation camps and the larger
Only the bigger hospitals had a room set aside as an office. In the smaller ones all the clerical work was done in the surgery and, while admitting some convenience in this arrangement because of the smallness of the staff, it would appear that a separate office, not necessarily large but close to the waiting room, is more efficient and easier to run. Clerical duties such as calling up and interviewing patients, filing records, writing reports, telephoning and typewriting should not be allowed to interfere with the work of the dental officer in the surgery. Little emphasis was put on providing efficient office equipment, probably because in most cases not enough emphasis was placed on the business capability of those expected to carry out the work. Untrained people were expected to run the clerical side of the equipment of perhaps sixteen or seventeen dental practices working to full capacity. They had to see that every man in camp was called for treatment in time to be made dentally fit before leaving for overseas. They had to study the movements of men from unit to unit as laid down in routine orders. They had to keep a record of work to be done, work completed and stores needed and expended. They had to type reports and correspondence, see that the dental records for each patient were forwarded to the proper quarter at the correct time, as well as arranging all details for the unit such as pay, leave and clothing. When it is remembered that, except by a fortunate accident, none of them could use a typewriter, except later when girls were employed, and that in the early part of the war it was even difficult to get a typewriter, their work stands out
This was where the mechanical construction of artificial dentures was carried out. All work for the patient was carried out in the surgery by the dental officer but the actual construction was done in the workroom by the mechanic to his instructions.
Benches were built round the walls for plaster work, vulcanisation, boiling out wax, packing rubber, setting up teeth and the hundred and one procedures connected with the work. Water, light and electricity were needed and gas for Bunsen burners, vulcanisers and gas rings. It was not possible to rely on a supply of coal gas for every dental hospital and, as it was the policy of the Corps to standardise all equipment, bottled gas was used. This was a rock gas mined in
The bench accommodation, including space for plaster work, polishing, packing, vulcanising, soldering, inlay casting and general work, together with the cupboards and drawers, was well designed on conventional lines and need not be described in detail.
In a small hospital the room was about 12 ft by 8 ft and in the big mobilisation camps was 40 ft by 13 ft 6 in., which was none too large for the volume of work that passed through it.
In the bigger hospitals a room some 18 ft square with benches round the walls was provided, and in the smaller ones a tent was usually used. The first sight to greet a patient in any NZDC hospital was a notice reading:
All ranks must parade with their toothbrushes and clean their teeth thoroughly before dental examination or treatment.
In most cases a sink was supplied for this purpose, but when there was no sink or running water, a field oral hygiene outfit and soakage pit were used. This was a metal tank of about 2 ft cube, containing water and standing on a wooden platform 3 ft 6 in. high. A rubber tube fitted with a clip came from the tank and rested when not in use in a jar of antiseptic attached to the stand. Alongside the outfit a hole was dug in the ground and filled with stones to form a soakage pit. To use it one wet the toothbrush by removing the tube from the antiseptic and pressing the clip. The teeth were then cleaned over the soakage pit, the tube being replaced in the antiseptic.
This, while obviously not as satisfactory as a sink with running water and proper sewerage, was a distinct advance on what existed in the 1914–18 War, and which continued through the Territorial interlude and even made an appearance in this war. To quote a memorandum to all dental officers dated
Where sinks and other facilities are not provided, Principal Dental Officers will take steps to have two buckets branded ‘Clean Water’ and ‘Waste’ respectively, placed on a bench two feet high in a prominent position at the entrance to the clinic, preferably inside the building, with a mug and a receptacle for common salt.
This was known as an oral hygiene bench, a name which expresses the meritorious intention but not the complete failure of its activities. Far from promoting oral hygiene, it was a menace to health and an encouragement to the spread of infection. The buckets were unprotected from dust and flies. Patients were puzzled by the whole outfit and sometimes mistook the clean bucket for the waste, and even if they correctly carried out the instructions, the water and mug were contaminated by the first user. The outfit has long since been discarded and it is inconceivable that enlightened knowledge of health will tolerate its resurrection.
From this general description it should be possible to visualise the conditions under which the NZDC worked in the various camps in New Zealand. Good, well-equipped hospitals built of wood, painted in many cases with camouflage, the interior polished and shining, a setting to impress the patient that this was no temporary service, no rough and ready tooth carpentry, but dentistry equal to that he received from the dentist of his choice before he joined the forces.
THE general organisation of the Dental Corps, the provision and training of staff, the purchase and distribution of supplies and the standard of dental health to be achieved have been described. Consideration must now be given to the main function of the Corps, its raison d'être, treatment. Practically every man of military age in New Zealand either had some degree of dental disease or was a potential casualty as a wearer of artificial dentures. The perfect natural dentition was so rare as to be an object for demonstration to other dentists. It is safe to state that the number of men possessing their own teeth who did not require some treatment from the NZDC during their term of service was negligible, and very few of those wearing artificial dentures completed the course without trouble of some sort. As the DDS wrote in his ‘Instructions to Dental Officers’ regarding the duties of the Corps:
This is to promote the highest order of dental fitness attainable for the fighting forces and to ensure that they are maintained in such a state. The quality of the fighting soldier depends on the basic factor of his degree of physical fitness in which the state of his oral cavity plays no small part. Experience in the last war and in this has proved that after troops have been engaged in battle, quite a considerable amount of dental treatment is required, particularly in replacing lost and broken dentures. This constitutes a vital problem with New Zealand troops, 50% to 60% of whom are denture wearers.
The New Zealand Dental Corps was not so much concerned with patching up the battle casualties as with reducing the number of those casualties by ‘promoting the highest order of dental fitness’ and ‘maintaining such a state’. This could not be achieved haphazardly and demanded a definite plan of campaign. Every man had to be dentally examined as soon as possible after his entry into the forces, firstly to assess the amount of treatment required, and secondly to provide a permanent record of his dental condition at that time.
The first examinations were carried out by civilian dentists as members of medical boards using a special form (NZ War 360) on which to record the result. The dental condition was recorded on this form but the amount of treatment was more especially
It was important that there should be a standard method of recording the results of examinations in the three services so that they would be intelligible to every officer of the Corps, so not only were the same forms used but the same symbolism was used. There is room for criticism of the symbolism adopted in New Zealand, and this took active form in the adoption of a different system in the
The instructions were that all ranks must be examined within forty-eight hours of entering camp. It was considered that one dental officer with an orderly, assisted by a clerk or the NCO in charge of the party, could examine on an average thirty men an hour. This may appear excessive and, without a full knowledge of the circumstances, the criticism that the examination must have been perfunctory is reasonable. It must be borne in mind that the figure is an average and that many of the men were wearing full artificial dentures and did not take long to examine. The cases that took the longest were those with good natural dentitions, when it was important that no lesion should be missed before accepting the responsibility of signing the patient as dentally fit. For those men who had some treatment to be done, it was more important to find out the approximate amount of work required to a reasonable degree of accuracy than to delay the beginning of treatment for the whole force by attempting to diagnose the more obscure cavities. When that man returned for treatment the occasional cavity that had been missed would be found. A completely accurate diagnosis in any case is impossible without the use of X-rays, and it would be difficult to use these at the time of examination of a large body of troops. In practice the examinations were extremely accurate.
If it could be certain that once a man was in camp he would stay there until his treatment was completed, the system outlined above would be reasonably satisfactory. Unfortunately this was not
Whatever the reasons, Form 361 was often late in accompanying the personal file, which usually meant that a diligent dental officer carried out his instructions and made out a new one, with the result that the records of examinations and treatments were spread over several forms. Even if this was not the case, the original record of examination was subjected to the risk of loss or damage by being continuously handled and transferred from place to place.
Appointments could not be made haphazardly and a number of factors that had not concerned the dental officer in private practice had to be considered. These were:
The training syllabus and camp routine orders had to be consulted. For example, it was inadvisable to make appointments for men whose companies were needed for rifle practice on the range or who were ‘Duty Company’.
The total time for treatment had to be estimated. Those needing multiple extractions had to receive priority so that as long as possible could be allowed for the mouth to heal before fitting artificial dentures.
It was necessary to estimate how long each course of treatment would take. Except in special circumstances, it was inadvisable to keep a man in the chair longer than an hour at a time. On the other hand, the greater number of times the man had to attend the more time he was away from his training, and the more time he wasted in going to and from the hospital and in waiting his turn for treatment. Also, time was wasted in the hospital in sterilisation of instruments. As much work as possible had to be done at each appointment consistent with a high standard of operative work and the patient's welfare.
Enough of different classes of work had to be called up to keep all departments of the hospital fully occupied.
Considerable tact was needed in convincing unit commanders that the time spent in the promotion of oral health in their men was not wasted in comparison with their general training. When it was seen that the Corps policy was to interfere as little as possible with training and duty, there was seldom any friction and most unit commanders became valuable allies.
In every body of men there was the ‘old soldier’ who welcomed the dental parade as an excuse to evade unpleasant duties. Appointments therefore were all made through the unit orderly room and an appointment and dismissal form, stating time of arrival and departure, was used.
Appointments were not made with individual dental officers except in such cases as ‘Trench mouth’, when continuity of treatment was desirable.
In the bigger hospitals it was customary to use one officer to do most of the extractions in the early stages and another to specialise in the prosthetic work so as to keep the mechanical staff fully occupied. The remaining officers would then concentrate on the filling work, which constituted the bulk of the work.
In the
On the average the treatment required by the aircrew trainees involved about 400 fillings per hundred men, which was practically the same as in
Before going into details as to how the treatment was carried out, it is well to state what was offered and how it was received. The DDS in his instructions to all dental officers stated:
The same care and attention to patients and the same high standard of dental treatment should be observed as would normally be expected in a high class dental practice.
This was the highest standard that could be set and in most cases it was fully appreciated, but there were some cases where it was looked on with suspicion. The cases were remarkably few but, as they constituted a problem which must inevitably occur, however high a standard is offered in the future, they must be considered.
In dealing with the large number of sailors, soldiers and airmen it is not surprising that there were some who, for various reasons, refused to submit themselves to the treatment prescribed. In many cases, by tactful handling, the dental officer managed to overcome these prejudices, especially where the cause was apprehension, but he could go no further than persuasion and, if the refusal was persisted in, had to refer the case to the man's commanding officer. To the commanding officer of the old school the answer appeared simple. An order was an order, and if it was disobeyed there were enough unpleasant penalties to see that it did not happen again. This view, however, was founded more on custom than on sound law, and the old soldier's philosophical observation that there was only one thing that could not happen to him in the
In
Any soldier refusing treatment will sign a declaration to this effect on NZ War 361 (overseas 361A) dated and countersigned by the dental officer concerned. Refusal to undergo treatment will not be regarded as sufficient cause for discharge although as a result of such a refusal he may not be up to the required standard unless a Medical Board, which will include a dental officer, be of the opinion that without such treatment the soldier is, or may become, physically unfit to carry out his duties.
The Deputy Adjutant-General summed up the position at the time in commenting on a specific case on
There does not appear to be any disciplinary action which can be taken in this case as it does not appear to be an offence. In future, provision could be made to ask the recruit if he is willing to undergo treatment before accepting him. In this case the alternatives are to let him go overseas as he is (probably unfit) or have him declared unfit by a board and discharged.
This was most unsatisfactory as it was bad policy to send unfit men overseas, where they might become unfit for duty and have to be sent back to New Zealand, and the alternative of discharge by a medical board in New Zealand eased the path of the obstructionist and malingerer. An attempt was therefore made to increase the authority of commanding officers.
In King's Regulations and Admiralty Instructions, Section 18 of the
There is the straight out malingerer who definitely refuses treatment. He willingly signs a statement on his dental history sheet that he refuses necessary dental treatment and this fact is reported to his commanding officer. Nothing happens. Hours are wasted in many instances endeavouring to persuade these men, but they are conscripts and do not want to be made fit for service, though the dental officers persuade a few. This is a tragic waste of valuable time which is a big factor when so much dental treatment is required and I regret to say that territorial officers in a few cases have encouraged them. Prior to this period men were anxious to go overseas and knew that they had to be dentally fit, but this incentive is gone and evasion is increasing, which is causing grave concern.
Obviously something had to be done. To invoke a law without sanctions was to undermine discipline and invite ridicule. There was much legal argument which it is not proposed to analyse as it is outside the scope of this history, but the position may well be crystallised in the words of the Assistant Adjutant-General of the Southern Military District:
To allow the refusal to go unpunished would undoubtedly be prejudicial to discipline but so also would a trial by Court Martial if it failed to result in a conviction.
A strategic withdrawal from an untenable position was carried out and on
It speaks well for the tact of the dental officers and the good reputation of the NZDC as a whole that the number of men and women who persisted in their refusal to undergo treatment was very small. Those who did persist were no longer any concern of the Corps, except that certified copies of their signed refusals were kept at Headquarters to refute any claims they might make in the future to have dental work done for them at the public expense, and to exonerate the Corps from responsibility for their dental condition.
It is now proposed to discuss some aspects of dental treatment as they were affected by service conditions and requirements.
Most of the extractions were carried out under local anaesthesia, except such cases as acute alveolar abscesses and similar conditions where this type of anaesthesia was contra-indicated. In cases of multiple extractions it was customary to admit the patient to the camp medical hospital for a day after operation for observation, nursing and special feeding. In other cases the co-operation of the Regimental Medical Officer and the unit quartermaster was sought to get special diet and easy duty. Occasionally the patient was either sent home on sick leave or to a field ambulance, military hospital or public hospital, but this only occurred if there were no facilities for hospitalisation in the camp. Where general anaesthesia was indicated, and this was limited to cases involving six or more teeth except in special circumstances, most of the main dental hospitals had machines for the administration of nitrous oxide and oxygen.
Where no machine was available the services of the medical officer were available to administer other anaesthetics. Intravenous evipan was a popular choice.
Although cases were admitted to the camp hospital, the dental officer continued to be responsible for them except for rations, discipline and nursing.
The services of dental officers with experience in oral surgery were available at the main mobilisation camps and to them could be referred cases of major oral surgery from sections where there were not the same facilities for diagnosis, hospitalisation and postoperative treatment. It must not be thought that they alone did all the oral surgery in their districts. The dividing line between the general practitioner and the specialist was no more clearly defined in the
The establishment of masticatory efficiency of long duration in the least time was the primary consideration in the choice of filling materials. Most were of silver amalgam with a protective lining of cement. Where aesthetic demands precluded the use of amalgam, as in the case of anterior teeth, synthetic porcelain was used. The malleted gold filling and the gold inlay had no place in army practice, but inlays of acolite and of a gold-coloured metal called ‘Allcast’ were used occasionally.
The ill favour with which the pulpless tooth is regarded by the dental profession is reflected in the very small amount of this work which was done by the NZDC. With full permission to do this type of work at their own discretion, the dental officers in New Zealand decided that only 14 in every 10,000 fillings should be root fillings.
This disease is also known as Vincent's Stomatitis or trench mouth, and, when it attacks the fauces, tonsils and pharynx, as Vincent's Angina. It is contagious and community life provides ideal conditions for it to become epidemic. A state of lowered vitality such as that following influenza, overwork, severe cold or lack of essential
The etiology being both general and local, combined with its epidemic possibilities, put the disease in the no-man's-land between medicine and dentistry. Its importance as a potential incapacitator of large bodies of troops demanded a clear decision as to whose responsibility it was to treat it and prevent it spreading. As the general health of the troops was the responsibility of the Medical Corps, some medical officers considered it was in their department. As the disease was an oral one, usually diagnosed by the dental officer, and as treatment was mostly local, the dental officers considered it was in theirs.
The instructions from the DDS to his officers were quite clear. They were to treat all cases and were given implicit instructions how to do it. They were warned to be continually on their guard to prevent the spread of the disease. They had to notify the DDS by telegram of every case diagnosed, in addition to notifying the medical officer and unit commander. Apparently the instructions from the Director-General of Medical Services to his officers were not so specific and the medical officers were left to form their own opinions as to who should treat the disease. There was justification for both views but no justification for the lack of co-operation between the two Corps when it came to treatment.
Matters came to a head in
During normal periods, namely when there is no epidemic or other unusual sickness rate in the mobilization camp, the Senior Medical Officer should retain all mild cases of disease whether contagious or otherwise, or accidents which can be effectively treated, in the camp hospital. This includes measles, mumps etc. As regards Trench Mouth in particular, there is no reason why this disability should not be retained in the camp hospital under the treatment of the Senior Dental Officer. The patient will of course be under the general control of the Senior Medical Officer for discipline etc. and the nursing personnel, but will carry out the treatment ordered by the
Dental Officer. I may say in passing that the camp hospital at Papakura has a staff of three trainedNZANS personnel withNZMC personnel, and the equipment, sterilisation etc., [which] is quite sufficient for dealing with all classes of minor disabilities including contagious diseases.
As you are aware the one great principle in the
Apart from treatment which was on standard lines, the most important consideration was to prevent the spread of the disease throughout the camp. The patient's eating and drinking utensils were kept away from the others and each patient received a printed card of instructions.
Most of the cases in New Zealand were of the mild sporadic type and nothing in the form of a serious epidemic occurred. In
It has already been pointed out that 50 to 60 per cent of New Zealand troops were wearers of artificial dentures of some kind. These were easily lost or broken and in some cases were a convenient excuse for malingering. With all these men potential casualties, it can be seen that the prosthetic department of the Dental Corps was highly important in the service organisation. Apart from dealing with the casualties when they occurred, the policy of the Corps was to keep the supply of artificial dentures to a minimum. This, of course, applied chiefly to partial dentures which, with certain exceptions, were only supplied where there was a definite masticatory insufficiency without them. Too many partial dentures were worn in the kitbag as it was, so unless the patient was cooperative or a dental cripple, it was a waste of time making them. A rule was therefore laid down which allowed wide discretionary powers but protected the dental officer from the odium engendered by his refusal to make luxury partial dentures. No denture of fewer than six teeth was to be made except on the express instruction of the Principal Dental Officer or officer commanding a dental section. While fully realising that the psychological aspect had to be Confirmed by personal conversation between the DDS and author,
All dentures were made for utility under hard conditions and the aesthetic considerations, while being far from neglected, had to be secondary to this. They were all made of vulcanite, although a certain amount of acrylic resin was available for repairs to dentures of other materials. To produce efficiency and conserve time, the workroom staff in the larger hospitals worked on the chain system. One or two prosthetic officers were appointed and the calling up of denture patients and organisation of the workroom were the result of consultation between them and the senior dental mechanic.
One of the greatest prosthetic difficulties was provided by those men who came into camp with septic mouths requiring extensive extractions. In the early stages of the war, when every man was urgently needed to build up the Division in the
The situation was met by a compromise. The teeth were extracted as soon as possible after arrival in camp, as long a time as possible being left for absorption to take place. Before embarkation dentures were made on the understanding that they would have to be remade overseas when further bone absorption had taken place. Many of
Taking everything into consideration, the results obtained in New Zealand for the men going overseas were very good and the highest standard of dental fitness was produced in the time available. There was, however, another problem connected with men who required multiple extractions. Some of them, after having had their extractions, were discharged from the forces instead of going overseas. The
Full upper or lower denture, £5.
Partial (including first tooth), £1 10s.
Each additional tooth, 7s. 6d.
Unexpected opposition was encountered from the Ministers of Defence and Finance who considered the fees too high. The Minister of Defence suggested that the hospital boards might do the work more cheaply, but on consulting the Minister of Health was told that all the hospitals were too fully occupied with their own work. Apparently the fact that the man would have to be brought from his home to the hospital, fed, boarded and returned home was omitted from the calculation of the cost. Fortunately the argument, which lasted from March to December 1940, ended without the necessity for a decision, as every relevant case was meanwhile attended to in a camp dental hospital and great care was taken that no future case could possibly fall into that category. There is no evidence that the private practitioner was consulted as to whether his patriotism would have prompted him to undertake the work at a financial loss, or at least at a nominal fee.
With so many dentures made for the troops, precautions had to be taken to see that proper care was taken of them. The following was therefore put in camp and routine orders on frequent occasions:
All ranks are warned that they are liable to be charged with the cost of replacements of artificial dentures lost through neglect. Dentures must always be removed and put in a safe place before going swimming or when sickness from any cause is likely. Particular care must also be taken during respirator drill and night exercises. Failure to carry out the above is the direct responsibility of the soldier concerned.
Where the loss or irreparable breakage of a denture originally supplied to an officer, soldier, airman or rating, either at his own or at the public expense, could be shown to have been due to any culpable act or omission on his part, he was placed under deductions of pay for the cost of the new denture. Under service conditions these costs were assessed at:
Each full upper or lower denture, £2 10s.
Each partial upper or lower including first tooth, 10s.
Each additional tooth up to twelve teeth, 3s.
Each case was referred by the dental officer to the relevant commanding officer, together with all information for his decision regarding liability. There was always the right of trial by court martial. Deductions were entered in the paybook and published in orders.
From the amount of emphasis laid on the provision and maintenance of artificial dentures, it can be seen that New Zealand troops are to a large extent dependent on an adequate dental service. It is doubtful if before the war this fact was fully appreciated and it is hoped that the experience of the war will not allow it to be forgotten. There is much truth in the statement by Bernard Shaw towards the end of the last century: ‘When you have the toothache the one happiness you desire is not to have it. When it is gone you never dream of including its absence in your assets.’
Among the instructions issued to dental officers was one relating to the arrangement of lectures to be given to the troops at regular intervals on oral hygiene and the care of the teeth. This most important subject was sadly neglected. The emphasis was on repair rather than prevention, for dental disease was firmly established, and popular opinion was that it was an inevitable companion of civilisation. The subject of preventive dentistry was therefore difficult to teach with any degree of interest. The enthusiast was regarded with polite tolerance of his idealism but with a firm conviction that his panacea would be irksome and probably of doubtful value.
That dental disease can be reduced by proper attention to diet and prophylaxis is beyond doubt. That a series of lectures on the subject can effect this reduction is no more likely in the
Why not therefore appoint a dental officer with the technical qualifications and lecturing ability to carry out this important duty? Specialists were appointed as oral surgeons, others as teachers of prosthetics, but the most important subject was given an ancillary role. The dental officer was busy mopping up an ocean of dental caries. Dry land was a chimera, even then consisting in his fancy of quicksand. It is small wonder that he doubted his ability to stem this mighty tide with his puny strength and begrudged the time from his well-earned recreation for the necessary effort. The duty was not neglected and many lectures were given. The point is that it is very doubtful if they did any good.
A better approach to the subject might have been to have concentrated on insinuating the postulates of a correct diet into the army rations. Dental disease is a concomitance with improper feeding. Our diet is impoverished by over-refinement of sugars and starches and provides ideal conditions for the growth of mouth bacteria. The lack of detergent foods removes the safeguard of automatic cleaning with its attendant gum massage, as well as depriving us of adequate exercise of the jaws. These and other dietary matters seriously affect the maintenance of dental health and should be given proper emphasis in the policy of the Dental Corps.
Under service conditions diet can be controlled and, with a fighting force largely depending for its efficiency on physical fitness, it should be controlled. The incidence of dental disease could be greatly reduced by the co-operation of dentists, producers, manufacturers, retailers and consumers, but the gap between the first and the last is too great to be bridged by idealistic propaganda while the fleshpots beckon so temptingly. Control could go a long way towards bridging this gap and still provide a satisfying and sapid diet beneficial to dental health and acceptable to the men. The Dental Corps has a duty to assist in this control and might well achieve better results by devoting some of the energy previously
What success would attend the Corps in this direction is problematical. A previous attempt by the DDS to encourage prophylaxis in the
The concession was something achieved, but as nobody could compel the troops to buy, there were probably many who went without. Admittedly nobody could compel the troops to use a brush regularly, even if it was issued free, but it is still felt that the decision was an unfortunate one and that an opportunity to educate the troops in at least one method of improving their health was neglected.
It is interesting to analyse the problems arising when troops are employed for any length of time where dental treatment is not available. This occurred with certain New Zealand troops during the
New Zealand entered into an obligation before the war that, in the event of hostilities, she would be responsible for guarding the cable station on
In peace the regular military forces do not receive free dental treatment although this is granted to the
Navy and theAir Force .In the NZEF all ranks were provided with free dental treatment and no distinction was made regarding the small percentage of regular soldiers serving with the NZEF. There is a resident medical officer at The
Army Secretary was not accurate in this statement as theAir Force did not receive free dental treatment untilJanuary 1940 . (Author.)Fanning Island but no dental officer and without considerable expense it would be difficult to make any provision for dental treatment for the platoon. The men will be on the island for at least six months and it is desirable that there should be no trouble from the dental side while they are there.The only, but not entirely satisfactory, solution is to ensure that every man is made dentally sound before he leaves New Zealand and where possible the work to be carried out for a period of six months ahead. As the soldier cannot be compelled to have this treatment carried out at his own expense, it is recommended that the platoon should be treated on the same basis as a force for overseas service and dental treatment provided by the Government. Until the teeth of the men have been examined it is not possible to give an estimate of the cost, but as these men were required to reach a certain dental standard before they were accepted for the Regular Force, it is not anticipated a large amount will be involved.
As the platoon will be sailing at an early date it will take some time to arrange treatment at the most economical rates and it would be helpful if you could treat this as an urgent matter.
This was recommended by Treasury and approved by the Minister. Twenty-six men were treated at a total cost of £95. This concession led to the removal of the anomaly whereby different classifications of fully mobilised troops received different dental privileges. On
The platoon left for
In
Herewith dental equipment and materials contained in a Dental Emergency Haversack … for your use and to supplement the dental syringe, needles, local anaesthetic and extracting forceps previously supplied.
The bradawl and floss silk are for the purpose of temporarily repairing broken artificial dentures, the method being to drill holes with the bradawl close to the line of fracture and lace the parts together with the floss silk….
This was only an emergency measure and the DDS was not happy about accepting responsibility for the force without further reducing the prospect of dental accidents. He wrote to the Adjutant-General on
With reference to the above force and the existing methods of selection for and despatch of reliefs, it is submitted that where it affects the dental condition of these soldiers, the position is unsatisfactory and resulting in 50% of this force being made up of men who are wearing artificial dentures. They were rendered dentally fit before embarkation on standard 2NZEF lines and an emergency surgical dental haversack with full technical instructions was issued with the first relief for the use of the medical officer and was replenished whenever it was discovered a relief was embarking, but no provision has or can be made for renewal or repair of artificial dentures without the provision of a full dental section NZDC.
The following is submitted for your consideration and approval please:
That as the Director of Dental Services is responsible for the dental treatment and maintenance of the dental health of the armed forces, it is requested that he be placed on the circulation list by General Staff when reliefs for ‘A’ Company and other special forces are being organised, in order that the question of their dental requirements may be met and arrangements made, where possible, for their dental maintenance.
That in the instance of ‘A’ Company the following dental standard of fitness be laid down.
The dental classification will be:
Dentally fit.
Dentally unfit.
Dentally fit means: No man who is otherwise medically fit will be rejected for dental reasons who has
Normal dental occlusion which may include soundly restored teeth or teeth capable of being rendered sound.
A masticatory efficiency of not less than nine points,
the distribution of the points being left to the judgement of the Principal Dental Officer who will take into consideration the physical condition of the soldier and the length of time the loss of masticatory efficiency has been existent. If a soldier has been able to stand up to the training in a mobilization camp or a heavy regiment of the NZ Artillery, eat three meals a day and be physically fit with only six incisors, a molar on one side and a premolar on the other side, all occluding, he can continue to carry out the duties involved with this force. See Appendix II.
Dentally unfit means: Those wearing or requiring the supply of artificial dentures to remedy a deficiency of masticatory efficiency, taking an absolute minimum of nine points efficiency, or presenting with an oral condition that is considered detrimental to his general health and a menace to his fellow soldiers.
This memorandum had two important results. Firstly, the DDS received the vital information to which he was justly entitled, and secondly, wearers of artificial dentures were debarred from service in places where full dental treatment was not available.
There were men in isolated places other than
On the outbreak of war enemy aliens were interned on
2067 . German Government propose on reciprocal basis dental treatment for civilian internees be provided at the expense of the interning power same as for prisoners of war. United Kingdom Government agree on behalf of their own internees. Please advise whether you agree for New Zealand.
Jordan
The Minister of External Affairs replied on 7 September:
No. 616. Your telegram No.
2067 . We are agreeable on basis of reciprocity to provide dental treatment for civilian internees of German nationality detained in New Zealand. Indeed we would point out that this free service has been given to German nationals during the whole period of their internment.
External
When it is realised that the New Zealand soldiers who were guarding the internees at the beginning of the war were members of the Regular Force, and as such ineligible for free dental treatment, the Government's interpretation of its obligation to enemy aliens was generous indeed. This gratuitous concession put the Government in a strong position when it came to dealing with all the petty complaints which they expected and received. Most of the internees accepted the benefits and appeared grateful, but some refused treatment from the dental officer, demanding attention from civilians, and others considered they were entitled to and demanded dental luxuries. As far as the Dental Corps was concerned, the standard of dental fitness and the treatment offered were identical with those for the mobilised New Zealand Forces.
Among the internees was a German who had been practising as a dentist in New Zealand before the war. He asked the Camp Commandant to allow him to have his dental engine with him so that he could work in the camp. At first sight this appeared reasonable and the Commandant granted it, providing no liability was incurred against the
The policy at present is for dental attention to be provided by the
Army dental section to all internees who require it, on the same scale and up to the same standard as that given to personnel of the armed forces.If permission were granted for the use of this dental engine, it would lead to requests for further equipment, instruments and stores which would involve the Government in an expense which is not justified. The amount of extra equipment which would be involved before an adequate service could be provided would be considerably more than the dental engine now asked for.
It is understood that there are other dentists on the island and there may conceivably be more in the future, all of whom would have equal claims to consideration, which, if not granted, would lead to a plea of favouritism.
Lastly, if the use of private equipment were allowed, a claim for deterioration on account of wear and tear would undoubtedly be made against the Government at a later date.
It is therefore recommended that the application be declined. The DGMS and the DDS are in agreement.
This was written in
It shall be permissible for belligerents mutually to authorise each other, by means of special agreements, to retain in the camps doctors and medical orderlies for the purpose of caring for their prisoner compatriots.
Legal advice was sought on this point. The legal opinion was that, considering there was a very complete service provided by the NZDC, this Article did not create any duty to allow the applicant to treat German internees, who incidentally were only in a bare majority. Apart from the legal opinion, an incident had already occurred which showed the inadvisability of granting the application. Just before being deprived of his instruments, the German dentist had extracted all the upper teeth from an Italian internee who had complained of a vague pain in the incisor region. The dental officer had seen the Italian a month before and had signed him as dentally fit. Apart from being a breach of customary ethics, which mattered little under the circumstances, the dentist's action placed the
In
It was therefore decided that the NZDC section should remain permanently in the camp and undertake all classes of work, which could be done with equal skill and much more expeditiously. The decision as to whether special work was necessary was left to the dental officer, with the right of appeal to the DDS.
This was a considerable concession and placed the internees on a better footing than our own men, who had to pay for special work, as it was considered impossible to implement the decision without providing all materials free. There were still some grumblers but, after explanation by the consul for
In late
In the various reports from the dental officers who examined and treated the internees are some interesting observations on dental conditions and peculiarities. They are insufficient to form scientific conclusions but are worthy of study.
14 February 1941 : I personally carried out a dental examination of internees and in no instance was it considered that dental treatment was urgent. A number of chronic conditions was found, being, it is estimated of some years standing. The general cleanliness of the mouths was bad, the Italians on the whole worse than the Germans.
8 January 1942 : The oral condition of the Japanese was very bad and apparently no attempt had ever been made at mouth hygiene. Practically everyone who did not require full extractions, required very extensive scaling and prophylactic treatment.
13 May 1942 : The oral condition of the Japanese, while showing improvement, still leaves much to be desired.
30 August 1942 : … the oral hygiene of the Italians is not as good as it should be. Nearly half the fillings were for the Germans of the older age group while the percentage of fillings required by the Japanese is small. The Italians without exception dislike dentures and every endeavour has been made to save teeth so that dentures can be avoided. Local anaesthesia is used extensively for conservative work.Racial characteristics have to be taken into consideration when doing prosthetic work. In particular the best results have been obtained with Germans when the setting up is such that a sliding protrusive movement of the lower jaw is easily made. These internees appear to make that movement the test of comfort in a denture, even though better aesthetic, and just as good functional results, could be obtained with a slight overbite.
All the internees who have had dentures inserted express satisfaction with the results.
8 December 1942 : It would appear that oral hygiene of German and Italian internees leaves much to be desired but that of the Japanese is quite good.
The improvement in the oral condition of the Japanese may have been due to the instructions given by the dental officer to their leader, who spoke fluent English. The philosopher might draw conclusions from these reports. The German with his practical outlook demanding mechanical efficiency even at the expense of aesthetic design. The mimicry of the Japanese in his ready adaptation to new conditions, exemplified by his effort to improve his oral hygiene. The laissez faire of the Latin, or should it be status quo?
When Japanese prisoners of war began to arrive in New Zealand they were given the same generous treatment. They were in camp at Featherson in the Wairarapa and were provided with an NZDC dental section as a matter of course, which is in marked contrast to the service received by our prisoners of war in
When the first troops arrived in New Zealand from the locum tenens.
New Zealand, however, was not the front line for the American troops and most of them soon moved up into the
The DDS arranged that those men attached to the
In
A ship that received regular attention from the NZDC was the No. 1 Netherlands Hospital Ship Oranje. She carried an NZDC section which, in addition to being responsible for the
The life of the Corps depended to a large extent on accurate information being individually recorded and collectively analysed. Most of the recording was standardised by the use of printed forms. Reports were daily, weekly, monthly and sometimes annually, each with its definite destination through rigid channels of communication.
Anything not covered in this way was embodied in a written report by the dental officer commanding the section. This report was not compulsory and was often omitted. It may not have appeared, either to the dental officers or to the DDS, to have been of vital importance at the time, but the value to the historian cannot be too strongly stressed. It represented the thoughts and problems of the officers most intimately connected with the details of the NZDC organisation which can never be recaptured by studying impersonal official reports. In this respect the war diaries of commanding officers overseas varied from the bare record of daily routine duties to vital human documents providing richly coloured miniatures to enrich the finished canvas. It should be borne in mind that apparently unimportant details when connected together often produce an answer of the utmost importance. The progress of the Corps in the future might well depend on the faithful recording of every detail, however unimportant it might seem at the time.
THE first commitment of any size made by New Zealand in this war was to send a force of approximately divisional strength to the
The general framework of the dental organisation overseas was envisaged in the light of experience in the First World War. This was a convenient, in fact the only, framework on which to build. That it had to be pulled to pieces and rebuilt could not reasonably be foreseen at the time, any more than that the type of warfare would be so different from that of twenty years before. The Director of Dental Services, a veteran of the First World War, laid down the framework and faced the decision of selecting an Assistant Director to build the new organisation.
He needed someone with some knowledge of past organisation and administration. Someone with initiative and organising ability; fit enough to withstand the rigours of a campaign in a difficult climate; strong enough to pioneer an efficient service and impress on all concerned its necessity; tactful, if known and unknown antipathies were to be overcome; young enough for a young man's war but sufficiently mature to have his judgment respected and his authority unquestioned. He chose wisely from among the dentists who volunteered for service at the beginning of the war.
James Ferris Fuller, BDS, had graduated at the
The story of the NZDC with
Captain Fuller's appointment to ADDS was gazetted on
You are privileged in being included in the Second New Zealand Expeditionary Force and you were chosen with the knowledge that you would uphold the honour and tradition of your Corps and conduct yourselves as officers and gentlemen. This is also an opportune moment to thank you for the loyal and strenuous service you have rendered under adverse conditions, the least being inadequate equipment and accommodation….
Overseas you will be responsible to the Assistant Director of Dental Services for the dental treatment of the troops. He will issue his ‘Instructions to Dental Officers’.
With the strictest observance of Service Regulations and Procedures, the continuance of the loyalty and co-operation you have shown, so will that essential
Esprit de Corpsbe built up and the traditions of the New Zealand Dental Corps and your profession upheld.
B. S. Finn,
Lieutenant-Colonel,
Director of Dental Services,
Army and Air
Army Headquarters,
1 January 1940
The lack of written instructions in itself was not serious as it was certain that much of the organisation would have to be left to the initiative of the ADDS. There was, however, a looseness of definition in the appointment which added to his administrative difficulties. It is presumed that it was intended that Captain Fuller was to be ADDS of the 2nd New Zealand Expeditionary Force about to assemble in the
The First Echelon embarked on six transports at
For the purpose for which they were issued, the haversacks were a success, but in the light of experience they fell short of the ideal. On the other hand, it must be remembered that there was an acute shortage of dental equipment in New Zealand, where the bulk of the dental work at this time had to be done. A comparison between the instructions issued by the DDS and the report by the ADDS on arrival in Egypt shows the intention, the practice, and the degree of success of the dental service on these first transports to leave New Zealand.
Your duties on board H.M. Transports are of necessity limited to the alleviation of pain and dental treatment of an urgent nature as dental equipment is not being sent out of New Zealand. However, an emergency outfit has been fitted in a Dental Emergency Haversack and has been placed on Stock Ledger Charge to the Ship's Quartermaster for your use on the voyage. You will be responsible that this haversack is handed over to the quartermaster prior to disembarkation accompanied by an indent for any shortages.
You will attend at all sick parades on board and co-operate with the Medical Officer in giving necessary dental attention and keep a record on Form N.Z.D. 3 (to be entered in the same form in your Day Book which you will receive at the N.Z. Base Depot).
You will strictly observe ‘Ship's Standing Orders’, be responsible for the discipline and supervision of the ship-board duties and training of your other ranks and also take your part in the ordinary routine of duties.
The dental emergency haversacks in themselves were excellent and satisfied all demands for the purposes for which they were issued, i.e., dental treatment of an emergency nature. It is felt, however, that for a voyage of practically six weeks duration there should be facilities available for treatment of a more comprehensive and permanent nature. The main dental problem on all transports is that of broken dentures; tiled bathroom floors and similar conditions increase the number of broken dentures and with a force in which 50% of all ranks are wearing artificial dentures, the percentage of denture casualties must inevitably be high. It is considered then that in a voyage such as this, equipment should be carried sufficient to enable repairs to dentures to be carried out.
Again, there were patients presenting with toothache where extraction was the only treatment for the reason that facilities were not available to enable old amalgam fillings to be removed and a dressing inserted. In the absence of more detailed equipment there should at least be foot engines and necessary other items on transports to enable these cases to be dealt with satisfactorily.
In instances where soldiers present for treatment and will require further treatment on arrival at the overseas destination it is essential that dental officers note details of work required and number, rank, name and unit of patient. From these lists it is possible to organise a satisfactory system of calling up patients. Urgency should also be noted.
As a guide to the future the recommendations of the ADDS were of value, but with the equipment position as it was in New Zealand at that time, vulcanisers for denture repairs and foot engines were in the shortest supply. At this time nearly all dentures were made of vulcanite.
The work done on the four transports carrying dental officers was:
Perversely, the largest number of dental casualties was on the two ships not carrying dental officers.
The convoy stopped at
There were two camps under construction near
One of Captain Fuller's first calls was on Lieutenant-Colonel O'Connor, ADDS of the British Troops in Egypt (BTE), and in this he was fortunate. Colonel O'Connor lent him two complete field dental outfits and one prosthetic one, withdrawing them from his own units for the purpose.
The accommodation question was not so easily settled. On discussing the matter with the British DCRE (Deputy Commander Royal Engineers) he was told that after submitting a plan for a hospital it would be about two months before the building would be ready for occupation as the application would be at the bottom of the list of priorities. He then tried the New Zealand CRE (Commander Royal Engineers), whom he had met on the voyage, apparently approaching him at a propitious moment for it was arranged that his sappers, as an exercise, would erect the building immediately, provided timber could be supplied. With Colonel O'Connor's assistance a plan was drawn, based on a simple standard living hut, timber was forthcoming, and the ADMS (Assistant Director of Medical Services) gave his approval for camp dental hospitals to be built at
The dental officers with the
Captain E. B. Reilly, attached to New Zealand Base Depot.
Lieutenant W. McD. Ford, attached to 4 Field Ambulance.
Lieutenant C. C. S.
This rigidity of allocation was in line with past policy, when it was usual for dental sections to be attached only to medical units. It was at variance with the ADDS's conception of the organisation, which was one of fluidity of movement throughout the whole force. It should be explained here that, although the ADDS was appointed on the advice of the DDS and was dependent on him for his
It is possible that if the equipment had arrived on schedule from the
He therefore set up a temporary camp dental hospital in the general Base Depot area consisting of two marquees, one surgical and one prosthetic. The two dental sections were withdrawn from 4 Field Ambulance and transferred to the Base Depot, allowing each officer to concentrate on a particular branch of his profession as well as to train his men in general and specialist duties.
This decision can be regarded as the birth of the new organisation, slightly premature by force of circumstances and consequently to be carefully nurtured. The DDS had to be told of the change so that reinforcements would feed, not poison, the infant. Official channels of communication were too slow so Captain Fuller, with the sanction of the ADMS, wrote unofficially by airmail asking that all officers in future reinforcements be sent without rigid allocation, ‘so that I can concentrate them without any movement difficulties according to units and work presenting in the respective camps.’ With the establishment of a service capable of satisfying all immediate demands of the force, there was time to examine the general position in more detail.
