New Zealand Medical Services in Middle East and Italy
At 3 General Hospital
At 3 General Hospital
The month of December was particularly busy for 3 NZ General Hospital at Bari. The hospital was still being developed on its new site, having 480 beds equipped by the end of November, and was preparing to receive further battle casualties when there was a devastating air raid on Bari harbour on the evening of 2 December. Explosions of ammunition ships resulted in nearly all the hospital windows being shattered, fortunately without serious injury to any of the staff or patients. In the docks area civilians and service personnel were killed and injured. Of the latter, 177 were treated at 3 General Hospital, 77 of them being admitted and 14 dying later. The service personnel admitted were suffering from blast and shock. Almost all were covered with a deposit of fuel oil, some had ordinary burns of the face and hands, while others suffered from mustard gas burns, which caused blistering and a severe degree of conjunctivitis.
The battle casualties arrived in good condition by ambulance train from San Severo, but it was difficult to provide equipped beds for the increasing number of patients. At times stretchers were used in corridors and unfinished parts of Beirut block, but the efforts of British engineers and the staff of the unit resulted in 1020 beds being available by the end of the month. Large numbers of convalescent patients were sent to the Convalescent Depot, and this relieved the congestion in the wards.
The hospital was short-staffed at the time, particularly as regards surgical officers. A surgical team was lent to the CCS for a short period but returned to the hospital before the heaviest work there. Fortunately, an orthopaedic surgeon was attached on 18 December and was able to treat the serious fractures. In the large buildings numerous special departments were set up and operating theatres constructed and elaborately equipped.
In the treatment of wounds penicillin was gradually introduced and secondary wound suture was performed in some cases. Dressing and the application of plaster splints was the common operative procedure.
During December 1611 patients were admitted, 926 being wounded; many of them required considerable attention, as is shown page 521 by the fact that the average number on the seriously ill list throughout the month was 38.
The evacuation of patients from Italy was at this time far from satisfactory. On one occasion 130 patients were sent at short notice to Taranto to be loaded on a hospital ship for 1 NZ General Hospital, Helwan, but it was found that the ship could not take Indian and British personnel together. Arrangements were eventually made for sixty-seven of the worst cases to be taken, but the remainder had to be left at 70 British General Hospital, Taranto, until another ship arrived two days later.
The following assessment was made of the results of treatment of battle casualties admitted to 3 NZ General Hospital from the Sangro battle:
The results in cases of penetrating abdominal and thoraco-abdominal wounds were satisfactory. Stomach and small intestine cases recovered well without complications, as did injuries to the spleen and diaphragm.
Wounds of the liver did not do so well and there were two deaths in four cases. Drainage of the abdomen in these cases was suggested.
A third of the penetrating wounds of the thorax were infected and five out of twenty-two had to have rib resection. It was advised that such cases be evacuated early from the forward areas and that intercostal drains should preferably be inserted at the base hospital where penicillin could be given. The instillation of penicillin into the pleural cavity and early evacuation was advised.
The severity of the cases in many instances has been notable. Multiple serious injuries are common, a number of cases having several such lesions as compound fractures of one or more limbs, together with penetrating wounds of the thorax and abdomen and multiple soft tissue wounds. These patients have travelled well and arrived in good condition. A justifiable conclusion is that these cases, almost entirely treated in NZMC units, are now surviving because of the standards of resuscitation and surgery in forward areas.
A blood transfusion centre for the Italian campaign had been set up at Bari and was functioning satisfactorily, providing adequate supplies of blood for both forward areas and base hospitals.