The New Zealand Dental Services
CHAPTER 22 — Early Days in Italy
Early Days in Italy
THE transports carrying the main part of the New Zealand Division and the field dental services arrived at Taranto on 22 October 1943. The transit area was some four miles from the docks in the Tesceda valley, Alguria, and here the dental units set up their tents and made it known that they were open for business. Only urgent work could be done as, apart from the emergency haversacks carried on the transports and one surgical pannier that 1 Mobile Dental Unit had managed to squeeze into the limited shipping space allotted to it, there was no equipment or transport. Still, by instituting a roster, one dental officer became duty officer each day and the others kept themselves fit by route marches and football.
The Mobile Unit moved forward with 5 Infantry Brigade, being the last group of New Zealand troops to leave the Taranto area. Five hundred and fifty vehicles moved in fine weather to the staging area at Altamura, where the night was spent in intense cold. The towns they passed through were poor and dingy but the countryside was glorious in the cloak of autumn, with golden or deep red vines and oaks covering the hills.
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 Corato, Andria, Canosa and Cerignola, the unit arrived at Foggia, which was showing signs of bombing and demolition, to find that the Division had moved on, and it was then sent to join 1 Mobile CCS at San Severo. The following day, in blinding rain, an attempt was made to find 4 Armoured Brigade at Termoli, but the brigade had moved two days previously so the unit joined in a very slow convoy towards the demolished bridge over the Trigno River, now spanned by Bailey bridges. Fortunately the German Air Force no longer held superiority as some thousand vehicles, nose to tail, took an hour and a half to move five miles. Cupello was reached that night and the unit bivouacked as well as it could in unpleasant conditions.
Rear Divisional Headquarters was found to be at Furci. Next day Major McCallum saw the ADMS and made arrangements to attach sections to units in the Division and elsewhere. The Mobile page 253 Unit's headquarters remained with Rear Headquarters and attended to urgent treatment in that area. This was much as was predicted at Takrouna, it being expected that in this static type of warfare there would always be troops available for treatment and little prospect of sudden movement.
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 Maadi and immediate emergencies met by inter-unit borrowing.
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 ‘Sangro’ will open the floodgates of memory among those who served there, linking them together with a bond swaged in the forge of common achievement and stamped with the hallmark of the pioneer. They had to contend with the snow, rain and mud of an Italian winter, amid widespread demolition by the retreating enemy. Sometimes they worked in buildings, but as most of these were damaged and poorly lighted by small windows, the extra protection seldom compensated for the trouble of moving the equipment in and out. Most of the work was done in tents, the dental officer standing in thick mud with rain driving in over patient, operator and equipment. Some of the experiences they recorded will give an idea of the conditions:
Major McCallum, War Diary, 1 January 1944:
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.1 tent. Only the good spirits of this grand crowd of fellows made even our existence worth recording.
1 European Personnel Indian Pattern.
Captain N. E. Wickham of 4 NZ Field Ambulance:
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 in Italy 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.
Captain P. F. Foote2 of 6 NZ Field Ambulance:
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 established page 254 in the schoolhouse, a distance of 4,000 yards from the FDLs.1 There were no ADSs forward of Castlefrentano and as casualties in the first battle for 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.2 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.
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 Europe, and, as most of the recently occupied buildings were harbourers of lice, the carriers of the disease, the discomforts of the tent were more cheerfully accepted.
On 18 January 1944 the Division moved out of this area in the strictest secrecy to the Fifth Army front on the other coast of Italy. Seven days' reserve rations and extra petrol were carried on each vehicle, making them much overloaded but, to the credit of the ASC drivers and the Motor Transport Sergeant, all the dental vehicles arrived without having to break convoy. They passed through Ariano, Bovino, Riatella, Grottaminarda, Avellino, Monteforte, Cancello and Caserta to the Alife area some miles south of Cassino. Here the units settled down amongst olive trees and towering mountain peaks overlooking the Volturno valley with the river winding through its tortuous course. There were heavy frosts but brilliantly fine sunny days, a bright beginning for an area the men were to know well for some time. Unfortunately it was soon found that this was but a beginning and that they had not finished with the rain, mud and cold. Sections were again page 255 attached to units and the work went on. Here they can be left while some consideration is given to the units left behind at the Advanced Base near Bari.
The Advanced Base Dental Section under Major B. Dallas, 3 General Hospital Dental Section under Major N. M. Gleeson and the Convalescent Depot Dental Section under Captain A. C. Dickens constituted the ‘hospital circuit’ of the organisation in Italy. Their policy was to guarantee dental fitness for every man in that circuit before allowing him to pass on to the next. It was an empiric organisation only and could not carry out this policy indefinitely with only three sections, but it was the foundation for a bigger one to be built up when Headquarters 2 NZEF moved to Italy. To this end a stone dental hospital was designed to a plan similar to that at Maadi. It was found to be impracticable, but a special hospital Nissen hut was designed instead, though not completed until March 1944.