Accommodation had already been arranged in the shape of two camp dental hospitals, each capable of providing nine chairs. Short of supervision of the construction, which actually proved to be very necessary, this problem could be temporarily forgotten. The chief worry was over equipment. It was intended to draw supplies from England on the lines of those used by the Royal
Already it was becoming apparent that the final solution to the problem was going to be a pooling of equipment from all sources and a re-issue on standard lines to an original and new design. Before reaching the smooth waters of standardisation, however, many tributaries had to be explored, all of which added their quota of interest and played their part in the simplification of a bewildering problem. Comment made at the time, when the mind was unbiassed by a knowledge of the solution, gives the only true picture and is reproduced for that reason, shorn only of tedious repetition and occasional picturesque phrases incompatible with an official history.
We have been able to realise the limitation of the R.A.D.C. Dental Outfits. I like their chair and case which is both light and extremely efficient regarding attachments and movements etc., and also the type of pannier with the collapsible front and removable metal cabinets of instrument trays. However your outfit, even though it is so much smaller and lighter, is infinitely better equipped, more practical and far more use in the Field. It is not possible to open out these outfits in the Desert for example and begin work, in five minutes. Tables, kidney bowls, dishes, primuses, buckets etc., have to be borrowed or stolen (Mostly the latter at the moment) before one can commence. In other words it is obviously designed for use in units where such items can be easily supplied, e.g., Field Ambulance, General Hospital etc. I was gathering further information from Colonel O'Connor today and, as he points out, they have no one in advanced positions in the field, they are at the moment very worried about the denture question in the field, examination of dental cases etc., and are looking for the solution —their solution, as he realises, is in your scheme.
The dental engine in the R.A.D.C. pannier is contained in a special metal case and will not fit the compartment in the New Zealand type. If you are sending our panniers you will have to send them with engines— otherwise let me know and I will see if they can possibly be procured from England. You will need to include both engine and cabinet. An engine cannot be fitted into the R.A.D.C. pannier so that if you are not sending our panniers I will either have to use two panniers or design a new one based on available B.T.E. dental equipment. The R.A.D.C. equipment should be ideal for Base units and for equipping the Divisional Dental Hospital.
Your cable for list of equipment that is being sent may be answered in one word. ‘None.’
I am sending you eight surgical panniers with engines (Straight Hand-piece and Contra-angle Handpiece, at great sacrifice so don't expect any more handpieces), cabinets, and not one other article.
The stores panniers will have nothing in but basins, eight chair cases, chairs, collapsible wash basins, dental officer and oral hygiene signs, pendant and pole, two blankets and any other darned thing we can spare and that is not saying much.
The list of equipment being forwarded from New Zealand with the Contingent (Second) is given. A list is given of the total equipment (Dental) requested from ‘Liaison’
Code word for New Zealand Military Liaison Officer,
London .London for the Dental Services with the2 NZEF . This latter list does not agree with previous information from New Zealand. The equipment issue is becoming confused and after discussing the matter with the A.D.M.S. it has been decided to write to ‘Liaison’ stating the position and asking for verification of the information in the above cable and elucidation of other doubtful points.
The problem can be summarised:
Royal
Owing to differences in design between British and New Zealand panniers, certain essential equipment such as engines and instrument containers were not interchangeable.
Sources of supply would be mainly British, supplemented by selected items from New Zealand, if and when procurable.
Very little was available from local purchase but some articles such as folding tables and similar furnishings could be made when time permitted the drawing of designs.
The urgent need was to collect equipment from every source, break bulk and re-issue to a new standard more closely related to the needs of the New Zealand Dental Corps. It was an attempt to simplify the issue by viewing the dental treatment of mobile and static troops as one problem from the professional angle, establishing a standard minimum scale of issue for every section wherever employed, and regarding specialist equipment as something to be added to this when circumstances so demanded.
This was the appreciation of the situation at the time and was, of necessity, theoretical, although in the light of experience in the
Apart from the equipment problem, there were daily questions affecting the general organisation requiring careful answers if the proposed service was to reach maturity in anything like the form in which it was visualised by the ADDS. Heads of all units were busy with their own problems and it was difficult for a junior captain in charge of a service on the outer fringe of the administrative circle to demand attention from brigadiers and colonels. Energy and perseverance, combined with idealism and a clarity of perception, broke these barriers and won respect and acknowledgment. Some of the early problems are of interest.
Discussed the artificial denture problem with the A.D.M.S., in particular the steps that might be taken to reduce the number of broken dentures presenting daily. It is felt that many of these are being wilfully broken and that steps should be taken to make it clear to soldiers that in cases of this nature repairs and renewals will not be undertaken at the public expense. Also discussed the position regarding oral hygiene and the uncared-for condition of the mouths of the majority of soldiers presenting for treatment.
As a result orders were promulgated by the GOC on both subjects similar to those existing in New Zealand. (See Chapter 11.)
A.D.M.S. will not authorise the use of the standard Oral Hygiene bench as used in New Zealand and objects, in particular, to the uncovered buckets.
A standard bench was designed, capable of being erected by sections where other facilities were not available and sufficiently small to be carried in the panniers.
Ascertained that new paybooks (AB64) are to be issued and that the finalised copy is already about to be printed. No provision has been made for space to insert particulars of artificial dentures supplied and steps had not been taken to replace N.Z. 361A, at present in the New Zealand paybooks. Discussed the position with the Paymaster and finally with the Assistant Adjutant and Quarter-Master-General. The latter is not prepared to print a page similar to N.Z. 361A but will insert a space similar to that in the British paybook and headed ‘Particulars of new dentures supplied’.
This emphasises the administrative wilderness in which the ADDS was wandering. It is remarkable that anything affecting the Dental Corps was not first referred to the head of the service for comment, and inconceivable that, had the ADDS been included in the ordinary distribution list, such an oversight could have occurred.
Letter received from D.D.S. to the effect that twelve officers, twelve orderlies and four mechanics are being sent with the second echelon. The dental condition of the force in relation to examinations in Egypt does not warrant this number of officers as filling work will obviously be of little concern for some time. The denture problem on the other hand necessitates a greater number of mechanics. The A.D.M.S. agrees with this opinion and A.H.Q.
has been cabled to the effect that six officers and six mechanics are recommended for the second contingent.
Army Headquarters.
The result of this cable was that seven officers, seven orderlies and two mechanics sailed with the
I still think, sir, that the number of dental officers should be kept down, both on account of the excellent dental condition (of the Force) and also as a matter of policy, otherwise the axe will go through something….
Dentures are a different matter—in fact alarming—and we cannot reduce a tremendous waiting list. It was for this reason that I recommended six mechanics with the six officers….
To me here it is a matter of tactics since I have the impression that the Division think we are going well over requirements. It seems to me better to be able to say that we cannot cope with the work than to have them think that we are overstaffed.
I notice your remarks regarding the amount of work presenting and am worried that you will let this influence you—as is evident by your last cable asking me to reduce my quota of 12 officers, 16 other ranks. It is too late
thank God for I assure you in three months' time you will be very grateful for them…. You talk of officers not being able to find work. What is the matter with their doing prosthetic work? It had to be done in the last war and certainly can be this time.
There was a noticeable disinclination on the part of the DDS to relinquish control, possibly from anxiety to shield the fledgling from familiar potholes of the past. Most of the potholes had been filled with the sands of time, while the wheels of progress had carved new ruts for only the present to see.
One of the main lessons learned in administration of the Dental Corps in this war was the folly of prejudging a situation without proper allowance for changing circumstances. This was borne out on many occasions, with the result that too many square pegs were designed for round holes. An example of this was the New Zealand Mobile Divisional Dental Hospital which the DDS proposed to establish, design, staff and train in New Zealand for attachment to
The unit was based on one that came into existence in the First World War to operate within the Division in addition to the orthodox establishment of the dental sections attached to the field ambulances. It was to be a self-contained unit and was to be trained in New Zealand. The intention of the DDS was that it should operate with the Division and have its own commanding officer separate from the ADDS. It was expected to arrive in Egypt with the
Headquarters' request for a report was the end of the first stage in the establishment of the Corps with
All ranks are being rendered dentally fit before leaving for Egypt and to achieve this there is one dental officer to every 200 men in camp in New Zealand.
The object of the Dental Corps overseas is to maintain all ranks dentally fit, to prevent a return to the uneconomical condition that mouths were in on enlistment, and to justify the … expenditure in New Zealand.
With the first contingent the basis is one dental officer to every 2,000 men. (Three dental officers apart from the A.D.D.S.)
With the second contingent the basis will become one dental officer to every 1,000 men overseas. (Arrival of seven dental officers.)
With the third contingent the basis will become one dental officer to every 600 men overseas. (Arrival of twelve dental officers.)
Thereafter the dental personnel will be such that there will be a basis of one dental officer to 600 and one mechanic to 1,200 men. [This ratio was changed later.]
This figure is an international one and is considered by the profession to be that necessary to maintain dental fitness.
The allocation of personnel will probably be as follows:
|
| Convalescent Depot 1 dental officer | |
Inf. and Gen. Base Depot | 1 dental officer | |
General Hospital | 1 dental officer | |
Field Ambulance | 3 dental officers | |
Divisional Dental Hospital | 8 dental officers | |
Total | 14 dental officers | This will leave a surplus of eight dental officers to be used as a ‘Pool’ and to be used in training camps etc., to augment units requiring additional dental personnel, e.g., should there be 700 men at Base, one dental officer will be attached. Should there be 3,000 it may be necessary to attach five dental officers.
Training Camps.
The policy is to establish camp dental blocks in training camp areas, NZDC personnel being temporarily detached from their units such as Field Ambulance etc., this arrangement not only enabling the maximum number of dental officers to use the minimum equipment but also enabling the maximum volume of work to be done with the least interference with unit training programmes.
Convalescent Depot .One dental officer, one orderly and two mechanics. This section is fully equipped and it is proposed that all ranks be examined on arrival at the depot and rendered dentally fit before returning to their unit or other formation, i.e., the soldier returns dentally as well as medically fit. The attached personnel can be augmented depending on the work presenting.
Infantry and General Base Depot.
One dental officer, two orderlies and one mechanic. As above it is proposed that all ranks be examined on being taken on the strength of this unit and, as far as practicable, rendered dentally fit before proceeding to the Field. The attached personnel can be augmented depending on the amount of work presenting.
Reserve Depot, Command Depot, etc.
If and when these are established, dental sections will be attached and a procedure similar to the above adopted.
Discharge Depot . (When established.)It is submitted that all ranks to be discharged should be returned to New Zealand dentally fit and to this end, and when work warrants it, a dental section will be attached to the depot. In the meantime the section attached to Headquarters
2 NZEF Base will render these men dentally fit.General Hospital (600 beds).
One dental officer, one orderly and one mechanic.
Dental Arrangements with the Division.
Field Ambulance Sections.
One dental officer and one orderly. The dental outfit with the Field Ambulance equipment has no provision for repair or replacement of broken or lost dentures.
A van, 12 cwt., 4-wheeled, is provided for the dental officer and his equipment. The above is in accordance with RAMC establishment.
Mobile Divisional Dental Hospital .50% of our troops are wearing artificial dentures, a feature peculiar to New Zealand troops. Denture casualties were a problem in the last war, and already more denture cases are presenting in a month with 6,000 men than present in three months with two Divisions of British troops in Egypt.
It is obvious that the Field Ambulance Sections are unable to deal with this problem, neither can they cope with the bulk of surgical and filling work that is present with troops. Without some other arrangement the evacuation of dental casualties is inevitable. For this reason the
Mobile Divisional Dental Hospital is once again being established.I have to admit that as yet I am not familiar with the details of this unit but expect details to arrive from New Zealand at any moment. The establishment is eight officers and twenty-six other ranks including cook, batmen and drivers.
According to a communication from Colonel Finn the unit is completely self-contained with its own transport. The fully equipped body and personnel are arriving with the third contingent. The chassis for a 3-ton Leyland Lynx lorry is
due to arrive from the United Kingdom in June. All available information is contained in notes written by Colonel Finn. I have revised these and enclose a copy.
J. F. Fuller,
Captain, NZDC,
ADDS
Egypt.
14 April 40
Colonel Finn's notes are included later when the details of the formation of the Mobile Divisional Dental hospital are discussed.
This report was well received and undoubtedly helped the Corps to gain a foothold on the administrative ladder. It received the following reply:
Memorandum for:
ADMS
The statement produced by the ADDS covering the distribution of the dental sections has been perused by the Comd. NZ Div., who wishes to express his appreciation of the clear manner in which it was set out.
The following comments are made:
Only one General Hospital appears to be allowed for but there appear to be ample officers in the ‘Pool’.
The ‘
Mobile Divisional Dental Hospital ’ while an excellent idea in principle, cannot in fact be either ‘Mobile’ or ‘Divisional’, in the true sense of the words. With a highly mechanized fast moving Division it would be very difficult for such a hospital to function as a real integral part of the Division. What would, in fact, happen would be that the hospital would proceed to the Overseas Base and there would wait until the Division came out for a period of rest. The hospital would then move up and commence operating. I gather that, in fact, it cannot function efficiently without remaining in one place for at least a week.The memo. from the DDS New Zealand is clearly based on memories of Trench Warfare in
France .I think the term ‘Divisional’ must be dropped. ‘Mobile’ could be retained and the hospital be known as the ‘Mobile Dental Hospital’.
W. G. Stevens,
Maj-Gen W. G. Stevens , CB, CBE, m.i.d.; England; bornLondon ,11 Dec 1893 ; Regular soldier; NZ Fd Arty 1915–19 (Maj); AA & QMG, NZ Div,1940 ; Officer in Charge of Administration,2 NZEF , 1940–45; GOC2 NZEF , 22 Nov 1945–6 Jul 1946.
Lieut.-Col.
AA & QMG
19 April 40.
With the formation of a Headquarters
All recommendations regarding dental arrangements and treatment with the
2 NZEF will, as at present, be referred to the ADMS or the Senior Administrative Medical Officer for his approval.
It can be seen that the ADDS was working on definite lines to establish a dental service for the whole force of extreme mobility, without any rigidity of allocation of personnel to any one unit. His views were receiving a sympathetic hearing from Force Headquarters and he was writing long letters to the DDS in New Zealand keeping him informed of progress. It soon became obvious that these letters, written from a sense of moral obligation to keep the DDS fully acquainted with the situation and to solicit his support, were adding to his difficulties. The DDS apparently regarded the radical alteration of his organisation as revolutionary and retrograde and attempted to influence the position by enforcing the rigidity of attachment originally suggested. Radical and revolutionary it was, and it created problems for the DDS in the provision of personnel and equipment, bound, as he was, to the shibboleths of the past and under an obligation to justify the quantities of his selection. His long experience and profound study of warfare made him hesitant to acquiesce in the demolition of an organisation that had won admiration in the past, but it could not be disguised that the possibility of changing circumstances might make it inevitable.
I note you say ‘Don't allot the personnel, but leave it free’ and I agree and will when the Division is formed, but have to allot personnel to Field Ambulance, General Hospital,
Convalescent Depot and, of course, theMobile Dental Section , but the balance I have marked as Base Depot and will [include] in the reinforcements. The Mobile Unit will not be broken up as they will all be selected and trained and MacKenzie will command not you as I stated in the original notes to ADDS and GOC. You have got your own job and cannot handle a unit like this…. you of course must see that you are at Base for no move has apparently been made to provide the ADDS Division as I asked. MacKenzie will have to be advisor to ADMS as OC Mobile Unit. The Unit (Mobile) as a whole can always be moved in its entirety and always be ready to divide up when war conditions admit and should never have to be left out of the movements of the Division and I see no reason why it should ever leave the Divisional area.Keep to the figures you quote as necessary to maintain dental fitness (one officer to 600) which I agree with and was working to until your cable came. Don't forget that you cannot draw on the Mobile Unit for any personnel nor the Medical Units. If you want officers or mechanics in addition to what is already on the stocks, be definite in your demand and I will get them away, but I should be warned in plenty of time if possible.
The Officer Commanding the Mobile Section is the link with ADMS and responsible to you through him.
There was no advantage to be gained by attempting to reconcile such fundamental differences of opinion and the ADDS had to content himself by relying on the security of his appointment within the
A decision has been made regarding movement and distribution of dental personnel in conditions such as this where the Force is concentrated in two training camps and where the General Hospital,
Convalescent Depot and Field Ambulances do not function in their normal manner. All Dental Corps personnel will be concentrated in dental blocks, one in each camp; the distribution of the personnel in the respective camp dental hospitals will be dependent upon personalities, ability etc. Dental Sections as shown on embarkation from N.Z. will not necessarily remain intact but may be reformed according to the ability either of the officers or other ranks. Thus it is essential that the NZDC be established as a separate unit to facilitate movements in particular and administration in general. To this end all NZDC personnel will be transferred from their present units to HQ2 NZEF Base on arrival. They will then be attached to Camp Dental Hospitals (or units requiring dental services) for duties and to neighbouring units for pay, discipline, rations etc. Dental sections with medical units will be reformed at a later date depending on requirements.
Already a decision had been made that, on the arrival of the
On
The position can be summarised under four headings:
Dental condition.
Equipment.
Administration.
Reallocation of personnel.
The Second Echelon had been treated by the NZDC in the mobilisation camps in New Zealand and could be presumed to be dentally fit, requiring little but maintenance with the exception of the denture casualties inseparable from a force of New Zealand troops. With the
The dental condition of the Force in regard to tooth cavities appears to be very good, although it will be realised that in the absence of an examination of all ranks, the only gauge is the rate at which the soldiers present voluntarily either with toothache or with the subjective knowledge that cavities are present.
It is now five months since they were rendered dentally fit. It is a conservative estimate that all members of a community require examination and treatment half-yearly and with New Zealanders in particular, cavities will develop in a shorter period.
It should be assumed therefore that although soldiers are presenting voluntarily for treatment there must, in addition, be an increasing number of men with dental decay that has developed since embarkation.
The number of daily patients, either with toothache or for fillings has increased since the last report [
25 March 1940 ].Dentures continue to be a problem and unaccountably continue to present at the rate of 6 to 8 per day. It has not been possible to reduce a waiting list that has been present since arrival in Egypt.
The most striking difference between the mouths of the Force when in New Zealand and their condition in Egypt is the unhealthy condition of the gingival tissues (gums) and it may be stated that this feature is the most noticeable impression received by the NZDC officers in the course of their daily duties and in reference to which they feel concerned.
The percentage of men presenting with inflammation of the gingival tissues is large and on the increase. They invariably show complete neglect of the toothbrush and inattention to the principles of oral hygiene.
The causative factors may be:
Inattention to oral hygiene measures, in particular, the toothbrush.
An infectious condition conveyed by drinking vessels, utensils, etc.
A general lowered resistance as a result of the sudden change in climatic conditions, environment, etc.
Whatever the cause may be it is evident that this septic condition must inevitably result in a general lowering of the resistance and increase the susceptibility towards alimentary and respiratory infections…. Cases of ulcerative stomatitis (Trench Mouth) have not developed although, as pointed out in my last report, most predisposing factors are present. If it should commence, there is every reason to expect that it would become prevalent to a marked degree.
Since my last report it has been increasingly difficult to maintain a regular attendance of patients. With the intensification of training this is, of course, unavoidable and in this respect, Brigade exercises in particular resulted in two quiet periods. Extended leave at Easter has also to be taken into account.
Captain Fuller's predictions were based on sound principles but fortunately were not substantiated, and the dental condition of the
There was sufficient equipment in Egypt for the existing personnel but more was on order from England in anticipation of the arrival of the
When the
The ADDS nominated the senior officer, Lieutenant J. R. H. Hefford, to act as his deputy and to be responsible to him through the ADMS for all arrangements. He sent by the hand of the ADMS full details of the organisation of the dental services with
Nominated the senior officer to act as my deputy and to be responsible through the ADMS to me for all arrangements. Have indicated that his responsibilities should be limited and that in so far as they are relevant ‘Instructions to Dental Officers
2 NZEF ’ must be strictly adhered to.
His apprehension was well founded, as will be seen when the account of the dental service with the contingent is given later. At the time nothing could be done about it.
The Second Echelon being dentally fit, or virtually so, one dental officer to
This reallocation was dependent on two factors:
That the disposition of the contingents remained static.
That the war situation allowed communication of men and equipment between England and the
At the time, it appeared as if the
Although full instructions were sent to the Senior Dental Officer by the ADDS, he was not given the opportunity to implement them or to overcome opposition. The result was that matters were taken out of his hands and the dental services became subservient to the medical, whose preoccupation with their own affairs is reflected in the relegation of the importance of dental treatment to a lower level than that in any New Zealand
The Second Echelon did not join the Middle East Force until early in
A … scheme of dental attention was put forward by the Senior Dental Officer…. The NZMC Administrative Officers dismissed the scheme and the NZDC personnel were left in localities completely out of touch with the troops.
It was not until practically six months later that the dental sections were placed with the troops where they carried out yeoman service, worked strenuously and rendered Units reasonably fit. A good example of the lack of assistance given to the NZDC was the fact that during the whole time the troops were in England, dental officers operated without gowns and for the most part without towels and soap…. The following extract from a report on the Service in the
United Kingdom by the Senior Dental Officer illustrates the atmosphere which prevailed.The
Army Dental Corps has extended to the NZDC every facility it could possibly offer us, has explained to us its system of operation and on many occasions their laboratory has done urgent repairs or vulcanisations for us.Most units of the NZEF have done their best to assist us and have been very tolerant in the matter of having to carry their men considerable distances for treatment.
The attitude of certain officers of the
NZMC however has been consistently hostile….It is obvious that the dental officers were working under unhappy conditions and [that] one and all realised that given the necessary authority they could be of more service to the troops. Under conditions such as this, the service could only be efficient either by being separated from the
NZMC or, if responsible to theNZMC , then only in the matters of policy affecting the health of the troops.Despite the above remarks, it must be realised that, as far as their specialist duties were concerned, the officers worked to capacity and individually carried out a good deal of treatment under adverse conditions. In the
United Kingdom , Units were dentally examined and made fit. On board transports, between theUnited Kingdom and Egypt, all Units were dentally examined and an appreciable amount of routine treatment was completed.
The original intention to attach dental sections to units in the
The delay in implementing a satisfactory dental service was fatal to the hopes of landing a ‘dentally fit’ force in Egypt. Even when the echelon was on the transport from England to Egypt, a journey of over nine weeks, the leeway was too great to be overcome under the difficult conditions on board. Excerpts from Captain Hefford's report on the voyage give some idea of the conditions of work and the dental state of the force:
The ship carried approximately 2,800 troops. There were three dental officers with three outfits and a kerosene vulcaniser. Accommodation was provided in two cabins with one porthole in each. The light was supplemented by extension electric lights. Being close to the side of the ship, the deck in these cabins had a considerable slope on it, making work in the field chairs difficult when the ship rolled, as it did in fairly moderate seas, being built with a flat bottom for the St. Lawrence River.
As no cards were available, the findings at examination were added on the side of specially prepared nominal company rolls. The amount of work required for each man was noted. Also whether he had artificial denture or dentures.
In addition natural dentures were classified as:
Teeth with a reasonable prospect of being retained for some years.
Mouths which, generally because of advancing ‘Gum’ degeneration, would probably require total extractions in the next two years.
Those cases where immediate extractions were indicated.
The examination was carried out on deck. It was not considered necessary to ‘Mop up’ those men who were not examined on the original days as the prospect of getting all the work done was never entertained.
The filling work showed a preponderance of interproximal fillings largely in lower premolars and upper molars.
Taking into consideration that the force was dentally fit on embarkation from New Zealand and had never been without a generous proportion of dental officers, the dental condition should have been better. It emphasises the danger of allowing work to accumulate. With the large number of artificial dentures, in this case 2185 single dentures in 2265 men examined, there will always be repairs and remodels as well as replacements of those lost. A soldier dependent on artificial dentures will obviously be less efficient without them and any delay in remedying that loss must react on the efficiency of the force as a whole. Dental caries is a progressive disease and the preponderance of interproximal cavities in the mouths of those examined above shows that the progression had advanced to a stage when a proportion of those teeth might have to be extracted. The ground was being prepared for more denture-wearers.
It is now necessary to return to the Egyptian scene of
At the beginning of June the troops were still in
The ADDS was anxious to try out the field organisation as soon as possible, and when two battalions and other troops moved to the region of
A certain amount of confusion was evident between Egypt and New Zealand regarding the amount and nature of equipment received from England, as well as of the number and status of reinforcement personnel required. There were several factors responsible for this. The exact nature of the War Office issue of equipment was not understood by the DDS, which made the cables from the ADDS, based on a presumption of this knowledge, unintelligible. The destination of the
The opportunity was now approaching to try out the organisation in the field. At the end of August the Division, as yet only of brigade strength, moved to the
Field dental outfits were measured and weighed to give information for loading tables. Mechanics practised packing and unpacking panniers. The dental sections to be attached to the field ambulance practised loading and unloading the 15-cwt lorry, which was to carry one complete section with surgical and prosthetic panniers, tent RD (Ridge, Double), personal kits, etc.
It was not possible to organise anything but a temporary service in the field at this stage but valuable information could be got as to the future role of dental sections, both with the field ambulances
The orthodox British dental establishment was found to be insufficient under field conditions, lacking flexibility and mobility. The break away from the traditional organisation was already paying dividends and attracting attention.
On
Reports from the Dental Sections attached to the 4th Field Ambulance in the
Western Desert indicate that the two dental officers are being of invaluable service to all troops in their area. The sections were carrying out routine treatment within the first twenty-four hours of arrival at the camp site and have since been very busy. Reports from outside sources relate that Senior British Officers tend to be impressed by the fact that the Field Dental Section is carrying out routine denture work in the Field with little or no difficulty. It seems essential that facilities be available for doing denture work in the Field and I cannot understand why on such a long line of communication, the British Dental Sections do not carry prosthetic equipment. The Dental Officer attached to Headquarters Company, 4th Field Ambulance (Lieut. W. McD. Ford) reports ‘BritishArmy equipment(is) quite satisfactory for a Standing Camp but in my opinion has to be augmented by too great an extent from QM Stores and then becomes too bulky for rapid movement. This is an unsatisfactory factor…. The New Zealand outfit would be ideal with its two panniers containing a minimum of essential equipment; especially the chair case with the collapsible table, canvas buckets and canvas wash basins…. This would eliminate having to rely on the Field Ambulance quartermaster for equipment…. The prosthetic outfit we have here is working very satisfactorily; the lathe head works very well with the treadle of the foot engine.’
In regard to the lathe head working well with the treadle of the foot engine, this was later found to be incorrect as there were frequent fractures of the treadle through overstrain. This was overcome by buying locally some hand-operated mechanical grinding machines. The emery wheel was removed and replaced by lathe chucks. These were included in the mobile field panniers. The gearing was such as to produce enough speed for polishing.
One of the difficulties of pioneering is to gain recognition of the new order by others. No dental scheme, however soundly conceived, could be put into practice unless it was recognised as part of the general organisation of the force. Hitherto, dental sections were attached to medical units and moved only with those units. Movement orders therefore only affected Mary and not the lamb. When it was realised that the dental task could not be accomplished under the limitations of this rigid attachment, it was not immediately appreciated that another unit had to be considered when movements were taking place. The Administrative Instructions No. 1, ‘Action in event of move of Division from
On
However, the exact number did not affect the general arrangements and he was able to outline his proposals at a conference of heads of services with the AA & QMG on 1 September. His diary of that date reads:
Submitted scheme as follows which was approved:
Present Camp Dental Hospital at Base to become
Base Dental Hospital , to be responsible for rendering all reinforcements and ex-hospital patients dentally fit before proceeding to the Field and that all personnel returning to New Zealand are also rendered dentally fit.The Divisional
Mobile Dental Section which is a self-contained unit to be located in a central camp area, to establish a tented Camp Dental Hospital and be responsible for the dental fitness of the third contingent in addition to carrying out a training programme.The ADDS's office and store to be transferred to Administrative Headquarters
2 NZEF located in a new building which will have accommodation for dental officers. This building would be used as a dental hospital when the camp is filled with reinforcements and the Mobile Section is in the Field.
The Base was to be at the extreme end of the camp area while the new office and the tented camp dental hospital were to be centrally situated. The ADDS was unable to advise about equipment as he was still in the dark as to what was being forwarded from New Zealand with the echelon, or if that originally ordered from England was coming soon. He could only assume that these matters had been satisfactorily arranged between
His plan for Dental Headquarters consisting of ADDS's office, NZEF store and reinforcements camp dental hospital, as well as the site, were approved. For the
The
On 29 September, in company with the ADMS, the ADDS went to
As already stated, there were more reinforcements than the ADDS expected, but this was not all. The echelon had brought no dental equipment with it, with the exception of the mobile laboratory, and even that had been left in
Dental officers with third contingent attached Base marched in. Equipment from the
Convalescent Depot is to be drawn and this will be issued to theBase Dental Hospital . Pending the arrival of equipment from England for theMobile Dental Section theBase Dental Hospital will have to work to capacity to cater for the requirements of the Third Contingent in addition to its normal routine duties. General Hospital,Convalescent Depot and 6th Field Ambulance will have to remain without equipment in the meantime. TheMobile Dental Section will occupy time with Field Training.
The
Informed all officers very frankly what was expected of them overseas as regards discipline, general demeanour and standards of dental treatment. It was very clearly emphasised that as much time and trouble must be given to treatment overseas as would be given to treatment in private practice. That when at the chairside they must consider themselves ‘Civilians in uniform’ and treat the men with all sympathy and understanding. When away from the chairside they must lose that self-consciousness associated with specialist officers in uniform and make every endeavour by the observance of military procedure to give their rank a military status at least comparable with that of other units.
There was nothing new in these remarks as they were impressed on all dental officers in New Zealand, but they are repeated in this context to show the importance attached to them in every sphere of operation. They also showed very definitely that the ADDS was determined to uphold the good name of the Corps and that defaulters from the strict code would be answerable to him. There were some defaulters, almost entirely in this transition period when work was not arduous, but on the whole there was little trouble and it can safely be said that eventually there was no happier service in the force.
The arrival of the
In
The unit has an establishment of 8 officers and 36 other ranks.
In the Field the main function of the NZDC is to maintain the dental health of the soldier and the orthodox establishment of one section attached to a Field Ambulance cannot cope with the work, especially as in any Force we are likely to raise for an expeditionary force, there will be, at a low estimate, 50% of artificial dentures worn. Knowing that in front line troops the fear complex will always exist, that dentures are readily broken and as easily lost, and that dental pain weakens a soldier's morale, it is acknowledged that there is a wide field for malingering, also that a soldier wearing an artificial denture is a potential casualty unless some provision is made to provide dental service as close as possible to the line. Experience has proved that once a soldier was evacuated from the fighting zone for dental defects, it was problematical when his company commander would see him again. In the last war the solution was the NZ Divisional Dental Hospital which was almost continually located in the
Divisional Headquarters area with its surgical sub-sections detached to various unit headquarters and diverting the denture work back to the Main Hospital Group. Dental pain was eliminated, dentures replaced and repaired in a few hours whilst the soldier was kept on the strength of his unit.The unit is self-contained, carrying its own reserve stock of materials and water, a fully equipped surgical and prosthetic dental outfit, tent operating and ridge tents, operating its own motive power, light and a Bottled Gas installation for heat in connection with prosthetic work. It accommodates five dental mechanics and two mechanics' orderlies. Two officers carry out their duties in tents which are pitched alongside the lorry—tent (operating) being available and as accommodation for troops under treatment. The remaining officers with a surgical pannier and chair case are attached to various unit headquarters and work in tents.
With its mobility, the personnel and plant are ready at all times to be utilised for any class of dental work and can be attached temporarily to any unit of the Force close up to their war stations, including the Non-Divisional units. It can augment the personnel of the Field Ambulance Section if necessary and the two in conjunction should assist materially in maintaining the rifle strength of the line.
The order has been placed in England for a Leyland ‘Lynx’ DXI chassis of special design which will be shipped to the
2 NZEF in June or July [1940 ] and the body which is a specially designed dental laboratory is practically completed at the NZ Railway Workshops. The steel frame of this body was designed to fit the Chassis ordered and is provided with hooks and slings for handling on land and shipboard. The interior will be completely equipped as a prosthetic laboratory for the provision and repair of dentures, with the exception of the expendable tools and materials which the War Office has been asked to provide.
Eight NZDC light field dental outfits for the Divisional
The unit was concentrated in
The normal location to be Divisional Headquarters Area, but the six 15 cwt trucks which are also self-contained and fully equipped to act as sub-sections are intended to be distributed about the Division as required and attached to units in Infantry, Field Artillery, Brigade Headquarters Areas for duty and rations. The specially equipped dental laboratory, the Officer Commanding and one officer will comprise Dental Headquarters with the remaining vehicles and those of the six sub-sections not allocated in outside areas, the whole being parked and distributed in the Area in accordance with the conditions prevailing. The Dental Laboratory, as equipped and staffed, is capable of an average of 175 dentures per week. It is proposed that the sub-section should send the work back to the Dental Laboratory, the motor cyclists acting as carriers. Provision is made for the addition of a prosthetic pannier and dental mechanic to any sub-section if found expedient.
The Officer Commanding will Command all NZDC personnel in the Field and is responsible through the ADMS Division to the ADDS
2 NZEF for the dental health of the troops in the Division. He will act as adviser to the ADMS on dental subjects and will submit all reports and proposed movements of NZDC personnel to him. He may communicate direct with the ADDS on technical subjects only.
Attached personnel from the NZASC were ten drivers for first-line transport, of whom one could be a corporal.
Tents R.D. were to be used as operating tents for the dental officers with the sub-section.
The unit was founded on theory based on conditions of trench warfare existing in the First World War. Mobility was added to its assets without knowledge of the degree of mobility possible in a motorised division. None of the personnel had been in action before, so they could only base their opinion of modern warfare on exercises in the field in New Zealand, which they were led to believe were true to type. On arrival in Egypt, therefore, believing themselves earmarked as a specially trained unit, destined to work only within the Division, they were inclined to be intolerant of
Outlined my ideas on the
Mobile Dental Section to its Commanding Officer, viz., the section will need to consist of a Headquarters and six completely self-contained detachments, each detachment carrying surgical and prosthetic equipment and a mechanic being included in the personnel. They will in effect become dental detachments attached to units in the Field and will have little or nothing to do with the Mobile Section Headquarters. It will not be satisfactory sending denture work back to the Mobile Laboratory except in tactical situations where the Force is static and where either the units or the Mobile Section can readily be found. The Mobile Laboratory will not necessarily be able to be used in the Field. This will depend on the degree of mobility and the condition and number of roads. It will be most satisfactory on the Lines of Communication. It will probably be the tendency to carry portable prosthetic equipment with the Headquarters, this equipment to be such that a mobile prosthetic laboratory can be improvised away from the vehicles and on the ground. The detachments will return to the self-contained Head-quarters when not wanted in their respective units, e.g., before a prospective advancement or retirement.
It must not be thought that the ADDS was not in favour of a
To O.C.
Mobile Dental Section .Reference your memo of even date on the subject (Channels of Communication) after discussion with Officer in charge Administration and AA and QMG it appears that the
Mobile Dental Section may at times be employed with the Division in the Field and at other times at the Base.
When with the Division the channels of communication are O.C.
Mobile Dental Section – ADMS (and if necessary – DDMS, who might ask advice of ADDS).When at the Base the channel of communication is O.C.
Mobile Dental Section – ADDS – DDMS.HQ NZ Div. 10 October 40.
This ruling would have placed the dental services in the field completely under medical control. It was indefinite in proclaiming the status of the OC
Interviewed DDMS and ADMS and discussed the question of channels of communication, powers of O.C.
Mobile Dental Section , his relation to the ADDS; in general the relationship between the Medical and Dental Services and in particular the relationship of the ADDS to the DDMS.The DDMS realises that the ruling of the ADMS will require modification. He has made me believe that my feeling that the service was becoming under the complete control of the
NZMC was an inference from the unfortunate choice of words in the ADMS's memo and that they had not intended any such policy. It was pointed out to the DDMS that the ADDS will be held responsible by the DDS for any shortcomings and that he will also be held responsible by the Dental Profession for general policy. Accordingly there can be only one authority – the ADDS. The DDMS has undertaken to have the whole question reconsidered by the Officer in charge Administration.
This sympathetic attitude of the DDMS brought excellent results and went a long way towards establishing a happier relationship between the medical and dental services. Colonel W. G. Stevens, Officer in Charge of Administration, became arbitrator and, after hearing both sides of the dispute, gave a clear and concise ruling:
… The situation has changed in the interval between the sailing of the
Mobile Dental Section and its arrival in Egypt. The present situation is as follows:
The DDMS is responsible for the health of the NZEF as a whole. The ADDS while retaining a certain degree of independence technically, is responsible to the DDMS for the dental health of the NZEF.
The ADMS is the deputy of the DDMS within the Division.
The ADDS commands the Dental Corps in the NZEF. The
Mobile Dental Section is therefore under his command as far as personnel and technical work is concerned and at all times [will] be at liberty to communicate with the ADDS direct on technical matters.While with the Division in the field, the
Mobile Dental Section comes under the command of the ADMS as far as its location and duties are concerned. It should communicate with the ADMS on these matters. If necessary the ADMS communicates with the ADDS, a copy of such correspondence going to the DDMS.The Officer Commanding the
Mobile Dental Section will presumably be the senior Dental Officer with the Division in the field and is therefore the principal adviser of the ADMS on dental matters.When not with the Division in the field, i.e., while under training in
Maadi Camp , theMobile Dental Section is under the ADDS for all purposes, the ADDS in turn reporting if necessary to the DDMS as in (1) above.Headquarters
2 NZEF , 14 October 40
This was in effect practically identical with the instructions given by the ADDS to the Officer Commanding the
Establishment – Headquarters Dental Services
2 NZEF .Ref your DD 4/1/349 dated 27 Sept. 40, the establishment drawn up therein is approved.
In order to clear up any misunderstandings, it has been arranged that a notification of the appointment of Major Fuller as ADDS
2 NZEF will appear in a future issue of NZEF orders.
To the ADDS and the Corps in Egypt the importance of this controversy lay in the success of the solution. To the historian, however, falls the duty to probe more deeply in order that the reasons for the controversy shall be exposed as a lesson for the commander of the future.
There is no doubt that the commander of the
The Mobile Unit will not be broken up as they will all be selected and trained and MacKenzie will command not you as I stated in the original notes to ADDS and GOC. You have got your own job and cannot handle a unit like this.
This was tantamount to a vote of no confidence by the DDS in the ability of the ADDS to carry out the command delegated to him. It meant that the ADDS was expected to accept full responsibility but was to be deprived of full authority. The attempt to influence the organisation of the dental service to the
Having fitted the
The embarrassment of too much staff and too little equipment was temporarily relieved by the Australian division at
The ADDS paid a visit to the field ambulance dental officer, whose experience in the field helped to crystallise his thoughts on methods of packing equipment. It appeared that the British outfits ought to be condensed, each pannier providing equipment for a definite task. By the rearrangement of the contents, one pannier could become surgical, one stores and supply, and the foot engine could be carried in a small, flat, specially designed ‘suitcase’. (It will be remembered that in the New Zealand surgical pannier the foot engine was included but that there was no room in the British pannier for it.) This would mean that the Dental Officer could move with surgical equipment only, or with equipment and engine, leaving excess stores behind at his headquarters.
On his return to
A subject demanding immediate attention was the appointment and promotion of officers, which under the rules promulgated by the DDS for the NZDC was producing some awkward anomalies. The search for a just solution to this problem required a consideration of many intricate details more of legal than of historical interest. The issue would only be clouded by including them so the description will be kept on broad lines, with more emphasis on policy than on ingenuity of solution.
Fundamentally, the anomalies were caused by a scheme of promotion of officers in the Dental Corps initiated by Headquarters in New Zealand, which was adhered to in that country but was unacceptable to the
The first course received a sympathetic hearing from the Military Secretary but met with strong opposition from the DDMS, who considered it unfair to some medical officers. The obvious suggestion that the discrepancy might be better adjusted by an improvement in Medical Corps facilities rather than a curtailment of those in the Dental Corps produced a deadlock while
The justice of the cause triumphed and, in spite of having complained by airmail letter to the DGMS about the Dental Corps rules for promotion, the DDMS did not wait for an answer but gave his approval. The necessary adjustment between the New Zealand and
It will be noted that the DDMS still acted on the assumption that the Dental Corps was under his direction as part of the Medical Corps, and this attitude permeated all the developmental stages of the Dental Corps. There were constant battles over channels of communication and innumerable conferences between the DDMS and the ADDS in which widely different opinions gradually became reconciled under a mantle of mutual respect and confidence.
At the end of October the
Should the unit be armed with weapons and trained in their use?
Should they be issued temporarily with weapons, trained in their use and later, in the field, issued with arms should conditions demand it?
Should the unit receive neither arms nor weapon training?
This brought up the whole question of the personal defence of medical and dental personnel, which apparently had not been fully considered before. The copy sent to the ADMS went on to the AA & QMG and from there to HQ
As a change from the navigation of the uncharted seas of administration, the appearance of a purely dental problem presented little difficulty of solution. Two patients from the Australian camp at A serious bone infection.
