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New Zealand Medical Services in Middle East and Italy

Staffing of New Zealand Medical Corps

page 471

Staffing of New Zealand Medical Corps

During this period there were difficulties in the staffing of medical units, in spite of the fact that the furlough scheme did not apply to medical officers because replacements could not be supplied from New Zealand. In June 1943 it was recorded that 73 medical officers had been lost to 2 NZEF up to that time; 42, mostly invalids, had returned to New Zealand; a few had been transferred to senior appointments with the Pacific force, 5 had been killed in action, 3 had died, and 23 were still prisoners of war. Only seven medical officers arrived with the reinforcements during the fifteen months to 31 December 1943.

With the shortage of doctors in New Zealand in 1942 and the demands of Home Defence and Pacific forces to be met as well as those in the Middle East, there had been some civilian criticism of the number of medical officers required for duty with troops overseas. In this connection DMS 2 NZEF prepared an interesting table setting out the position in 2 NZEF on 19 November 1942, whereby it was clearly shown that the ratio of medical staffs to patients in 2 NZEF medical units was much less than in comparable civil institutions in New Zealand.

No. of Patients MOs Sisters WAAC NZMC Orderlies
1 Gen Hosp 1001 20 85 76 169
2 Gen Hosp 668 17 57 45 153
3 Gen Hosp 731 20 85 68 162
23 Fd Amb (Camp Hosp) 252 4 75
1 Conv Depot 944 4 15
1 Rest Home 11 1 1
2 Rest Home 81 1 1 3 15
3 Rest Home 49 1 1
—— —— —— —— ——
Totals 3737 66 230 193 590
—— —— —— —— ——

The DMS 2 NZEF commented:

Thus it will be seen that for 3737 patients there are 66 medical officers. If we compare this with one of our metropolitan hospitals, say Auckland Hospital, we see there are at least 22 residents, 7 stipendiary medical officers and 56 part-time medical officers, a total of 85 for some (?) 800 patients. The rest of the table affords similar comparisons; 230 Sisters—trained nurses; 193 part-trained nurses; and 590 orderlies many of whom are employed as cooks, porters, etc.

Though the conditions were not strictly comparable, the comparison did show that the military hospitals were not overstaffed.

There was a constantly recurring complaint of shortness of medical officers in the hospitals, mainly on the surgical side, during the latter part of 1943. The Consultant Surgeon pointed this out in a special page 472 report in October, stating that the position was such that the treatment of serious casualties might become difficult. This position had been brought about by the return of senior medical officers to New Zealand, and also by the appointment of specialists to administrative posts in the Division. No orthopaedic surgeon was available in the force, two of the three active orthopaedic surgeons having been invalided to New Zealand, and the third promoted to command a field ambulance. At the same time the general surgeons were depleted, twelve senior men having been evacuated to New Zealand. At the end of 1943 there was also a shortage of eye, ear, nose and throat specialists as well as anaesthetists. Special efforts were made to train six young surgeons at the base hospitals and the CCS in an endeavour to relieve the situation.

Very few of the younger officers had had the previous surgical training to be capable of being rapidly and efficiently taught in base hospitals so as to bring them up to the standard required for surgical teams with the field ambulances or casualty clearing station. In Italy, surgery in the medical units was maintained at its high standard only by the available surgeons exerting themselves to the utmost, especially in the forward areas.

Suggestions from the National Medical Committee in New Zealand that economy of medical officers be effected by disbanding one of the base hospitals were again stoutly rebutted by the DMS 2 NZEF in October 1943. It was pointed out that the New Zealand Force was very scattered (in Egypt and Italy) and the tactical situation was such that without three hospitals the medical service would lose the flexibility so necessary for efficiency.

During the time 2 NZEF had served overseas two hospitals had each moved on five occasions, while the other had been called upon to make four moves. In all, therefore, there had been fourteen ‘hospital moves’. To pack up, move, and reopen a hospital took two months or longer. Thus for at least twenty-eight months (14 by 2), and probably longer, 2 NZEF had already worked on a two-hospital basis. It so happened that almost always there was one hospital on the move. This had been made necessary by the moves of New Zealand troops to England, Egypt, Greece, Crete, Western Desert, Syria, Tunisia, and Italy, and by the desire of all concerned that New Zealand sick and wounded, wherever possible, should be looked after in New Zealand hospitals.

It was also pointed out that we had been able to reciprocate in some measure by looking after British and other forces in our hospitals in return for the considerable amount of work done for our men in the British hospitals. It would have been wrong to have expected Britain, with her large number of civilian casualties caused page 473 by the bombing of her cities, to carry an extra burden by looking after our sick and wounded in the Middle East as well as carrying the whole of the administrative burden. Rather should our force have accepted some of the clinical burden by looking after British cases, and it is very gratifying to record that that happened, especially when 3 General Hospital was located at Beirut, and to a lesser extent at Tripoli, and throughout the war at Helwan hospital.

In retrospect, it would have been difficult to look after all our 2 NZEF patients in two general hospitals, even though so many battle casualties were admitted in their acute stages to British hospitals, and the incidence of infectious disease was not generally high.

The admission of many of our Division's cases to British hospitals, however, especially in the Canal Zone, lessened the strain on our own hospitals, which were never overtaxed, even when the epidemic of hepatitis was at its height. Arrangements were made for the transfer of New Zealand cases to our own hospitals for administrative convenience, especially to enable the serious cases to be boarded and prepared for evacuation to New Zealand.

On 18 September 1943 Majors Caughey1 and D. McKenzie returned to 2 NZEF after serving for some nine months with 1 British Neurosurgical Unit at 15 Scottish General Hospital. They had been specially asked for in February 1943, and the Consultant Surgeon MEF had expressed appreciation of the valuable and timely help they had given in specialised surgery when all formations were working at high pressure on the casualties in Tripolitania and Tunisia, and the provision of skilled care for the neurosurgical cases at the base became imperative.

1 Col J. E. Caughey, m.i.d.; Dunedin; born Auckland, 8 Aug 1904; physician; physician 2 Gen Hosp May 1940–Feb 1943; 1 NZ HS Maunganui Nov 1943–Jun 1944; in charge medical division 2 Gen Hosp Jul 1944–May 1945; CO 3 Gen Hosp May–Oct 1945.