This was the position when Headquarters 2 NZEF, including Lieutenant-Colonel Middlemass as ADDS, arrived at Taranto on 25 January 1944. Two other dental units arrived at the same time, viz., 2 Mobile Dental Unit and the Base Depot Dental Hospital. Headquarters was set up in San Spirito, a small town seven miles north of Bari on the Adriatic coast. In Bari itself was 3 General Hospital and at San Basilio, 35 miles south of this, was the Advanced Base now containing the Base Depot Dental Hospital, 2 Mobile Dental Unit and the Convalescent Depot. The ADDS's store was housed in two adjoining huts at Advanced Base as there was no room for it at San Spirito. It still distributed supplies to the dental sections, in turn being stocked from ADDS, Allied Force Headquarters, every three months, picking up the supplies at Naples. The original source of supply therefore continued to be British.
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 1 Mobile Dental Unit was struggling with an increasing volume of routine examination and treatment. On the other hand, at the Base, the Base Dental Hospital was unable to work through lack of accommodation and was being used for camp fatigues, while 2 Mobile Dental Unit was providing sections to work on base personnel. The time was over-ripe for a reorganisation of the whole service to meet new conditions, but this was left to Lieutenant-Colonel Fuller, who resumed his duties as ADDS on 1 March 1944.page 256
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 1 Mobile Dental Unit, replacing its existing CO and, in turn, each of the others holding senior appointments in the Corps. Saturation point had been reached regarding both field rank and senior appointments and, with no furlough or exchange scheme in operation, the senior men in the middle of the gradation list were denied opportunities for advancement and promotion.
1 Forward Defended Localities.
2 Regimental Medical Officer.
Reorganisation for Close-country Warfare
The type of warfare in Italy was very different from that recently experienced by the New Zealand Division in North Africa. Instead of rapid movement with long lines of communication, there was now concentration into a comparatively small area, with only short moves having little effect on the locations of dental units. Certain non-divisional units had been disbanded and the number of men on the Lines of Communication had been decreased. On the other hand, the Division in the field had been augmented by the addition of 4 Armoured Brigade, bringing the total strength up to between fifteen and eighteen thousand. Dental officers were still allotted to the force on the basis of one to every 1000 men. The number was according to this ratio but the distribution was at fault. With the Division there were eight dental officers with 1 Mobile Unit and one with each of the three field ambulances, a total of eleven to treat 15,000 to 18,000 men. The dental officer with the CCS could not be included as he was outside the divisional organisation. At the Base, however, apart from the General Hospitals and the Convalescent Depot, there were two dental units carrying more than was required, viz., 2 Mobile Dental Unit and the Base Depot Dental Hospital.
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:
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 Ad- page 257 vanced Base 2 NZEF. This hospital would operate at first with only three officers, its duties, although similar to those of 1 NZ Camp Dental Hospital, consisting principally, for a time, of work passing through the NZ Reception Depot. From time to time, if 1 NZ Mobile Dental Unit should happen to be otherwise fully engaged, Lines of Communication units away from Advanced Base would be treated by detachments from this hospital.
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 7 March 1944.
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 2 NZEF.
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 Army Medical Stores could supply new ones they page 258 must be procured elsewhere. A cable was sent to the liaison officer at the New Zealand High Commissioner's Office in London asking him to procure seventy-two contra-angle and twelve straight handpieces, preferably from Army Stores but, failing this, from any source. Captain Pickerill was in England undergoing a course in maxillo-facial work and it was hoped that he could bring them with him on his return to Italy. This was one of many cases which made it seem that there was a lack of appreciation of the requirements of dental stores and equipment. The three-monthly supplies to replenish the NZEF store were frequently late in coming to hand and it became difficult to comply with the monthly indents from the units and sections. For example, the indent submitted on 9 March 1944 for the period April to June was not expected to arrive before June, although being intended for use during April, May and June. The last supplies had been received in December 1943. Apart from the regular supply for a service doing a large volume of work, there was the fact to be considered that it was working under conditions which placed a strain on equipment, especially that with moving parts such as handpieces. It is small wonder that equipment was wearing out. Admittedly, Medical Stores themselves had a three to four months' time-lag between ordering and receiving their supplies but, by this stage of the war, they would have had a reasonably accurate knowledge of the amounts required by each dental service. They suggested to the ADDS that he should indent every month instead of every three months as was then the custom.1 This was an acknowledgment that they were not stocking in advance against commitments that could easily have been assessed. Their supplies came from North Africa, the United Kingdom and the Middle East. To work to so fine a margin in time of war was alarming to the NZDC, which was dependent on them for its very existence.