In
It was becoming apparent that the Mobile Dental Section in the form in which it was trained and established would need further modifications before being ready for work under field conditions. Already the limitations of the mobile dental laboratory have been mentioned, and this meant that more mechanics would be needed if sub-sections were to take over some of its duties. It was
Commander Royal
On 13 December the unit moved to
The
Two other matters concerning the
The NZDC organisation was not only beginning to take shape but was attracting attention from other dental corps in the
Colonel McCallum [newly appointed DDS of the
Army Dental Corps] rang me yesterday fromMiddle East [Headquarters] and has come to realise that they have been working along the wrong lines as far as dental treatment in the field is concerned. Largely as a result of the publicity given to us by Ford [Captain W. McD. Ford, NZDC] up in the desert and from conversations with him he now intends putting mechanics with British Field Ambulances. War Office are showing signs of similar opinion. As McCallum says their policy has been centralisation; he now realises that it should be decentralisation. That is my opinion too, even within the Division. The small sections are the only solution in modern warfare.Lieutenant-Colonel Downs, the Australian ADDS is interested in the organisation we have developed. Colonel McCallum who is also keenly interested met him in
Palestine and discussed some of our ideas with him. Downs is coming down fromPalestine on the quest for details and McCallum has asked me if I would meet the two of them and take part in a three party discussion.
At the close of the year it appeared as if smooth waters had been reached but in the second week of
Interviewed ADMS at
Helwan in reference to the question of administration and command of dental units in the Division; discussed all angles of the case at some length and we were unable to come to an agreement or decision. The ADMS feels that the Division should be considered as being in the field and that now all dental personnel within the Division for all purposes are part of his command; that their function and duties are no concern of the ADDS; that the ADDS may not communicate with the dental officers direct and that in effect the Dental Corps personnel within the Division are lost to their Corps. On the surface, this dispute would appear of minor importance; the details of the case concern channels of communication, in particular to indents, weekly returns, etc. and arguments over these apparently minor details created the impression that the complaint is petty. But actually the whole question, built up on minor details, becomes a major issue. It is not the details to which one objects as the service will run no less efficiently if all correspondence without exception passes through the ADMS but it is the spirit of the matter, the attitude of the Medical Service as expressed by the ADMS who states that the dental sections in the Division are his concern entirely; who states that their ultimate responsibility is not to the ADDS. Thus it is a question of the principle involved.The ADMS states that since the ADDS is responsible to the DDMS so are the dental personnel in the Division responsible to the ADMS entirely. This attitude in practice will not create inefficiency where we have as at present an ADMS who actually will not obstruct the work of the NZDC but on the other hand the appointment could quite easily be filled by an officer with no understanding of dental service problems and who, without dental intervention, would obstruct the work of the NZDC.
Difficulties such as this always arise where personnel of one arm of the service are attached for duty to another arm of the service but in our instance the position is made considerably worse by the fact that in an indefinite manner the ADDS is responsible to the DDMS and by the fact that the Medical Services consider that the dental services are part of them. In other words the dental service has independence only when it suits the other party. Normally there is no friction; it is even possible to state that there should be no friction but yet, to the detriment of the dental services, in each instance where the senior administrative Dental Officer proposes a policy which will conflict with medical opinion, the proposal, instead of being considered by an outside and unbiassed opinion, is invariably quashed in the early stages through having to pass through medical channels. The liability for this to happen always exists.
In the case of the NZDC there would appear to be only one solution—an independent service with the head of the service directly responsible to the Adjutant-General's branch. It then follows that within the Division the administrative arrangements may be either:
A DADDS to be on Divisional Headquarters Staff when the Mobile Section is within the Division, to be responsible for the dental arrangements within the Division and to co-operate and work in conjunction with the ADMS.
the ADMS to act within the Division on behalf of the ADDS as regards dental matters.
These comments written at the time reveal a depth of feeling probably engendered by a fear that further encroachment was imminent and that the carefully laid plans for a dental organisation for the whole force would be adversely affected. The important fact was that the troops in
As an example of this attitude the following two extracts from reports are quoted:
Paragraph 7. The examination of units of the first contingent indicates that extensive treatment would be necessary to render these troops TOTALLY dentally fit and that it would take 3 to 4 months to produce a contingent requiring no further dental attention. But it is now 14 months since organised treatment was carried out, such treatment being directed towards rendering the contingent completely dentally fit, and therefore this present position came as no surprise. It was never anticipated that the present opportunity of ‘reservicing’ the contingent would become available, so that actually the position might have been worse.
Therefore from a broad outlook and considering the effect of the present dental conditions on their efficiency as healthy soldiers, one can only state that the dental health of the first contingent is satisfactory, providing that all cases which may otherwise give trouble in the near future are attended to while in
Helwan Camp , i.e., a practical rather than a total dental fitness might need to be aimed at as regards the first contingent.
Under the direction of the ADMS the attempt has been made at
Helwan to achieve TOTAL dental fitness with the result that the Division will be moving to the field with one third of the units totally dentally fit and two thirds who have had no treatment whatsoever. It would have been better to have made an attempt to achieve a practical dental fitness throughout the contingent and to have completed the urgent and important treatment in the mouths of all men requiring attention and to have left the minor cavities etc. untreated.This was advised in paragraph 7 ‘Report on Dental Services’ dated 1 Feb. 41.
The reasoning was sound and the advice of the ADDS to this end was given to the only quarter available to him, the DDMS. Had there been closer co-operation between the ADMS and the ADDS this advice could have been given direct and the mistake would not have occurred.
There was one branch of treatment where the very closest cooperation existed between the Medical and Dental Corps. Maxillo-facial injuries produced problems requiring specialised medical and dental knowledge closely knit as a team, each part dependent on the other. The training of these specialists was being undertaken in England by
The number of maxillo-facial injury cases to be expected in modern warfare is difficult to assess. For example, in the First World War there was a very large number of cases attributable to shell fragments and rifle bullets. In this war there were fewer from this cause, probably due in some measure to the increased lethal power of the weapons which killed rather than maimed. On the other hand, the greater use of motor transport increased the accident rate and produced the bulk of this type of injury. Fortunately, simple cases, such as jaw fractures without undue complications, can be handled by the average surgeon and dental surgeon, leaving the specialist free to concentrate on the complicated ones. Again, the big cases are not treated in a hurry and one surgical team can cope with a large number. The emergency treatment for these cases such as arrest of haemorrhage, maintenance of respiration and treatment of shock is carried out before the patient reaches the hands of the specialists.
In February the ADDS received from the DDMS a file relating to the appointment of medical and dental officers for the course in treatment and containing recommendations from
In
Discussed with AA & QMG,
2 NZEF Base the question of command of NZDC Officers and the procedure to be adopted in instances where breaches of discipline occur. He assumes that the ADDS commands NZDC personnel in the2 NZEF and accordingly in all instances where breaches of discipline are reported as regards officers the papers will be sent to the ADDS who will either discipline the officer himself or decide that the case requires investigation by higher authority. (In the case of1 Camp Dental Hospital ,Base Depot Dental Hospital andMobile Dental Section when at Base the ADDS in the latter instance would direct the officer commanding the unit to frame a charge, prepare a summary of evidence and make application through him for a Court Martial.)The powers of Officers in command of
1 Camp Dental Hospital andBase Depot Dental Hospital have never been sufficiently defined and at present these officers appear only to have the powers of Company Commanders. NZDC personnel who have committed offences which cannot be dealt with by a Company Commander are tried before Officer Commanding Headquarters Company in the case of the Camp Dental Hospital and Officer CommandingReception Depot in the case ofBase Depot Dental Hospital . The dental units are formed as Units of the2 NZEF and now it is felt that NZDC personnel where possible should be disciplined by NZDC Officers. Accordingly application will be made to Headquarters2 NZEF Base for these Officers to be granted the powers of Officers Commanding Detachments in accordance with Para 577 K.R. (1935 )while acting as Officers Commanding their units. King's Regulations.
This was a distinct advance as the powers of a company commander are strictly limited in comparison with those of an Officer Commanding a detachment. Discipline within the units was more easily maintained and the Corps spirit was enhanced.
Meanwhile,
At the same time, further consideration was given to the provision of dental reinforcements. The scheme whereby dental staff attached to transports could be retained was not entirely satisfactory. There was apparently a mental attitude of dissatisfaction in personnel unexpectedly retained for service in the
The establishment of the general organisation having been described in some detail, it is now convenient to study how that organisation fitted into the
For the purposes of dental treatment, the Expeditionary Force was divided into three groups, each with its own dental problems:
Reinforcements entering training units in Base Camps. Also, office and administrative personnel in these camps.
Troops in the field, i.e., Advanced Base, Lines of Communication units, non-divisional units and the New Zealand Division.
Sick and wounded passing through General Hospitals,
To understand the dental problems connected with these groups it is first necessary to study the flow of troops between the groups. The following diagram will help the reader to visualise this:
On arrival in Egypt all reinforcements entered a training depot in a Base Camp before being posted to units in the field. Although they had all been made ‘dentally fit’ before leaving New Zealand, they were immediately examined again and treated if necessary. This was in accordance with Dental Corps policy, which was not to allow anyone who was not dentally fit to proceed to the field. The two Camp Dental Hospitals carried out this work in addition to attending to the regular six-monthly examination and treatment of the base administrative staff. They were dealing with fit men of a static force undergoing training and were working under much the same conditions as existed in the mobilisation camps in New Zealand. One small difference between the camp dental hospitals in Egypt and New Zealand was in the keeping of records. In New Zealand records were of the utmost importance as an indication of the state of the mouth on entry into the force for comparison with the condition on discharge. As Colonel Fuller wrote in the New Zealand Dental Journal of
Records are not retained in this group when the treatment of the soldier has been completed. The objects are to examine men, to complete all treatment and to see that no man proceeds to the Field unless completely dentally fit. Since this object is attained in every case there is no point in forwarding records to the Field with the soldier. Should he return eventually to the Base Camp it will be through a General Hospital and/or
Base Reception Depot , where he will be examined and treated, and from which he will enter the Base Camp dentally fit.A simplified method of charting is used which records, not so much the condition of the mouth, but rather the work actually requiring' attention. Throughout the entire service, in point of fact, the emphasis is on the practical, and any procedures found to be merely of academic use are discarded immediately. Our responsibility is the creation of an efficient
Army Dental Service of war-time use and duration only.
With the exception of a few men who through sickness were sent to hospital, the troops left the training camp for service in the field, entering this second group dentally fit. Dental treatment then became governed and limited by general conditions and military circumstances. The moment for which the soldier had been trained had arrived and the Dental Corps had played its part in producing him as a physically fit member of a fighting force. Everything had been done to reduce to an absolute minimum the occurrence of dental pain and to prevent his loss from his unit because of dental lesions. The responsibility of the Corps, however, did not end at this point, nor did the soldier have to await his return to Base or hospital for future dental attention. Within the Division each of the three brigades had a field ambulance, to which was attached a dental section consisting of dental officer, clerk-orderly and, later, a
No organised attempt will be made on every occasion (in the Field) to render every man dentally fit. This is neither necessary nor desirable if troops have been sent forward dentally fit, for, if attempted under all circumstances, it would be out of proportion to other needs.
Therefore it is the duty of dental units in the Field to ensure primarily that the standard of dental fitness attained in base areas does not deteriorate unduly. Their duties are thus concerned mostly with maintenance and with attention to work of an urgent nature. For example, in the open, highly mobile warfare of the
Western Desert (North Africa) in 1941 and 1942, it was the duty of dental units in the field to ensure primarily that the standard of dental fitness attained in base areas did not deteriorate unduly during those phases when the Force was actively engaged and in consequence mostly on the move.The position is entirely different however when field units are resting or reforming and training or performing duties outside active areas of operations or occupying static (or virtually static) forward defended localities, etc. Under these circumstances the treatment carried out is the same as that undertaken in Base Camps and is organised with a view to rendering each unit dentally fit once every six months.
In this group, which can be conveniently called the ‘Action circuit’, it can be seen that the aim was to promote practical rather than actual dental fitness and that the Corps, in attempting the former, in many cases achieved the latter. Before leaving this group it is timely to quote the words of the ADDS:
The size of the Service must be in balanced proportion to the other needs of a force whose purpose is primarily to fight. The Service must never be organised and expanded to such an extent that some of its operations, when measured in relation to the purpose of the force, are unnecessary; nor should they ever hinder essential military activities of units of the force but, on the other hand, their effect should be continually to contribute towards and act as a stimulus to general fitness and efficiency.
The third group was the ‘Hospital circuit’. Soldiers in the field, either divisional or non-divisional, who became casualties through sickness or enemy action, were evacuated to a General Hospital
This compulsory immobilisation of men afforded a good opportunity for the Dental Corps to establish complete dental fitness and the group was organised to ensure that no man left the circuit until this was accomplished. Dental sections were attached to the general hospitals and to the
The ADDS at his headquarters kept in touch with every dental unit and could interchange or augment personnel to achieve the objective of each group. Especially was this of value with dental units in the field, for, knowing the dental condition of every unit of the force, he could notify dental officers of those units which became due for organised treatment.
Just as there was a regular progression of men in the
Dental Corps casualties, that is those who were evacuated beyond a Regimental Aid Post, would enter the hospital circuit in the same way as any other casualties, but on reaching the
THE story of the campaign in
The decision to send the Division to
It is easy to be wise after the event, and easier still to level criticism and apportion blame, but not quite so easy to recapture the spirit of the moment or to analyse dispassionately the decisions born in immaturity. Many of the records were lost in
The decision to send dental sections with the field ambulances and the General Hospital was in accordance with established custom and needs no comment. It is from an analysis of the movements and activities of the Mobile Dental Section in this campaign that valuable lessons can be learned. Who sent the section to
Before the departure for
When not with the Division in the Field, i.e., while under training in
Maadi Camp , theMobile Dental Section is under the ADDS for all purposes, the ADDS in turn reporting if necessary to the DDMS.
On the other hand, the ADMS (Division) apparently regarded the concentration of the Division in
While with the Division in the Field, the
Mobile Dental Section comes under the command of the ADMS as far as its location and duties are concerned. It should communicate with the ADMS on these matters. If necessary the ADMS communicates with the ADDS, a copy of such correspondence going to the DDMS.
At first sight it may appear of little consequence who was in command of the section, especially as much bigger issues were occupying everybody's minds. Had free use been made of the consultative clauses in the administrative instructions it would have mattered little to whom the
20 March 41. Notified of date of movement of
Mobile Dental Section .21 March 41.
Mobile Dental Section will remain atHelwan Camp until date of departure. They are the sole occupants of the camp.26 March 41.
Mobile Dental Section moved to Field.
Unfortunately there is no trace of the movement order for the section to leave
At the time of the move from
Since arrival of troops in
Greece , and up to date, rations have been largely M & V [meat and vegetable stew], no supplies of fresh meat, bread or vegetables being available until 1 April. Many cases of broken dentures due to hard biscuits have occurred and as these can only be repaired byMobile Dental Section it is apparent that this unit should be retained and function with the Division.
The biscuits were of the dog-biscuit type and, according to reports, were a test for the strongest teeth. In the New Zealand Division with its high proportion of artificial dentures the results were serious. At one time there were something like 800 broken dentures War Diary ADMS,
Having discussed why and by whom the section was sent to
The 2nd
Mobile Dental Section , shortly after its arrival in Egypt, was altered on the orders of the ADDS Middle East, Lt-Col Fuller, from a divisional unit to a non-divisional one. From the section OC's point of view, this was a serious change for it greatly increased the difficulties in such things as obtaining the unit's motor transport and various other items of equipment. To some extent this change was responsible for the loss of the unit inGreece owing to it being separated from the Division. This meant that, until such time as the Division could be contacted in the Field, the section operated as an independent command, entirely cut off from divisional intelligence. In the type of warfare that characterised this campaign, this proved to be a great disadvantage. Being attached to a Division is a very different thing from being part of a Division and especially is this the case during an evacuation scheme.
Before continuing with Major Mackenzie's story, certain comment is called for on his statements and deductions. In the first place, the change from divisional to non-divisional status was not on the orders of the ADDS but of Headquarters
Great difficulty was experienced in Egypt in obtaining the necessary motor transport. Finally it was obtained by going outside the
2 NZEF (organisation) and dealing direct with Headquarters Middle East. The end justified the means and the unit left forGreece with:
One 5-ton Albion, reconditioned by Italian Prisoners of War and fitted with the
Mobile Dental Laboratory .Two 3-ton Bedfords.
Seven 15 cwt. Ford trucks.
Two Motor cycles.
One Humber Snipe car.
One Water Tank trailer.
All the 15 cwt. trucks were fitted with adjustable covers by the unit's carpenter and plumber. This allowed for easy packing and bigger loads. All the transport was satisfactory in
Greece .The
Mobile Dental Section moved as an independent unit toGreece as the Division had been there for some time.Helwan Camp was left at 0700 hours on 27 March 41 and the transit camp on the outskirts ofAlexandria was reached that evening. Although all orders received for the move toGreece had been carried out, no provision had been made in this camp for the unit. The same difficulty again arose in regard to transporting the unit toGreece but, after much arguing and many interviews, the drivers and transport went on one ship and the remainder of the unit on another.
Alexandria was left on 1 April 41 and the personnel reachedGreece 36 hours later. The drivers on the transport ship took four days and received numerous air attacks, two men being slightly wounded when a bomb hit the ship. Only minor damage was done to the unit transport.In Greece nobody seemed to know much about us. Finally, Colonel Gentry
(AA & QMG NZ Div. Hqs. in Maj-Gen Sir William Gentry, KBE, CB, DSO and bar, m.i.d., MC (Gk), Bronze Star (US);
Lower Hutt ; bornLondon ,20 Feb 1899 ; Regular soldier; served North-West Frontier 1920–22; GSO II NZ Div 1939–40; AA & QMG 1940–41; GSO IMay 1941 , Oct 1941–Sep 1942; comd6 Bde Sep 1942–Apr 1943; Deputy Chief of General Staff 1943–44; comd NZ Troops in Egypt, 6 NZ Div, and NZMaadi Camp , Aug 1944–Feb 1945; 9 Bde (Italy )1945 ; Deputy Chief of General Staff 1946–47; Adjutant-General 1949–52; Chief of General Staff Apr 1952–Aug 1955.Athens ) instructed the NZ Liaison officer, MajorRattray ,in
Maj N. A. Rattray , MBE, m.i.d., Croix de Guerre (Fr); MLC; Waimate; born Dunedin,7 Nov 1896 ; soldier and farmer; Royal Irish Fusiliers (Capt) 1915–22 (twice wounded); p.w.25 Apr 1941 .Athens to send us toKaterine . The unit leftAthens on 7 April and reachedLarissa on the morning of 9 April. Here the Area Commander, Brigadier Parrington,ordered the unit back to Sub-area commander at
Larisa .Athens . The unit was accordingly withdrawn 15 miles back toPharsala ,where the Number 1 NZ General Hospital was located. Colonel McKillop (OC 1 NZGH) gave us permission to work in his area. The following day the unit was working and a sub-section under the command of Captain J.
Col A. C. McKillop , m.i.d.; bornScotland ,9 Mar 1885 ; Superintendent, Sunnyside Hospital,Christchurch ; medical officer,1 NZEF , 1914–16; CO1 Gen Hosp Jan 1940–Jun 1941; ADMS Pacific Section,2 NZEF (Fiji ), Aug 1941–Jul 1942; ADMS 1 Div (NZ) Aug 1942–Mar 1943; diedChristchurch ,5 Aug 1958 .Dodgshun was sent to the NZ Reserve Motor Transport at
Capt J. T. Dodgshun , MBE;Gisborne ; bornGisborne ,26 Apr 1915 ; dental surgeon; p.w.27 Apr 1941 .Larissa continuing to work there until that unit withdrew.On 11 April the ADMS, Colonel
Kenrick ,visited the area and expressed surprise at the unit being there and gave written orders for it to proceed to the slopes of
Brig H. S. Kenrick , CB, CBE, ED, m.i.d., MC (Gk);Auckland ; bornPaeroa ,7 Aug 1898 ; consulting obstetrician; Otago Regt 1916–19 (Capt); woundedApr 1918 ; CO 5 Fd Amb Dec 1939–May 1940; acting ADMS2 NZEF , Jun–Sep 1940; ADMS NZ Div Oct 1940–May 1942; DMS2 NZEF May–Sep 1942, Apr 1943–May 1945; Superintendent-in-Chief, Auckland Hospital Board.Mount Olympus . These orders were countermanded again by Brigadier Parrington. He again ordered the unit back toAthens but Colonel McKillop was in need of help in the evacuation of the hospital, and the NZ and Australian nurses were evacuated by the unit toAthens . This meant leaving some of the equipment behind. Headquarters inAthens refused us permission to return toPharsala to collect the remainder of the equipment but, bearing in mind its value and the difficulty in replacing it, CaptainNoakes and four drivers were sent back as a salvage party. Unfortunately they were unable to proceed further than
Capt P. Noakes ;Auckland ; bornWaihi ,20 Jun 1914 ; dental surgeon; p.w.27 Apr 1941 ; repatriatedSep 1944 .Lamia and returned toAthens empty handed.The unit rested for a day and then went to Voulas,
the Advanced NZ base. It was decided to establish the unit headquarters in this area. Accordingly a German doctor's house and surgery were commandeered for this purpose and Captain Near Athens.
Greenslade and three officers, Captains Crawford, Noakes and
Maj D. A. Greenslade , m.i.d.; Dunedin; born NZ15 May 1908 ; dental surgeon; p.w.21 Apr 1941 .Spencer ,with their orderlies, set up their sub-section with the
Capt R. D. Spencer ;Wanganui ; bornPalmerston North ,25 Sep 1914 ; dental surgeon; p.w.Apr 1941 .Mobile Dental Laboratory . The remainder of the unit intended to return toThebes .The night before we were due to leave we were ordered to evacuate
Greece and hand over the unit transport to NZ Base. The drivers volunteered to stay behind with their trucks. SergeantReilly and Private
Sgt W. D. Reilly ;Auckland ; bornTimaru ,22 Aug 1903 ; chemist; p.w.Apr 1941 .Tippett ,against orders, joined the rearguard party who were to cover the evacuation.
Pte G. C. Tippett ;Whakatane ; bornOpotiki ,5 Oct 1916 ; dental mechanic; p.w.Apr 1941 .Each officer of the
Mobile Dental Section was put in charge of 50 men (wounded and convalescent) with orders to evacuate them from the beaches aroundAthens . Owing to the shipping losses this could not be done. When the last party had left for the ships, I collected the unit together and intended making for the Peleponnese where further evacuation was taking place.Captain Ritchie (Medical) asked me if I would take the walking wounded with me. We set out for
Maj A. W. S. Ritchie ;Christchurch ; born NZ12 Aug 1915 ; medical practitioner.Corinth about 300 strong but, unfortunately, walked right into the lines of the German Parachute Division and were taken prisoners. Some evaded the parachutists but next day ran into the supporting motorised division.
It would appear from this report that there was no definite policy as to how the
There is room for argument that the rapidity with which the war situation changed precluded the use of the unit as a dental hospital even on the lines of communication or at the Base. The same argument, however, can be used to produce a strong case for keeping the unit well out of the way until conditions were such that it could operate as it was designed to do. It must have been obvious that there was little chance of a static position arising when routine dental treatment could be undertaken. The urgent need was for a laboratory to repair broken dentures, and for this work all that was wanted was the dentures not the men. The unit could not work while travelling but, when fully established, was capable of handling a large number of dentures. To be fully productive the periods of mobility must be reduced to a minimum, and for this reason the unit could be of little value while the Division was in action of
The ‘
Mobile Divisional Dental Hospital ’ while an excellent idea in principle, cannot in fact be either ‘Mobile’ or ‘Divisional’, in the true sense of the words. With a highly mechanised fast moving Division it would be very difficult for such a hospital to function as a real integral part of the Division. What would, in fact, happen would be that the hospital would proceed to the Overseas Base and there would wait until the Division came out for a period of rest. The hospital would then move up and commence operating. I gather that, in fact, it cannot function efficiently without remaining in one place for at least a week.
For the purpose of repairing broken dentures, the section could have been ready to begin operations as soon as the dentures arrived from the Division.
It would appear, therefore, that the section was not used correctly in
I wish to record my appreciation of the assistance rendered by Major MacKenzie and the
Mobile Dental Section . Had it not been for their help it would have been impossible to evacuate the hospital and to get the sisters safely toAthens . During the last few days he was with us he placed his transport entirely at our disposal and by its help we were able to send fit men to rejoin their units and to send lying cases to the railway at Phaleo-Pharsalas to the ambulance trains.
The story of the capture of the personnel of the section has already been told by Major Mackenzie, but some further light is thrown on the conditions at the time by a report from Staff-Sergeant J. Russell, NZDC:
The
Mobile Dental Section stationed at Voulas Camp, 7 miles East ofAthens received orders to evacuate immediately at 0200 hours on 22 April 41. We arrived at dawn at the evacuation beach,Megara , 35 miles West ofAthens . We stayed under the olive trees until the evening of 25th when we filed down to the beach to await lighters from the ships. At 0300 hours Saturday 26th we were told to go back to the road as the ship had a full load and could take no more that night. In the dark I lost contact with some of the unit but made the road where several Greek ambulances were pulled in beside the road. With 13 men aboard an ambulance we drove off to report to the next evacuation beach over theCorinth canal. Ourambulance was first away and by dawn we had crossed the canal but had not reached the evacuation beach. We hid for the day and then went on to Argos . The ambulance was then taken over for wounded so we attached ourselves to an Australian convoy. We reached the beach that night but had to return along the road as a guard to watch for German paratroops. On arriving back at the beach we discovered the ship had left, so we hid through the next day and came down to T beach, Naplion. The next evening, Sunday 27th, no ships arrived so we hid again. At 0900 hours on Monday the Germans cut us off on a point by the beach. We escaped by swimming off this small peninsula back to the mainland north of the Germans. We then marched for two days and two nights to a village called Helles, furthest point East, South ofCorinth canal. We then rowed to the island of Spetsai and paid a Greek fisherman to take us to Crete. We leftGreece the next night and made a small island by dawn. Here owing to rough weather, we stayed two days and on Saturday 3 May at midnight reached Melos Island. Our party consisted of 4 officers and about 60 other ranks.
On Melos island there were already 50 men awaiting the
The loss of the men and equipment was serious for the Dental Corps. Under the conditions of the evacuation it was inevitable that the equipment and transport would have to be abandoned, but the loss of the men appears to have been just bad luck.
There are certain salient points that can well be emphasised in regard to the use of the Mobile Dental Section in modern warfare:
It is extremely important that it be clearly understood how the section is attached to the Force and to whom it is responsible. There is no place for an individual commander cut off from vital intelligence reports. The channels of communication should be so firmly and rigidly established as to be unshaken by the confusion of battle. They should be so deeply ingrained as to become second nature.
The
There is no advantage in keeping the
It now remains to account for the four dental sections attached to the General Hospital and the three field ambulances.
At the time of the evacuation the dental section attached to the General Hospital was well established at
The three field ambulance sections were kept fully occupied on dental treatment until the time of the withdrawal. From this moment treatment became an impossibility and the officers were employed on various field ambulance duties. The 4th Field Ambulance section under the command of Captain C. C. S. Loeber was evacuated to Egypt. According to a report received by the ADDS, Captain Loeber was made full use of in other capacities when dentistry became impracticable and carried out these duties with distinction. He was in the rearguard action from
The 5th Field Ambulance section (Captain J. R. H. Hefford) and the 6th Field Ambulance section (Captain C. C.
On Crete the two officers carried out dental duties each day at No.
There is an interesting account of the dental condition of the troops in
On arrival in
Crete on 25th April 41, it was found that the English 7th General Hospital nearCanea was without the services of a dental officer, who had met with an accident. Captain Cook, with Colonel Bull's
Brig W. H. B. Bull , CBE, ED;Wellington ; bornNapier ,19 May 1897 ; surgeon; CO 6 Fd Amb Feb 1940-May 1941; ADMS NZ DivMay 1941 ; p.w.28 May 1941 ; DGMS,Army HQ, 1947–57., volunteered to help with Captain Cooper A.D.C., permis- sion permission who had also arrived with remnants of the 26th General Hospital from
Army Dental Corps.Greece . From reports all over the island, the 7th General Hospital was the only one which functioned as a complete dental centre. Men came from everywhere and it was usual to be seeing up to 100 persons daily for treatment.Vincent's angina was rampant. Fortunately … a satisfactory treatment was mastered early. It was impossible to hospitalise any Vincent's cases unless the patient's general condition demanded it; it was impossible to get men daily for treatment when they lived any distance away and unfortunately there was a limited supply of chromic acid.
The routine treatment was as follows: initial application of chromic acid followed with hydrogen peroxide. At the same visit the inter-dental spaces were packed with well-teased packs of cotton wool impregnated with zinc oxide, oil of cloves and powdered sulphanilamide stiffly mixed. Anyone from a distance was dismissed for five to seven days and, according to Captain Cook, almost every case was free from infection on return. Penicillin was not on issue at this time and did not become universally used in the treatment of Vincent's angina until the end of the war.
Dental officers with the field ambulance in action had little time for reports, which were usually given verbally on return to Base and, as they wrote no war diaries, there is no documentary evidence of this campaign on the files to include in a history. The vividness of their experiences, however, is sufficient excuse for accepting as reliable the following account from Captain Hefford of 5 Field Ambulance, written almost ten years after the campaign. From it can be gathered some impression of the conditions under which these sections had to work and the extent to which modern mobile warfare limited their activities:
The equipment and Motor Transport were embarked on one ship and we were sent aboard the 2,400 ton Greek ship ‘Corinthia’ ahead of most of the unit to act as liaison with other NZ units and to arrange embarkation. French of a sort was our medium of expression. Five minutes before we started I extracted an abscessed lateral incisor for our unit grave-digger with a pair of artery forceps gripped by a pair of pliers borrowed from a truck driver on the quay. No anaesthetic of course.
Having been used to carry mules and troops to
Albania , the ship was full of fleas with the result that my neck swelled to such an extent that my collar would not come within 2 and a half inches of buttoning up and I spent 3 days in a British Hospital inAthens getting deflated.The passage to the
Piraeus took four days as our convoy was diverted after being spotted by Italian Air Reconnaissance. This was an unfortunate encounter for the Italians as our place was taken by theMediterranean Fleet who mauled theirNavy at the Battle of Matapan.Two days after leaving hospital I took a train to
Katerine and scrounged a car to drive south over theOlympus Pass to join the unit which was establishing Main and Advanced Dressing Stations later to be used by the4 Field Ambulance to evacuate casualties from the fighting in the Olympus Pass . Here the MDSadopted the policy of dispersal and concealment as distinct from that of displaying the Main Dressing Station.
Red Cross . I got my dental centre under the steepest part of a hill and spent some days there during which timeGermany became at war withYugoslavia andGreece .Following the decision to abandon the line
Aliakmon River -Katerine we handed over to the 4 Field Ambulance and moved in snow to theServia Pass area, again digging in and camouflaging. Here we received unwelcome treatment from Stukas until some wounded Austrian prisoners we were treating persuaded us to show theRed Cross which proved highly effective. From then on 5 Field Ambulance, unless attempting to hide for security reasons, moving in convoy or situated near Bofors guns abandoned digging and dispersal and was never attacked from the air. We were able to do some urgent work for British Artillery and RoyalArmy Service Corps units here as well as treating six to ten cases of Vincents among the Australians. Here we also found there were a number of broken dentures among N.Z. troops. The ADMS ordered these to be sent to theMobile Dental Section located with the No. 1 General Hospital atPharsala . These dentures were never seen again as the Hospital and theMobile Dental Section evacuatedPharsala .One night here an alarm that parachutists were landing behind us, although proving to be false, cured me of wearing pyjamas to sleep in.
Our next withdrawal was to the
Thermopylae position. During this our truck broke its front axle by Lake Xymas near Domokos village. The replacement involved me in a 120 mile drive through Lamia Pass and back under heavy air attack for 12 hours. We had not long been established in a luxurious Bath House building at Kamina Vola when the ADMS sent us into concealment under some trees where we set up the section under a tarpaulin and got to work on some fillings and extractions.Almost immediately we were ordered to destroy all war equipment, leaving medical equipment intact, and withdraw to the South-East of
Athens where we were to remain concealed and await evacuation with 5 Brigade. We went by night convoy with full headlamps and hid in the olive groves all day. On arrival at the beach we destroyed all Motor Transport and tyres and went aboard H.M.S. ‘Glengyle ’ in the ship's landing craft without even getting wet feet. Before abandoning my dental equipment I put a hypodermic syringe, some local anaesthetic and two pairs of extraction forceps in my respirator haversack. These were very useful later for emergency extractions.A feature of the 5 Field Ambulance operations in
Greece was the very full information we were given of the situation most of the time and the fact that except for occasional accidents to vehicles such as mine, every move was made as planned. We handled about three quarters of the total casualties of the NZ Division and this precision would not have been possible but for the tremendous activity and efficient organisation of our Commanding Officer, Colonel J. Twhigg, N.Z.M.C.
Brig J. M. Twhigg , DSO, ED, m.i.d.;Wellington ; born Dunedin,13 Sep 1900 ; physician; CO 5 Fd Amb Jul 1940-Nov 1941; p.w.Nov 1941 ; repatriatedApr 1942 ; ADMS 3 NZ Div Aug 1942-Apr 1943; DDMS2 NZEF (IP) Apr 1943-Aug 1944; ADMS2 NZEF (UK ) Oct 1944-Feb 1946.H.M.S. ‘
Glengyle ’ arrived atSuda Bay inCrete on Anzac Day in the afternoon. We had a meal at the Suda Bay Field Kitchen and set off on a long weary march to the Transit Camp, a big olive grove at the back ofCanea .During our stay in
Crete from 25 April to 1 June there was no rain, nor was any expected until September. Water was scarce and came from village wells, being unsafe to drink unless first boiled. Purification tablets could not be issued although it is believed that a good supply of these had been amongst the equipment inGreece . This was probably a factor in the incidence of dysentery among the troops after the action period when the water could not be boiled. We kept reasonably clean by sea bathing and by clipping our hair short and I kept myself and the section fit by cross country running over the hillside tracks, an exercise about which the men had mixed feelings.There was eventually a demand for dentistry and as the only dental equipment was at No. 7 General Hospital (British), I was detached for duty with that unit. I joined it in the afternoon of 19 May, the day before the attack. Captain C. C. Cook, Dental Officer with 6 Field Ambulance (NZ), the Dental Officer from 26 General Hospital evacuated from
Athens , the Dental Officer, mechanic and orderly of 7 General Hospital with Cook's and my orderlies and a stray mechanic from the NZMobile Dental Section were the dental personnel.Next day we were driven into our slit trenches by enemy planes towing gliders and low-flying aircraft machine gunning and dropping bombs. Parachutists and gliders had landed and occasionally we heard Huns with Tommy Guns patrolling near us. Fortunately they were mopped up by a patrol of the 19 NZ Battalion who told us to go down to the beach and disperse among the rocks. Some of the ward tents, the dispensary and the Medical Stores tent caught fire, destroying most of the morphine and a lot of splints and dressings.
I joined up with an Australian Medical Officer, a gynaecologist from
Melbourne , and, having collected some rations, we found a sheltered ledge about ten feet above the shore in the Western promontory. On top of the point was a ruined church supposed to have been started by St. Paul. I climbed up there every hour to see what was happening inland but could see little except a few mortar bursts. At dusk we went over to the operating tent and casualties started to arrive. All night the Australian gave the anaesthetics, Captain Gorovitchof the 7 GH did the surgery, I was his assistant and the Quartermaster acted as theatre sister. The cases were all transported to a limestone cave in the Eastern promontory. We had 4 gallons of water for all our scrubbing so had to rely on lots of soap for antisepsis. Most of the work was excision of damaged tissue and the application of plastic bandage slabs but there were some amputations and even the removal of an acute appendix.
Capt Gourevitch , RAMC.The next day we transferred the operating theatre to the big cave ready for the night's work which was much the same as on the previous one. Much of the work had to be improvised in the absence of special equipment. Most of the Thomas splints, for example had been destroyed in the fire so we merely put a clove hitch round the ankle and tied the foot to the handle of the stretcher putting the foot end about 18 inches higher than the head. We managed to evacuate some cases to destroyers in
Suda Bay but most of the lying cases had to stay behind until the Germans took over the island. The War Artist missed an eerie and striking picture of our nightly operations. A huge cave with the floor on several levels; rows of stretchers; a couple of Medical Officers doing dressings by torch light; tea being made over primus stoves with biscuits being spread with margarine and marmalade and the operating table under an acetylene flare.
During this period I was seldom called on for dental troubles but took out two teeth. One NZ infantry man came in, still with fixed bayonet, sat down, had the tooth out, thanked me and, grabbing his rifle walked out.
Meantime the 5 Field Ambulance had withdrawn from
Maleme to a building on top of the middle point previously used as the hospital officers mess. I rejoined them and the following night moved to a position in a village church in the foothills. We pitched half a dozen tents on an open paddock nearby and with plenty of red crosses in evidence were not molested by the Germans although the neighbouring olive groves were regularly plastered by the tail gunners.The next move was at night. The unit had acquired a few trucks as, except for red cross vehicles, nothing could move in daylight without being shot up. I was commanding Headquarters Company for the march and was leading but had to get the sergeants to march on each side as I kept going to sleep and walking into the ditch. When we got to Stylos, the Australian Medical Officer and I had a good day's sleep hidden under the foliage of a fig tree.
We moved on next night but made slow progress as the column was very ragged, being overtaken by trucks and stragglers. Finally we abandoned the road which seemed to be metalled with round stones the size and shape of cricket balls and took to an old mule track under the trees in the bottom of a gully. After crossing the
Askipho Plain , lying flat on our faces every time a plane appeared, we reached the village ofImvros where unit headquarters had already arrived by truck, establishing themselves in the church. We worked hard on casualties that night and all next day, unmolested under our red crosses.The Division had by this time lost so many of its Medical Officers, who had stayed behind with the wounded, that the Commanding Officer decided to take the remaining MOs and medical key personnel by truck to as near
Sphakia as possible. I persuaded him to take my orderly with him and I was left with the Quartermaster to march out the cooks etc., about 20 men. The CO and main body embarked in the ‘Glengyle ’ on the night of 29–30 May. Dawn on 30 May found me with my marching party high on the hillside overlooking the sea near a few scattered cyprus trees. We broke up into groups of three or four for some sleep under the trees but were soon disturbed by marines looking for sites for rifle pits and were told that they were going to hold that position that day. I could only find about ten of my party, the others evidently having decided to move on. We made our way across country down the hill and arrived at Force Headquarters about a mile fromSphakia at 10 a.m. immediately setting to work to assist a British MO in a nearby Aid Post. He rewarded me by showing me how to slice up chocolate iron rations into cubes in a mug of hot water, making, on account of the salt in the ration, a much better cure for thirst than plain water. Later in the afternoon Captain Cook NZDC arrived looking a lot thinner.I then reported to Major Kennedy
Elliott who as DADMS Crete Force was the senior medical officer, the ADMS having left the previous night. I was instructed to collect about ten men and establish a beach-head aid post as the previous night
Lt-Col J. K. Elliott , OBE, ED;Wellington ; bornWellington ,24 Aug 1908 ; surgeon; RMO 18 Bn 1939–40; surgeon1 Gen Hosp Nov 1941-Jun 1943; CO 4 Fd Amb Jun 1943-Apr 1944; Orthopaedic Consultant (NZ) Jun 1944-Mar 1945.Sphakia had been heavily bombed and the same was expected this night. Two destroyers were expected but could not take seriously wounded men. We got down fairly close to the beach under a big boulder having gathered up a couple of men who had been hit the previous night. One of these had both legs paralysed by a blow in the back. During the next day we gathered up more wounded and by improvising sticks and crutches got them all mobile, even the man with the paralysed legs whose condition was evidently due to severe bruising, the effects of which were beginning to wear off. I was getting worried about not being allowed on the beach with my team but fortunately a message I sent to BrigadierHargest bore fruit. I was instructed to see Lt. Col.
Brig J. Hargest , CBE, DSO and bar, MC, m.i.d., MC (Gk); born Gore,4 Sep 1891 ; farmer; Member of Parliament, 1931–44; Otago Mtd Rifles, 1914–20 (CO 2 Bn, Otago Regt); comd5 Bde May 1940-Nov 1941; p.w.27 Nov 1941 ; escapedItaly ,Mar 1943 ; killed in action,France ,12 Aug 1944 .Andrew of the 22 Bn. and received from him a written order instructing the guard to allow my party onto the beach at dusk. Dusk found us sitting in a corner of the beach with about 120 sailors, soldiers and airmen in various states of disrepair and we were all taken off in the first few landing craft and ferried out to H.M.S. ‘
Brig L. W. Andrew , VC, DSO, m.i.d.;Wellington ; born Ashhurst,23 Mar 1897 ; Regular soldier; Wellington Regt, 1915–19; CO 22 Bn Jan 1940-Feb 1942; comd5 Bde 27 Nov-6 Dec 1941; Area Commander,Wellington , Nov 1943-Dec 1946; Commander, Central Military District, Apr 1948-Mar 1952.Abdiel ’ a minelaying cruiser. Again no wet feet.We arrived at
Alexandria in the afternoon of 1 June and next day I reported to the ADDS at the Base. My dysentery here caught up with me, having been kept under control with Tincture Opii for long enough, and I landed up in No. 3 General Hospital remembering very little of the next few days.
It would appear from this account that the dental officer with the Field Ambulance was chiefly engaged in duties other than dentistry and that these duties were very imperfectly defined. Like every other unit, the Field Ambulance was undergoing a baptism of mobile warfare of a degree of intensity never before experienced. Captain Hefford's conduct throughout the ordeal is deserving of the highest praise and consistent with what would be expected of a dental officer in similar circumstances. On the other hand, they were not the duties for which a dental officer was placed in the field, being the outcome of exceptional conditions at the time but nevertheless conditions that could be expected in future campaigns. It became obvious to the ADDS that there should be a clearer definition of the duties of a dental officer with field ambulances and, as will be seen later, this was done after the Libyan battle. Captain Hefford was fortunate in escaping from
Although the loss to the Dental Corps was a bitter blow, there were compensations arising out of the
Major Mackenzie wrote:
It is probably no exaggeration to say that the dental officers captured in
Greece and North Africa were of more value to the health of our troops as Prisoners of War than on the other side of the wire. The majority of the men caught atDunkirk had had no dental treatment at all before being sent toFrance . Prisoners coming in later were in a better condition but it was never possible to keep pace with the amount of work presenting. Generally speaking the German authorities were not interested in the health of the Prisoner of War. There were one or two exceptions to this rule….As far as I know, the bulk of the dental work done in
Germany was carried out by New Zealand Dental Corps Officers and men. They all worked under most unfavourable conditions and carried out their duties in a manner most fitting to the traditions of the New Zealand Dental Corps.
ON returning to Egypt the Division moved into the
As there was now no
Meanwhile, in
Apart from these two concentrations of troops, 6 Infantry Brigade was stationed in the Canal area, Brigade Headquarters and one battalion were at
As was to be expected after the
The number of artificial dentures lost or broken during the operations in
Greece andCrete was considerable and when the troops returned to Egypt the position was alarming. A relatively large percentage of men returned to this country without their dentures and in each instance it was stated that they were lost either during operations on land or during one of the two evacuations.The loss of dentures can be attributed to many causes some of which are unavoidable, others indicate either negligence or wilful intent to lose them, but whatever the reason may be, the fact remains that the loss of dentures under active conditions does occur to an abnormal extent and no doubt will occur in future campaigns.
It was found that the hard biscuits which form a large portion of the rations played havoc with artificial dentures and from all units breakages were reported in large numbers. Many of these broken dentures either had to be, or were, removed and placed in kit bags, haversacks or pockets and thus were lost or left behind at the evacuation.
It is of interest to compare the returns for denture work during the period February, March and April with the corresponding figures for May, June and July. The first period covers the interval before the Division moved to
The issue of new full dentures and repairs to broken dentures are nearly trebled in the second period.
Another difficulty which faced the Corps immediately after the
The first step in the re-formation of the Corps was to replace the lost personnel and equipment; the second was to turn to profit the lessons learned. There was no reason to doubt the correctness of the policy already laid down, but there was a need to ensure that all components of the organisation should be so constituted as to guarantee its successful fulfilment. The opportunity had arisen through misfortune to design the tools for the work rather than adapt the work to the tools available.
Eight dental officers, eight mechanics and four clerk orderlies arrived with the
Certain anomalies regarding rank in the Dental Corps needed adjustment before new establishments were finalised. The three dental hospitals, i.e., the two Camp Dental Hospitals and the
… in my view the ranks of members of the Dental Corps should be settled on a Corps basis. At the present time the establishments for General Hospitals provide for the dental officers attached being Majors or under whereas in point of practice the appointment will normally be filled by a captain (except for one existing specialist appointment—and possibly an additional one to be made on arrival of an officer from England).
The appointments of Majors to Dental Hospitals is probably sound: but liberty of action for the Dental Corps might well be preserved here so long as the total Corps Establishment is not exceeded.
Suggested establishment therefore is:
|
Lt-Cols. | 1 | |
Majors | 5 (if the specialist from England proves to be sufficiently highly qualified, one more Major then wanted, to make 6). |
The Officer in Charge of Administration, with whom the ADDS was chiefly concerned, considered this a reasonable allocation on the grounds that it should be a balance between the number in a battalion and the percentage in the Medical Corps, i.e., about one-sixth the total number of dental officers. He sanctioned it as such and agreed to reopen the subject should the establishment of the Corps be increased in the future. The ADDS was promoted to the rank of lieutenant-colonel on
The establishments of the Camp Dental Hospitals were then altered to permit the commanding officers to be either major or captain, the senior dental clerk orderly was given the rank of WO II, and the number of orderlies was increased by two. The same status was given the commanding officer of the
In the field ambulances the important change was that a dental mechanic was included in the establishment. This was a natural corollary to the experiences of the Division in
The new
The equipment began to arrive from New Zealand in early August on a generous scale and of a type and quality leaving little to be desired. There were, however, certain items not suitable for use in the field and some deficiencies which experience had shown should be included. Consequently, it was decided to receive it into the dental store, not as complete outfits but as individual items, and to build up entirely new field outfits. The deficiencies were to be made up either from Medical Stores or by buying from local supply houses.
For example, the equipment for a complete Field Dental Section had hitherto consisted of chair case, prosthetic pannier, surgical pannier and store pannier. The foot engine had been carried in a compartment in the surgical pannier and items which could not be packed in the surgical or prosthetic panniers had been carried in the store pannier. The first change was to remove the foot engine from the surgical pannier and place it in a specially constructed case, which could either be carried independently or in the chair case. All the surgical equipment could now be carried in the surgical pannier and the prosthetic in the prosthetic pannier, allowing the store pannier to be dispensed with. Each section was provided with a portable mechanic's bench, complete with trestles and with screw holes and bolts in the correct positions for assembly. The fitted mobile dental laboratory, so prominent a feature of the previous section, became a Field Dental Laboratory, consisting of
The
FROM the point of view of the Dental Corps, the Second Libyan Campaign started on
Luftwaffe and the orders were that all ranks should live in dugouts. A wholesome respect for the
At
The original intention at
The field ambulances continued, therefore, to treat all casualties and the
On
The three field ambulances and the
When the field ambulances were captured, Captain Loeber's orderly and mechanic, Sergeant C. H.
The results of the campaign can be conveniently summarised:
Practically no dental work was possible under the conditions existing in the battle area. The dental personnel were used almost exclusively for other duties.
Captains Aitken and Skegg, Sergeant
All field ambulance equipment was lost, Captain Loeber's by shellfire and the rest by capture.
The
Most units of the Division returned after the battles of
Firstly, there was the use made of the sections attached to the field ambulances. Here was a specialist officer, deprived of the opportunity of practising his specialty, being used for work for which he had an imperfect training and which would have been better done by a trained officer. Without in any way belittling the services rendered by these officers or questioning their willingness to help in every way, it is pertinent to ask why they were even in the locality where such services were needed. It would appear that they would have been more correctly sited with the headquarters of the field ambulances during battle, a position from which they could have been sent wherever their professional services were required and when these services could be used. This was a view endorsed by one of the officers commanding a field ambulance. It is poor policy to train a racehorse for use in a plough. Both the horse and the ploughing will suffer.
The same argument applies to exposing valuable equipment to unnecessary risk. Unless conditions are reasonably static the dental section has little use for anything other than an emergency haversack. Equipment could therefore be kept at a reasonable distance and produced only when there was a chance of it being used.
Secondly, it would appear that the
Divisional attachment had certain advantages, as also did non-divisional, and only experience in the field could adjust the balance. The pros and cons are stated by the ADDS and Major Middlemass:
Nothing would appear to be gained by attaching the unit to the N.Z. Division, particularly in the present indefinite, half-hearted manner. Actually when the unit moved originally from
Maadi Camp to theWestern Desert it was not intended that it should become attached to the Division. The unit was moved under a GHQorder from General Headquarters,
Middle East .Maadi Camp to HQ 13 Corps, but on arrival atBaggush was claimed and annexed by N.Z. Division.When the Division moved forward to a concentration area, the Mobile Section marched out to attachment to Eighth
Army . Subsequently when EighthArmy moved, the section became attached to HQ 83 L of C.When the Division returned to Headquarters, 83 Lines of Communication.
Baggush it became attached to them again, more or less. During the period when the unit was attached to the Division, all Divisional orders had to be complied with, many of which did not concern the unit. Also, the section was considered by the A.D.M.S. to be one of his Medical Units. Numerous irrelevant returns had to be sent to him, returns which concerned medical units but which were not applicable to a dental unit. TheMobile Dental Section became one of the A.D.M.S.'s five medical units and became tacked on to the end of the other four. Naturally the unit was the last to receive consideration. There was no friction nor sign of it, but nevertheless the position generally was one in which the unit was attached to the Division without receiving any of the advantages of such a position.N.Z. Division is always either moving or about to move, and, when it does,
Mobile Dental Section remains behind until conditions become reasonably stable. When Division moves, the unit has to become attached to theHeadquarters of the area or sub-area in which the Force is situated. It seems logical to conclude that in the first instance the section should move to the vicinity of the Division but, being a non-Divisional unit operating on all units of the 2 NZEF , it should be attached to the Headquarters of the area or sub-area in which the Division is located. Then it would be dealt with and controlled in the same manner as other2 NZEF non-Divisional units. When Division moved there would be no disorganisation. The unit would be under the local control of the senior Medical Officer of the area concerned. It is felt that the unit would operate more smoothly and efficiently under this arrangement.
The NZ Division was hurriedly moved from
Syria toMatruh in order to help stem Rommel's apparently irresistible advance on the Nile Valley. 1 NZ Mobile Dental Unit moved with the Division as far asCairo and then proceeded independently toMaadi Camp with LOB personnel. This was the first occasion on which the unit had moved with the Division. Hitherto, it had always moved independently of the latter—up toBaggush , down to the Canal Area, up toMaadi and finally up toAleppo . This involves the issuing of a separate movement order byMiddle East , through a variable number of Movement Control Officers to the area in which the unit is located and would seem to serve no useful purpose beyond demonstrating that No. 1 NZ Mobile Dental Unit is a non-Divisional unit. Indeed it has the disadvantage that the late arrival of the unit in the Divisional area or billets has always meant a re-arrangement of some Divisional unit in order to provide room for the Mobile Dental Unit. InBaggush ,4 NZ Field Ambulance was affected; in the Canal Area, the5 NZ Field Ambulance ; inAleppo the 21 NZ Battalion. It is certainly inconvenient to these units while it is most certainly not to the advantage of 1 NZ Mobile Dental Unit.All these difficulties and unnecessary inconveniences can be overcome by attaching the unit to the Division before the latter moves. Provision is then automatically made for the supply and movement of the unit, and allocation of an area on arrival at the destination is carried out by Divisional Headquarters. Less administrative work is required and there is less inconvenience to all concerned. It should be remembered too that when the unit is some distance from Base, and operationally this must always be so, it must move under Divisional arrangements. It is unwise therefore to break the normal routine on the comparatively few occasions when it is possible for
2 NZEF to move the unit.Finally there is no loss of time in commencing work on units, at the latest on the day after the Division arrives in an area. Such is not possible if the unit moves under separate orders.
These opposing views were reconcilable by a fuller knowledge of how, where and when the Mobile Dental Unit could operate. The fullest co-operation between the ADDS, the OC Unit and the ADMS made it possible for attachment to the Division to be done with discretion, to their mutual advantage without the dangers so clearly demonstrated in
After the
APART from the Division and the troops at the Base, there were other New Zealanders in the
The section, under the command of Captain H. G.
On 2 December 41 we reached the Egyptian-
Palestine frontier and camped. Both that night and the following day exceptionally heavy rain fell and we suffered a delay of several hours atBeersheba where the bridge was washed away. Travelling with a convoy via Gaza and El Ramele we reached Jerusalem on 3 December. Next day I went to the Hotel David only to discover that Force Headquarters had moved and the remaining staff knew nothing of the whereabouts of NZ troops in Trans Jordania orPalestine . I got a map of Trans Jordania and on 5 December set out for Akaba viaAmman where we stayed the night at the R.A.F. station.On receiving assurances that the main
Amman -Maan road was in good order we left for Maan but again the weather upset our plans. Some 30 miles south ofAmman terrific rains forced me to turn the truck west and out of the Wadi which was fast becoming a river. That night, after some difficulties, we reached Kerak in the hills and stayed at the barracks of theArab Legion . Despite the language difficulty, these people did everything possible to make us comfortable. Rain persisted all that night and thefollowing day so that we could move neither backwards nor forwards. Next day, 8 Dec., I made contact with two RASC trucks which had been marooned at Quatran and we decided to try and get to Maan via Tifilia—the main road being completely impassable. After a difficult day, pushing each truck in turn, we reached Mazer, a distance of only 30 miles. Again we stayed at a fort of the
Arab Legion of whose kindness and hospitality I cannot speak too highly. The following day, conditions being greatly improved, we arrived at Maan staying the night with the Trans-Jordan frontier force. Even that part of the journey was not without trouble as the heavy going raised our petrol consumption and although I managed to buy 4 gallons from a native store we had to pool all our petrol to get the three trucks as far as Shoback, 30 miles from Maan. All the remaining petrol was then put into one truck which went on to Maan and returned with supplies for the others. At Maan I found that part of the 21 ME Coy was atNaqb Ashtar , about half way between Maan and Akaba, and I reached this camp on 10 December setting up my tent there…. Severe storms prevented work next day—the camp is at a height of 4,000 feet—but since then conditions gradually improved and I hoped to go on to Akaba about 16 December.At Naqb Ashtar I completed, amid rain and snow, as many of the [men] as were available and, still in the rain, slipped down the steep face of the Naqb to the Great Red Plain of Guweira, now a vast sea of mud. After some 15 miles of this the truck foundered in a hole….
Our puny efforts to push it out were unsuccessful so we sat down to await the arrival of a large truck that I knew to be following. To this we tied the little Bedford truck and, like a child dragging a toy in the gutter, it towed us across the plain to the hard stony ground at the head of the Wadi Ithm, whence a very rough track lead to Akaba….
It was at Akaba that I met an English Officer in charge of Royal Engineers stores who needed dental treatment urgently. In return for my treatment he provided us with piping and canvas from which we made a canopy for the truck. This … was the only way I could get some cover which was essential if we were to continue to travel through these stormy lands….
All work here was completed and, as the road was again passable, we left Akaba on 29 December getting back to
Naqb Ashtar without assistance. Here they had collected the untreated men of the repair section and when these had been made dentally fit we left forAmman on 31 December.As the weather had been fine for some days and after consultations with a very odd Arab-living Englishman, Abu George, I decided on the route via the Wadi Hasa. This would cut out the mountains of the Kerak route but, in case the rain caught us in this lonely desert, I arranged with the OC Trans-Jordan Frontier Force at Maan to have us checked through his forts on the way. If anything went wrong they were to come out and look for us. We were fortunate and after travelling over the worst road I have ever seen, reached Maan that night. Next day, 1 January 42, I left Maan in heavy rain in search of the 36 NZ Survey Battery known to be somewhere in the
Jordan Valley and was lucky enough to cross the bridge at Es Salt a few hours before it was washed away. As we neared Jericho we saw a group of New Zealanders across a flooded stream which we forded without trouble and were directed to the Survey Battery's camp higher up theJordan Valley .The weather was execrable—Jerusalem was under snow—but I completed the work on the Battery by 9 January and set out in search of No. 1 Section of 21 ME Coy, who were on the
Haifa -Bagdad road inIraq . Rain made ituseless to try to cross the desert to Marfrak so I spent the night in Jerusalem. After refuelling at the Allenby Barracks we set off for Nablus on the minute and implicit directions of a Military Policeman. When the sun came out and the shadows were seen to be lying exactly the wrong way we found we were nearly at Hebron so returned to Jerusalem and tried another M.P. Again the careful instructions with the result that we started on the road to El Ramele and Egypt. Finally broken English and the greater accuracy of the local police got us to Nablus in the pouring rain and we spent a night and day in a small Australian Camp waiting for the weather to improve. Leaving next morning on the long run to Marfrak we were lucky to meet a NZ truck on the shores of Lake Tiberius and receive our exact location otherwise we might not have got to Marfrak that night. The next day our route was across the dreadful black desert of
Iraq to the Iraq Petroleum Company's pumping station H.3. Here the NZ troops were so scattered that I used the truck as a taxi to bring them in for treatment. Bitter winds and terrific frosts made working conditions unpleasant but the Petroleum Company's officials kindly lent me a room in one of their huts.From H.3. we moved down along the pipe line to G.1. and completed treatment for the 21 ME Coy, leaving for
Haifa on 17 January to find the Headquarters Section of that Company. Severe dust storms and later heavy rain delayed us and night found us at Tiberius…. Here for the first time the truck gave serious trouble. Two spark plugs gave out and there being no 14 mm plugs to be got we had to crawl over the hills toHaifa which we reached in the afternoon…. After much difficulty I got authority from Ordnance atHaifa to get plugs from a Depot on the road toTel Aviv . Here they only had 18 mm plugs so I accepted them in the hope of trading them inTel Aviv which we reached on 20 January. We had no success inTel Aviv but left the following day for another Depot atSarafand . We caught them before breakfast and bemused for they swapped the plugs with not a form to sign. At our best four-cylinder speed we hurried away lest they awake and begin the usual delaying action, stopping a mile or so down the road to fix the truck.Our work in Trans-Jordan,
Iraq andPalestine was completed and we set course forBeersheba and across theSinai Desert to the canal. We reached it in darkness but the Australians when they recognised us threw their bridge across allowing us to reach the road staging post that night. Next morning we left forMaadi reaching there at 1400 hours on 23 January 42.
This was an example of how the whole service was built up as a combination of small self-contained units. It showed how a dental section could perform all the functions of a Camp Dental Hospital or a
In early
The Mobile Dental Unit is intended to serve the NZEF as a whole and will therefore from time to time be moved where it can most usefully carry out its duties.
The decision whether the Mobile Dental Unit or part thereof is to be attached to NZ Division or to be withdrawn from NZ Division rests with the DDMS and it is for him to say at what stage attachments are to commence or cease. The ADDS is the adviser of the DDMS in this as in other matters.
When NZ Division is under orders to move from one location to another it will be the responsibility of the ADMS to raise with the DDMS the question whether or not the Mobile Dental Unit or such part of it as is attached to NZ Division is to move with the Division.
This gave the ADDS a stronger position and more control over the maintenance of dental health in the force.
The number of troops in
It was recommended, therefore, by the ADDS that 2 NZ Camp Dental Hospital should be disbanded and 2 NZ Mobile Dental Unit formed in its place. Should large numbers of reinforcements arrive in the future the Mobile Unit could always re-form as a camp hospital, or, as dental personnel arrived, a new hospital could be formed.
Authority was granted on
By the end of
It is convenient at this stage, after the withdrawal of the Division from the Libyan campaign and before following it farther, to take stock of the results of the work of the Corps. In his report of
With the exception of 5 Brigade Group, which is at present under treatment, the entire Force is virtually dentally fit.
A most striking feature is the almost complete absence of Acute Ulcerative Gingivitis and Stomatitis (Trench Mouth) a condition which is prevalent in all Forces in the
Middle East other than the2 NZEF .The
2 NZEF is probably in better condition dentally than other Forces in theMiddle East and, in general, all men with carious teeth have had them filled. Furthermore, mouths are inspected regularly and maintained in healthy condition. Since all Forces in theMiddle East are living under similar conditions it would seem as if the predisposing cause of the disease is mainly the presence of either salivary calculus or carious teeth which, by lowering the resistance of the gum tissue locally, provides a home for the pathogenic organisms to flourish and multiply.
Regarding trench mouth, it is interesting to note the precautions, other than those mentioned in the above report, taken by the NZDC to prevent an outbreak and to compare them with those taken by the
In the NZDC every case was treated by the Dental Officer but was also reported to the Medical Officer, with a recommendation that it be strictly isolated. In addition to this it was recorded on a dental history sheet which was sent to Headquarters for attachment to the soldier's personal file. Any suspected outbreak was reported immediately to the ADDS, with reasons for the suspicion and details of the steps being taken to prevent further spread of infection.
The Dental History of the Royal Air Force published by the Air Ministry in
The importance of being prepared for outbreaks of this disease when personnel were living under war time conditions was realised. The difficulty of deciding what constituted an outbreak was overcome by making all dental officers report if seven or more persons in any one week developed the disease. Vigorous measures were planned to control outbreaks and a special team consisting of a dental officer experienced in the treatment of diseases of the gums and two dental hygienists was formed to be sent to any station on which an outbreak had been reported. Extra dental hygienists were available if required. However, as this team was only formed in
1943 , treatment before this date was undertaken by unit dental officers with such extra assistance as could be provided. Fortunately outbreaks were so seldom encountered that only on four occasions was the team required.
Constant vigilance was common to both Corps and the elimination of salivary calculus was recognised as one fundamental in the prevention of the disease. The British service recognised this by the employment of dental hygienists and the NZDC by repeated emphasis in instructions to dental officers. Seven cases in one week in one unit would have created a state of extreme urgency in the NZDC. Apart from this, the elimination of caries was a large contributing factor in the prevention of the disease. The NZDC had to work at high pressure to achieve this result and it was working on the ratio of one dental officer to 1000 men, while the ADC with the
The work done by the NZDC to achieve this happy result during the twelve months 1 February 1941 to 31 January 1942 is as follows, the corresponding figures for the previous twelve months being given in parentheses:
In view of the fact that 67,000 men were examined during the year it can be assumed that most men in the force were examined at least twice.
EARLY in
The first task of the NZDC was to see that the Division was dentally fit before the move. With the exception of 5 Infantry Brigade Group, this had already been done by February so dental forces were concentrated in
On
On the first day he arrived at Jerusalem for discussions with the British ADDS on administrative and supply problems. Leaving Jerusalem on 15 April on his way to
Next day the ADDS visited the headquarters of the Division at
On 18 April the ADDS travelled from
The only dental section not so far inspected was that with 1 NZ
It has been mentioned that many men other than New Zealanders were reporting to the NZDC for treatment and, as it has already been pointed out that the success or failure of the Corps' task with the New Zealand troops was a matter of delicate balance, it became necessary to issue some directive lest the main objective suffer. Every New Zealand soldier was made dentally fit before leaving New Zealand and every soldier had to return to civilian life dentally fit. The NZDC with the
Naturally, pressure was brought to bear on New Zealand dental officers by troops other than New Zealanders to do as much work on them as possible. The directive from the ADDS was therefore not only a restatement of the policy of the Corps but an authoritative instruction on which the dental officer could lean to avoid the embarrassment of refusal. It was a commonsense document and can be briefly summarised:
Relieve pain, repair essential dentures and even make new ones if a man is obviously ill through lack of them. In other words, observe the usual code of ethics.
Complete all work for New Zealand units.
If time permits, do more extensive work for other units.
There was some argument that, as the British Government was supplying the stores for the NZDC in the
British troops did not arrive in the
Middle East dentally fit. This fact explains the very large amount of work in arrears which NZ dental officers have observed in the mouths of British troops and in consequence of which they will have realised that the prospects of them now attaining a standard comparable with our own, even with dental officers on the basis of one to every 1,000 men, are somewhat remote.It is therefore apparent that if officers of the NZDC were to undertake extensive treatment for British troops, the total effect on those troops would be relatively small; this policy would be accompanied and offset by a rapid deterioration in the standard of dental health within the
2 NZEF . There is no room for a relaxation of present efforts.Thus, it may be said that it is not that the
2 NZEF is over-endowed with dental officers but that, in our opinion, other troops have been short supplied in the past.
It is understandable that the British troops were continually asking for treatment as they had nothing like the NZDC organisation under field conditions. For example, in
Imperial troops have been presenting for treatment. The relief of pain and the insertion of necessary fillings have always been carried out. Denture work has, however, been refused except for repairs. The English soldier is in rather an unfortunate position in this area as no arrangements seem to have been made for his treatment. There is certainly no possibility of his receiving any work in the way of remodels or new dentures as the nearest dental centre is at
Beirut , about 230 miles away.
THE beginning of
The New Zealand Division was hurriedly moved from
The 5th Field Ambulance dental section was fortunate in not losing its equipment. The Dental Officer, when the brigade moved into battle, decided to leave his mechanic and heavy equipment at
At the beginning of July, the Dental Corps was working in its most concentrated form. From servicing a long line from
The units previously being treated by
It was not long before the Division began to notice the absence of regular dental treatment. The first to ask for it was 6 Infantry Brigade, and two sections of 1 Mobile Unit were sent to it. By the time they arrived the brigade had moved forward again. Fourth Brigade was then withdrawn from the battle to
A noticeable feature of recent months is the surprisingly small amount of attention 2 NZ Division required during the period of action. The number of men who had to leave their units for dental attention was negligible.
Between 16 June 42 and 27 July 42 only 50 NZ troops in the Field reported for treatment and the total treatment carried out by the three NZ Field Ambulances amounted to 20 extractions and 8 dressings. There was, therefore little need for NZ dental officers at all, whereas in the neighbouring Ambulances of other Forces it is reported that the Dental Officers were working full time on their dental casualties.
The above mentioned figures are abnormally low for dental casualties—particularly for New Zealanders—and it can only be assumed that the benefit of fully organised treatment is being felt throughout the Force.
Although the dental officers with the field ambulances were not overtaxed with casualties they could not be dispensed with on this account, as they were kept busy on a variety of duties. They did not keep their mechanics or heavy equipment with them except when conditions were expected to be reasonably static, and they carried out their duties from an emergency haversack. There were a certain number of jaw injuries to be attended to but, as pointed out earlier, these were much fewer in this war than in the last. The administration of anaesthetics took up an appreciable amount of time. During
Although there was little dental work required for the Division in the field, there was a different position at the Base. This was so far the longest action in which the Division had taken part and there were more casualties coming into the General Hospitals. To implement the policy that no man should leave the General Hospital-
Once again it was noticed that the number of maxillo-facial cases was small. Out of a group of
On
While the Division was in the training area in September-October 1942 preparing for the battle of
Before going on to the battle of
The unit was moved around five separate locations until we set up where we are now, north of the Divisional Sector ready for the show which has just taken place.
Had a few good days' work in which I made some of the unit dentally fit, and then the 6th were withdrawn and we commenced operating.
Most of the casualties from the land action came through us and we had one very busy spell with about 400 in 24 hours—many severe cases for operation among them. Was up all that night giving anaesthetics. The same night we had one extensive jaw injury which kept the Medical Officer, my mechanic and myself busy for a considerable time. The MO had to do an emergency tracheotomy and we had some difficulty in devising a support for the jaw during travel. Put a Stainless Steel wire on to the teeth on the larger fragment and attached it to a Kramer wire from a plaster headcap. A combined effort on the part of all three of us which seemed the best we could do with 40 or more cases, all urgent, waiting for operation. [This case travelled well, arrived in good condition at the General Hospital and progressed well.—Author.]
Have kept up with the dental cases all the time. The matter adjusts itself as, when there is a rush of battle casualties, nothing much comes back for dental treatment.
Have at last had a genuine experience of dentistry under fire. Was finishing a big filling when we had a Stuka raid, with two bombs 50 yards from the dental truck. Patient, orderly and I hit the slit trench at about the same moment—the patient still had a mouthful of cotton rolls…. Filling was undamaged and completed before we examined the bomb craters. We were really very lucky as the whole area was scattered with fragments—through the roof of the theatre, mess tent, etc. No unit casualties.
THIS was the period during which the Eighth
Between 20 and 23 October 1942 the New Zealand Division moved forward from the training area to take up battle positions, but the Mobile Dental Unit remained at
Only one month had passed since the Division left
Fourteen days were spent in this area until the Division moved across the desert in a flanking movement by way of
The unit was therefore instructed to join No. 1 NZ Casualty Clearing Station, remaining and moving with that unit so that the Division would know exactly where it was if required. On 5 December it moved to
The situation, 13 kilometres north of
It was understood that the Division would remain here for a short period only, probably over the New Year, so Headquarters and its sections were immediately distributed throughout the Division so that all men wanting treatment would have ready access to it. The dental officers from 5 and 6 Field Ambulances joined the Headquarters group.
It is convenient to pause at
The General policy of the Unit is to keep rendering units dentally fit at every opportunity but, at the same time, to give priority to casualties. It had been thought that the Ambulances would have been able to deal with the bulk of the latter and that this unit could have confined its work largely to routine work. This, for various reasons, is not possible under active service conditions.
In the first place, there are too many casualties for the Ambulances to treat in the time available. The length of the period out of action usually seems to be so small that the treatment of the casualties takes up the greater part of the time of all dental officers in the Field with, as a result, fewer routine examinations. Repairs become too much for one mechanic, although these could be decreased by repairing cracked and broken dentures only and leaving the replacement of teeth until later.
Secondly, the MDS of each Ambulance is, as a rule, located in a Divisional Medical area which is often some miles away from the Brigades, the ADS only being located with the latter. The dental sections of my unit, on the other hand, are located within the Brigades with the natural result that all work goes to them rather than to a MDS some distance away. Consideration was given to having the Field Ambulance dental officer with the ADS when a Brigade was out of action but the precedent that a dental officer is always with a MDS is too well established to be lightly departed from.
A third factor … is that it is general policy within the Division to have only one MDS open and, although there is no reason why the dental officer of the closed MDS should not work, in actual practice all dental patients that go to a MDS go to the one that is open. The one that is closed may not even be in the same area. Distribution of work between all dental officers within the Division is attempted wherever possible as is being done at present but this cannot always be carried out.
The speed of action in this chase after Rommel was finding out chinks in the armour of the organisation but, as the ADDS pointed out in a reply to this report, the answer was in Major Middlemass's own hands as adviser to the ADMS on dental matters. If he considered that the work of his unit and the efficiency of the dental treatment of the Division were being affected by not having a dental officer with the ADS, it was for him to advise the ADMS to that effect.
There were other difficulties due largely to the long line of communication and to enemy action. Water in the
In the early weeks of
Indications were that the Division would remain in the
The Division was now a great distance from its base so it was decided to form an Advanced Base at
It had become obvious that 1 Mobile Unit had as much as it could manage with the New Zealand Divisional Headquarters Group, 5 Brigade Group and 6 Brigade Group. No. 2 Mobile Unit had been working in
Even with the most careful conservative treatment there were bound to be some cases where the natural dentition deteriorated beyond the stage where the teeth could be saved. This is serious enough in civilian life, but with a force in the field is infinitely worse. Major Middlemass reported from
A certain number of patients requiring complete extractions are now presenting. With many of these men the retention of their teeth during three years of war has been made possible by persistent and periodic conservative treatment of the gingivae [gums] thus keeping them in a fair state of health. The almost negligible number of cases of Vincent's infection within the Division is evidence of the effectiveness of this treatment. Now, however, excessive recession of the gingivae and loosening of the teeth is becoming apparent and the stage has been reached … where conservative treatment is no longer indicated. Old partial dentures, so often the forerunner of full denture prosthesis, are a contributing factor.
These extractions will be carried out in a Casualty Clearing Station if a hospital is not available. Here the patient will receive the necessary care and attention and any post-operative treatment that may be indicated. Dentures will be inserted as early as possible to avoid sending men out on operations without teeth.
Judging by the returns of the number of extractions carried out in the
Another interesting fact was noted in the same report from
Another practice that has been found necessary on occasions in the Field is the making of a new denture instead of remodelling an old one when the time for treatment is uncertain. Sudden movement of units has resulted in men having to move without a denture which has been in the process of being remodelled with insufficient time to complete fitting and processing. To avoid this, new dentures are now made even though remodelling would suffice, wherever there is any uncertainty regarding the period that a unit will remain stationary. The old denture is taken from the soldier at the time of insertion of the new one.
The common sense of this is obvious. Except on the grounds of economy or the preservation of stocks in short supply, it appears that, for the comparatively few cases that come into this category, it is better to allow the patient to keep the old denture as a spare than to demolish it for the value of the teeth.
In early March the Division moved out of the
War Diary ADDS,Moved forward in the Mobile Dental Unit utility car. Am carrying five days' rations and sufficient benzine for 700 miles or more. In the evening found 1 NZ CCS on the13 March 1943 :Ben Gardane -Medenine road. The Division is on the move again and commenced the move fromMedenine today to its next assembly position. The 5 Field Ambulance is, however, still atMedenine but moving tomorrow. Found the Ambulance in the late evening and discussed dental matters with the dental officer attached.
The Division was on the move to an assembly position in the far south in preparation for a ‘left hook’ at the
Drove up to14 March 1943 :Medenine in the early morning. This town which fronts theMareth hills is within range of enemy guns. Drove back to CCS and discussed dental matters with dental officer attached. Located6 NZ Field Ambulance while they were on the march. Moved on toBen Gardane and in the late afternoon found 4 Field Ambulance on theBen Gardane -Foum Tatahouine track. At2000 hours moved out on to the Divisional axis again and drove through the night, the final hours across open desert, locating Advanced Divisional Headquarters in the final hours of darkness.
Saw ADMS and discussed dental matters with him. Delivered dispatches to the GOC15 March 1943 :2 NZEF and collected dispatches from him forCairo .6 NZ Field Ambulance arrived here at dawn and after lunch with them I began my journey back toTripoli . On the General's suggestion I did not return by theBen Gardane track but made a wide sweep south through the desert to avoid convoys and to travel over better tracks. Bivouacked the night on a high plateau aboveDehibat . The country was fascinating with deep gorges and precipitous canyons of many colours. The native Berberine villages are troglodytic.
Major Middlemass was deputy for the ADDS and was responsible for general co-ordination. In particular, he co-ordinated the systematic treatment of units and supplied reinforcements to dental sections in the field. Major B. Dallas was responsible for ensuring that all personnel moving to the field from the Advanced Base were dentally fit. Major Gleeson, dental officer attached to 3 General Hospital, was responsible for the control and direction of the dental aspect of maxillo-facial injuries.
It might be thought from reading the account of the ADDS's tour of the forward areas that dental sections there would do little more than cope with emergencies. It is of interest, therefore, to note part of the report of the dental officer with the CCS, Captain E. P. Pickerill, for the month of
Although certain sections of the CCS remained on their trucks at
Ben Gardane , the dental section was set up to relieve the congestion of patients at 15 CCS nearby. These consisted in the main of non-NZ troops and kept my mechanic and myself consistently busy.Practically all cases of non-NZ troops requiring new dentures were referred to British CCS's but it will be noticed that Corporal
Madigan (the mechanic) has been kept very busy with repairs, establishing a record for the month—66.
Cpl A. J. S. Madigan ; born NZ17 Dec 1919 ; farm labourer.Two cases of impacted wisdom teeth were referred by British Field Ambulances and have been successfully treated. I lay claim to be the first person to have removed an impacted wisdom tooth in Medinine.
The unit moved three times in the month. Work done is as follows:
|
Examinations | 207 | |
Fillings | 122 | |
Extractions | 107 | |
New and Remodelled dentures | 9 | |
Repairs to dentures | 66 | |
General anaesthetics administered | 53 | |
Maxillo-Facial cases | 10 |
This would have been a good month's work under any conditions but under field conditions was remarkable. It is all the more remarkable when it is realised that during all actions from the battle of
At the beginning of April, the Division had reached
No.
The method of attaching sections to units on this occasion was somewhat different from usual. As a rule the OC Mobile Unit arranged everything with the commanding officer, second-in-command or adjutant of the unit concerned. On this occasion, however,
This was virtually the end of the campaign as no further major action was fought on this front. The work carried out by the dental sections during this last phase is interesting as it demonstrated that dental work can be carried out in B Echelon areas during static or semi-static warfare, while it certainly should be carried out whenever a unit is brought out of the forward defended localities into an area such as the main divisional area. Major Middlemass's comments on this method of operation were a remarkably accurate forecast of future conditions:
Mobile warfare as it was known in the desert would seem now to be finished and future tactics will probably consist of attacks interspersed with periods of static or semi-static warfare of variable lengths with forward units holding defended positions. The operation of the Mobile Dental Unit from the time of the Battle of
Takrouna to the end of the North African Campaign, i.e., keeping the headquarters group some distance in the rear and sending sections forward to treat units when they are in a passive role, is probably a prelude to the method of working the unit in future operations.
As will be seen later, this was precisely what happened when the Division joined the Eighth
Major Middlemass's experiences with the Mobile Dental Unit established that unit as a functional entity with the force and laid a firm foundation for future dental organisation. His summary of lessons learned in that campaign is therefore valuable, although based on only one type of warfare:
The unit should move and remain with the Division provided the tactical position permits. Its place should be with the Administrative Group.
Note. It can move under any conditions but there is no object in taking transport over rough terrain if it can be taken over good roads after the Division has gained its objective.
In static or semi-static positions it is best situated with the Main Dressing Station, depending on the tactical situation. If this is not possible, a section or sections can be sent to the MDS.
Daily contact should be maintained with
Note. A complete section attached to the open MDS served the dual purpose of providing an extra dental officer to carry out routine duties while his colleague was working in the theatre and of making available an officer to carry out liaison duties between ADMS and OC Mobile Dental Unit.
During an advance such as this the placing of the unit under Corps administration for movement is not good practice. Corps will not necessarily move it when the Division wants it.
Note. After the advance from
The foregoing account, dealing of necessity with the organisation of dental treatment for the whole force, gives a broad picture of the campaign as it affected the NZDC. It is incomplete, however, without a closer examination of the conditions under which the work was carried out and the difficulties confronting the individuals who made up the dental team. The dental sections closest to the actual conditions of active warfare were those attached to the field ambulances. Captain N. E. Wickham, NZDC,
The change from the defensive to the offensive at
Alamein had its effect on the Dental Officer, for from the commencement of the highly organised advance across North Africa it became obvious that all his energies must be concentrated on dentistry. Especially was this the case for the FieldAmbulance Dental Officers as, with rapid advances across the desert, they were often the only ones with the Division. The precedent created in previous campaigns, and in such publications as the ‘ Army Medical Manual’, of using the dental officer in the Field Ambulance for extraneous duties such as Messing Officer or Liaison Officer had to be broken. Except for specialised duties for which his training fitted him, such as administration of anaesthetics or first aid, he must be left free to concentrate on his own work.There was always dentistry to be done and in the desert the only respite was during the relatively long moves which, though not restful, provided a welcome change from dental routine. Most of the dental work was of an urgent nature, such as relief of pain, treatment of gingival infections, urgent fillings, replacement of lost or unserviceable fillings, the repair of broken dentures and the replacement of unserviceable and lost ones. There were hospital facilities for multiple or impacted extractions and for post-operative treatment and observation. There was a well equipped operating theatre with anaesthetist and staff and a well-stocked dispensary. Apart from the work for NZ troops there is always a big demand from others. Even civilians made demands on the dental officers. These were treated only for the relief of pain but, especially in
Italy , clamoured for other treatment. Here the formula ‘Signor Churchill non permisse’ was sufficient deterrent although one more astute individual suggested that Mr Churchill need not know about it.Early adequate treatment of maxillo-facial injuries was very important and the Dental Officer with the Field Ambulance was usually the first to see these cases as he would probably be at the MDS. In the highly mobile warfare of the desert it was usually many days before these casualties reached the Maxillo-Facial Unit so treatment had to be as thorough as possible.
The ability of the dental officer to administer anaesthetics was more frequently used in North Africa than previously. The battle casualties arrived at the MDS in large numbers and, since the CCS was further back, more extensive surgery had to be carried out then and there. Most of the operations were short ones and pentothal was usually the anaesthetic of choice. After administration of the required dosage the anaesthetist could assist the surgeon and save time by attending to some of the minor wounds. Often in the desert after working for days in a hot sticky canvas theatre with only a few hours' spell, one was faced with a large amount of accumulated dental work. At other times, the dental tent being pitched near the theatre, it was a question of dentistry by day and anaesthetics by night.
An infrequent but important duty was the dental examination of unidentified bodies. Dental evidence has at times proved invaluable in the establishment of identity of such bodies.
Captain Wickham found faults in the transport and accommodation provided for the dental section with his field ambulance. Unlike the Mobile Dental Unit and the other field ambulance, his dental section had no transport of its own but had to share a 3-ton vehicle. This was unsatisfactory for the truck became loaded with all manner of gear and personnel, making it difficult to locate, unload and sort out the dental equipment when it was needed. Together with the erection of the tent, this was a formidable task for three men, and the mobility and general efficiency of the section were
Individual ingenuity, added to an excellent relationship with the workshops in the Division, produced refinements in the standard equipment, increased efficiency and provided extra comfort beyond the bleak though adequate necessities of dental practice in the desert. For example, the lack of a saliva ejector was keenly felt and led to awkward moments during operative and surgical procedures. An efficient substitute was improvised by reversing the plunger and valve of a motor-tyre foot pump and connecting it to a reservoir and ejector tube. The mechanic's hand lathe, requiring two to operate, was converted into a foot-treadle lathe which could be operated alone. Equipment was made in the workshops to enable gold inlays to be made, possibly a luxury for field dentistry but nevertheless an additional service should time and circumstances permit. Even the greatest ingenuity, however, could not completely disguise the discomforts and defects of operating under active war conditions. Captain Wickham's description gives some idea of the general conditions:
The experiences of a non-combatant such as a dental officer are routine and, for the most part, unexciting. Some of these however may prove of interest and provide a rough picture of every day life in the field. The more exciting ones when under attention of the enemy by shell fire or bombing and strafing from the air are infrequent though vivid enough to leave a deep impression.
The desert'. Associations and memories conjured up by these two words are deeply engraved and will far outlast those related to life in
Italy . Physically it is just an ever-extending expanse of brown, barren terrain, mostly flat, hard-surfaced and covered with stunted shrub growth but, in places, soft and sandy and in others, rocky and ragged. In places it rises to hills and mountains and in others gives way to precipitous escarpments and deep wadis. Spiritually it holds a fascination and possesses a character that draws and holds one insidiously. Its length and breadth, its utter silence and its complete disregard for man convey a sense of the everlasting. Except when molested by man's war machines, it lies as it has for centuries, pure, unspoiled and quiet, changed only by nature whose winds obliterate scars and conceal the past. Here, away from the civilization of cities, one was thrown into close contact with men for long periods under all sorts of conditions. Tempers were tested but one developed a peculiar sense of humour and achieved a spirit of camaraderie which will long be remembered.Since for the most part, one was continuously moving across the desert, life revolved about the truck and its crew. It may have been one of the
small 15 cwt. class though, more probably, it was a sturdily-built, all-steel, 4-wheel-drive three-tonner, the type to which Field Marshal Montgomery attributed very largely the success of the Eighth Army . One of many motor vehicles scattered over the surface of the desert as far as the eye could see. When the Division moved in convoy in long lines up to 10 abreast with 100 yards between vehicles, each one left in its wake a small cloud of dust as the whole assembly moved relentlessly forward as one unit.A typical day on the move would be something like this. An hour before dawn, the blackest and coldest time of the night, a voice using a variety of expressions announced that a new day, just another day, was about to begin. In complete blackness, no lights being allowed, one groped for clothes, rolled up one's bed-roll, threw it onto the truck and set off for the cook's vehicle for a breakfast of biscuit porridge and a soya bean sausage. One was saved the shock of the early morning wash by a scarcity of water. Shortly after first light the collection of trucks and ambulances that comprise the transport of a Field Ambulance were bumping along in dispersed desert formation.
If there is one thing more than another that a soldier considers essential, it is his mug of tea so, in addition to the midday stop for lunch of canned meat and hard biscuits, stops were also made for morning and afternoon ‘brew-ups’. All day one's ears drummed to the screech of second and third gear travel for the going was too rough to permit the use of top gear except on rare occasions. All day one's body was fatigued by continual bumping as well as being generously coated with fine dust. In the late afternoon a halt would be called and the vehicles would be dispersed for the night. Having excavated a shallow slit trench incorporating a hip hole for comfort, one laid out the bed-roll and set off for the cook's truck. Here the hot meal of the day consisted of tinned meat and vegetables followed by rice and dehydrated apples.
By the time the problems of the day had been discussed the next thing was to find one's own truck again in the darkness. Wise and experienced men carefully noted its position in daylight or took a compass bearing on it from the cook's truck as, although there might be only a few hundred yards to cover, moonless nights in the desert are really black, landmarks nil and directions meaningless.
At times during pursuit when an endeavour was being made to cut off elements of the enemy, travelling would extend well into and through the night. These night moves were carried out in the entire absence of lights, each vehicle blindly following the one in front as closely as possible. They were particularly hazardous and the miracle was that so few trucks suffered serious damage from the jolting and bumping over rough terrain.
Whenever, during the advance, the Division paused to fight a battle, a Field Ambulance in the matter of an hour, set up its tents and equipment, dealt with casualties and then remained behind to evacuate these whilst another Field Ambulance went ahead with the Division.
Working conditions … were difficult. Ample light being essential, one was obliged to accept with it exposure to the prevailing weather conditions. In the desert this often meant working in a flapping tent with fine dust, whipped up by an angry wind, swirling into every nook and cranny, covering equipment and even the field of operation. Maintenance of equipment, especially working parts of it, was a real problem under these conditions whilst instruments dropped on the ground in soft sand or mud were difficult to retrieve. Only modified asepsis under such circumstances
was possible and often, as one had begun some surgical operation, a picture of a clean, neat surgery or theatre with instruments neatly laid out and white-clad figures in attendance, flashed vividly before the mind. Yet, … remarkably few cases developed post-operative complications. Sometimes the patient and operator were bathed in perspiration and the instruments almost too hot to handle, whilst, on other occasions the operator's hands were too cold and numb to work and the patient too cold to remain sitting in the chair. Though disconcerting at the time, in retrospect there is humour, belonging to these times in the desert, such as when diving for one's slit trench during an air raid one found it already fully occupied by one's patients awaiting treatment.
The policy of dental treatment in the field, ‘to ensure that the standard of dental fitness attained in base areas does not deteriorate unduly’, was carried out. In his quarterly report of
Once again it has been difficult to maintain continuity of treatment in forward areas but this is to be expected. In fact, for planning purposes the conditions of recent months should perhaps be considered the normal. Nevertheless, despite the continual movement and action, dental units in the field have succeeded in maintaining a fairly constant return of work. Needless to say, however, there are some sections of the Division whose treatment at the moment is in arrears, but this occasions no great alarm since the Division only needs to be disengaged for a reasonable period for these arrears to be made good by the dental personnel concentrated in the Field.
There are four salient points arising from this account of the North African campaign that should be stressed:
The handling of the Mobile Dental Units during such a war of uncertain movement as exemplified by the withdrawal of them from the field to avoid unnecessary hazards was correct tactics.
During a victorious advance with the odds in our favour, the place of the Mobile Dental Unit is within the Division.
On the march across North Africa, despite extreme mobility, the Mobile Dental Unit was able to play a useful and worthwhile part.
The forecast of the OC
IT is convenient at this stage to look back on the year
The dental returns, for New Zealand troops only, from 1 January to 31 December 1942 are as follows:
It is estimated that the average strength of the
Of the 30,000 men of the force, 7000 is a fair estimate of those without any natural teeth, i.e., wearing full upper and lower dentures. The incidence and development of dental caries was such, therefore, that 43,000 fillings were needed for 23,000 men, or about 1·87 fillings per man per year.
It was estimated that on
The small number of teeth extracted as compared with the number of fillings inserted, viz., 11 in every 100, can be regarded as a tribute to the quantity and quality of conservative treatment the men had had and were having at the hands of the NZDC.
As far as the figures show, the whole force was examined twice during the year and, with the exception of
One very significant fact comes from a study of this year's activities and that is that organised and systematic treatment of a group does make an impression on the volume of maintenance work to be expected in the future. The denture problem is probably reasonably static in the New Zealand Armed Forces, but the incidence of caries can be and was reduced during
DURING the early weeks of
Other things, too, were happening at this time which considerably affected the Dental Corps. The first was that, at the express wish of Headquarters Oranje as ship's dental officer for a three weeks' tour to Oranje's dental officer, came ashore in the meantime. Major Middlemass was appointed to take over the duties of ADDS as well as his command of 1 Mobile Unit but, until he could be flown from
The second was Scheme RUAPEHU. The New Zealand Government decided that a large number of long-service personnel should be returned to New Zealand on furlough. It was not expected that the draft, consisting of all married men and a large percentage of single men of the First, Second, and Third Echelons, would leave
It had always been the practice to make all men returning to New Zealand dentally fit. In this case, the large number in the draft (about 6000) and the short time between the publication of the names and the date of departure made it impossible even to attempt it.
The return of the Division to the Delta and the decision to quarter it in
The Division arrived in
The Hospital Ship Oranje returned to
During July, while the Division was being treated under good conditions in
The
At the same time Scheme WAKATIPU, under which the balance of the First, Second and Third Echelons were to return to New Zealand, was launched. These men were not expected to leave until the end of November, when those of the Ruapehu scheme who were coming back to the
Two interesting discussions took place during August on the functions of field ambulance dental sections and mobile dental units.
The first was between Lieutenant-Colonel Middlemass and Major-General Austin, DDS of the War Office,
: He [Major-General Austin] considers that having a dental officer permanently attached to the MDS of Field Ambulances results in a considerable waste of the dental officer's time. Instead of carrying out dental duties, very often he is asked by his commanding officer to do other regimental duties. Apart from this, when the Ambulance is not in action and resting, very frequently no patients are available in the same area. This is all perfectly true.12 August 1943 In view of these facts Major-General Austin is of the opinion that the organisation should be such that the dental sections attached to a Field Ambulance can be detached and placed in an area where it will do the greatest good, e.g., at the ADS or even with a line unit which may be resting. The location of dental officers would be controlled by an ADDS at Corps or
Army Headquarters. These views coincide with my own to a large extent at the moment. Certainly something will be done to make greater use of ambulance dental officers and bring them more under control of a Senior Dental Officer in the Field. OC1 Mobile Dental Unit can perform the functions of a DADDS.
24–25 August 1943: In further discussions with Major-General Austin about dental officers in the field he said he thought one solution might be to have Mobile Dental Sections only in the field and no attached dental officers to the Ambulances. ADDS Corps orArmy would decide where these sections were to go. When it was considered necessary to have a dental officer attached to an Ambulance, e.g., when it went into action, aMobile Dental Section would be attached. As far as2 NZEF is concerned the administration of NZDC in the Field could be improved by two means, each of which would give the same end result—unity of all NZDC personnel under one senior dental officer instead of the present organisation where 8 officers in the 1 NZ Mobile Dental Unit are under command of the Unit CO but who has no authority over the dental officers attached to the Field Ambulances.The administrative position could be consolidated by increasing the establishment of a Mobile Dental Unit by three sections to include the dental sections attached to the Ambulances, which would thus become part of the Mobile Dental Unit.
The other solution is to make the Mobile Dental Unit a Divisional one with a DADDS at Divisional Headquarters. The first alternative would probably be the one of choice.
Major-General Austin's views were naturally based on his knowledge of the British organisation wherein the dental officer attached to the field ambulance was less concerned with continuous dental work under all conditions than his counterpart in the New Zealand Forces. It must be remembered that during action, especially during such a long and vigorous operation as the pursuit of Rommel across North Africa, the dental officer with the New Zealand Field Ambulance worked almost beyond the limits of human endurance. He was dental casualty officer for a brigade, maxillo-facial expert, anaesthetist, first-aid assistant, sometimes liaison officer and often fairy godfather to troops less fortunately situated than his own. The brief respites from this were when the Mobile Dental Unit caught up with the Division. It is reasonable to grant him at least a reduction of tempo at these times. He was still responsible for casualties from his brigade, but the systematic and more extensive treatment belonged to the Mobile Unit. As a member of the field ambulance he was part of his brigade and belonged exclusively to it. He was always there when he was wanted, he absorbed something of the tradition of the brigade in general and of his field ambulance in particular, he shared their triumphs and vicissitudes and was accepted as one of a team. To make him just one of many Mobile Unit dental officers would be to sacrifice a degree of individuality impossible to recapture. His duties were not the same as those of the officers with the Mobile Unit and to that extent he became something of a specialist in his own branch. General Austin's proposals, therefore, while possibly applicable to the British organisation, did not apply to the New Zealand field force. Lieutenant-Colonel Middlemass's concurrence with them was based on his experiences as OC Mobile Dental Unit in the field. Later, as the result of further observation and, after full discussion with Lieutenant-Colonel Fuller on his return, he fully supported the blueprint laid down originally. At the time, however, the recent North African campaign, a victorious advance against decreasing enemy resistance, dominated the position and hid the broader concept designed to cover all types of warfare. This is exemplified in the second discussion which took place between Lieutenant-Colonel Middlemass and the ADMS regarding the use of the Mobile Unit. They were in full agreement on four fundamental points, which
The Mobile Dental Unit should move with the Division in the Administrative Group. The Unit should either be completely within the Division or completely away from it. In the event of a sea-borne invasion the Unit would be among the last to be moved, probably with the Divisional Workshops.
This conclusion was satisfactory for the type of warfare envisaged but was a dangerous precedent to establish too firmly. The infinite variety of circumstances met in warfare must dictate the policy at the time. When under the command of the Division in the field, all movements and attachments of the Unit were made by the OC in consultation with the ADMS, and as these two were, or should be, in constant communication, it was unnecessary and unwise to prejudge the position.
There are occasions when a section from the Mobile Dental Unit could be attached to the open MDS even when the latter is operating in very forward areas. Very often the dental officer attached to the Ambulance may spend a large amount of time in the theatre and is then unable to carry out work on dental casualties. The section from the Mobile Unit would be able to do this work while the Ambulance dental officer would carry out the necessary wiring, etc., for maxillo-facial wounds. Further, the number of dental casualties that present at an MDS is often more than one dental officer can cope with.
This, of course, was based on experiences in the recent campaign, probably at
There are times when a section from the Mobile Dental Unit may conveniently be placed with the ADS, e.g., in static warfare where the Division is holding a front, a dental section located at the ADS makes the evacuation of dental casualties back to the MDS unnecessary. The Field Ambulance dental officer must remain with the MDS in order to be available to assist in the treatment of any maxillo-facial wounds.
Where, however, an MDS is closed and two or three ADSs are evacuating to one MDS, then the dental officers at the closed MDSs may move up and carry out dental treatment at their respective ADSs.
This was an academic point and proved to be neither necessary nor practicable. In static warfare, such as occurred in
Dental personnel at Ambulance dental sections come into the administrative control of the OC
This has already been discussed but was sufficiently out of line with the policy set out by Lieutenant-Colonel Fuller to become the subject of a special directive added later to his book of instructions for dental officers:
Where a Mobile Dental Unit is attached to a NZ Division in the Field, the officer commanding the Unit has no authority or power of command over the dental officers attached to the NZ Field Ambulances, but, nevertheless, it will be his task to co-ordinate on behalf of ADDS
2 NZEF , and in his absence, the local arrangements as regards dental treatment within the Division.
There were even occasions when the Field Ambulance dental officer, holding different opinions from those of the OC Mobile Dental Unit, was empowered and encouraged to forward his views to a higher authority by different channels. An example of this was the procedure to be adopted when an outbreak of Vincent's infection was suspected. Paragraph 19, sub-paragraph (b) of ‘Notes and Instructions’ reads:
When an outbreak of Vincent's infection in an area is suspected by a dental officer he will furnish a report immediately to ADDS
2 NZEF detailing the reasons for his apprehension and the steps being taken to prevent further spreading of infection.If the outbreak is suspected by an Officer of a NZ Mobile Dental Unit attached to a NZ Division, or by OC the Unit, the report will be furnished to ADDS
2 NZEF by OC the Mobile Dental Unit. The report will also be forwarded to ADMS the Division and will embody recommendations to him for a local administrative medical instruction on the subject.If the outbreak is suspected by a dental officer attached to a NZ Field Ambulance or NZ Mobile CCS he should immediately raise the matter with OC the NZ Mobile Dental Unit attached to the Division. The latter may then decide to carry out the procedure outlined in sub-para (
b) (2) above. If, after raising the matter with OC the Mobile Dental Unit, the dental officer feels he should takeaction independently he should furnish the report described in sub-para ( b) (2) above, with the following modifications, viz., the copy for ADMS should be made out to OC the NZ Field Ambulance or NZ Mobile CCS for onward transmission by him and a third copy should be forwarded to OC the Mobile Dental Unit for information.
Before leaving the subject of the discussion between the ADDS and ADMS, there are two other matters on which comment should be made. The first was that the Mobile Dental Unit was to display the
The Division moved to Burg el Arab in mid-
Apart from the field units, New Zealand Advanced Base was reformed as a unit of the
Meanwhile,
These arrangements did not have to last long as, late in November, the decision was made to transfer Headquarters
Training depots and parts of certain services were to remain at
It was hoped that all patients in 1 General Hospital would be made dentally fit before leaving the hospital, so as to relieve
Reinforcements.
All reinforcements from New Zealand were to go to
Repatriated Personnel.
Besides acting as a reinforcement camp,
Those in
Routine treatment of the staff of Maadi Camp.
These were to be examined and treated once in every six months, the work being carried out between the arrival of reinforcements.
As the New Zealand Store was moving to
A number of protected personnel were repatriated at this time from
The end of
The following table gives a comparison of the work carried out in the four years:
The full officer strength of the Corps was not reached until
It will be noted that, in spite of the fact that 6319 more examinations were carried out in
On
The GOC
2 NZEF has instructed me to express to you his appreciation of your work with the Division. He realises the large amount of work involved and the high dental standard of the Division.signed:
R. D. King,
Colonel,NZMC .
Brig R. D. King , CBE, DSO, m.i.d.; Greek Medallion for Distinguished Deed;Timaru ; bornTimaru ,25 Feb 1896 ; medical practitioner;1 NZEF 1918–19 (Private,NZMC ); physician1 Gen Hosp 1940–41; CO 4 Fd Amb 1942–43; ADMS 2 NZ Div Jun 1943–Dec 1944; DDMS NZ Corps Feb–Mar 1944.
ADMS 2 NZ Div.
THE transports carrying the main part of the New Zealand Division and the field dental services arrived at
The Mobile Unit moved forward with 5 Infantry Brigade, being the last group of New Zealand troops to leave the
The troops were now high up in the hills and it was cold and damp, with a thick Scotch mist which took fully two hours to clear to a visibility of twenty feet. Passing through
Replenishment of stores was difficult at this time as the source was No. 7 Advanced Medical Store, which had only limited supplies. Additional indents had to be placed with the dental store at
The Division remained in this area for nearly two months which marked a definite chapter in the saga of the Dental Corps. The Sangro River gave its name to this front, and to this day the word ‘
Routine treatment was impossible this morning as most of our tentage collapsed at 0300 hours under a severe snowstorm. The area was a shambles…. Any attempt at drying out was useless. Drains were made and all spare personnel were housed as comfortably as possible in an E.P.I.P.
tent. Only the good spirits of this grand crowd of fellows made even our existence worth recording. European Personnel Indian Pattern.
The tented life in the field under winter conditions in
Italy depresses the morale but a source of comfort to every soldier is the charcoal brazier. Charcoal is a common form of fuel inItaly and a small tin of glowing embers sheds a considerable amount of warmth in a tent or bivouac. It also gives out a certain amount of carbon monoxide but casualties from this are relatively few. The tin is energetically twirled, before dark of course, to produce a brazier full of glowing coals which will not fill the tent with smoke.
Perhaps the most unique and picturesque setting this dental section has operated in so far in
Italy was in Castlefrentano during the Xmas-New Year period,1943 /44. So as to be in a building the MDS was establishedin the schoolhouse, a distance of 4,000 yards from the FDLs. There were no ADSs forward of Castlefrentano and as casualties in the first battle for Forward Defended Localities.
Orsogna were heavy, the dental section was called on to do additional duties. The dental officer administered anaesthetics and the orderlies were stretcher bearers. The surgery window, without glass, looked on to the Appenines which were completely snowclad and, during daylight, a magnificent sight from the chair.One of two things happens to a soldier who reports sick for dental reasons in the line. He is either held till the unit comes out to rest or he is evacuated to the open MDS depending on the decision of the RMO.
The former are generally denture troubles or broken fillings which are not causing great inconvenience while the latter include acute troubles and Vincent's Stomatitis. In one area I was in, movement in and out of the line could only take place during darkness so the dental casualties arrived for breakfast and left after dinner at night. Regimental Medical Officer.
From time to time a down-trodden Italian peasant would ask for dental attention usually after suffering pain for weeks that no New Zealander would put up with for days. Every dental officer who has worked in the Division in
Italy will recall the familiar sight of a party of peasants cautiously approaching the tent, one of their number peeping at you through yards of woollen scarf. After ‘multi parlare’ chiefly by the relatives about ‘multo dolore’ and ‘niente dormire’, the tooth is located and, amid much holding of hands and performances is extracted.
It can be readily understood that the intense cold made it very difficult to operate, especially in tents. Apart from the disadvantages already mentioned of operating in buildings, there was the danger of contracting typhus fever which is common in southern
On
The
This was the position when Headquarters
The distribution of sections throughout the force was uneconomical but continued in this form through the month of February. With the Division, the field ambulance dental sections were dealing with casualty work and
Before describing the reorganisation, one result of Colonel Fuller's return should be mentioned. It had originally been intended that Colonel Middlemass should be granted furlough in New Zealand on handing back the command. Circumstances had altered, however, and it meant that he had to revert to the rank of major, return to his former command of
The type of warfare in
One solution would have been to move 2 Mobile Unit up to the Division but there were difficulties associated with this. The organisation would have been uneconomical and cumbersome and the duties of the respective commanding officers of the Mobile Units might have clashed. Colonel Fuller had a better solution:
Both 2 NZ Mobile Dental Unit and NZ
A new unit, 2 NZ Camp Dental Hospital, with the same establishment as 1 NZ Camp Dental Hospital should be formed from the disbanded units and located, primarily, at
NZ Mobile Dental Unit should be expanded from a unit of eight officers to one of twelve, four complete sections being transferred to it from 2 NZ Mobile Dental Unit. This would mean that, with the three Field Ambulances, there would be fifteen dental officers available in the field, although not necessarily always employed in the field.
With this rearrangement the headquarters of one of the Mobile Dental Units would be dispensed with, and there was a corresponding saving in transport, dental and ordnance equipment, and personnel. As regards personnel, the dental service would lose positions for three staff-sergeants and three corporals, offset by an increase of two sergeants. This was of no great moment, especially as the ADDS intended to bring up the whole subject of rank in the Corps.
His recommendations were approved and took effect from
A further recommendation by the ADDS that the number of majors remain on a Corps basis, increasing in number from five to nine, was granted.
The ADDS also submitted a recommendation concerning other ranks in the Corps. The NZDC other rank had no prospect of attaining commissioned rank and, under existing regulations, could rise no higher than WO II. It was felt that the senior NCO in the office of the ADDS, who carried out the duties of Adjutant and Quartermaster to the dental service, if unable to be commissioned, should at least be a WO I. Similarly, the WO II with the newly constituted Mobile Unit now carried greatly increased responsibilities and should be similarly ranked. These were approved by Headquarters
The stores position at this time was not entirely satisfactory. All supplies came from British sources and it was not always possible to obtain as much as was required. Handpieces had become worn, allowing the bur to wobble and vibrate. For some reason new ones were difficult to procure and reconditioned ones were unsatisfactory. Those in use had seen four years' service and were due for replacement, so unless Memorandum from DDMS, AAI, to ADDS
TO preserve continuity in the story of the Italian campaign it is necessary to return to the Fifth
For six weeks the Division fought a bloody battle on this front. Dental treatment was consequently spasmodic, but by the time that the Division was withdrawn the Mobile Dental Unit had been reinforced by the addition of the extra sections from the disbanded
On the
In early April the subject of furlough for the 411 officers of the first three contingents who were still with the force was reopened and a ballot was taken among the dental officers as to who should be included. Majors Middlemass and B. Dallas were successful. Major McCallum therefore resumed command of the Mobile Unit and Major J. W.
The Division left the
In this type of warfare, with front and back areas of the Division so close to each other, most of the dental work was carried out in the back areas. The sections could be recalled and reattached easily and, even when the lines of communication lengthened, as they did when the Division again came under Eighth
A considerable amount of work was done for other than New Zealand troops. When the
The first few months of
One need only say that, wherever a dental section was found, there also would be a patient occupying the chair, boot soles facing tent door outwards, another waiting his turn nearby; dental officer head down operating at the chairside morning and afternoon, day in day out; mechanic in the background at his bench industriously supplying artificial dentures from laboratory to chairside.
June saw the Division advancing, now in the heat of an Italian summer, with the dental sections still attached to units and the headquarters of the Mobile Unit creeping up behind by stages. Where possible, unit headquarters was located near to the open MDS of the field ambulances, this being the most suitable area for the treatment of casualties and for keeping in touch with the dental sections. The dental sections were with the B echelons of units while the troops were in action, and at the various unit headquarters during rest and training periods. Another dental section was with the L of C units. From
Then for the first time since fighting began in
The next phase in the campaign, the taking of
On
An experienced NZ Dental Officer in his monthly report makes the following statement:
‘On enquiry it has been found that all patients examined here have been made dentally fit within the last six months. Nevertheless, as can be seen from the weekly returns, about half those reporting required gross scaling, and on enquiry it was established that in the majority of cases no such scaling had been done for the last twelve months. Obviously it is of no great value to concentrate on saving teeth by fillings if they are going to be lost by pyorrhoea.’
In comment on the above statement, I think it quite probable that a tendency has crept in to pass by unnoticed a proportion of cases that rightly should have been scaled. Will you please take care not to overlook this aspect of dental treatment.
Shortly after receipt of this, seven extremely virulent and five mild cases of Vincent's stomatitis were reported from the Division. What might have been a serious outbreak was averted by immediate isolation of the serious cases in hospital and suitable treatment of the others. An inquiry was instituted to find the reason for the outbreak. The result is interesting and instructive.
If scaling had been neglected, and it is understandable that the more obvious filling work might overshadow the importance of prophylaxis, there would be many mouths in a receptive condition for the disease. Unless by accident, a dental officer would not suspect its presence among the troops until a patient reported through pain or illness, and it was unlikely that he would so report until the disease had reached that stage. As the disease is contagious, efforts were made to trace the source of infection. The significant fact emerged that there was a large increase at the same time of venereal disease, traced to contact over a wide area with the Italian populace in the Divisional Rest Area at
It was then the Italian summer and working conditions were pleasant among wooded hills and vineyards famous for Chianti wine. The country, however, was known to be highly malarious and strict anti-malaria precautions had to be taken. The prospect of casualties from malaria was alarming to the Corps as the margin for wastage was extremely small. Several other factors were causing anxiety in this respect. Firstly, two dental officers had returned to New Zealand on furlough. Secondly, three were boarded for medical reasons and returned to New Zealand. Thirdly, Captain Pickerill, who had been in England undergoing a maxillo-facial course which had already extended longer than was at first expected, was recommended for a medical board on arrival back with the
The controversy in this last factor was between Headquarters in New Zealand and those in
An appeal has been received from NZ Headquarters in the
United Kingdom for these personnel to be supplied forthwith, as circumstances have arisen to increase the urgency. It may be taken that the appeal is a really genuine one. It is incumbent upon us to exert every effort to meet it…. The difficulties of the situation are fully appreciated by this Headquarters and have been communicated toLondon .
At great sacrifice and at the expense of
DDS considers insufficient provision has been made for dental requirements. He recommends as follows. (A) Personnel group HQ, 1 officer ADDS, 1 WO I, 1 S/Sgt, 1 Sgt, 5 Rank and File, total 9. Dental Pool, 20 officers (5 majors, 15 captains), 2 S/Sgts, 18 Sgts, 9 Cpls, 41 Ptes, total 90. (B) Full dental equipment and stores for 20 operators.
Above to serve
Navy ,Army , Air. He expects extensive work and strongly recommends all be made dentally fit before departure fromUK which is in accordance with general policy and greatly in interests Prisoners of War.Personnel to be provided (A) 3 officers 12 other ranks by ‘Fernleaf’.
(B) 10 officers 26 other ranks from Prisoners of War. (C) 8 officers (including ADDS) and 40 other ranks from New Zealand. These and equipment etc., to be despatched by direct ship estimated time of departure 25 August. HQ
2 NZEF .
A copy of this cable was sent to volte-face and, in effect, made it appear that New Zealand considered that the inclusion of any
Dental personnel to be supplied by
2 NZEF viz., 3 officers, 12 other ranks cannot leaveItaly until early September…. Suggest therefore for consideration that replacements being sent from NZ to2 NZEF for this party should be sent direct toUK and that we do not supply any personnel.
This was agreed to and the
A further drain on the resources of the Corps in the
At the beginning of August, Major McCallum relinquished the command of
On 25 September Colonel Fuller fell a victim to infective hepatitis (jaundice) which was claiming many victims in the force. He was admitted to 1 General Hospital but continued to attend to service affairs while a patient, being assisted by Major Johnston, OC
In early October the proposed move of Advanced Base to
Reinforcements continued to arrive in Egypt from New Zealand and
November ushered in a change in command of the NZDC with the Principal Dental Officer.
Before handing over command, Colonel Fuller made a concession from his original ideal. It was one forced on him by circumstances over which he had no control. It had already been agreed that, on the cessation of hostilities, no attempt would be made to examine
Reinforcements for the Corps were not coming to hand as quickly as anticipated owing to an altered date for the arrival of the Oranje on 15 December. At the same time word came from New Zealand that five others were on their way, four of them by the Hospital Ship Maunganui. Major Colson took over command of
With the battle moving steadily northward, the greatest concern in regard to treatment was the lengthening of the Lines of Communication, throwing an added strain on those dental sections responsible for the treatment of non-divisional units. It meant that the responsibility had continually to be changed from one section to another, with frequent redistribution of personnel. At the end of
With the Division in the
1 NZ Mobile Dental Unit
1 NZ Mobile CCS
4, 5 and 6 NZ Field Ambulances.
Note. A detachment from the Mobile Dental Unit had been sent to Rome to treat the staff of the New Zealand Forces Club there.
At
1 NZ
1 NZ General Hospital. Maxillo-facial specialist, Major A. T.
At
2 NZ General Hospital.
At
3 NZ General Hospital. This hospital now had two dental officers and the requisite number of other ranks to handle all treatment in the
At
A detachment of 1 NZ
At San Basilio.
2 NZ Camp Dental Hospital.
In Egypt.
1 NZ Camp Dental Hospital at
The returns for the year 29 January 1944 to 27 January 1945 show that even more work was completed than in the previous year, 1 February 1943 to 29 January 1944. Static warfare, with its greater facilities for attachment of dental sections, would account for this to a large extent, though shortage of staff would counteract some of this advantage. The previous year's figures are in parenthesis:
It is significant that the number of extractions in proportion to the number of fillings had noticeably decreased, showing again that conservative treatment relentlessly carried out was having its effect.
During February, March and early
In the middle of April the type of warfare changed with the breakthrough at the
On 1 May the headquarters of the Mobile Unit began its longest move for some time, crossing the Rivers Po and
Skeleton staff only. Official holiday.
In contrast the Mobile Dental Unit's diary reads:
9 May 1945:
0800 hours. Weather fine with promise of heat.
0830 hours. Treatment of casualties presenting.
0915 hours. CO called on CO
1200 hours. Normal daily routine.
It is possible that the two hours spent with the CO 4 Field Ambulance were in other than official pursuits, even if the time was a little unusual for a social call. It is more probable that the large number of denture casualties anticipated and realised after every action was enough to monopolise the thoughts of every dental officer in the field.
Naturally the dental service was affected by the changed role of the Division, but this did not happen suddenly. To begin with, treatment continued as before but, after several weeks, adjustments had to be made to meet the new conditions. Generous leave was given to divisional troops which interfered with routine examination and treatment. Later a different position arose and all dental officers were besieged by troops wanting a ‘check over’ and the casualty rate rose to high proportions. Lost and broken dentures came in in numbers far greater even than when the Division was in action. The penalty of having to pay for loss of dentures by negligence seemed to have little deterrent effect after hostilities had ceased. It was found necessary to withdraw several sections of the Mobile Unit from routine treatment and place them throughout the Division to cope with the increased casualty treatment in their immediate vicinity. In contrast to this, the general hospitals became less busy as casualties were not coming in from enemy action. Several replacement schemes were in force whereby those men with the longest service overseas could be returned to New Zealand, being replaced
No attempt was made to examine and systematically treat the personnel returning to New Zealand under the replacement schemes, although all who wanted treatment could have it. This had been agreed upon between
It has now been decided that personnel certified dentally fit within four months of embarkation for NZ will NOT, repeat not, be dentally examined on arrival in NZ unless on personal request. Every effort will therefore be made to render all personnel dentally fit before embarkation. Dental history sheets of those requiring dental examination or treatment only to be attached to personal files. Dental Officer with draft to prepare nominal roll of those requiring examination and/or treatment for delivery to DDS.
The ship's dental officer would have neither the time nor the facilities to examine a large draft and raise the required nominal rolls, so it meant that examinations would have to be completed before embarkation. More dental officers would have to be kept at the two base hospitals.
a) b) winding up c) either of these two. With the exception of those who volunteered for these services, officers and men would be released strictly according to length of service when circumstances permitted. The equity of this decision was not fully appreciated by New Zealand as repeated requests for individual releases were made, irrespective of the order of priority.
On
Regarding stores and equipment, it was proposed to send everything to New Zealand, as was being done with medical stores. This, however, was not agreed to by New Zealand, who stated that they wanted nothing but the maxillo-facial equipment. It was therefore decided to offer it to UNRRA, which agreed to buy it.
IN the search for an ideal there is fascination in the intricacies of the chase, satisfaction in the smoothing of the way and pride in the development of efficiency and power. All played their parts, important parts, in the story that has just been told. Yet all are subordinate to the ideal which runs as the only sure path through the maze of complicated detail. Lest the bypaths should lose us in their seductive lanes, it is right that the highway should be floodlit that its surface may be examined for imperfections and the seal set upon its laying. Let us quote the policy on which the reader may judge the degree of achievement. ‘Notes and Instructions relating to the Organisation and Administration of the NZ Dental Corps
It is the purpose of the NZ Dental Corps to provide a service within the Expeditionary Force that is readily accessible to every soldier and that, by being on a scale sufficient practically to eliminate oral sepsis from the Force, makes the maximum contribution towards the common effort of developing and then maintaining a high degree of physical fitness among the troops. Moreover, its efforts must reduce to an absolute minimum the occurrence of dental pain throughout the Force and, as far as possible, prevent the loss of effective men from their units on account of dental lesions.
Because of the fact that every soldier is made dentally fit in New Zealand prior to embarkation, it is the consequent responsibility of the NZ Dental Corps in the Expeditionary Force to endeavour to maintain every man in that state…. Furthermore, by maintaining that standard, the well-being and efficiency of the
2 NZEF as a whole will be favourably influenced, a consideration that is important above all others.In addition, the NZ Government has undertaken to return every man to civilian life dentally fit when the time arises. Hence, it is desirable, for this reason also, that the standard of dental fitness within the Force should not be allowed to deteriorate, even though the above Governmental undertaking may have no direct bearing on the immediate war effort overseas.
In general the scope of the dental service must be wide, extending from the specialist branches of oral surgery and the dental aspects of maxillo-facial injuries down through the Base dental installations, whose conditions closely approximate those of civil practice, to the dental service in the Field which, although operating under active service conditions, must also be adequate and complete.
In general, and in keeping with the constantly changing features of war, the organisation must be flexible and capable of immediate modification and expansion to meet special circumstances. In particular, it must be designed to serve a Force whose component parts are, for the most part, mobile.
Lastly, the size of the service must be in balanced proportion to the other needs of a Force whose purpose is primarily to fight. The service must never be organised and expanded to such an extent that some of its operations, when measured in relation to the purpose of the Force, are unnecessary; nor should they ever hinder essential military activities of units of the Force, but, on the other hand, their effect should be continually to contribute towards and act as a stimulus to general fitness and efficiency.
On these postulates the organisation and equipment were based. The road was not easy but, from the early squelching in the mud through the comparative comfort of macadam to the ease of the autobahn, it was followed with determination and courage. No soldier was ever far from a dental section of some kind, neither was oral sepsis nor dental pain allowed to interfere with his efficiency. The precious asset of dental health was not only his for the asking but was cherished for him by the constant vigilance of the dental service. Not only was his dental health maintained, it was improved and he was encouraged to appreciate its value and co-operate in its establishment. All this was done without interfering with his duties as a soldier or seriously curtailing his hours of leisure. He was treated as an individual, not as a cog in the war machine. There was always a danger that the struggle for material results might submerge the right of the individual to human consideration and sympathy. This was recognised as one of the risks to be run in an impersonal socialisation of a personal service and steps were taken to lessen that risk. The ADDS wrote an article for the New Zealand Dental Journal from which the paragraphs relevant to this subject were deleted in
Institutions, organised services and communities, where the craftsman and the scholar are regimented, tend to become soul destroying. In the case of the dental profession, war time service in an Expeditionary Force probably suppresses, or even destroys the individuality of some operators. That is inevitable. War demands that the individual shall contribute his personality to the common cause. In any event, no dental officer is justified in expecting directly to profit by his service experience.
The greatest weakness is the tendency for operators to pay less attention to the approach towards patients and the handling of them. Those who have left civilian practices to join an
Army Dental Service find suddenly that their livelihood ceases to depend on these requirements. Consequently, unlessthe weakness is known and guarded against, there can be a tendency in Camp Dental Hospitals and similar units for patients to become just a series of numbers in the minds of the operators. When that happens, the dental officer himself is well on the way towards becoming merely an automaton. A war time Dental Service is not a post-graduate unit for officers fresh from university and we advise them not to view it as a school for gaining experience and furthering their training.
We draw the attention of junior dental officers to these dangers and we prevent the growth of the purely mechanical outlook. Fortunately there is a safeguard. Every dental officer knows that the soldier is entitled to treatment and attention of only the highest order from the profession and, as it happens, the very standards which must be maintained to achieve this purpose are themselves a protection.
Within the limits permitted by military requirements, every effort is made to ensure that an officer retains independence in his technical work; no steps are taken to supervise or inspect it and no detailed instructions are issued to tell him how operations shall be executed. This is necessary for another reason as every officer is eventually required to serve in the Field, and usually is asked to operate an independent sub-unit in circumstances where he must rely on his own resources.
All officers are asked to consider themselves civilians in uniform when at the chairside (but only at the chairside and at no other time), and to handle and approach every patient with that attitude in mind.
The position should not arise when a soldier is lost to his unit during a critical period on account of insufficient treatment at an earlier date or because the treatment was carried out inefficiently. There is no opportunity or excuse for taking those risks which become justifiable in civilian life by virtue of the fact that, should trouble develop, the patient is within easy reach of the surgery or another practitioner nearby. In the Expeditionary Force it must be assumed that, when the treatment is completed, the soldier will be going to a unit in the Field where conditions will be vastly different. Therefore clinical risks cannot be taken.
This chapter may well close with a quotation from a letter from
Thank you also once again for all you have done in the
Middle East andItaly . The New Zealand Dental Corps in2 NZEF has won a great and well deserved reputation. I am very grateful to you for the part you have played in making it the efficient organisation it is.With every good wish,
Yours sincerely,
B. C. Freyberg
ABOUT 1100 miles north of New Zealand in the South Pacific Ocean is a group of 250 islands collectively known as nom de guerre ‘B Force’, and equipped it to the best of her ability by almost completely denuding her own defences.
This force was assembled in
The force arrived at Rangatira and the men were initiated into active service conditions by a lengthy route march which successfully dispelled any illusions they may have had that their functions were purely sedentary. The camps were not ready so most units had to find temporary accommodation. The dental section was located in what had previously been the
Time, however, was important and, with the limited staff available, the Senior Dental Officer was anxious that the dental condition of the troops should have no chance of deteriorating. He wore a
In this series, Fijian place-names have been spelt as pronounced, e.g.,
On 22 November the second dental section arrived from New Zealand, but as this was to be attached to 7 Field Ambulance at Namaka, it was sent on immediately by road transport. Namaka was about 150 miles by road from
In addition to the field dental outfits for each section, large stocks of materials and spare equipment had been shipped from New Zealand to establish a bulk store. It was intended that this should be under the direct control of the Senior Dental Officer but, as there was as yet no permanent dental hospital, it was stored temporarily with other army stores. The climate of
Meanwhile, in
By this time it was mid-December and the section moved one step nearer its proposed home by taking up quarters with the Regimental Aid Post of 29 Battalion in ‘A’ camp at
There were at that time quartered in ‘A’ camp, the 29 Battalion, the main body of 18
Army Troop, someArmy Service Corps and ourselves. Roads were still under construction and the mud was atrocious. It was here we made our first contact with the squeegee…. In later days we were to know it well. It was a heartbreaking job and a backbreaking one too to keep the dental surgery looking anything like a surgery. With the torrential rain and the clinging mud tramped into the building on numerous pairs of … army boots, the floor rapidly acquired a film of mud…. Twice a day it was cleaned by pouring buckets of water over it, in a more or less scientific manner of course, removing the muddy water with the … [squeegee] and returning the resultant ‘Porridge’ whence it came. Let it be said it was an amazingly efficient method of floor cleaning.
In this temporary home, under these somewhat primitive conditions, 18
The permanent home of the Dental Corps in the
It was a very pleasant place in which to work. Hot and cold running water, electric light and efficient drainage were installed and the interior of the suite, with the exception of the store room, was painted. Best of all, authority had been got to purchase a large ice box for the surgery. In this climate some method of providing cold water for cooling impressions and storing denture cases is essential. One would not be entirely wrong in suggesting that an occasional bottle of warm beer may have found its way into the ice chest in preparation for a cold drink after working hours.
Things had now sorted themselves out in
There were enough expendable and non-expendable stores and equipment to last both dental sections for a long time without further stocking from New Zealand. Owing to the uncertainty of the war situation and the fact that there was no supply house in
Each dental section had field equipment with a normal three months' supply, so very little was drawn from the bulk store for some time. This store, although situated in the same building as the
The Brigade Dental Officer carried out both staff and executive duties. In addition to being responsible to the Brigade Commander for all dental arrangements for the force, he was the only dental officer in the
On
The Samabula telephone rang at 0930 hours and a voice announced that a hurricane was expected. Immediate steps were taken to protect all equipment and personal gear. Two men were detailed to look after the men's belongings in their quarters, a Staff-Sergeant to look after the gear in the Sergeants' hut and a sergeant and private to remain with the Brigade Dental Officer in the dental hospital.
Very little time elapsed between the warning and the onset of the storm. Windows to windward were boarded up and those to leeward kept open, and a very difficult job it proved to be, as they were of the type which were hinged at the top and pushed outward at the bottom, being held out by wooden bars. No sooner would they be propped open than they would shut again and most of the day was spent, soaked to the skin, trying to keep open windows which just wouldn't stay that way. The object in keeping windows open on the leeward side is to allow the wind, or some of it, to pass through the building. This reduces the force applied to the windward side which might otherwise be enough literally to push the building over.
The storm reached its height at midday and from then on gradually
decreased. We were fortunate in sustaining little damage even in the bulk store, mainly due to the stores sergeant who worked like a Trojan to protect his beloved stores. Just before the storm reached its peak the workers in the dental hospital received reinforcements as the staff-sergeant had been forced to evacuate the sergeants' quarters, the hut having developed such a lean as to be voted by all present as unsafe. As the hurricane abated in the late afternoon a sigh of relief went up all round. It had been an eventful and very tiring day and preparations had to be made for the night. The dental hospital became sleeping quarters for our sergeants and several Field Ambulance men whose quarters had also been destroyed. Planks and trestles were used to sleep on as the floor was covered in slimy mud to a depth of two or three inches. One feature of a first class hurricane is that the wind picks up fine silt with the result that everything is covered with a film of mud when the show is over. It took days to wash everything down after the storm.
In the evening, as everybody was preparing for an early night, the camp fire-alarm rang and fire was found to have broken out in one of the stores containing a lot of inflammable material. Unfortunately for us, the hut occupied by our men was close to this so all personnel and gear had to be moved out until the fire was under control.
Many of us had expressed the wish to experience a hurricane about which we had heard so much but few want to repeat the experience. A few days were sufficient to repair the damage to the dental hospital, mainly some panes of glass ruined by amateur and over-enthusiastic carpenters and general cleaning and drying out equipment.
The big motor transport field workshop, less than a hundred yards from the dental hospital, was flattened out but the Corps escaped lightly. Loss or damage to the equipment would have seriously affected its programme.
With the arrival in
One of the difficulties arising out of the shortage of staff centred round the dual appointment held by the Brigade Dental Officer. Besides being dental officer of the section at
By the middle of April all troops in both areas, with the exception of some artillery at Momi Bay, were dentally fit. Momi Bay was some 15 miles from Namaka, so the dental section moved out and treated the gunners under field conditions. This was the first time the section had had an opportunity to work in the field, although it had been on manoeuvres with 7 Field Ambulance at Caboni (pronounced Thamboni) for a week in March as an exercise. At Momi Bay it worked in bell tents with coconut palm leaves as a floor covering and commandeered a Fijian bure, or thatched native hut, as a laboratory. In a week the section returned to Namaka. In accordance with policy, the first relief for the force arrived from New Zealand in
The new relief brought increased work for the Corps. All the men had to be examined and there were the inevitable late postings who had not received treatment in New Zealand. There was plenty of work, but life was made pleasant by the hospitality of the people of malua. As yet only the distant rumblings of war were heard and there was some resentment by the New Zealanders at being condemned to stay in a backwater, however pleasant, while their friends in the
At the end of
All ideas of limiting service in
Both brigade dental hospitals were now fully equipped to look after themselves. They were their own accounting units and indented on the bulk store for their dental requirements and on the Ordnance Department for their other needs. The western area, defended by 14 Brigade, was large and the units were scattered. Headquarters with one battalion and some smaller units occupied Namaka, one infantry battalion was at Momi Bay and another at Sabeto (pronounced
The men were a mixture of old and new troops, so the only way of finding out how much work there was to do was to examine them all and start afresh. A dental section was detached from the Brigade Dental Hospital and sent to 37 Battalion at
The 8 Brigade dental hospital in the
With the expansion of the New Zealand Forces, the
The ADDS asked that his establishment be increased by one officer and five other ranks, as, with the
Captain J. P. S.
I found that both Fijians and Indians had enamel which was comparatively easy to cut, and what a pleasure it was to work on a Fijian, you could just about walk into his mouth, he had such well-developed jaws. Their lips were surprisingly soft and flexible and they were usually very good patients. My only complaint was that their huge mop of fuzzy hair pricked my left forearm making it quite itchy.
Following the expansion of the force in
One of the early problems was that of motor transport, a problem shared with practically every unit on the island. The war equipment table laid it down that each Brigade Dental Section should have one 2-ton truck and one motor-cycle, but even these modest demands could not be met until the end of
There was no provision for
New Zealand Dental Corps transport was therefore the responsibility of NZDC personnel, an ideal state of affairs. Being driven and maintained by the ‘Firm’ they take a good deal more interest in their vehicles and in the job as well as ensuring unification of control.
It is difficult to agree with this opinion. No doubt the NZDC drove and cared for its vehicles well, but it cannot be denied that it was lucky to have had men in the Corps with previous experience of heavy trucks. It is unfair to the
On
A recent addition to the organisation in the western area was a commando school at Vatakoula where men were trained in bush warfare. They were specially selected Fijians, officered by Europeans, and their task was to establish themselves in the hinterland and, in the event of invasion, to infiltrate into the enemy's lines and harass him. Their standard of physical fitness had to be exceptionally high and the Dental Corps, by reducing the possibility of dental casualties, could play an important part in the success or failure of the operation. First, all the men had to be made dentally fit while training at Vatakoula, for when they left there they would be in wild country where dental treatment was impossible and their only communication with headquarters would be by wireless. The Officer Commanding 14 Brigade Dental Section, relieved of some of his duties by the arrival of an extra officer, undertook the work himself. Even with the most meticulous care, however, it was impossible to guarantee complete immunity from dental trouble and some arrangements had to be made to meet these emergencies. Although, where possible, the troops lived off the land, they had to send down occasionally for some rations. There were pre-arranged points for these rations to be picked up, and if treatment was needed the commandos could send a signal and a dental officer with emergency haversack would meet them there. Actually the number of casualties was very small, a tribute to the work of the Brigade Dental Officer. Just after completing the work he was evacuated to Namaka hospital with acute tonsillitis, and then to New Zealand for surgical treatment. The ADDS attributed his condition to overwork and again expressed his concern at the pressure at which dental officers were expected to work in that trying climate.
At this time 17 Field Dental Section was with 1 Battalion,
As time went on it became apparent that big changes were imminent. The Americans were expected to undertake the defence of
Meanwhile, the American dental units had arrived, with Lieutenant-Colonel Semons as Senior Divisional Dental Officer. The ADDS took him with him on his final tour of the island to show him what facilities were available, after which most of the Corps returned to New Zealand. This is a convenient point at which to pause while the story of the dental service to the
The first detachment of the Royal New Zealand Monowai and SS Rangatira on
Royal New Zealand
With the limited flying facilities, the number of men was small, at least not large enough to keep a dental section fully employed; but, even before
It is questionable whether this separation of command was wise, as the
The reasons for the decision can only be guessed. Possibly the
The ADDS was in
Captain Stocker arrived in Wahine, somewhat hurriedly according to his account:
The ‘Wahine’ was poorly equipped for tropical troop-carrying, having no forced ventilation to the cabins, which became almost intolerable, with ports sealed from well before dusk to dawn. It was so stifling that the men in the lower cabins made no attempt to sleep there, preferring the open deck instead….
Approaching
Fiji we became increasingly conscious of heat and humidity, …. [and of] steep craggy hills shrouded in misty cloud…. We had had no time to get suitable clothing and, in that hot humid climate we were soon in a sorry state. The ADDS was most helpful in getting an issue for the men and some speed out of an Indian tailor on my behalf….My first impressions of
Suva were of heat, sweat and smells, with at night hordes of cockroaches. Long months afterwards I was to develop quite an affection forSuva , the smells gradually fading and the heat, which at first had made my shirt wringing wet, becoming tolerable.
The section was then taken by a communications flight DH89 from
It was a relief to be up in the cooler air again as we skirted around
Suva , being careful not to annoy ack-ack batteries, and proceeded around the Southern coastline. There were many attractions and novelties on that first trip—rice fields, swamps, small farms, plantations, neat native villages, fishtraps and many more, but the most striking were the gorgeous colours of the sea and coral reef. Mile after mile we flew, right down close to the beaches, following the line of the coral reef which encircles the island.
Nothing was ready for it at
At one stage they were building a large water tower about thirty yards from our sleeping quarters. We soon got used to sleeping through the din of a motor-driven concrete mixer but, every time they took an eight pound hammer to jar loose the concrete sticking to the sides, we came back to earth smartly. The mess kitchen at Nadi was of interest if visited late at night as everything, stores and all, seemed absolutely alive with cockroaches. If you gave a box of currants a smart jolt, those which did not scurry off were the currants.
It was not long before the framework of the new building, which was to be an extension of the medical one, was erected but shortage of labour and building materials prevented its completion for several months. Windows, lining and plumbing were hard to get, and small things, such as screws and hinges, sent the dental officer on frequent shopping expeditions to
The finished building consisted of two rooms, workroom and surgery, with a covered verandah running the full length of the medical and dental departments as a waiting room. The lack of an office, which Captain Stocker suggested could easily have been supplied by partitioning off part of the verandah, was a decided disadvantage. Except in the field, where recording and reportings should be kept at the lowest figure, there is enough clerical work in a dental section to warrant the provision of a separate office, apart from the inadvisability of using the surgery for other than its proper function.
With permanent quarters, the section settled down to serious work. There were many men transferred to the
Soon the Americans arrived in increasing numbers with Fortress and Liberator bombers, a welcome sight but raising a problem in accommodation, which squeezed the dental section out on to a corner of its verandah until a camp was built for the newcomers a mile or two away. These Americans were ahead of the main body of
It was interesting to note the Americans' enlightened ideas about dental surgery. A surprisingly large number of them came to me asking for treatment or a check up ‘Just in case’. What is more, some of them had the courtesy to come back and tell me that when their own dental officer arrived he had expressed favourable comment on my work.
Although I may be in error here, I gathered that, despite the lavish scale of equipment available to the Americans, the NZDC could learn little from them about keeping the men up to the mark as regards dental treatment. We in the Corps have had years of great opportunity to get in some quiet propaganda for dental health and oral hygiene. How well we have carried out this obligation to our profession, only time will tell. Although the average American mouth which I saw generally had a more attractive dentition than that of the average New Zealander, I also saw some shocking mouths and … some very mediocre work.
He also commented that the enamel of the Americans' teeth did not appear to be so ‘glassy hard’ as ours, giving his opinion that this may have been due to the continual chewing of candy, gum or peanuts.
It was now
From early May to late August the
At this stage the American Forces took over the defence of
This brings us to the point at which we left the army story, and from now on the description applies to all three services.
It will be remembered that when most of the New Zealand troops left
In October, after consultation between the DDS and the heads of the
RNZAF Station,
A dental hospital was built at Laucala Bay (pronounced Lauthala), just out of
Headquarters,
This was 18 Dental Section, which now became attached to the above command to be responsible for the dental health of all
No. 4 General Reconnaissance Squadron.
The dental section attached here was to look after
No. 17 Dental Section ceased to exist, its dental officer returned to New Zealand and its other ranks went to
The Senior Medical Officer of the American Forces was approached with a request that his dental officers should do all conservative treatment for the
Captain Stocker became Senior Dental Officer in bures had to be used.
The organisation was ample to treat the three New Zealand services, but the
Most of these troops were Fijian natives whose dental condition, according to a long and comprehensive report by
The new organisation, which was additional to the existing
Although there was some dispersal of troops, the main concentrations were at
Huts of bark, bamboo or palm leaves are used almost exclusively by the natives of the bure has a framework of native timber lashed together and on this are constructed sides of native grass or caneleaf thatching, the roof being thatched with the same material. They are cool, waterproof if well constructed, and resist most weather conditions, even hurricanes. Certain modifications can be made without sacrificing these advantages, such as incorporating windows or doors, providing floors of wood or concrete and installing electricity, running water and drainage. There is a certain risk of fire as, in areas with little rainfall, the materials get tinder dry, but this did not apply to
At this time Fijian troops were being used in the Solomon Islands. Though the policy was to give only limited treatment for these men, it was necessary to reduce the possibility of dental casualties as much as possible by eliminating gross lesions before they left
It needed accurate diagnosis and sound judgment to assess a standard of reasonable fitness and long hours of work to establish it. Brigadier
I would like to draw attention to the excellent job of work that has been done by the NZ Dental Detachment here. The Detachment has at times been called on to work hard and continuously over fairly long periods to ensure that the teeth of all ranks of units proceeding overseas were in a satisfactory condition; the work has always been done on time and done well, as well as to the satisfaction of those receiving treatment.
While appraising the application of the detachment to the task in
The DDS refused the request but made arrangements with a dental section attached to the
In justice to Brigadier Dittmer, he could not have known at that time that considerable changes were mooted in the dental organisation in
The DDS was adamant and his decision was upheld by Headquarters in
The DDS held that the NZDC had fulfilled its mission in the interests of the dental health of the Fijian natives and European soldiers for three and a half years, more especially in the last two.
The dental detachment returned to New Zealand in
Of the
The relative
The coverage of these men was adequate and in accordance with the usual custom of the NZDC. The position of the Fijian native, however, was more confused. It is obvious that the ideal would have been to establish complete dental fitness throughout the whole force but this was beyond the resources of the NZDC, quite apart from
My opinion is that 90% of the natives and half-castes (European) are not really concerned about their dental condition but will report for extractions only when in pain. This is the only type of treatment they appreciate. The Fijian Government have shown no interest in our work nor have they requested that they receive a higher standard of treatment. I have observed that extensive dental caries does not affect the natives' health or physical fitness to the same extent as the Europeans. In fact, before the detachment arrived the Europeans and natives received no organised treatment from the
Army , the Europeans reporting to the local dental surgeon and the natives to the Fijian dentist attached to the Colonial War Memorial Hospital.
In view of this report it would appear that there was little to be alarmed about in the dental condition of the natives, nor was there more work than could be reasonably expected from
I regret having to say that, if the withdrawal of the complete dental detachment was assisted or brought about in any way by the reports of Major McDonald, that officer either did not fully appreciate the situation here or he was anxious to have the dental detachment return to New Zealand for some other reason.
Presumably there must have been expert opinion to back up this statement and it is proper to investigate the source. The
Actually, the dental situation in the forward areas was satisfactory, as shown by a cable to the DDS:
Dental condition F.M.F. first battalion, Europeans fit, all necessary extractions for natives done. Third battalion and first Dock battalion, Europeans fit, natives have had emergency treatment, more required.
In view of this the Brigadier was informed by the DDS that the dental officers in
The
I am informed by the Senior Medical Officer that there is the greatest difficulty now in obtaining dental treatment for New Zealand
Army and Fijian personnel, particularly as regards prosthetic work, and it is felt that there is a definite need for a dental section to be attached to the New Zealand Camp. Might this question be taken up with the Director of Dental Services with a view to the provision of a satisfactory dental service.
Somewhat naturally this antagonised the two dental officers in
In November, at the request of the Senior Medical Officer of the
Fiji Military Forces and in company with Mr. Vosailagi, I examined one Company of the third battalion of theFiji Military Forces, the personnel being wholly Fijian and the number 113. The examination was thorough and disclosed a considerable amount of conservative work to be done. For the 113 men, a total of approximately 500 cavities were found. This figure is not so alarming as it sounds because, included in it, were large numbers of deep pits and fissures, which may or may not be carious. The amount of advanced caries was not very great. A notable feature of the men's mouths was the large amount of heavy calculus deposit with accompanying gingivitis. The number of extractions and dentures required was very small.
To include only the figures without the explanation would certainly reveal a serious state of affairs.
To get all these men dentally fit on the New Zealand
Army standards would require the services of a number of officers for some considerable period, particularly when it is realised that it is impossible in the Fijian climate to maintain the same rate of work as in New Zealand.
The present set up seems adequate to give the Fijian troops sufficient treatment to keep them in reasonable dental health and free from pain and their present condition is incomparably better than it was on their enlistment.
I found the general condition of the native members of the
Fiji Military Forces to be very good and I think the position as regards the dental fitness has been erroneously reported. This is particularly evident in denture work required as, from observations, it appears that they have expected partial dentures where there are perhaps two anterior teeth missing and thirty perfectly formed teeth remaining, a very common condition amongst them. Oral hygiene generally is only fair and to remedy same would, in my opinion, take some time and in the majority of cases would be time wasted.
Presumably these expert opinions were not accepted, for on
Dental condition of all battalions
Fiji Infantry Regiment very serious. Urgent need two dentists and three mechanics for repair and denture work. Work required extensive and urgent. Government dental service quite inadequate here and no prospect of improvement locally in dental service for battalions.RNZAF officers can undertake only European personnel.
Obviously the
What followed is an excellent example of the wisdom of placing the control of the Dental Corps in its own hands. The Director-General of Medical Services in New Zealand, finding that the DDS
He agreed to take over the responsibility for the natives up to a specified standard only, by temporarily neglecting the
No insertion of metal or cement fillings.
Extraction of teeth only where considered necessary to obviate pain or to remove septic conditions.
The provision, remodel or repair of artificial dentures. Partial dentures to be provided only where there is insufficient masticatory efficiency without them.
Prophylactic treatment up to a point if the Government dentist cannot cope with this phase of the work.
The RNZAF dental officers had very little difficulty in doing what was necessary for the natives and it was only a fortnight before the Senior Dental Officer cabled
Third and Fourth battalions completed to standard required except small amount of denture work. First battalion to be treated by Vosailagi. No assistance required.
All denture work for the first battalion was also carried out by these officers free of cost to the
By adopting a common-sense standard instead of ‘Crying for the moon’, the
From
Everything was finished by
Little has been said of the
THIRD New Zealand Division originated in
New Zealand's commitments in other theatres of war had already strained her limited resources and she could not immediately produce another full division, so, although the organisation was divisional, the strength was only two brigades. Actually the Division never operated at a greater strength than two brigades and, as will be seen later, even these had to be disbanded before the end of the war. There were hopes, however, at the time of organisation that somehow or sometime a full division would eventuate and the Dental Corps had to be prepared for this. There had to be a basic organisation, which could expand with the Division without upsetting the administrative arrangements, yet be adequate to give coverage without waste of staff.
The establishment was based on the ratio of one dental officer to 1000 men. Excluded from this was the ADDS, whose duties were purely administrative. Lieutenant-Colonel O. E. L. Rout was appointed ADDS in
The Assistant Director of Dental Services [is] to be responsible on behalf of the Director of Dental Services,
Army Headquarters,Wellington to the General Officer Commanding the Third Division through the Base Commandant.
For the general administration of the New Zealand Dental Corps in accordance with the principles laid down in ‘Instructions to Dental Officers NZDC
1942 ’ and distribution of the NZDC personnel amongst the units of the Force to the best advantage in the interests of manpower and efficiency.For advice to the General Officer Commanding the Third Division and Base Commandant on all dental questions affecting the dental health of the troops.
For co-ordination and consultation with the Assistant Director of Medical Services to the Third Division on all questions affecting the general health of the troops.
For the control, maintenance and issue of all dental equipment and stores from the Advanced Base Dental Store and submission of requisitions on the Director of Dental Services,
Army Headquarters,Wellington as required.
Appearing over the Adjutant-General's signature, these instructions were addressed to the Headquarters of
The truth is that ‘Division’ does not seem to have made up its mind just how we are responsible, re what and to whom, and it is all very awkward while this stage of flux and floundering disorder lasts. The General definitely has the right idea himself, according to our conversation the other day, but even up to that date had forgotten to pass on the result of your conference with him to AA & QMG and to General Staff. In the meantime they decline to give a definite answer. The ADMS says that all technical stuff is to go through him and everything else through the Base Commandant. The Base Commandant says that I've nothing to do with him and quotes our amended ‘Administrative Instructions’.
Nothing can be found of any amended instructions to throw light on the Base Commandant's remark. The letter goes on:
The ADMS interprets ‘technical stuff’ to include his decision as to where I'm to put my section, which is ‘With medical units where possible’, and a desire to have all my Circular Administrative Instructions—General Staff Instructions and Circular Memoranda handed on through him. I'm getting everything except General Staff instructions direct and I've got them all. The General Staff instructions are sent through ADMS and I've got just two out of twelve that I know of.
The ADDS's task was made difficult and unpleasant. A rigid adherence to the terms of his appointment was inviting an open breach with Force Headquarters, while an acquiescence with the absorption of his command would rob him of all initiative in the performance of a carefully calculated undertaking. As an example, the ADMS's desire to attach dental sections ‘With medical units where possible’ conflicted with the advice the ADDS had received from the DDS in the Administrative Instructions, of which the ADMS had a copy.
The permanent attachment of a dental section to a Field Ambulance or General Hospital is not indicated as the Force is at present constituted owing to the extreme shortage of specialised dental personnel and the great amount of dental treatment required in the three arms of the New Zealand Forces. At no time can NZDC officers be spared for such duties as Assistant
Adjutants, Intelligence Officers or Liaison Officers with Medical Units. They can be employed more usefully in the maintenance of dental fitness on the Lines of Communication or Base Depots, but where their services are considered necessary to co-operate with Medical Officers in Maxillo-Facial Injury cases or where a medical unit is favourably situated to enable a subsection of a Mobile Dental Section to function among the troops of the line, it should be made available by the ADDS or his representative, the OCMobile Dental Section .Medical Headquarters in
Wellington received a copy on1 September 1942 , which makes the following minute sheet the more remarkable:
Adjutant-General.
Re:
3 Division , New Zealand Dental Corps.I presume that the relationship of the ADDS,
3 Division and New Zealand Dental Sections to ADMS will be similar to that of2 New Zealand Division ,Middle East . It has not been suggested that the New Zealand Dental Corps will be directly under ‘A’ [Adjutant-General] but I am anxious that there shall be no misunderstanding.(signed)……
Brigadier,
DGMS (Army and Air) 29/10/42DGMS.
Have you discussed this with DDS? I presume he agrees with arrangements in
Middle East .(signed)……
Brigadier,
AG, 1/11/42
Adjutant-General.
I have not discussed this with the DDS. As regards his agreement with the arrangement in the
Middle East , this was laid down early in the war and so far as I am aware, there has been no deviation, but I am particularly anxious that similar conditions should hold as regards3 Division . My reason for mentioning this was because of the DDS's memorandum in which he asked that the New Zealand Dental Corps should be completely separate from the Medical Corps under the Adjutant-General.(signed)……
Brigadier,
DGMS (Army and Air) 3/11/42
The relationship of the ADDS to the ADMS was clearly stated in the Adjutant-General's Administrative Instructions of
Headquarters of the New Zealand Dental Corps is at Headquarters
2 NZEF under the administration of an Assistant Director of Dental Services. This officer, who is responsible to the Director of Medical Services for the dental health of the Expeditionary Force, is in command of the Dental Corps with the Force; it is under his direct control on all policy and technical matters and he commands all New Zealand Dental Corps personnel.
The DGMS had on more than one occasion stated that the Dental Corps should be under his command as a specialist branch of medicine. Others held different views which had been expressed in tangible form by authoritative instructions.
While all this was going on, the Division was being formed in the Northern Military District of New Zealand. The men were being treated and the dental organisation was taking shape. Until
It was important that the organisation should be capable of expanding as the force grew, that it should not be too rigid and should be able to be conveniently serviced for supplies and designed to meet either static or mobile conditions. The nucleus can be divided into three parts:
Headquarters and Advanced Base Dental Store
This was administrative headquarters of the ADDS. He had as staff a warrant officer second class, a staff quartermaster-sergeant, two clerk orderlies, one a staff-sergeant and one who could be a corporal, a storeman packer, batman and an
Base Dental Hospital and NZDC Reinforcement Depot
As its name implies, this was a hospital capable of treating troop concentrations and of absorbing reinforcements to the Corps, either for its own use or for posting elsewhere. The original establishment was for a major in command with three captains or lieutenants; one sergeant as clerk; six orderlies, of whom one was a staff-sergeant, one a sergeant and one a corporal; four mechanics, of whom one was a staff-sergeant
No. 10 Mobile Dental Section
This was capable of providing a headquarters section and six or possibly seven self-contained sub-sections for attachment to the headquarters of any unit not actually engaged in the battle area. A sub-section could be either complete with mechanic or could be used as a purely surgical unit, sending prosthetic work by motor-cycle transport to the nearest field prosthetic laboratory.
The commanding officer was a major, who had with him seven captains or lieutenants. There was a warrant officer second class as staff quartermaster-sergeant; ten orderlies, of whom one was a staff-sergeant, four sergeants and two corporals; eight mechanics, of whom one was a staff-sergeant, three sergeants and one corporal; two motor-cycle orderlies, a cook and two batmen. There were in addition fourteen ASC drivers, of whom one was a sergeant, with permission to have a corporal, lancecorporal and a driver-mechanic.
Transport consisted of one heavy car, two 30-cwt four-wheeled dual-rear covered trucks with portable laboratory fittings, eight similar vehicles without the fittings, two motorcycles and a 15-cwt water truck. They were equipped as for the Base Hospital but with enough panniers to equip each sub-section and the headquarters section. Specialists in maxillofacial injury work were included for attachment to a general hospital or other medical unit if required.
It was probable that on occasions this mobile section would be attached to large formations such as a brigade, far from the ADDS and his headquarters. On these occasions its commanding officer would assume a similar relationship to the Brigade Commander as that of the ADDS to the GOC and would not communicate direct with the ADDS except on technical matters.
There was an opportunity to test this organisation in New Zealand while the Division was training in the
The force was bound for
We disembarked on New Year's Day and in a fifteen mile trip by motor transport to the staging camp at Dumbea, received our first impression of the island of
New Caledonia . Predominant impressions were of intense heat, clouds of dust and almost barren hills, the only relief to the landscape being the ubiquitous Niaouli tree, which, with its characteristic outline and foliage, was to become a familiar sight during the following months. After remaining a few days at the staging camp, we travelled some ninety miles by motor transport toBourail where Base Headquarters NZEF, IP had been established.Bourail is a small township of some five hundred very mixed inhabitants, French, Javanese, Tonkinese, Kanakas and the results of their interbreeding.
The ADDS had arrived three weeks before this and had set up headquarters and the store in a wing of L'EÁcole Communale, which was eminently satisfactory after the rooms had been cleaned, a certain amount of calcimining done and repairs carried out by the unit. Benches and bins, mostly of the large pigeonhole variety, were built out of old timber and cases.
There was a hitch in the arrival of the equipment from New Zealand. The Base Dental Stores arrived with the last draft but the unit equipment, classed as priority B, was left behind and did not arrive until 3 February. This was a serious setback. Four subsections of the
The valley was surrounded by hills heavily wooded with niaouli trees and had a good stream for water supply and bathing. The first hospital was of tents sited along the top of a ridge within easy distance of the Base Training Depot, but later, when prefabricated tropical huts became available, a well appointed hospital was built on the same site. This was to treat all troops in the base area and, on the arrival of reinforcements from New Zealand, to examine and treat them before they were posted to divisional units. The treatment of the divisional troops, which were scattered the length
Throughout the force there was a general shortage of transport and, although the
The ADDS controlled the maintenance and issue of all stores, everything, from whatever source, being issued to him in the first place. If it had been possible to draw all stores from New Zealand, as was the case in
From the Director of Dental Services at
From United States Controlled Stores. These, which included everything for denture construction, needed a special requisition and the approval of the dental surgeon of the American Command.
From United States Maintenance Stores. These were a monthly maintenance schedule direct from the 21st Medical Supply.
Theoretically, there was nothing wrong with this arrangement. It mattered little to the ADDS where the supplies came from so long as he could be sure of their arrival. In practice the position was most unsatisfactory. The first maintenance supplies came from the
Meanwhile the Advanced Base Dental Store satisfied all demands but could not restock with such essentials as silver alloy, silicate cements, hypodermic needles, sheet wax or plaster of paris. Indents for these and other urgent supplies had to be placed on
The organisation was fully tested in the early days in
Urgent treatment was carried out for the French and native population, who were most appreciative. Their teeth were badly neglected. The French farmers and their families, most of them appearing to be poorly off, were on the whole friendly and, despite the language barrier, offered some home life, one of the things the men missed most. Most of the leisure hours, however, were devoted to keeping fit. Until the advent of organised sport, swimming in the rivers and occasionally at excellent surf beaches was all the exercise to be found.
On 24 February the Corps suffered its first casualty. Captain B. S.
The intention was to examine and make dentally fit every man in the force once every six months, but with wide dispersal of troops, scarcity of transport and no margin for sickness or accident, this was not feasible. The ADDS reported on
It has been considered that an average figure for maintenance conservative treatment after six months is 50 fillings for 100 men, taking into consideration that 50% to 60% wear either partial, single or complete dentures. It was found however that examination of a cross section of 75 men of 30 Battalion, which was rendered dentally fit in February 43, disclosed 54 fillings for the 75. It appears therefore, subject to confirmation when general examination of all units is carried out after the six-monthly period, that the maintenance figures may be somewhat higher. This may be attributed to (
a) Diet, (b) Conditions affecting general resistance, (c) Acclimatisation period. Steps are being taken to advise all personnel in oral hygiene andspecial care of the teeth and oral tissues but it is anticipated that the treatment required to maintain the Force will necessitate strict periodical survey of all units. It is expected that, even with the assistance of dental units arriving from New Zealand, it may not be possible to begin re-examination and treatment strictly within the six-monthly period in the first instance, the amount of casualty work also being a factor.
Dental officers had been working at the ratio of one to 1500 men instead of one to 1000 as originally intended. Everyone agreed that more staff was needed but there was little unanimity when it came to deciding the form it should take and how it should be apportioned. The DDS and the ADDS based their calculations on the amount of work to be done and a wide experience of the number of officers and men needed to carry it out. The new establishments they submitted for approval were practical but immediately became a bone of contention. The Medical Corps wanted dental sections attached to the Casualty Clearing Station and the
In the face of this opposition, what should have been a simple addition, designed specifically to meet a known situation, became an exercise in the art of sophistry and intrigue. The DDS, sure of the accuracy of his appreciation, submitted the establishments in a different form to achieve the same result. The issue became confused in a maze of correspondence out of which the DDS arose triumphant, having seized on a mistake to get his men overseas before it was discovered. As will be seen later, the end fully justified the means. Anything less than the establishment provided or a rigid attachment of personnel to medical units would have made the task impossible.
In addition to the reinforcements from New Zealand, the dental section which had been working on
At the moment I do not think any transport, or at any rate anything more than a limited amount of transport, is required for the Dental Services with this Force. For operations such as those which may be ahead of us, the transport is more likely to be boats than trucks. I suggest however that the establishments as drafted, be approved, but that in the meantime no effort be made to fill the transport requirements. It is more important that such vehicles as we can get from New Zealand should be allotted to units which have to undertake cross-country tasks.
This was eminently reasonable and apparently the Dental Corps could draw transport from the general pool when moves were necessary. Unsuccessful efforts were made to have the Quartermaster in charge of the Store commissioned as a subaltern, as was the case in the Base Dental Store in
About
The first task of the Dental Corps was to concentrate in the two brigade areas, Taom Valley and
The ratio of dental officers to men again became one to 1000, which later proved to be none too many. In the climate they were to work in sickness could be expected to take its toll. Already in
The Division was virtually dentally fit on embarkation, the condition of the base units was described as satisfactory and the curtain was ready to rise for the second act.
For security reasons the forward area had been referred to as MAINYARD and was now revealed as
The first port of call was Vila on the island of
Leaving Vila harbour on 1 September, the convoy arrived at
Sub-sections were attached to units but the days of leisurely training were over and the Division was feverishly busy. ‘On active service’ really meant what it said and few were inclined to waste precious time on dental parades. Casualty treatment was all that could reasonably be done and the routine of examination and treatment, as carried out at the Base, could not be attempted. This was anticipated and was the chief reason for the intense drive for dental fitness at the Base, but the need for constant vigilance was not forgotten. As the ADDS reported on
There is a noticeable similarity in the amount of dental treatment completed in the Base Area (Necal) and in the forward area (Mainyard). In other words, the amount of treatment required to make fit and maintain 5,000 men in Necal is about the same as the casualty treatment carried out for 13,000 men in the forward area. The natural conclusion is that there is a considerable amount of treatment outstanding in the forward area.
It is when the fighting forces come out of action and concentrate in static form that the Dental Corps can catch up with arrears. This never happened with the whole
The
Before going any further it is opportune to glance at the character of the war in the
Conditions were harsh and difficult. Rain fell, drenching the men and soaking their equipment and stores and turning the jungle into a bog. Progress was slow, amounting to only 300 to 600 yards a day during contact with the enemy, and a company front was rarely more than 100 yards wide. The men moved along narrow tracks in single file, hindered by tree roots and clutching vines and always on the alert against ambush or enemy traps. The construction of roads was impossible and would have taken months of work with bulldozers. Every noise was suspect, for the Jap, hidden among the roots of the trees or up the trees themselves, held his fire until patrols came within five or ten yards…. Every yard of ground had to be searched thoroughly, and when it was declared clear by the patrols, other troops followed round the coast in landing craft, establishing bases at sites dictated by openings in the reef for the next probe forward.
Quite obviously there was no place for the Dental Corps in warfare of this type. Its contribution was to see that all men going out on these patrols were in such a good state of dental health that dental casualties, unassociated with general casualties, could be ignored as being too few to affect the efficiency of the campaign. There was therefore no need, and indeed no justification, for placing a dental section further forward than the Casualty Clearing Station. It was the medical policy to evacuate all casualties as soon as possible, so anything serious affecting the Dental Corps, such as maxillo-facial injuries, would be sent back immediately.
As an example, in the
The capture of
Arriving on 8 October, they were attached to 17 Field Regiment and 30 Battalion, both at Gill's Plantation, on the edge of a low cliff behind
Climatic conditions forced the sections to work shorter hours than they would have done at the Base, allotting time for rest and recreation. Hobbies were encouraged, one of the most popular being the fashioning of knick-knacks from the abundant supply of scrap metal. The popular sports of
Very soon No. 5 Sub-section of
Transport was one of the chief difficulties and in most cases was by boat. Typical reports from a sub-section give some idea of this:
Sub-section 10/2 landed at
Barakoma onVella Lavella and were attached to Headquarters 30 Battalion, located at Bauroto Point on the South side of the Mumia River. Arrangements were made to treat each of the outlying companies … in turn, moving … by Higgins boat.17 January 44.—For the past week heavy running seas and driving wind and rain have made transfer from this area impracticable. All our equipment has been ready and waiting for barges since 28 December. We are expecting to be moved about 19 January to Ruravai on the East coast where the whole 35 Battalion will be concentrated.
20 January 44.—Treatment is being maintained in the 35 Battalion combat team but great difficulty is being experienced with transport. All communication is by water and heavy seas have hampered operations. In order to move to a new location with another company … it was necessary to employ native canoes to negotiate the heavy surf to reach the LCT {Landing Craft Tank}. All equipment was transferred from shore to ship without damage or loss.
Even though the troops were not engaged with the enemy, there was never a time on
While 14 Brigade was on
The Treasury Group consists of two islands, Mono and
It appears strange that only one sub-section was sent for a force of this size. This must also have occurred to Brigade Headquarters, which immediately sent an urgent signal to
On 1 December sub-section 10/6 also left
Rain was more or less continual, with seas of mud everywhere, and the heat and humidity made conditions most unpleasant. Stores and equipment were easily damaged by moisture and even sandpaper, arbor bands and discs had to be packed in airtight tins. The tins of a well-known and popular brand of cigarettes became passports to popularity with the Dental Corps.
The resources of
With only casualty treatment being carried out for the Division in the forward areas it was obvious that there must be some deterioration in the general dental condition. The Mobile Section must have reinforcements, so, anticipating the request, the ADDS instructed three sections in
In all good faith he asked Force Headquarters to cable New Zealand for three Grade I orderlies to be sent as soon as possible, little suspecting that this simple request was to involve the force in an argument with
The Adjutant-General replied to the cable:
In view of the direction that no further reinforcements for any arm are to be despatched to
2 NZEF , IP, it is requested that you submit toArmy Headquarters an explanation of your demand for further NZDC personnel, action concerning which is, therefore, being withheld pending receipt of your advice.
This cable, dated
Reference your D330/7/91 of 14 January, this has been referred to ADDS for his comments.
At the time of despatch of the signal his explanation was that he had arranged this matter with the DDS in New Zealand in order to ensure that the dental requirements of this Force could be efficiently attended to. At the present time the ADDS is visiting the forward areas but on his return a further reply will be despatched.
Your statement that you have a direction that no further reinforcements for any arm are to be despatched to 2NZEF, IP, is noted but it would have been appreciated if such information had not been sent under open cover.
At a recent conference attended by the GOC of 2NZEF, IP, DGMS of NZ Military Forces and the DDMS of 2NZEF, IP, it was arranged that to assist in relieving the shortage of medical practitioners in New Zealand, immediate replacement of those medical officers who had returned, or who were returning, to New Zealand on the grounds of sickness or to take up civilian work would not be asked for except those already promised. In these circumstances the DGMS agreed that, should an emergency arise, necessary medical officers would be immediately despatched either for temporary or permanent duty.
The first part of your cable would appear to render such promise null and void but before referring this correspondence to the GOC, could we be advised that the decision that ‘No further reinforcements for any arm are to be despatched to 2NZEF, IP’ will not be adhered to in the case of replacement of medical officers should they be required.
A separate communication is being despatched in regard to the replacement of personnel who have been returned to New Zealand on compassionate grounds.
The ADDS returned to
Whether I was going to Infantry Reinforcements or to New Zealand roll, medically graded IV on grounds of insanity wasn't clear for the next ten minutes.
It would appear that if it is necessary to sit on a circular saw it is unwise to inquire too closely which tooth did the damage.
Everything soon quietened down and no grudges were held on either side. The ADDS got his orderlies, a dental officer was tactfully switched with someone else, and a section at the camp at
The roofs of the two four-man huts at
Bourail camp were lifted off and tossed into the next valley. I don't know yet if they are repairable. A good job of work was done collecting the stuff and getting it under cover. All tentage was flattened and in some cases so were the huts. My staff is living temporarily in some rooms in the school here until accommodation is rebuilt. The camp really did look a sorry sight when I went up first thingyesterday morning…. The camp dental hospital was all but flattened but everything is under control and an emergency surgery had been erected. ‘Business as usual’. Subject to check, there appears to have been no loss of equipment right through. The dental sections North of Bourail were not inconvenienced very much at all. At Moindah the bure had the roof blown off but as the natives were due the next day to put a new one on anyway, the storm saved the trouble of taking the old leaking one off.
At the end of
It was known early in
The operation being planned was an assault on Maj-Gen Rt. Hon. Sir Harold Barrowclough, PC, KCMG, CB, DSO and bar, MC, ED, m.i.d., MC (Gk), Legion of Merit (US). Croix de Guerre (Fr);
The Green Islands Group is an atoll, that is to say, an island or number of islands surrounding a lagoon. It is of coral formation covered by dense jungle, and at that time there were only a few native clearings and two coconut plantations, Pokonian and Tangalan. By the time the dental sub-sections arrived there Japanese resistance had been overcome, two airfields, a bomber and a fighter strip, were well on the way to completion, roads were being made and the troops were settling down to another garrison period. The
A problem common to all on
After working for about a month, the sub-sections found they were losing ground and had to ask for reinforcements. 10/1, which had not previously been further forward than
The end of
Headquarters and Advanced Base Dental Store. At
No.
Detachment from camp dental hospital at Néméara with the Artillery Training Depot, working in a 24 ft by 16 ft native type bure, laid out as a surgery with one chair, laboratory, office and store combined and a waiting room.
1 Dental Section at the transit camp at Nouméa in a prefabricated building laid out similarly to the bure at Néméara.
2 Dental Section, attached to 2
1 Maxillo-Facial Injuries Section, attached to 4 NZ General Hospital in the Dumbéa valley and, like the hospital itself, accommodated in well-built prefabricated huts.
Headquarters
2 Maxillo-Facial Injuries Section, although still attached to the Casualty Clearing Station, had moved to an attractive site some 50 yards along the coast because of a general building programme being undertaken by the CCS.
5 Dental Section was moving from unit to unit.
10/HQ. Attached to 22 Field Ambulance.
10/1. Attached to 30 Battalion.
10/2. Attached to 37 Battalion.
10/5. Attached to 37 Battalion.
10/3. Attached to 8 Brigade Headquarters.
10/4. Attached to 29 Battalion.
10/6. Attached to 34 Battalion.
3 and 4 Dental Sections were attached to 36 Battalion.
The troops at the Base were virtually dentally fit, those at the FMC were expected to be so within a week and work was progressing as fast as possible for the two brigades.
Because of her natural resources and her geographical position on Allied lines of communication, New Zealand was asked by the Allied authorities to undertake a greatly increased programme for the supply of food and other primary products as part of the general war strategy. This she could not do without reducing the number of her armed forces. She wanted men for farming, butter and cheese factories, freezing works, building and construction, sawmilling and coal mining, and she wanted them ready for work in July. Third Division was chosen as a source of supply and was to be whittled down to about a third of its strength, leaving only a cadre force to be built on in the future should occasion arise.
The method of selection need not be elaborated on at this stage, although later it concerned the Dental Corps intimately. Suffice it to say that the men were allowed to express a preference for the different classes of work and were asked to co-operate. The main concern of the Dental Corps when the GOC released the news in
It was expected that they would return to New Zealand according to industrial priorities and that this would be spread over a considerable period. Meanwhile the cadre units would remain at their stations in the forward areas until the future of the depleted Division was known. Before returning to New Zealand, everyone would spend some time in
At first sight it would appear reasonably easy to make all returning men dentally fit but actually there were many difficulties. One of these concerned the Department of Dental Hygiene, the Government department controlling the civilian board of examiners and the subsequent treatment of discharged men. Sensing the urgency of the situation, the Department asked the NZDC in the
A further anomaly concerned the right of men who still had work to be done to choose any civilian dentist from the list of those co-operating in the scheme. In principle this was right and, in the case of those men who were fully discharged from further service with their destiny in their own hands, it was not only just but was reasonable and convenient. Those returning from
As a check on the dental health of the force, records had been kept according to sub-units such as companies, batteries or troops. With the decision to return men to New Zealand this system became obsolete overnight. Men were taken from all units and classified according to trade or occupation, collectively grouped as APR, that is Awaiting Passage for Return. Reclassification under this heading would mean complete re-examination of the whole force, which was impracticable. An attempt was made and about 400 men each day were collected for examination. The trouble was that, with medical boarding, working parties and the hundred and one things moving troops had to do, this was probably the only day the Dental Corps would see these men. As much treatment as possible would
The same thing happened in
By the end of June there were only about 9000 troops on
Reduction of staff simply meant reducing the size of the Camp Dental Hospital. By the end of July, most of the stores were packed and from then until the middle of October, men and equipment were returning to New Zealand. All drafts of ‘Essential Industry’ personnel were returned dentally fit, with the exception of occasional men ill in hospital and the negligible few who refused treatment.
As from 5 p.m. on
The Dental Corps comes into close association with more individuals of a force than perhaps any other service; how close is shown
From this it can be seen that, with examinations and treatments, at least 82,846 appointments were made in a force never in excess of 18,000. Truly can it be said: ‘Dens sana in corpore sano’.
THE Tongan or Friendly Islands are in the southern
New Zealand's first association with See Chapter 11, pp. 118–20.
In
As yet, apart from the men mentioned above, New Zealand had accepted no responsibility for the defence of inter alia for the dental health
The force was expected to be about
They sailed on
The Field Dental Section could be split up into three fully equipped sub-sections. It was originally intended to attach one to each battalion of the brigade group, viz., 1 Tongan Battalion, 2 Tongan Battalion, and 6 Canterbury Battalion which took over from 34 Battalion on 8 March. After conferring with Brigade Headquarters, however, Captain Wimsett decided to keep his headquarters section at Houma, partly because of the widely scattered units and partly because patients sent in from the other sub-sections for specialist services such as X-rays could be more conveniently handled at this centre.
Headquarters Section therefore looked after the middle and western parts of the island, the main units being 1 Tongan Battalion, Engineers, Ordnance,
On 9 March one sub-section was attached to 2 Tongan Battalion at the aerodrome and consisting of New Zealanders and Tongans undergoing training. Here the accommodation was in American pattern tents of ancient lineage, so frail that one tent had to be covered by another to get reasonable protection from the incessant tropical rain. These were only used for quarters as two good Indian pattern linen and cotton tents were on issue to each sub-section for surgery and laboratory, so that on starting work the sub-section looked much like any early-war section in New Zealand except for the rain, heat, steam, mud and mosquitoes.
The other sub-section was attached to 6 Canterbury Battalion at Mua. The companies of this battalion were spread over the northeastern part of the island. Unlike the Tongan battalions, there were no natives in this battalion so there were no suitable rations for a Tongan orderly who would normally be attached to the dental sub-section. The section therefore had to do without one.
Apparently the Tongans made good orderlies as Captain Wimsett wrote in one of his reports: ‘Both lads did exceptionally good work and displayed a keenness that could well be followed by all ranks.
Regular examination and treatment was carried out and, when it was decided to reduce the garrison in
Captain Wimsett reported:
It might be appropriate to mention here that the NZDC arrived probably the best equipped unit of the Force. Suffice it to say that we had three hammers and the Engineers only one. The main equipment ship did not arrive until May and until then units had to do their best with what facilities they could make available for themselves. Lack of transport was naturally a great drawback. We were at all times greatly indebted to the Engineers who, despite their own lack of equipment were most helpful in all ways and assisted materially in maintaining the sub-sections in a reasonable state of repair.
When the Dental Corps left
If the Tongan native gained anything from his brief association with the New Zealand Dental Corps, the advantage was not entirely one-sided. The opportunity to examine the mouths of natives from different localities in the Tongan group provided further proof of the damage done to the natural dentition by the white man's diet. Much had been written on this subject but it was seldom that such an opportunity arose to observe at first hand. Captain Wimsett's report on the subject therefore merits inclusion in this history:
Of 460 recruits examined, representing four companies of the 2 Tongan Battalion, 195 were found to be dentally fit. Those requiring treatment averaged about one filling per man. Many of them required scaling and cleaning only. These men's teeth are remarkably free from caries though, where this is present, it seems to be of a virulent type. Gum conditions are markedly poor and extensive calculus deposits almost universal, and in most cases teeth require extraction for these reasons. These men have had no dental attention except for occasional extractions usually by Tongan Medical Practitioners and do not appear to employ any type of prophylaxis.
This report applied to recruits, mostly from the outlying islands such as Haapi, where the natives were living away from the influence of white people.
Those personnel who were recruited from the larger villages and especially from Nukualofa, showed extensive caries…. Those natives who lived on a natural diet of yam, taro etc., showed very little caries but still extensive calculus. Those who were able to get bread and canned meats, to which they were very partial, showed extensive and multiple caries plus the usual calculus.
The significance of these observations brings to mind the report made some years ago by Weston Price, a much travelled American research worker, who found similar conditions prevailing in countries whose inhabitants live under somewhat similar conditions to the natives of the Tongan islands. This report is not concerned with any theories but is a statement of cold, hard, and undeniable facts as they were found.
Here was the same story as in
The connection between civilised diet and dental caries is obvious, but the menace of calculus with its handmaiden pyorrhoea is present with the native in his natural existence and is something that warrants further research. Even in his natural existence the native does not use his jaws as much and as vigorously as his distant ancestors did. Gone are the days when the teeth were used to kill the prey and tear the flesh from its bones. Gone also is the mechanical cleansing this exercise would give to the teeth. Loss of function carries penalties and human jaws are growing too small to accommodate all the teeth, as can be seen in the number of third molars with insufficient room to erupt. Captain Wimsett noticed this in the Tongan natives:
One other fairly common occurrence was the number of impacted third molars. The Tongans have, like our Maori people, large wide arches (I never saw one case with a Gothic arch), yet on account of the large teeth there still was not enough room in a number of cases. These impacted and unerupted third molars caused them a considerable amount of trouble and, as is to be expected, it was found necessary to remove them. Access however, as might be expected, is very good and I gained considerable experience in this class of work. Generally speaking the teeth of the Tongans are not difficult to remove.
From the conservative aspect the teeth are somewhat similar to those of our Maori in that the extent of the caries was more real than apparent. Malignant growths of the oral tissues were occasionally seen but mostly only when the case was apparently hopeless as the native seeks help only when sheer necessity drives him to it. On enquiry I found that cancer as the layman understands the term is rare in the Tongan people. Although tuberculosis is very common among the natives I did not see any oral manifestations of the disease and would say that tubercular ulceration of the oral mucosa was rare. The Tongan makes a good patient and is co-operative and grateful for anything one does for him, particularly if the work entails the replacement of anterior teeth which makes him the cynosure of all eyes among his brethren.
The Tongan Group is serviced from
ABOUT 930 miles from Bounty. At the beginning of the war, apart from the presence of a cable station, the inhabitants, of whom there were about 900, lived a peaceful existence under antiquated conditions in a quiet backwater of civilisation under the administration of the Australian Government. There was no electricity except for individual plants at
Suddenly, as a result of the rapid development of the war in the
There were certain differences between this undertaking and that of other theatres of war in the
The detachment arrived on
Although the delay in the arrival of equipment was not great on this occasion it is reasonable to emphasise the importance of the emergency haversack always being available for the use of the dental officer. If, instead of being made a unit issue, each officer was issued with his own haversack to be carried as part of his personal kit, there would never be an occasion when he was ‘grounded’ for want of equipment. He could be made responsible for its contents, would account for all items used and would replenish it from unit stock. Some idea of the working conditions can be got from the following report dated
Equipment and stores arrived safely in a good state of repair. Owing to the climatic conditions (humidity 95% at times) and through conversation with the local dentist, all surplus stores have been put away in lever lid cannisters, of which supplies are ample owing to the consumption of large quantities of service biscuits….
Definite precautions are necessary for the secure packing of any future stores as the ship is unloaded in the roadstead on to lighters, usually in a heavy swell, and then from the lighters on to the wharf, requiring much handling. Wiring and the use of substantial boxes should obviate any loss of stores.
The port facilities were certainly primitive, consisting in the main of two moles, one at
The first examination of the troops showed that the dental health of the force was good. Out of 1483 men, all but 262, who were on special duties unloading stores or setting up camp, were examined between 15 and 31 October: 826 were dentally fit and 395 required treatment, mostly fillings.
The number of remodels (97) and repairs to dentures (58) was in excess of what might be expected in a force which had recently arrived from New Zealand, but the explanation was simple. The fault lay with the service biscuits, which were one of the main items in the ration and were so hard that those whose dentures were not completely stable could not eat them, and even those wearing stable dentures broke teeth on them. The only thing to do was to remodel every unstable denture immediately, even if in the normal course this would not have been done for several months, and also to expect a continual succession of repairs. As there were about 100 wearers of acrylic dentures in the force, an urgent demand for this material had to be made on
The medical detachment continued to house the Corps for some months as the dental hut was not ready until
The Australian workmen had brought with them an American medical and dental section consisting of two medical officers and one dental officer. The equipment included a complete field dental pannier very similar in its contents to the New Zealand surgical pannier except that the folding chair was not carried separately but was packed into the pannier itself. As the American sections were due to leave when the aerodrome construction was finished, the ‘N’
Force medical detachment was anxious to take over all their stores but this did not materialise, at least as far as the dental section was concerned.
During
In
Extractions were negligible and new dentures too few to be taken into account. Apparently the biscuits were still taking their toll for the number of remodels and repairs, though less, was still high. The new examination was just completed when sudden movement orders were received. There was to be a general relief of units, including the dental detachment. There was no time to do other than urgent work such as extractions, fillings and repairs to dentures. Nevertheless the force left the island in a satisfactory dental condition.
A new dental detachment took over at the beginning of
I would like to place on record the very excellent work done by the previous section, for not only were their efforts responsible for this section operating in the shortest time possible but also they did much to improve the conditions under which we are living. Everywhere I have been I have been greatly impressed by the high opinion held of the Corps.
On 24 May a start was made on building the dental hut. Until its completion on 1 July, the dental section continued to work at the ‘Burnt Pine Hospital’. Competitive sport, especially baseball, claimed the Corps as ardent enthusiasts, so much so that the DDS
Owing to the prevalence of physical injuries entailing lengthy absence of dental officers from duty, it is regretted that their participation in organised games such as football, hockey etc., must cease.
In May a further responsibility was thrown on the Corps. The local dentist died and the Administrator asked Captain Hope to provide emergency treatment for the people until a dentist could be obtained from
From the middle of
On
Meanwhile Captain Murray and his two orderlies had moved into the dental hut with their quarters close by in the
In
All on the island were dentally fit before the section left at the beginning of July. Each new draft from New Zealand was made dentally fit before embarkation and it was not found necessary to call on the services of the
In
LATE in
Leander, being based there. The battle of
The New Zealand Dental Corps was not concerned with the first five months that the New Zealand squadron was on the island as urgent dental treatment was provided by the dental hospital at the 25th
No. 3 GR Squadron had established headquarters at The Air Command of the South Pacific.Louis McLean, with the equipment aboard, had put in to Nouméa in
The original camp for the squadron was poorly situated in the jungle which, in the wet season, made conditions trying but possessed the advantage of providing natural camouflage. Later, the permanent
The construction of the dental hospital was begun on
After commending the efforts of the men of his section as amateur carpenters, Captain Allan wrote as follows to the DDS:
The only building supplies available at the camp were the walls of the building. It is safe to say that every other camp on the island was solicited for building supplies such as nails, timber, netting, taps, pipes, light fittings etc. For instance, the surface of the plaster bench was covered with aluminium salvaged from the petrol tank of a crashed ‘Flying Fortress’.
The hospital was completed on
The arrival of 9 Squadron heralded the reorganisation of the
At
Headquarters No.
One General Reconnaissance Squadron.
One Fighter Squadron engaged mainly in training but also providing night-fighter patrols at
No.
At
Headquarters RNZAF,
At
One Flying Boat Squadron and one Flying Boat Training Flight.
At
One General Reconnaissance Squadron with a detached flight at
At
One General Reconnaissance Squadron.
One Fighter Squadron.
In New Zealand.
One Fighter Squadron and one General Reconnaissance Squadron in training to relieve the respective squadrons on completion of their tour of duty.
Later reorganisation saw the disappearance of the squadron establishments of ground crew and the institution of fighter and bomber maintenance units. In turn, this led to the establishment of
At the time of the formation of the No.
It therefore became apparent that the dental services should be reorganised and on
Early in
The
When the
A headquarters section consisting of two officers and eight other ranks.
No. 1 Sub-section consisting of one officer and three other ranks.
Actually this organisation was a change in name only as already Major Allan and Captain J.
All reinforcements and replacements for the Corps were sent direct to Group Headquarters in the first place. Postings for duty were then made by the Group Dental Officer. The tour of duty within the Group area for dental officers and other ranks was to be a minimum of twelve months, with the exception of the Group Dental Officer where a maximum of two years was recommended. The reason given for the longer tour of duty for the Group Dental Officer was that it was considered better to interfere as little as possible with the official relationship with the Americans, especially regarding stores.
Despite this arrangement, however, Major Allan handed over his command to Major W. M.
R.N.Z.A.F. personnel on arriving at
Espiritu Santo , where the headquarters section was located, were immediately examined and, as far as possible, those going to forward areas were made ‘Dentally fit’ before leaving. The … men were more readily available for treatment at Base….The dental condition … was, on the whole, excellent. Number 3 Squadron had been without treatment for six months before N.Z.D.C. facilities were available and on examination needed only one filling per man….
Later, when the establishment of the R.N.Z.A.F. was being increased and reinforcements and replacements were arriving frequently, a number of drafts required treatment on a scale that was higher than average. This state of affairs was soon rectified in New Zealand and then the necessity for examining drafts on arrival disappeared.
Throughout my tour of duty in the
Pacific I observed that the standard of dental health was particularly high and maintenance, in my opinion, was less than that needed in New Zealand. It was anticipated that, owing to the lack of fresh fruit and vegetables, there would be a relatively high incidence of gingival conditions but this was not the case. From February 43 to April 44 not one case of Vincent's Stomatitis was reported while the number of cases of simple gingivitis was very low….The health of all ranks was excellent. During the period February to May 43 Dengue Fever was rife at
Espiritu Santo …. Dysentery, sinusitis and a transitory type of Migraine were prevalent…. Malaria control units throughout all the islands were exceptionally efficient….The morale of all N.Z.D.C. personnel was excellent and all ranks were willing and conscientious in the performance of their duties. One of the most pleasing results of my tour of duty was to note the way in which all ranks turned their hands to carpentry and constructed the dental hospitals in the areas. It is not boasting to say that all the dental hospitals were a credit to the New Zealand Dental Corps.
As at
Headquarters Section at Base Depot,
There were approximately 1250 men stationed at the Base, representing a ratio of 625 to each officer, although the Senior Dental Officer, by reason of his administrative duties could not spend much time at the chairside. There was a monthly intake of 500 transient personnel which makes the figure 1250 an underestimate.
Sub-section 1 at
There were 1300 men to whom must be added 225 of No. 6 Flying Boat Squadron and 75 of the Royal New Zealand
Sub-section 2 at
There were 1200 men of the
There were therefore four dental officers, or more accurately three and a half, responsible for the full treatment of 4050 men and limited treatment of over
Headquarters No.
There was to be a Headquarters Section with five sub-sections, consisting of six officers, i.e., one major and five captains, and nineteen other ranks, of which thirteen were dental clerk orderlies and six mechanics. This gave the greatest flexibility both for distribution throughout the Group and for further expansion. There was to be an Advanced Base Dental Store attached to the Headquarters Section in a similar manner to that in the dental service attached to
About this time it became known that the No.
The RNZAF in the
Headquarters Section. Attached to Headquarters at
Headquarters No.
Headquarters RNZAF Station,
Bomber Reconnaissance Squadron.
Bomber Servicing Units.
No. 1 Sub-section. At
Fighter Squadron.
Fighter Servicing Unit.
Flying Boat Squadron. (At Halavo Bay, Florida.)
Royal New Zealand
Radar Squadron.
Works Squadron.
No. 2 Sub-section. At
No. 3 Sub-section. At
TBF Squadron. Torpedo Bomber Fighter.
TBF Servicing Unit.
SBD Squadron. Scout Bomber Dive.
SBD Servicing Unit.
No. 4 Sub-section. At
No. 5 Sub-section. At
Headquarters Base Depot.
Base Depot Workshops.
Bomber Squadron.
Bomber Servicing Unit.
Transit Camp.
By the end of
The first three months were rather difficult because of the uncertainty of what would be the future role of the R.N.Z.A.F in the
Pacific .Since 1 June, when the Headquarters Section moved to
Guadalcanal and the establishment was increased, the work has proceeded much more smoothly although it has been difficult to plan ahead because of the lack of a definitepolicy for the R.N.Z.A.F. in the Pacific . This of course was due to factors over which Air Department and No. 1 Islands Group had no control.However, the policy for the next few months is now fairly well defined and I think it is quite evident that we will need a substantial increase in our establishment.
The total number of men in the No. 1 Islands Group will, I understand, increase to 8,000 or 8,500. When I wrote on 30 August about an increase in establishment it was thought that squadrons would be established on
Emirau andGreen Islands . A few days later it was decided that a squadron would also be located atLos Negros in the Admiralty Islands.Another complication has arisen at the seaplane base at Halavo,
Florida Island . In the past the squadron there has been treated each six months and casualties in the meantime have been treated by the United States Dental Officer attached to the Base. I am now told that theUnited States squadron will be withdrawing so we will have to visit Halavo frequently in future. As 450 men are involved they are too big a unit to leave for any length of time. Halavo is half a day by ship fromGuadalcanal .The same position will occur at
Los Negros . There will be about 300 to 400 men and they will have to be visited frequently, probably by the dental officer atEmirau .Under the new organisation there will be 700 to 800 men at both
Emirau and Green islands and about 400 to 500 atBougainville .The number at
Espiritu Santo , now 1,350, will soon be increased to 1,800 by the arrival of No. 5 Flying Boat Squadron fromFiji .As I visualise the developments in the next few months, I think our establishment should be increased to nine or ten officers and three should be posted as soon as possible…. As the size of the section grows, more and more of my time will be taken up with administrative work and I will no longer be able to spend a full day in the clinic.
As a result of Major Cunningham's recommendations a new establishment, consisting of a Headquarters Section and ten subsections, was authorised on
Assuming the number of men in the group to be about 8500 and excluding the Senior Dental Officer, the ratio worked out at one dental officer to 850 men. This was low compared with other theatres of war and with New Zealand, but units were small and scattered, sometimes into groups of no more than 400 to 700 men long distances apart. Groups of this size could not be left without a sub-section for any length of time, so it meant that more subsections were needed than if the men had all been congregated together. They had all been treated either at an
In operations such as those in which the
On
During its existence from June 1944 to October 1945 No.
Until the end of hostilities the dental organisation continued to be a Mobile Section with varying numbers of sub-sections. On
Authority given to cancel establishment No. 1 RNZAF
Mobile Dental Section with effect from 20 October 45 and to establish three self-contained dental sections as advised.
Three self-accounting sections were formed, stocked with adequate supplies for four months and stationed at
A high standard of oral health was maintained for all men by systematic examination by units. The average airman was made ‘dentally fit’ three times during his twelve months' tour of duty: once before leaving New Zealand and twice by the
It is considered that the good health of the soft tissues is due in no small measure to the large quantities of citrus fruit juices and the vitamin concentrates B1 and C which the men were encouraged to take each day. All the dental officers consider that the gingival tissues are healthier here than in New Zealand and the increased amount of vitamins B1 and C must be given some of the credit.
This opinion was endorsed almost word for word by Lieutenant-Colonel Simmers in a report dated
While giving due credit to this diet, it is felt that the strongest emphasis should be placed on the necessity for constant vigilance against the mechanical irritation of salivary and seruminal calculus, the main etiological factors in periodontal disease. It is significant that in the
From March 1944 to March 1945, 11,530 patients were treated, and of this number 2134 were scalings. From
Fillings required per man were between 0.7 and 0.9 and extractions were never above 0.06 per man. The bulk of the denture work was remodelling and repairing, although a certain number of new full and partial dentures were made. From this it can be seen that most of the work was maintenance, with oral prophylaxis demanding much of the dental officer's time. In the
One interesting problem arose in connection with the
The men were quartered and rationed by the Americans and were eating food to which they were not accustomed, and which was perforce under the existing conditions lacking in full vitamin content. This may have been the cause of some of the post-extraction haemorrhages noted by Major Washbourn. That at least was his opinion, and he went so far as to adopt preoperative medication as a routine, although no mention can be found of this being done by other dental officers in the Group.
When it came to making appointments for treatment there were certain important factors to be considered. The average patient in the
Most supplies were through monthly indent on the
Certain stores were available from the United States Medical Supplies, but too much reliance could not be put on this source as
As many stores from
The same trouble was experienced in keeping certain stores and equipment as was seen in
Spirit lamps and primuses were used in surgeries and workrooms instead of bottled gas, which in
Matches are very scarce and a packet or two would be very useful if they could be included in the indent. Sufficient draught to keep the place cool plays havoc with the spirit lamp and a considerable number of matches are used.
The answer from Headquarters,
Later, when the supply of electricity was better, some electric sterilisers and water heaters were supplied. Other electrical equipment such as polishing lathes and fans followed shortly afterwards. Such things as electric lathes and fans had been considered as luxuries, but Major Cunningham on his return to New Zealand in
Up to this time, all unserviceable equipment had to be returned to New Zealand before it could be written off the charge of the Senior Dental Officer. Similarly, there were no local facilities for writing off missing equipment. Authority was now given for all equipment, other than glassware, which had become unserviceable through fair wear and tear, to be written off by a local Board of Survey consisting of two dental officers other than the accounting officer. It was suggested that this board meet every three months. Items of glassware broken in use were to be entered on Form 138 (an army form which was an application to write off stores) and not returned to
On account of the lack of air freight, supplies of workroom plaster, artificial stone and other items of a high weight-to-value ratio were procured locally under lend-lease. This countermanded an order of
There were no standardised plans for the building of dental accommodation in the Islands Group with the result that there was a variety of structures. All contained the essentials but differed according to the ingenuity of section commanders. Environment and the character and availability of materials, as well as the limitations imposed by lack of experience in construction, influenced the choice of design. Most were erected by the Dental Corps men themselves, except for certain special work such as plumbing and electricity and a general expert supervision.
Rain and heat were constant companions and buildings had to be constructed with this in mind, although it was found to be impossible to shut out all the rain and keep cool as well.
As has been stated earlier, the dental section with the
Books, magazines and digests were sent to the forward areas from time to time and current issues of the principal dental journals of the world were circulated among the officers. A monthly newsletter was also started to keep closer touch between Headquarters and the scattered sub-sections. Hobbies were encouraged and were numerous and varied.
Some idea of the conditions and of the general life can be gleaned from the following excerpts from narratives supplied from dental officers who were there:
Number 5 Flying Boat Squadron Camp is situated beside the sea at 50 to 100 feet altitude so there is a cool breeze to make living conditions pleasanter. The camp itself is in the middle of a coconut plantation and consists, for the most part, of Quonset huts. The administration is American so the food to a large extent consists of American dishes. These were enjoyed as a novelty but were not really palatable to us. Facilities are available for swimming, basket ball, volley ball and table tennis and in addition there is a good library and outdoor picture show. Launch trips are always a great delight….
At the Base depot there is a well established camp, very clean, with well-constructed buildings, good roads and all possible conveniences such as electric iron and hot and cold showers. This camp compares very favourably with those on
Air Force Stations in New Zealand.The hours of duty are 0730 to 1130 and from 1330 to
1615 . This leaves two spare hours in the middle of the day for reading, relaxing in the shade of a palm or swimming. Gardening and boat building are other forms of recreation. Fresh milk is one of the things missed most.
… a beautiful spot just like a tourist's guide to the South Seas. Jungle in the background, palms, coral sand beach, coral reef with breakers on the outer edge and deep blue sea beyond.
We established the section in one end of the medical hut with the chair in the open doorway to get the best light and began work under the curious gaze of an audience of natives.
On the Saturday evening a native arrived from the Catholic Mission about twelve miles away with a note from Father LeClark … requesting my assistance with a maternity case, a delayed placenta. We went there on the Sunday and were greatly relieved on arrival to find that our services were not required.
During off hours we built a raft of oil drums and bamboo and using a viewing glass spent many hours examining the underwater life of the reef. Also, wearing goggles and armed with bows and arrows we hunted fish to the advantage of our general education but with little increase to our rations.
Halavo Bay is on the Western shore of Florida facing
Guadalcanal and about 15 minutes by launch fromTulagi . It was formerly a Melanesian mission station but, with the advent of the Japanese, the natives fled inland.We shared a Quonset Hut with the American Dental Officer. Living conditions were good and food excellent and there were pictures every night and an occasional travelling concert party. We had our own vegetable garden with plenty of tomatoes and cucumbers.
The experience of erecting our own building was thoroughly enjoyed. Everything was done by the men of the section except cutting the rafters and the lighting and plumbing installations. The kit of tools was a Godsend as the Works Section could only spare one hammer and a rip saw.
The camp site was well chosen on clean coral with rapid drainage. The climate is good, the average temperature being about 85 to 90 degrees.
The study and hunting of butterflies can be followed to some extent and some beautiful specimens were obtained.
H.M.N.Z.S. ‘Kahu’, the New Zealand Naval Base on the island is attached to an American Naval Unit and the camp is situated in the midst of a coconut plantation at the head of Renard Sound. Climatic conditions are good with the Anopheles mosquito not in evidence.
Excellent swimming is obtainable at Lingatu, an American Recreation Centre on the opposite side of the island. Launch trips to neighbouring atolls interspersed with deep sea fishing for bonita or tuna help to pass our leisure hours.
The section is well known for its interest in queer insects of which there are great numbers, especially butterflies of all colours.
The climate is one of the best in the area, the temperature remaining much the same all the year round, i.e., 90 degrees in the daytime and 72 at night. The soil is sandy so the rain which is daily and often heavy soon drains away. Very few fruits grow on this part of the island.
The ship steamed into Hamburg Bay,
Emirau Island, situated in the St. Matthias Group…. The island is small, some 7 miles by 4 at its widest part. It is the island where the survivors of the sinking of the ‘Rangitane ’ were landed.The heat is intense, particularly with the glare off the coral strip and shoreline but against this, the rains and storms bring welcome relief from the incessant dust and cloudless skies.
The camp site was cleared out of the dense jungle. Timber as we understand the word does not exist but there are many young saplings which are invaluable for our type of tropical building.
The camp, abandoned two months previously by the Americans, was a dilapidated affair of broken down buildings and rotting tents, the whole
place overgrown with rank weeds, vines and creepers. Snakes abounded and the small barking toads made sleep almost impossible. Scores of pigs wandered about as if they owned the place. However these were only first impressions. As the weather improved and the mud hardened, the weeds were cleared, the tents made habitable and the pigs driven away, more or less, and we found we had a camp as good as any on the island.
The following figures give details of the treatment afforded by the
Knowing that the
In conclusion, it would appear that the
The remarks of Lieutenant-Colonel Simmers on
I wish to record my appreciation of the service rendered by all ranks. At all times their general conduct has been very good. They have worked consistently well under trying conditions and the results of their efforts have been evident in the dental service rendered to the R.N.Z.A.F. and in the number of excellent sections which were constructed by their own efforts and initiative.
IN
The unit was assembled in
It will be remembered that 66.9% of the personnel are wearing artificial dentures and must rely on these, and in some cases a few well-filled natural teeth, to assimilate their daily rations, apart from being middle-aged men serving under severe climatic conditions. Under such conditions artificial dentures are readily broken and as easily lost and the wearers must be considered as potential casualties unless facilities for the supply and repair of dentures are available as close as possible to the sphere of activity. The same applies to recurring dental caries for there is nothing like dental pain to weaken a man's morale.
The destination of the unit was revealed as the
The section was equipped with panniers and chair case containing a full NZDC field dental outfit and three months' supply of expendable stores. Included in this was a bottled rock-gas pannier containing two cylinders, each of 20 lb. content, and fittings all ready for use. This gas was a product of the Imperial Gas Company of
The control of the section was vested, as far as practicable, in Air Headquarters, Sqn Ldr E. C. Smart;
The unit left Narbada and, after five and a half days of atrocious weather, arrived at Newcastle in Narbada, which was to undergo a survey, and was sent to No. 2 Embarkation Depot at Bradfield Park,
Due to an outbreak of parotitis and rubella the greater portion of the unit is still in
Australia and the date of embarkation is still indefinite.Seventeen patients have had urgent treatment since leaving New Zealand, eleven have been denture repairs, four acute apical conditions, one osteomyelitis, which I am treating in hospital, and one serious ulcerative stomatitis which has since developed parotitis and has been isolated at Prince Henry Hospital.
The medical officer of the unit, Captain N. H. North,
The voyage took eighteen days and began in SS Bontekoe, a Dutch ship of unimpeachable standing until she took on a deck cargo of cattle at Soembara Besar. Fortunately the British agent at
On arrival the dental section went to
Having regard to the opposition from the
He [Group Captain Bodie] was agreeably surprised at the type, standard and degree of mobility of the equipment.
In view of the difficulties … I quote, with his knowledge, the view Group Captain Bodie took of this matter. He accepts responsibility for the signal to the effect that the dental treatment could be done here, purely because he would not admit otherwise. He (now) expresses pleasure at its inclusion because, situated as we are, he realises it could not have been given satisfactorily, if at all.
Certainly the sine qua non. Captain
I have established contact with the
RAF and attached dental personnel throughout the command, the headquarters being at Seletar onSingapore Island. I have also investigated the replenishment of stores position. The system is most unsatisfactory, the position being roughly as follows:—All equipment and stores are indented six monthly direct from England as they have no medical or dental depot in the Far East Command. The requirements are eighteen months in arrears and, generally speaking, I am in a better position as regards stores and equipment than the whole of the
RAF at Seletar.For requirements of C class
stores I associated myself with the Principal Dental Officer at Seletar in requesting power of local purchase, and in this matter the position is satisfactory. Consumable.
In view of this alarming position and by virtue of being fully equipped for at least three months, the NZDC was able to make an offer to the Principal Medical Officer for the
The first few weeks in
On
Sergeant Goodwin and I remained at
Kallang till 31 January 42 and then rejoined our unit. We completed the treatment of Squadrons 488 and 243. While atKallang we carried out casualty clearance during the raids and an ambulance was at my disposal. I worked in co-operation with the Medical Officer.On 1 February, orders came for the unit to transport equipment and personnel to Oosthaven (in
Sumatra ). The dental equipment was loaded on 2 February but on 3 February the vessel suffered direct hits and near misses from a bombing raid…. The hold carrying my equipment was on fire and salvage at that stage was out of the question. The same afternoon, in company with Squadron-Leader Smart and Captain North, I reported to Air Headquarters and was instructed to be at Tengah Aerodrome at 0300 hours on 4 February for transport to theNetherlands East Indies for urgent oral surgery work. I duly reported but was informed, with the Air Officer Commanding's apologies, that accommodation was not available. I therefore returned to the Dairy Farm. The same day I returned to the ship to attempt salvage of the equipment. I was partially successful but the Rock Gas equipment, vulcaniser, chaircase and contents and some personal gear were irretrievable. The vessel had 32 feet of water in her hold and was in danger of capsizing, consequently I deemed it unwise to stay below any longer.On 5 February Air Headquarters asked me to stand by for air transport to
Sumatra .At
1600 hours on 6 February orders were received to evacuate the unit as shell fire was making the site untenable. Embarkation was to be by1900 hours. The salvaged section equipment was packed and sent to S.S. ‘Darvel’. At1830 hours another despatch from Air Headquarters asked me to stand by. I asked for further details, but as none were forthcoming, I refused to carry out the instructions, my reply being sent at1845 hours.The unit was divided for embarkation and transport, some to travel on S.S. ‘
City of Canterbury ’ and some on S.S. ‘Darvel’. To keep the section intact, I had to travel on one vessel while the equipment and stores were on the other.We arrived in the ‘
City of Canterbury ’ atBatavia at 0800 hours on 9 February and camped at the Konig Wilhelm School. I sent a telegram next day to the DDS reporting our safe arrival inJava . For two days there was no information as to the whereabouts of the ‘Darvel’ but eventually shearrived on 12 February. Our casualties suffered in transport from Singapore were removed to the General Hospital inBatavia .On 13 February the unit, except for half the officers, was transferred to Buitenzorg. On 20 February I was instructed to collect what hospital injuries I could and embark them for
Australia on S.S. ‘Marella’.
The telegram from Captain McCowan to Colonel Finn of 10 February was not delivered and, until it was safely in
THE treatment of maxillo-facial injuries requires a close cooperation between the medical and dental professions for, apart from the usual surgical procedures connected with gross tissue destruction and bone fractures, there are special factors in injuries to the face and jaws that are intimately associated with the teeth. It can in fact be said that the key to a successful restoration of facial harmony often lies in establishing correct relationship of the jaws, the one to the other. There is a dental problem here requiring a high degree of manipulative skill and an intimate knowledge of dental prosthesis. The infinite variety of injuries ranging from the simple mandibular fracture to the destruction of half the face makes it impossible to label a case as medical or dental. The best results are got by working as a team in which the plastic surgeon, dental surgeon, dental mechanic and many others play their parts.
In the First World War when casualties of this type were numerous, such a team was working at Sidcup in England under a New Zealand plastic surgeon and dentist, Major H. P. Pickerill,
It was not until
At the time these arrangements were being made the New Zealand Expeditionary Force in the
The plastic surgery and maxillo-facial hospitals to which the New Zealanders were attached were at Basingstoke, East Grinstead and St. Albans. They worked under the permanent dental staff. The officers were allotted cases for which they became responsible and the mechanics, after making splints and appliances for hypothetical cases, took their full share in making them for cases under treatment. An account of the methods of treatment and of the types of cases seen in these hospitals is too technical for inclusion in this history, but the reader who is interested is referred to an article by Captain Gilbert published in the New Zealand Dental Journal of
While these men were training in England, 2 NZ General Hospital at
When the New Zealand Division suffered its first battle casualties in
In
When Major Hutter and Captain Brebner were confronted with a casualty with a shattered mandible whose general condition was rapidly deteriorating through pain, sepsis and the inability to take nourishment, they decided that unless the mandible could be quickly immobilised the patient had little chance of living. Ordinary methods of treatment such as splints or wiring were impracticable and the only hope was to use the pin fixation method. If there was no apparatus provided in the equipment, then they must make their own. With the help of a nearby Royal New Zealand Dental Journal of
When 2 NZ General Hospital went to
The delicacy of the decision was briefly this. Should many be withdrawn from general duties to concentrate on a specialty which could employ only a few or should those few partially train enough of their colleagues to ensure a satisfactory chain of treatment in the force? The latter decision prevailed, and although only four dental officers received full courses of training, a large number of others were intimately associated with maxillo-facial treatment in its various stages.
In
There were then two fully trained teams of New Zealanders working in the
The establishment of maxillo-facial injury teams was the nucleus of the treatment of this class of case, but the team could not function properly without the intelligent co-operation of medical and dental units in the field. The team was usually in a hospital many miles from the battle area. Cases needed treatment before reaching the hospital. Apart from the obvious need to get the patient to the hospital alive and reasonably comfortable, the nature of the treatment in the early stages largely influenced the degree of success to be expected at the hands of the specialists. The importance of this had been emphasised in England and a memorandum had been sent out by the
In line with his policy of interchangeability of all officers within the Corps, the ADDS then asked Captain Gilbert to prepare a course of instruction so that all dental officers would know what to do in the field and would have a proper appreciation of the course of treatment at the maxillo-facial centre. Demonstration models and diagrams were prepared to illustrate the various methods of fixation. Case histories with X-rays and photographs were assembled from actual cases seen in England. The course was given twice on occasions when it was possible to assemble the officers at the Base, so that eventually all dental officers with the
Fully organised plastic surgical and maxillo-facial units were attached to two British hospitals in Egypt at
In the meantime more New Zealanders were training in England. Major Brownlee,
New Zealand was proposing to form a plastic surgical and maxillo-facial unit in New Zealand, similar to those in England, to
The unit was established at
In maxillo-facial work it is possible to lay down certain fundamental principles but no instructions could possibly cover the infinite variety of injuries. Much must therefore be left to the ingenuity of the individual operator. During the later stages of the North African campaign the lines of communication were so long that it might be some time before a maxillo-facial casualty could reach a specialist centre. More had to be left to the dental officer on the spot, and in many cases it called for nice judgment at a Main Dressing Station or Casualty Clearing Station whether treatment should be extensive or merely palliative. It is greatly to the credit of the dental officers at these stations that, without the benefit of specialist training, their application to the task brought such good results. Some indeed seemed to have a natural aptitude for this class of work and it is a curious coincidence that the dental officer attached to the New Zealand Casualty Clearing Station, through whose hands passed a great number of casualties, not only from the New Zealand Division but from many English units, was Captain E. P. Pickerill, NZDC, son of the surgeon who was in charge of Sidcup in the 1914–18 War. His article on ‘The Treatment of Maxillo-facial Casualties in a CCS’ and one by Captain N. E. Wickham, NZDC, on ‘The Treatment of Maxillo-facial Casualties in the Field’, both of which appeared in the New Zealand Dental Journal of
The work of Captain P. Noakes, NZDC, at 5 Australian Hospital in New Zealand Dental Journal of
Every officer of the NZDC who was in a position where he might be called on to render emergency or preliminary treatment for jaw injuries, whether overseas or in New Zealand, was equipped with a field maxillo-facial outfit. This applied to dental officers attached to field ambulances, Casualty Clearing Station, operational air squadrons, flying training schools, warships and hospital ships. The number of maxillo-facial casualties among New Zealand troops was proportionally small and cannot be accurately assessed for the future, but it is reasonable to assume that there will always be a need for an organisation to treat this type of casualty. The increased lethal power of modern weapons makes more of these cases fatal, but the greater use of mechanical transport at higher and higher speeds must leave in its train many injuries of this type.
The experience of the 1939–45 War shows that it does not need many highly trained specialists to handle the work, but that it is essential that every dental officer should have at least a working knowledge of the science. The average dentist in civilian practice has no opportunity to see this type of work and might go through the whole of his career without treating a single case. It is from these men that the dental officers of the future will be drawn, and it is unlikely that without encouragement they will devote much time from their busy practices to give more than a cursory thought to a subject of academic interest only. The good results in wartime
THROUGH the accident of capture of the complete Mobile Dental Section in
It is probably no exaggeration to say that the Dental Officers captured in
Greece and North Africa were of more value to the health of our troops as prisoners of war than on the other side of the wire. The majority of the men caught atDunkirk had had no dental treatment at all before being sent toFrance . Prisoners coming in later were in a better condition but it was never possible to keep pace with the amount of work presenting. Generally speaking the German authorities were not interested in the health of the prisoners of war. There were one or two exceptions to this rule. As far as I know the bulk of the dental work done inGermany was carried out by NZDC officers and men.
The German attitude towards dental treatment for prisoners of war varied in different camps according to the humour of the commandant. Generally speaking, in the early stages of the war it was one of indifference or even obstruction. Reports from dental officers bear out many instances of antagonism from the German authorities. Captain J. G. W. Crawford, NZDC, writes:
On
June 18th 1941 we began dental work in this camp (Oflag VB Biberach, 25 miles south of Ulm) which numbered about 800. The equipment was fair with collapsible chair and electric engine but materials werenot over plentiful. A German Army Zahnarzt [dental surgeon] from time to time smuggled us in extra supplies especially local anaesthetic of which we were always short. Unfortunately for us this man committed suicide later but he had always been a good friend to us. Orders from the German authorities prevented us from using local anaesthetic on French and Slav prisoners. British officers were the only men who were granted the privilege of having local anaesthetic for extractions. There were many hectic scenes when we extracted teeth for the unfortunate French prisoners.
It can readily be understood that because of the sadistic instructions of the Germans, the extractions for French or Slav officers were limited to cases of extreme urgency. The enforced prostitution of his profession must also have added considerably to the strain imposed on Captain Crawford. Later he moved to
Since my arrival in this camp last December there has been no opportunity for making artificial dentures. Towards the end of May 43 a large number of teeth arrived from the
British Red Cross Society . In addition several flasks and some wax were sent. I have endeavoured to get dentures processed at an outside laboratory but that has not been possible. I have also tried to get the necessary vulcaniser, polishing lathe etc., from the German authorities but they are unable to supply. I have in my books 200 men in need of either full upper and lower or full upper or lower dentures. This list does not include at least 100 men with broken dentures.
It is inconceivable that the German authorities could not provide a vulcaniser for the camp and this clearly shows their unsympathetic attitude in not allowing the dentures to be processed at a laboratory outside the camp. It was not until
Captain R. D. Spencer, NZDC, described similar troubles about artificial dentures in his camp:
In Fort 13, very largely owing to Captain Cook's tact in dealing with the Germans and his organising ability, we gradually built up an excellent surgery with two sets of equipment and a very good laboratory. The German doctor was far from co-operative and much of the equipment was obtained by ‘under the counter’ dealing with a German dentist in Thorn. This was paid for with
Red Cross funds and not infrequently with our own meagre cigarette supply. All the teeth were supplied by theBritish Red Cross Society as was rubber but the Germans supplied acrylic resin and also quite good filling materials.At
Stalag 357 on my arrival on 14 July 44 there were approximately 100 men requiring dentures, many of them having been without teeth since the date of their capture as far back as1940 .All prisoners of war were entitled to be fed on the same scale as German Base troops. This clause of the Convention was flagrantly broken by the Germans and they did not attempt to conceal the fact that we were not
being fed according to the Geneva Convention, in fact they admitted that we were being fed on the microscopic German civil non-workers' ration which was to begin with:
1 lb potatoes per day.
Dried peas or swedes (usually the latter).
300 grams of brown bread made from half rye flour and half potato flour.
6 ozs per month of fresh meat, usually horse.
About a level tablespoon of sugar and margarine per day.
The German doctor seemed powerless to increase the ration but he did try, when pressed, to provide facilities for me to make teeth for the many who had none.
Even this meagre ration was cut down early in
Captain C. C. Cook, NZDC, who was captured in
June to November 41. I was attached to the staff of the Barrack set out for the sick. In no way could this be called a hospital and conditions were primitive. The German in charge, Major Shott, was unco-operative and rude. For dental work the only instruments available were:
1 pair upper root forceps
1 pair lower wisdom forceps
2 useless elevators
1 glass syringe
1 box Harvard cement
1 box Synthetic porcelain cement.
There were no facilities for heat sterilization and lysolat tablets were used.
This equipment was added to in September and by 20 November, when the whole camp was moved to
On arrival at Fort 13, Stalag XXA, Thorn,
Weideman was most unco-operative and rude and made working conditions as awkward as possible for all officers. He shifted at least twelve medical officers from the Stalag at various periods and the only reason he left the dental officers was that he couldn't replace them. Theoretically he was in charge of all medical personnel but, in practice, he allowed dental treatment to be in charge of Dr. Lebrun, the German
Army Dental Officer in Thorn. This worked admirably as Lebrun was more co-operative but unfortunately he was shifted about May and Weideman then ordered all dental requests to be referred to him. He was most scrupulous in inquiring into the use of everything ordered and quite often refused things. He was outwitted however by a very good contact being made with the only large dental depot in the district and the best of everything was available for filling work.The denture position all throughout
1942 was most unsatisfactory. Up to the end of February all denture work was paid for individually or by raffles. From then on the supply of dentures was controlled by the GermanArmy through Weideman and up to the end of August, 32 Full Upper or Full Lower dentures were supplied out of a conservative estimate of 260 required. The German order was ‘Only men suffering from stomach trouble caused by the absence of dentures are to receive them and workers are to have preference.’ Non-working NCOs were therefore to be left without anything. The mechanical work was done by five British dental mechanics working for German civilian dentists.
The position of the edentulous prisoner of war was bad enough when his only qualifications for relief were to be a worker and become ill, but that was not all. Having reached the stage when his dentures were authorised, there was no guarantee that he would receive them expeditiously. Captain Cook reported that the processing of dentures from the camp by the British dental mechanics working for the German dentists was allotted the lowest priority. The German authorities would not supply wax, teeth or rubber, and Weideman would not allow a vulcaniser in camp until he was later persuaded to do so by a representative of the International Red Cross.
Mechanical equipment for a laboratory began to arrive at the end of January 43 and also a consignment of wax, teeth and rubber from England. On 23 February 43 the first denture was made in the Stalag and by March the laboratory was in full swing. It is convenient to mention here that the first lot of dentures made were a number sanctioned by Weideman under the German
Army scheme for stomach cases as far back as the beginning of October 42 and held back by him for five months until the laboratory was opened. For some time the forms of these men were kept as evidence of his failure to look after the general health of prisoners of war but they had to be left behind on movement from Thorn. At the time it was not thought prudent to have an open breach with him by demanding that the Germans should make the dentures as the laboratory was more than we really expected.
The British War Office gave instructions to dental officers to forward reports through the protecting power and on reading these
The first dental treatment for prisoners of war in this area (Kreis Cosel) was provided by a civilian practitioner who did fillings, extractions and dentures the cost being met out of camp funds (canteen profits). There is no record of the work but the total bill was
1773 Reichmarks. The first prisoners of war here being Arbeits Kommando E/3, CaptainsWarren and Noakes, NZDC, were posted here in February and May 42, both bringing with them a few instruments. They obtained permission to buy materials and instruments from a private firm and gradually equipped the dental centre which consisted of a small hut, 9 feet by 12 feet, serving as a surgery, laboratory and, in bad weather, waiting room. Up to the time of leaving the camp, these officers made 90 dentures with the assistance of Staff-Sergeant Turner A.A.M.C.
Capt J. Le B. Warren ; Dunedin; bornAuckland ,15 Mar 1916 ; dental surgeon; p.w.27 Apr 1941 .In December 42 I came from Marlag and Ilag, Stalag XB and later Milag Nord where I had been in charge of the dental centres and relieved Captains Warren and Noakes. More material was bought including a Field Dental Chair and large stocks of Palapont, Paladon [acrylic resin denture materials] wax and filling materials. Owing to the shortage of teeth a method was evolved of making stocks of teeth from Palapont and between 50 and 60 dentures were made before the
Red Cross supplies arrived.Men were charged 30 Rms
for dentures to cover all costs for materials etc., and the scheme worked excellently, the accounts being kept by the canteen at E/3. In May 43 the German authorities withdrew permission to purchase materials and paid the latest incurred so the nominal charge of 30 Rms has been stopped. Reichsmarks.
At
Prosthetic treatment cannot be carried out in this camp. Shortly after prisoners of war came here in September 42, permission for prosthetic treatment of any sort was refused by the German authorities on the grounds that there was a great shortage of dental rubber, artificial teeth and wax. An assurance was given, however, that if these materials were supplied by the British, prosthetic treatment could be carried out by a German civilian dentist in the locality, an arrangement which existed at Oflag VI/B. When the necessary materials were obtained from the
British Red Cross Society , application to have dentures made locally outside the camp was refused onthe grounds of the great demands being made on the German dental technicians. It was agreed that urgent repairs to dentures could be carried out, the British supplying the necessary materials, but of some twelve dentures sent for repair, only three were repaired after some four months and the rest were returned unrepaired. The extreme urgency of prosthetic treatment was discussed on several occasions by the Senior British Medical Officer, the Senior Dental Officer and the German Camp Doctor and on 5 June 43 it was agreed that the processing of dentures would be permitted in the camp. An indent for equipment was submitted to the German Camp Doctor together with a request for a British dental mechanic to be sent to the camp. The German camp doctor submitted the whole matter to the appropriate German authority. On 18 June a Senior German Medical Officer visited the camp hospital and in the course of his inspection made notes of the prosthetic position and it is hoped that it will not be long before a prosthetic department can be established. At the present time 53 officers require full dentures. This is due mainly to extractions which had to be carried out after capture. A much greater number require dentures remodelled or repaired. The supply of partial dentures for many cases is very necessary, many patients lacking the minimum number of teeth for adequate mastication. Nevertheless the greatest concern is for the edentulous and for those prisoners of war who must remain edentulous until repairs are carried out on their dentures.
At Reserve Lazarett Obermasfeld,
Accommodation. 1 surgery and 1 laboratory—satisfactory.
Equipment—satisfactory.
Materials.
Surgery—sufficient. These have been supplemented recently by the British Red Cross.
Laboratory. The supply of materials has been sufficient to cover the output of dentures. Early this year it was becoming more difficult to obtain artificial teeth. In March however a consignment was received from the
British Red Cross Society . Oflag A/Z and the BritishStalag IXC (Molsdorf) forwarded similarRed Cross consignments to this centre as the prosthetic work for those camps is carried out here. At first dentures were processed in vulcanite but now Paladon is used exclusively and sufficient rubber has been obtained to repair vulcanite dentures. With the arrival ofRed Cross consignments the present stock of artificial teeth are adequate for future requirements. Providing that issues of materials by the Germans continue as they have to date, the dental position can be regarded as good.
There are many more reports from different camps, some good, some bad, but enough have been quoted to show that the German policy was indefinite, allowing the different camp authorities to
When delegates of the International Red Cross Committee visited Reserve Hospital number 128 (Stalag IIID) in June 43 it came to their notice that the conditions which had to be fulfilled before artificial teeth would be provided by the German authorities were:
At least fifteen teeth must be missing.
There must be proof that most of the missing teeth had been lost by the prisoner of war during his captivity.
There must be from the absence of natural teeth incapacity to work. In the view of His Majesty's Government, insistence that artificial teeth can only be supplied where there is compliance with the above three conditions is entirely incompatible with the provisions of Article 14 of the Prisoners of War Convention which, in its second paragraph lays down that the expenses of the treatment of prisoners of war needing medical and surgical care, including the cost of temporary remedial apparatus (and artificial teeth are clearly apparatus of this kind) shall be borne by the detaining power.
His Majesty's Government therefore request the Swiss Government, on their behalf, to represent strongly to the German Government that the conditions mentioned shall be cancelled both at the Reserve Hospital number 128 and at any other hospital or camp where they are imposed and that henceforth there shall be in regard to artificial teeth and dental treatment, proper compliance with Article 14 of the Convention. They request to be informed in due course of the German response to these representations.
Notwithstanding the lack of co-operation from the Germans, a large amount of work was carried out by NZDC officers and men in captivity. Their enthusiasm and determination to work for their fellow prisoners made them invaluable in the camps and even the Germans recognised their worth, if only as an acquittance of their own obligations. Captain Carter of the Australian
Major MacKenzie and his Mobile Unit were split up after capture in
Greece . The C.O. and one other being sent off to Belgrade and Lieutenants Noakes, Warren, Spencer, Crawford and Dodgshun remained in the main prisoner of war hospital atPiraeus . Here Lieutenant Noakes became responsible for all jaw injuries, doing work of a high order, the others doing routine dental work including dentures. They were still at it when I left the hospital in late August. Owing to their industry, practically all patients were sent intoGermany dentally fit. The value of their work is such thatthey have already been warned by the German authorities that they will not be repatriated till after the Armistice.
The practice of dentistry in a prisoner-of-war camp was not only affected by the limitation of equipment and facilities but was influenced by the conditions under which the men were living. As it was extremely difficult to provide artificial dentures, it was essential that as many of the natural teeth should be preserved as possible. Extractions were therefore carried out only in cases where general health was threatened or for the relief of pain. Some teeth which would normally be extracted were saved by root filling, even though the absence of satisfactory means of ensuring asepsis made this a doubtful risk. It was necessary to decide in each case whether the man was better off with a risk of focal sepsis from a devitalised tooth under conditions when resistance might well become lowered, or deprived of a valuable masticator. Prophylactic treatments such as scaling and polishing were important. With lowered resistance due to dietary deficiencies, especially of vitamin C, there was always a danger of outbreaks of Vincent's infection and it was imperative that the oral tissues be kept healthy. A constant watch had to be kept to ensure that teeth carefully preserved by filling were not lost from pyorrhoea. Toothbrushes, pastes and powders were unobtainable in the early days and the diet contained few self-cleansing foods. There was a vicious circle. Masticatory inefficiency and poor diet led to lowered resistance, which in turn threatened further to destroy the masticatory machine.
Some prisoners of war had had little dental attention before capture so, with the great demands on the dental officers' time, it was impracticable to attempt to make them dentally fit. All that could be done was to make them as comfortable as possible by judicious extraction and the insertion of temporary fillings. There was always more work for the dental officers than they could do. Their policy was therefore to examine all the men regularly and concentrate on what was most urgent.
Although all the dental orderlies and mechanics were not employed as such, many of them were attached to dental officers in the various camps. One of the most remarkable examples of dental service to prisoners of war was provided by Bombardier J. F.
In some cases patients were sent from one camp to another for certain classes of dental work.
Though kept busy with routine treatment, some of the NZDC officers found time for research. As Major Mackenzie wrote in the preamble to an article for the New Zealand Dental Journal:
A Prisoner of War camp provides an excellent field for research work into the possible causes of dental caries. It would be difficult to find a similar institution so isolated from the outside world where the inmates are so ready to co-operate in experiments, where the exact diet is known and where it is so easy to keep them under observation. Furthermore, those interested in this work have the leisure to study and think unhampered by the distractions of normal life.
Major Mackenzie studied the acidity of the saliva in relation to the incidence of caries among his fellow prisoners. He made a careful study of their daily diet and, with a home-made microtome, prepared several hundred sections of extracted teeth. His findings were published in the New Zealand Dental Journal of
The German policy was to use captured medical and dental officers and personnel to treat prisoners of war both in camps and special prisoner of war hospitals. As a general rule in this hospital [Reserve Lazarett Obermasfeld] the treatment was planned and carried out at the discretion of these officers.
The general conditions of the hospital were not good, mainly due to overcrowding. Most of the wards had a full complement of double-deck beds with only about three feet separating each bunk. When it is considered that a big percentage of the cases were orthopaedic with infected wounds requiring prolonged treatment, the difficulties will be appreciated.
Diphtheria is a fairly common disease on the continent. An epidemic, fortunately of no great magnitude, broke out during the last few months. This was the greatest problem and worry as, although isolation within the hospital was possible for suspects, discharged patients had to go to allow for the constant inflow of admissions. This policy was adopted by the Germans on the grounds that admissions could not be diverted elsewhere.
Under normal circumstances many of the more serious jaw injuries would have been treated in a maxillo-facial centre. The repatriation of wounded was subject to much delay and did not exist at all until October 43. Usually the patient did not see a medical commission before four to six months' treatment had been completed. If passed, about six months elapsed before repatriation took place.
Since no elaborate treatment such as plastic operations or bone grafting could be undertaken, the patient's treatment was delayed for a considerable period before specialist services were available at home.
In the earlier part of his time at the hospital there were few maxillo-facial injury cases as most of them were treated at German hospitals. Later, however, he saw a number from the Anglo-American
Psychologically the officers and men of the Dental Corps had an advantage over the average prisoner of war as they were spared the boredom of idle hours but, physically, the continual work under adverse conditions took its toll, especially in the form of anaemia. One New Zealand dental officer who suffered from severe anaemia throughout most of the period of his captivity describes something of the hardships of the life:
Captured about 20 miles on the
Athens side ofCorinth while endeavouring to make for the Corinth Beaches, where we had heard that a last evacuation was to be made by theNavy the following night, I was sent with three of my colleagues to help in a temporary hospital inCorinth .Here four overworked doctors under Captain A. N. Slater NZMC were trying to bring some order out of chaos among the badly wounded men from the battle for the Corinth Canal Bridge. We worked here for ten days assisting the medical officers. Over half the patients had no beds and were on stretchers on the floor and even in the corridors. The only food brought into the place was that supplied by the Greek volunteers who came in to help the nurses. Captain Slater and I made several visits to the German Military Commandant of the town asking for food for the hospital and on each occasion were promised that something would be done. It was not however until the end of the sixth day that the remains of the soup left over from the dinner of a nearby German hospital arrived.
Capt A. N. Slater ;Wellington ; born Dunedin,13 Nov 1900 ; medical practitioner; medical officer 4 Fd Amb Oct 1939–Jan 1941;1 Gen Hosp Jan-Apr 1941; p.w.Apr 1941 ; repatriatedJun 1944 .After that things began to improve until, a few days later, we were all transported to a very much better place in
Athens which was being run, under the Germans, by the staff of the 5th Australian General Hospital which had been captured intact and had been allowed to keep much of its valuable equipment. During the time I was there (June to December) just under 2,000 wounded prisoners of war passed through, many of them having been flown from Crete.Until reinforcements of doctors arrived from
Crete , I was assistant anaesthetist to Captain Slater but later was able to turn my attention to dental surgery. I kept details of my work in my diary but the Germans found it and confiscated it.The Germans themselves were short of food in the
Athens area owing to the destruction of all road and rail bridges intoAttica from Salonica and the Pelopponese and the activity of Russian, British and Greek submarines in the Bay of Salonica.Early in December the whole hospital staff and patients were transferred to Salonica on the deck of an oil tanker and, after a day or two, entrained for
Germany . After eleven days in the train we arrived at Thorn inPoland and became attached to Stalag XXA on 1 January 42. I was living in Fort XV with about 600 other ranks, mostly NCOs, and held dental parades every day for the relief of pain, the only equipment available being my emergency kit.
He was appointed to
I was in charge of a column of 1,500 men, half Americans, and we marched from 12 to 16 kilos a day, although the first day we had to go 22 kilos. The occasional tooth was extracted on the march but my duties were mostly medical. Twenty to thirty men left the column every day in a state of collapse. They were collected together later by a medical officer
into three large barns. Chronic diarrhoea, dysentery and bad feet were a constant embarrassment. Of the four orderlies, two of them collapsed and had to be left behind before we crossed the Elbe. Two days after crossing the Elbe we received liberal supplies of Red Cross parcels and terrifying attacks by rocket-firing Typhoons on the same day. One column lost 42 killed and over 60 wounded in one attack. We learned afterwards that they thought we were Hungarians. We were liberated on 2 May by the 1st Airborne Division.
Such were the conditions and such were the men. They were given the opportunity to perform a valuable service and they grasped it with both hands. To them is due the credit of turning to the general advantage what at first appeared to be a tragic loss to the Corps. The prestige of the New Zealand Dental Corps has been enhanced by their devotion to duty.
AFTER the Allied invasion of
The Military Liaison Officer in
With the
This establishment, based on sound experience, was the ideal but it was difficult to fill. The Corps still had many obligations,
I did hope that some of the prisoners of war would, when they had had a spell, welcome a job of work though, as you know, when I first put the proposition up to the Adjutant-General, I stated that it was not a fair thing to ask them to operate. He disagreed, hence the policy that they would come in and help and take their post graduate courses later, for it would seem that it will be many months before the prisoners of war get back.
There was much criticism of this decision, firstly in New Zealand and later in England. It had already been announced in the press Dominion, inter alia, that the Government of New Zealand ‘would leave no stone unturned or grudge any expense in providing our sailors, soldiers or airmen all necessary dental attention to restore them to normal health as soon as possible after their years of captivity’. The British
A more serious criticism came from an authoritative source. Major-General F. T. Bowerbank, Maj-Gen Sir Fred T. Bowerbank, KBE, ED, m.i.d., Order of Orange-Nassau (
On medical grounds I strongly oppose the employment, after their release, of officers and other ranks of the Dental Corps who are repatriated prisoners of war. They should be treated exactly the same as combatant officers and other ranks and should be returned to New Zealand.
In my ‘Appreciation of Accommodation Requirements, New Zealand Prisoners of War’ dated
20 May 1944 (while I was in England) I stated:‘I should like to emphasise here that all repatriated medical officers and other ranks should be given leave and should be treated exactly the same as combatant officers and other ranks. This I consider important.’
In the face of this it was not possible to get authority for the establishment as suggested, but it was decided to leave it to the ADDS in England to appeal personally to repatriated prisoners of war to assist voluntarily. In most cases this appeal was successful and only a small but vociferous minority requested immediate repatriation, and even this was short-lived.
The NZDC unit, comprising 11 officers and 52 other ranks, left Ruabine, arriving in Liverpool on 29 October. It set up a section on the ship with the help of the Chief Engineer who provided, among other things, a cargo light and an adapted fan motor for use as a lathe. On arrival it moved to
Headquarters and Advanced Base Dental Store consisted of the ADDS, a WO I as sergeant-major, two dental clerks, one of whom was a staff-sergeant, a sergeant as head storeman, a corporal store-man, batman and two NZASC drivers. They had a light motor car and a covered 15-cwt truck as transport.
The Depot, under Major W. McD. Ford, had its own headquarters for assembly, training and distribution of personnel. It could provide sections to staff Wing Camps and other depots of the
As yet the unit could not be fully employed but it set up sections wherever New Zealand troops could be found, with the exception of those attached to the Royal
While waiting for the arrival of the prisoners of war their policy was to examine, render fit and maintain New Zealand servicemen
In order to appreciate the problem it is necessary to outline briefly the plans of the Reception Group for handling prisoners of war on arrival.
The Group was formed in
On arrival at the various wings according to their arm of the service, the men were to be medically and dentally examined, re-clothed and re-equipped, provided with pay, ration cards and gifts from the
The ADDS began to have doubts about getting any men for long enough to complete treatment. He had already finished work on all available service personnel and the staff in
In
Whereas the dental condition of the troops in England had showed 120 fillings and 24 dentures to each 100 men, the examination of prisoners of war showed 150 fillings and 46.5 dentures to 100 men, with 81 per cent requiring treatment. Fortunately reinforcements arrived. An officer, mechanic and orderly were annexed from the Hospital Ship Oranje and three officers arrived from the Central Mediterranean Force. The NZDC repatriated prisoners of war were not immediately available as operators but most of them began duty during June.
It soon became obvious that it would be impossible to make everyone dentally fit before embarkation for New Zealand. Most men could only be examined before going on leave. The few who did not go immediately on leave were allowed to stay only fourteen days in the Reception Group. The shipping position was uncertain and little warning could be given of the departure of drafts. The only solution was to work long hours when the men were available and to send a dental section with each incompleted draft to work on the ship on the way to New Zealand. This was at least one way of granting priority of repatriation to NZDC prisoners of war.
By the end of the year most of the men had returned to New Zealand and the members of the dental detachment had either gone with them or had made their ways to a university in England or the
In addition, eight returning transports carried dental sections and, although figures of the amount of work done on board are not available, it cannot have been inconsiderable.
By
Reviewing the position as a whole, it must be accepted that there was full justification for sending a detachment to England; it was none too large for the task; the majority of repatriated prisoners of war welcomed the opportunity to aid in the work and the result was satisfactory. There are, however, some matters that deserve comment. The sudden and unheralded embarkation of troops could not be avoided and will probably be a similar obstacle in any future war, but there are other obstacles that might be reduced in the light of experience.
One concerned the provision of surgery and laboratory accommodation on the troopships returning to New Zealand. It took some persuasion to correct the opinion that a cabin 8 or 9 feet square, four decks down with no ventilation and a lamp screwed on the wall, was adequate for a busy dental officer. The first two ships made some improvements at the urgent instigation of the ADDS and in later ships the accommodation was good. The Andes, in particular, had first-class accommodation below the boat deck forward on the port side.
Another arose from the difficulty of sending accurate data back to New Zealand from the three services by the fact that the
In conclusion, the granting of requests by dental officers for postgraduate study is something that could be better defined. It would appear that there was no set policy as to who was entitled to take these courses and no list of accepted schools. Quite often arrangements were made in all good faith, only to be cancelled on instructions from New Zealand.
This chapter may well conclude with a letter from Air Commodore K. L.
I feel it is appropriate at this stage to place on record my fullest appreciation of the grand services rendered by Lieut-Col. Rout and his officers and other ranks to the members of the R.N.Z.A.F. Dental treatment of the R.N.Z.A.F. in the
United Kingdom is primarily the responsibility of the R.A.F. but, owing to shortage of skilled staff, the R.A.F. has never been in the position to provide more than emergency treatment.The N.Z.D.C. officers have met this deficiency to the fullest degree with the result that the dental welfare of our personnel has left nothing to be
desired…. Lieut-Col. Rout and his officers have on all occasions co-operated to the fullest degree and I have no hesitation in expressing the satisfaction felt by our personnel. I would be grateful if you would convey my personal thanks to the personnel concerned. A copy of this memorandum is being forwarded to D.D.S. at
Army Headquarters, New Zealand.
(Extract from New Zealand Gazette No. 20,
In pursuance and exercise of the powers and authorities conferred on me by the Defence Act, New Zealand Gazette on the twenty-third day of January, one thousand nine hundred and fourteen; and I do hereby declare that these regulations shall come into force as from the date of publication thereof in the
692. The New Zealand Dental Corps shall consist of—
Administrative Officers: (a) Director of Dental Services, ranking as Lieut.-Colonel; and (b) two Assistant Directors of Dental Services, ranking as Majors.
The Administrative Officers shall rank as Staff Officers.
Executive Officers, ranking as Majors, Captains, and Lieutenants, shall be employed—(a) with the troops at the front; (b) with the New Zealand Expeditionary Force Reinforcements in camps or on His Majesty's New Zealand transports in such proportion as the Minister of Defence considers necessary; and (c) as principal dental officers of military districts.
Under category (2b) as many dental mechanics as may be considered necessary may be appointed, with the ranks of Sergeant and Sergeant-major.
Civilian dentists for duty in Districts: Civilian dentists will be appointed by the Director of Dental Services in each recruiting centre for service in connection with the dental examination of recruits for the New Zealand Expeditionary Force.
These Officers may, on the recommendation of the Director of Dental Services, be granted honorary military rank.
693. The Director of Dental Services will be responsible for the efficient working and control of the Dental Corps, and all appointments thereto will be made by Defence Headquarters on his recommendation. He will be responsible for the organisation, training, and distribution of officers and non-commissioned officers of the Corps; the calling-up of officers for service with the troops, abroad and in camps; advice as to an examination of all dental stores and equipment; miscellaneous professional questions, dental statistics; arrangements for accommodation, operating-rooms, and tents; the allocation of civilian dentists to recruiting centres; co-operation with the
694. Executive officers will be responsible for the completion of dental treatment begun prior to men going into camps or embarking on troopships, the treatment of fresh cases as they arise, and the repair of dentures.
The necessary accommodation will be provided, and all requisite materials supplied to dental officers in camps, who will receive no remuneration other than their salaries.
Executive officers appointed to camps will reside wholly in camp. In special cases only the Director of Dental Services may grant permission to reside wholly or partially out of camp.
695. Civilian dentists employed in districts for the examination of recruits: Recruiting dental officers will examine the teeth of all recruits, except those found to be permanently medically unfit, and will chart the teeth of each recruit found dentally deficient. They will hand each recruit a form, and refer him to the nearest branch of the Dental Association, which will allocate him to a dental practitioner for treatment.
696. Whenever possible treatment shall be completed before the recruit again reports at the recruiting centre for despatch to camp. Should this, however, be impossible through (a) exigencies of treatment, or (b) the inaccessible location of the recruit, the completion of treatment will be effected in camp.
697. If the circumstances of the recruit be such that he is unable to support himself whilst undergoing treatment prior to being attested, the Defence Department will endeavour to find work for him whilst he is under treatment. Every endeavour should be made by the dentists and employers of labour to co-operate so as to ensure that the hours of labour may be interfered with as little as possible.
698. When a dental surgeon concerned has treated the recruit he will fill in the forms as (1) dentally efficient; (2) requiring treatment; particulars of treatment to be specified.
The form (No. 3) will be returned by post to the Recruiting Office when the recruit is called up, and will be forwarded to the Senior Dental Officer in camp.
699. It is considered that recruits should, where possible, pay for their own treatment, but in the case of those unable to do so the fees charged, which will be at the ordinary hospital rates, will be forwarded by the dental surgeon concerned to the Director of Dental Services, who will certify the claim and forward it to the Defence Department for payment.
700. The dental examination of a recruit will be made after the medical examination.
701. Candidates for appointment to the New Zealand Dental Corps must be registered dental practitioners.
Appointments, except to the higher administrative ranks, will be made as follows:
All appointments will, in the first instance, be to the rank of Lieutenant. If the circumstances indicate that a Captain's commission is desirable, the Director of Dental Services shall have power to recommend a dental practitioner, of not less than three years' standing, to be Captain.
Promotion from Lieutenant to Captain will be by merit, on the recommendation of the Director of Dental Services.
702. The uniform for officers of the New Zealand Dental Corps will be as laid down in the New Zealand Dress Regulations for officers of the Territorial Force. Staff officers will be entitled to similar distinctions to those worn by Staff officers of other professional corps.
703. Officers of the New Zealand Dental Corps will be subject to the regulations relating to discipline as prescribed for the Territorial Force.
704. Officers of the New Zealand Dental Corps will draw pay at Territorial Force rates when employed with the Territorial Force. They may be appointed to the Expeditionary Force or for duty in camps for the New Zealand Expeditionary Reinforcements, and will draw Expeditionary Force rates of pay.
Officers of the New Zealand Dental Corps who are dealing wholly or partially with organisation and administration during the initiation of the corps, and the present emergency, will draw such pay as may be from time to time approved by the Hon. Minister of Defence.
Civilian dentists, with or without honorary military rank, employed in the districts examining recruits, will receive remuneration at the rate of one shilling per head for each recruit examined.
705. The New Zealand Dental Corps will be under the control of the Adjutant-General.
As witness the hand of His Excellency the Governor, this sixteenth day of February, one thousand nine hundred and sixteen, in the presence of—
Dental standards required are set out in four groups:
Armed Forces for home defence.
Large Expeditionary Force.
Small Expeditionary Force, for garrison duty abroad.
Temporary employment in New Zealand.
On mobilisation, candidates who are capable of being made dentally fit for general service and are willing to receive treatment, or are wearing satisfactory well-fitting artificial dentures to remedy a deficiency of natural teeth, will not be rejected for dental reasons.
The acceptance or rejection of a recruit will depend on the relative position of the sound or repairable teeth and his ability to masticate efficiently.
For convenience in determining masticatory efficiency, the teeth in the upper jaw which are in good functional opposition to the corresponding teeth in the lower jaw will be considered according to their functional value.
Each incisor, canine, premolar and underdeveloped 3rd molar will have the value of one point.
Each first and second molar and well developed 3rd molar will have the value of two points, e.g., if the whole of the 16 teeth are present in the upper jaw and in good functional opposition to corresponding teeth in the lower jaw, the total value will be 20 or 22 points according to whether the 3rd molars are well-developed or not.
The dental classification will be:
‘F’ Dentally fit.
‘T’ Dental treatment required.
‘U’ Dentally unfit.
Dentally fit (‘F’) means:
Those who have normal dental occlusion, which may include soundly restored teeth or well-fitting dentures to remedy a deficiency of natural teeth, or requiring treatment which will not take more than three working hours to complete.
N.B. Prosthetic work will be confined to remaking, remodelling and repairing which must be completed within twelve hours from impression taking, the recruit's presence only being required for a portion of the three working hours.
Those who have a masticatory efficiency of not less than twelve points, e.g., they should have at least ten sound teeth in the upper jaw articulating with ten sound teeth in the lower jaw, of these teeth there must be two molars articulating on the right and left of each jaw, in order to masticate their food without the aid of artificial dentures.
N.B. Well-filled teeth will be considered as sound.
Dental treatment required (‘T’) means:
Those who are capable of being restored to normal dental occlusion or to twelve points of masticatory efficiency by conservative means and not by the provision of dentures.
Those falling below twelve points of masticatory efficiency who are capable of being restored to normal occlusion by the provision of dentures, or requiring immediate extractions and subsequent provision of dentures after normal alveolar absorption is completed, provided always that they do not fall below a minimum standard of nine points.
N.B. The distribution of the nine points must be left to the judgment of the dental examiner who will also take into consideration the physical condition of the recruit.
NOTES:
An earnest endeavour must be made to assess the approximate time required for the necessary treatment on a Working Hour basis, and the dental examiner will record the estimated time on the form in the line provided under ‘CLASSIFICATION’.
None of the recruits classified in classes ‘F’ and ‘T’ should normally require to be absent from military duty in camp for longer periods than those required for the actual treatment given.
Dentally unfit (‘U’) means:
Those presenting with advanced stages of pyorrhoea or other septic conditions necessitating total extractions with extensive alveolar absorption.
Those whose dental condition necessitates extractions which will cause them to fall below a nine point minimum standard of masticatory efficiency.
Those presenting with ulcerative stomatitis in any stage.
N.B. These men should be specially warned that they are suffering from an infectious disease and require immediate treatment by a dental surgeon.
NOTES: Those classified ‘U’ are thus defined as those who, to be made dentally fit, would require considerable time off from military duty, over and above that required for actual dental treatment. They are thus NOT ACCEPTABLE for Home Defence in the first instance.
Such a force may be:
Mobilised de novo.
Formed from a home defence force already mobilised and in training camps, etc.
Standard: Only those classified as ‘F’ on NZ War 360 will be accepted primarily. Where, however, extra recruits are required to make up the requisite numbers a proportion of those classified ‘T’, who may be rendered dentally fit ‘F’ within a reasonable period (the actual time to be decided) may be accepted.
N.B. In case (1) above, those classified ‘F’ who may require up to three working hours' treatment will be treated by civilian practitioners before they enter mobilisation camps. If any class ‘T’ are accepted later they will
In case (2) above the necessary dental treatment will be carried out in the already existing camp dental hospitals.
Only those recruits who are classified as ‘F’ or who can be made dentally fit within Three Working Hours will be accepted.
N.B. (1) Where fillings etc., are necessary, the operations should be capable of being completed within twenty-four hours of his acceptance by the Board if the exigencies of the service demand.
(2) Prosthetic work will be confined to repairs, relining or remodelling, and in each case, utility is to be the only consideration. The patient's presence may only be required for a portion of the three hours, but the laboratory work must be completed during the next twelve hours, with a possible limit of twenty-four hours.
The fourth group, the standard required for men to be temporarily employed in New Zealand, was covered by an amendment of
(3) In considering nine points as a minimum of masticatory efficiency the physical condition of the recruit, his vocation in life, combined with the length of time the loss of efficiency has been existent, must not be overlooked. If a man can do a hard day's work, eat three meals a day and be physically fit with only six incisors, a molar on one side and a premolar on the other side, all occluding, he can carry on in a mobilisation camp until the deficiency is remedied in camp, if found necessary.
Colonel B. S. Finn, DSO, ED
Lt-
Capt J. G. W. Crawford
Maj W. G. Middlemass
WO II R. B. Radley
S-Sgt W. R. Paine
Sgt R. H. Watson
Lt-
Maj J. G. Brown
Maj W. G. Middlemass
Capt E. P. Pickerill
Capt W. T. Simmers
WO I N. W. McInnes
WO I R. F. McKillop
WO I S. G. Tonks
S-Sgt D. N. Anderson
S-Sgt E. J. S. Cox
S-Sgt C. A. Frater
S-Sgt C. F. Jackman
S-Sgt G. H. Ritchie
Sgt F. J. Haughey
Sgt G. Hughes
Sgt R. G. Patterson
Sgt A. A. Strawbridge
A considerable number of statistics are given in the text of the history and it is not proposed to repeat them here. There are some, however, which may be conveniently grouped to give some idea of the condition of the men of the Armed Forces and the amount of work done for them by the New Zealand Dental Corps. They are approximate only as complete accuracy of recording is not possible under every condition of warfare. Suffice it to say that they are sufficiently realistic as a basis for study and errors would be of omission rather than exaggeration.
These figures are the result of an examination of the Second and Third Echelons and the 4th, 5th and
A comparison of these two sets of figures points to the younger age of the Territorial group, in which fewer wearers of artificial dentures would be found, and consequently fewer fit mouths on examination with more filling work needed to achieve dental fitness.
These figures are the result of striking an average from a large number of reports.
The total population of New Zealand at the end of the war was approximately 1,750,000. During the whole of the war 215 dentists were mobilised for service with the Armed Forces for varying periods, but at no time were all these serving together as executive officers. It took three years for the Corps to reach peak strength, after which there was a gradual retrenchment. Taking these facts into account, the volume of work is formidable.
THIS book is largely based on the official records of the New Zealand Dental Corps, more particularly those of the Director of Dental Services and his assistant directors with
Report on the New Zealand Dental Services in the 1914–18 War by Colonel T. A. Hunter, then Director of Dental Services, New Zealand Dental Corps.
Official narrative by Major G. H. Gilbert, NZDC.
War diaries and reports of the ADDS
Carbery, Lt-Col A. D., The New Zealand Medical Service in the Great War, 1914–18. Whitcombe and Tombs,
Drew, Lt H. T. B. ed., The War Effort of New Zealand. Whitcombe and Tombs,
New Zealand Dental Journal—various issues.
New Zealand Gazette—various issues.
Medical history of the British
Dental history of the Royal
New Zealand Pacific Story and Guadalcanal to Nissan.
Annual reports of the General Officer Commanding,
Regulations for the Military Forces of the Dominion of New Zealand,
Newspaper files.
Abdiel, HMS,
Adjutant-General,
Advanced Base Dental Store,
Advanced dressing stations,
In Pacific,
Aldridge, Sick Berth Petty Officer F. E.,
Algie, Hon. R. M.,
Allan, Maj T. B.,
Andes,
Andrew, Brig L. W.,
Anzac Forces in
Arabis, HMNZS,
Arbutus, HMNZS,
Army Base Dental Store,
Artificial dentures, breakages,
Assistant Director of Dental Services, See also
Assistant Director of Dental Services in See also
Assistant Director of Dental Services, See also
Assistant Directors of Dental Services, Northern, Central, and Southern Military Districts,
Assistant Director of Medical Services,
Barrowclough, Maj-Gen Rt. Hon. Sir H.,
Batten, Ldg Sick Berth Attendant J. E.,
Benson, Capt J. R.,
Beresford, Capt J. S.,
Blue, Maj S. A. S.,
Bontekoe, SS,
Bowerbank, Maj-Gen Sir F.,
Brander, Capt C. H. M.,
Brick, Lt J.,
British Forces—
Bull, Brig W. H. B.,
Caldwell, Air Cdre K. L.,
Camp dental hospitals, Egypt,
Casualty Clearing Station,
Clark, Mr G.,
Coates, Rt. Hon. J. G.,
Colonial War Memorial Hospital,
Commando school,
Constable, WO II C. H.,
Corinthia,
Corkill, Surg Capt H. K.,
Davies, Maj L. P.,
Davies, Surg Lt (D) J. C. W.,
DeBerry, Surg Lt (D) A.,
Dental hospital, establishment of first,
Director of Dental Services—(1916–30, see see see
Recommends new organisation,
Director-General of Medical Services,
Dornhorst, Capt H. F. W.,
Downs, Lt-Col (Aust ADDS),
Eagan, Cpl U. G.,
Echelon, First—
Echelon, Second—
Elliott, Lt-Col J. K.,
Elliott, Maj R. D.,
Emergency Medical Service,
Equipment—
Finn, Col B. S., See also
Fleet Dental Surgeon,
Francin, Lt P.,
Fuller, Col J. F., See also
Gambia, HMS,
Gill, Ldg Sick Berth Attendant T. E.,
Goodwin, WO I E. A. J.,
Gray, Maj C. G.,
Green, Capt J. M.,
Halavo bay,
Hawksworth, Capt J.,
Henderson, Surg-Gen R. S. F.,
Hercus, Lt-Col Sir C.,
Hooper, Bdr J. F.,
Home, Surg Cdr (D) A.C.,
Horne, Capt C. K.,
Hospitals—
Hunter, Mr J. S.,
2 Indian CCS,
Jacobs, Capt F. J.,
Jones, Hon. F.,
Jordan, Rt. Hon. Sir W.,
Kahu, HMNZS,
Kelly, Capt R. J.,
Kenrick, Brig H. S.,
King, Brig R. D.,
Kiwi, HMNZS,
Kronfeld, Lt-Col M.,
Lawson, Maj A. T.,
Louis McLean,
Luftwaffe,
McBrearty, Capt J. M.,
McCallum, Maj G.,
McCowan, Maj A. I.,
McDonald, Cpl W. W.,
Mackenzie, Maj J. A. S.,
Madigan, Cpl A. J. S.,
Matai, HMNZS,
Maxillo-facial injuries,
Middlemass, Lt-Col W. G.,
Military Districts, Northern, Central, and Southern,
Moore, Cpl L. W.,
Morgan, Sgt L. St J.,
Moss, Maj K. T.,
Mottram, Capt R. H. B.,
Mount, Mr H. S.,
Mullany, Sgt V.,
Murray, Capt R. R.,
Namaka Camp,
Narbada, SS,
Neal, Capt R. B.,
Presents caravan trailers,
New Zealand Dental Corps—
Reinforcements,
Work in England,
New Zealand Dental Detachment, NZDC,
New Zealand Forces—
Relieved by American Forces,
Strength,
Divisional Hdqrs,
New Zealand Joint Staff Mission,
Njimirovsky, Dr Z.,
North, Wg Cdr N. H.,
Park, Brig R. S.,
Prisoner of war camps—
Rattray, Maj N. A.,
Reilly, Sgt W. D.,
Reinforcement Depot,
Ritchie, Maj A. W. S.,
Rout, Lt-Col O. E. L., See also
Royal
Royal New Zealand
Royal New Zealand
Ruahine, TSS,
Rudd, Col L. F.,
Russell, S-Sgt J.,
Saunders, Col J. Ll.,
School of Instruction,
Seed, Capt W. S.,
Sheppard, Lt F. D.,
Slater, Capt A. N.,
Smart, Sqdn Ldr E. C.,
Smith, Cpl E. J.,
Sprague, Maj L. R.,
Stephenson, Surg Lt (D) E. H.,
Stewart, Maj R. D.,
Sutherland, Capt G. D.,
Taupo Scheme,
Taylor, Sgt R. H.,
Tippett, Pte G. C.,
Tompkins, Capt K. P.,
Training Depot,
Treatment in NZ—
‘Trench Mouth’. See
Tui, HMNZS,
Twhigg, Brig J. M.,
Ulcero-membranous stomatitis (Gingivitis),
Venture, HMS,
Vincent's stomatitis. See
Viti, HMS,
Wahine, SS,
Wall, Capt M. J.,
Wallis, Surg-Cdr (D) S. R., RN,
Wilkes, Gp Capt T. M.,
Wilkie, Capt B. S.,
Wilkinson, Rear-Admiral T. S.,
Women's Royal New Zealand Naval Service,
Wycherley, Surg Lt (D) H. C. B.,
This volume was produced and published by the
THE AUTHOR: