New Zealand Medical Services in Middle East and Italy
RAISING AND TRAINING OF MEDICAL UNITS
RAISING AND TRAINING OF MEDICAL UNITS
4 Field Ambulance and 4 Field Hygiene Section
The medical units called up with other units of the First Echelon for entry into mobilisation camps in October 1939 were 4 Field Ambulance and 4 Field Hygiene Section. From 4 October 1939 the main bodies of these units entered Burnham Camp, whither the advance party of officers and NCOs had proceeded on 26 and 27 page 34 September. These units were the normal field medical units for the brigade group of the First Echelon as a fighting force.
The officer appointed to command 4 Field Ambulance at Burnham was Lieutenant-Colonel Will,1 and there were nine other medical officers and a quartermaster, a dental officer, and a chaplain with the unit. The NCOs were drawn mainly from 1, 2, and 3 Field Ambulances of the Territorial Force, in which the majority had seen several years' continuous service. They had attended courses of instruction, passed first-aid and nursing-orderly examinations, and were, on the whole, a very capable group. The main body of men was mostly without military or medical training. The men for 4 Field Hygiene Section were placed under the command of Lieutenant Wyn Irwin,2 who had been a district health officer.
Training consisted in instruction in first aid, the system of evacuation of casualties, the work of stretcher-bearers, clerical and nursing duties at advanced and main dressing stations, the recording of casualties, field cooking, and in hygiene methods used on field service. By the time final leave came in the last two weeks of December the original group had become an efficient unit.
Embarkation of First Echelon
In the advance party which left New Zealand on 11 December 1939 in SS Awatea were two men of 4 Field Ambulance, and they were joined in Egypt by Lieutenant Harrison,3 who had come from the United Kingdom and who became acting Deputy Assistant Director of Medical Services to the Expeditionary Force. The main embarkation of the First Echelon took place on 5 January 1940. At Lyttelton 6 officers and 217 other ranks of 4 Field Ambulance and 1 officer and 28 other ranks of 4 Field Hygiene Section embarked on HMT Dunera. At Wellington other Medical Corps personnel, comprising Colonel K. MacCormick,4 Assistant Director of Medical Services to the Expeditionary Force, 8 regimental officers, 18 sisters of the New Zealand Army Nursing Service, and 4 medical officers and 12 nursing orderlies and dispensers from 4 Field Ambulance, page 35 embarked on the Orion, Strathaird, Empress of Canada, Rangitata, and Sobieski.
The regimental medical officers and nursing sisters were split up among the transports and were able to establish small ships' hospitals to attend to any sickness cases during the voyage. The convoy sailed on 6 January 1940.
3 Maj T. W. Harrison, OBE, m.i.d.; Hanmer; born Dunedin, 9 May 1912; medical practitioner; DADMS 2 NZEF Jan–Mar 1940; Registrar 4 Gen Hosp Jul–Oct 1940; 4 Fd Amb Oct 1940–Sep 1942; surgeon 1 Mob CCS Sep 1942–Jul 1943; surgeon 3 Gen Hosp Jul 1943–Jun 1944.
4 Brig K. MacCormick, CB, CBE, DSO, ED, m.i.d.; Auckland; born Auckland, 13 Jan 1891; surgeon; 1 NZEF 1914–19: Egypt, Gallipoli, France–OC 2 Fd Amb Dec 1917–Jan 1918; DADMS 1 NZ Div Jan-Oct 1918; ADMS Northern Military District 1930-34; ADMS 2 NZEF Jan–Oct 1940; DMS 2 NZEF Oct 1940–May 1942, Sep 1942–Apr 1943.
Medical Units with Second Echelon
To form the field medical unit for the Second Echelon the officers and NCOs of 5 Field Ambulance, under Lieutenant-Colonel Kenrick,1 commenced a course of training at Burnham on 8 December 1939, concluding it on 6 January 1940. Most of the officers and NCOs had had some years of territorial training. The main body of the unit began to arrive in camp on 10 January 1940. Most of the men were new to medical work as well as to army life. Like 4 Field Ambulance before them, they were given training in all departments of field ambulance duties. Training was extended into April, pending the arrival of ships to take the Second Echelon overseas, and 5 Field Ambulance left Burnham for Lyttelton on 30 April to go by ferry to Wellington, where the unit embarked on HMT Aquitania on 1 May. The strength of the unit, including attached personnel, was 14 officers and 230 other ranks.
As planned, a general hospital staff was called up with the Second Echelon. The first members of 1 General Hospital began to assemble at Trentham Camp on 12 January 1940 under the command of Colonel McKillop.2 Only a few had had previous territorial training. Training consisted of squad and company drill, first aid, bandaging, and stretcher drill, while as many men as possible were employed in rotation at the camp hospital where they were given lectures by sisters of the NZANS. The hospital's establishment provided for specialists in the different branches of medicine and surgery. In addition to experienced general physicians and surgeons there was a specialist in tropical medicine, an orthopaedic surgeon, an eye and ENT surgeon, and an anaesthetist.
1 Brig H. S. Kenrick, CB, CBE, ED, m.i.d., MC (Greek); Auckland; born Paeroa, 7 Aug 1898; consulting obstetrician; 1 NZEF 1916–19: infantry officer 4 Bn; CO 5 Fd Amb Dec 1939–May 1940; acting ADMS 2 NZEF, Jun–Sep 1940; ADMS 2 NZ Div Oct 1940–May 1942; DMS 2 NZEF May–Sep 1942, Apr 1943–May 1945; Superintendent-in-Chief, Auckland Hospital Board.
2 Col A. C. McKillop, m.i.d.; Christchurch; born Scotland, 9 Mar 1885; Superintendent, Sunnyside Hospital, Christchurch; 1 NZEF: medical officer, Samoa, Egypt, Gallipoli, 1914–16; CO 1 Gen Hosp Jan 1940–Jun 1941; ADMS 3 Div (Fiji) Aug 1941–Jul 1942; ADMS 1 Div (NZ) Aug 1942–Mar 1943.
The staff of 1 Convalescent Depot was assembled at Trentham at the same time as that of 1 General Hospital and underwent the same training. They were originally under the command of Lieutenant-Colonel Spencer,1 but on the eve of sailing Colonel Spencer was given command of 2 General Hospital and Lieutenant-Colonel Boag2 took his place. The convalescent depot also embarked at Wellington on the evening of 1 May 1940, its ship being the Empress of Japan. Its strength was 5 officers and 49 other ranks.
1 Col F. M. Spencer, OBE, m.i.d.; born Rotorua, 3 Oct 1893; medical practitioner; 1 NZEF: NCO NZMC 1914, medical officer 1918–19, 1 Gen Hosp, 1 Fd Amb, 1 Bn Canterbury Regt; CO 2 Gen Hosp Apr 1940-Jun 1943; died, North Africa, Jun 1943.
Medical Units with Third Echelon
On 1 February 1940 there began at Burnham Camp a training course for the NCOs of the field medical unit to accompany the Third Echelon. It was attended by twenty-five men. Practically all of them were raw recruits who (unlike 4 and 5 Field Ambulance NCOs) had not had any territorial training.
The Commanding Officer of 6 Field Ambulance, Lieutenant-Colonel Bull, entered camp at Burnham on 2 April and other officers arrived on 16 April. The main body of 6 Field Ambulance was mobilised on 15 May and entered on a comprehensive scheme of training, which culminated in combined exercises with infantry battalions and the construction of a large underground dressing station.
With a total strength of 234, the unit embarked with other units of the Third Echelon at Lyttelton on 27 August, its ship being the Orcades. Other ships embarking troops at Wellington were the Mauretania and Empress of Japan.
Officers and prospective NCOs for 2 General Hospital entered Trentham Camp on 17 April, to be followed by the main body of the unit a month later. The standardised medical training was carried out, with the addition that nursing orderlies received training in the Wellington Public Hospital as well as at the camp hospital. Colonel F. M. Spencer was its commanding officer.
Embarkation on the Mauretania took place at Wellington on 27 August 1940, and the unit strength was 18 officers (including the chaplain), 39 nursing sisters, and 148 other ranks. The convoy carrying the Third Echelon sailed for Egypt on 28 August and there linked up with the First Echelon. The Second Echelon was still in England.page 37
3 General Hospital (4th Reinforcements)
After tentative plans made earlier in 1940 for the mobilisation of a third general hospital had been cancelled, representations from General Freyberg in September 1940 led to the calling-up of 3 General Hospital in October. The Commanding Officer, Colonel Gower,1 entered Trentham Camp on 27 October and the rest of the unit arrived in the next three days.
The 4th Reinforcements then in camp embarked in three separate sections, and according to the usual practice a medical officer and a few orderlies were sent with each departing transport. No. 3 General Hospital embarked on the Nieuw Amsterdam with the third section of the 4th Reinforcements on 1 February 1941, the number embarking being 14 officers (including a dental officer and a chaplain), 48 sisters, and 143 other ranks.
After the departure of 3 General Hospital no further medical units were formed in New Zealand to extend the medical services of 2 NZEF in the Middle East. Other units, notably the Casualty Clearing Station, were established in the Middle East. This enabled full use to be made of the capable officers and men who already had considerable experience of overseas conditions.
Medical reinforcements from New Zealand proceeded overseas with each general reinforcement and also on HS Maunganui.
First Echelon—Voyage to Middle East
Of the six transports selected to convey the First Echelon overseas, five were passenger liners and one a regular army troopship. The liners were the Orion, Strathaird, Empress of Canada, Rangitata, and Sobieski and the troop transport the Dunera. Except on the troopship, most of the troops were quartered in cabins, the regular passenger accommodation being augmented in some cases by extra berths in the larger cabins. In general, most of the troops on the passenger liners, with the possible exception of those in the holds, travelled with all the usual comforts and facilities afforded the peacetime tourist. (This was not the case for later reinforcement drafts.) In the Dunera the troops were not so fortunate. This ship was a specially constructed troop transport, used before the war to take drafts of British troops to Indian and Eastern stations. Cabins were allotted to officers and senior NCOs, but all other ranks were quartered in troop-decks.
On all transports the health of the troops throughout the voyage was good. Each troopship carried at least one medical officer, three page 38 nursing sisters, and a number of medical orderlies to staff the ship's hospital. During the voyage all personnel were vaccinated. The men were done in small batches so as not to interfere unduly with training and ship's fatigues. In addition, there were a number of TAB inoculations of men not done in camp.
Seven major operations were performed on the Sobieski—five of them for removal of appendix. On the Strathaird a successful operation for the opening up of a mastoid was performed with the aid of an electric drill borrowed from the ship's engineering staff and two carpenter's chisels.
Ships' hospitals, although considered small should any epidemics have occurred, were sufficient for the voyage. The most common illnesses experienced on board were tonsillitis, mild influenza, measles, and diarrhoea. Preventive ablution centres were established at ports of call, regular medical inspections of troops were carried out, and some cases of venereal disease treated. In addition, medical officers gave frequent lectures on health precautions in the tropics, personal hygiene, and on conditions in Egypt.
An epidemic of acute diarrhoea of unknown causation occurred on the Dunera. An interesting feature on this ship was the apparatus for manufacturing ‘eusol’ in bulk from sea-water by electrolysis. This solution was used for the daily scrubbing of troop-decks, mess tables, latrines, etc.
Shortages of medical equipment, particularly of instruments necessary for a major surgical operation, were frequently commented on in voyage reports from each transport, but no serious difficulty ever arose. The chief needs included drugs, nursing equipment, sterilisers, and surgical instruments; stretchers, splints, and bandages were also needed for training hospital staffs, and additional fittings were required in ships' hospitals.
Ventilation on the transports suffered, particularly at night, because of the necessity of keeping hatches and portholes closed and doors opening on to the decks covered with heavy blackout curtains. With natural ventilation thus reduced to a minimum, temperatures below decks at night were high, those taken at midnight on one occasion on the Sobieski ranging from 90 to 93 degrees Fahrenheit. Recommendations were made by the medical officer of this ship that hatches should be partially removed at nights and protective devices erected to comply with the blackout; also that screens should be built outside all doors leading on to decks to allow them to be left open at nights without the danger of lights showing.page 39
Second Echelon—Voyage to United Kingdom
The ships which conveyed the Second Echelon overseas were the Empress of Britain, Aquitania, Empress of Japan, and Andes. These were all passenger liners. The convoy, which sailed on 2 May 1940, was joined off the coast of Australia by other ships. Its destination was ostensibly the Middle East, though there was still some doubt about this at the time of its departure. When the convoy was proceeding towards Colombo from Fremantle on 15 May its course was changed to take it to Capetown and thence to the United Kingdom. The United Kingdom Government's War Cabinet had decided that, in view of the anticipated declaration of war by Italy, it would be inadvisable for the convoy to continue to the Middle East.
As with the First Echelon, medical officers, nursing sisters, and orderlies were posted to each ship to staff ships' hospitals and give medical treatment. The wearing of rubber-soled tennis shoes on transports was a source of trouble, just as it had been with the previous echelon. The medical officers of the First Echelon had recommended sandals but the Defence Purchase Division, on the score of cost, and also because of the lack of suitable leather, decided against any change.1 Foot troubles were the inevitable consequence, in spite of precautions, in this and succeeding drafts going overseas. Besides developing fungoid infections on the feet, troops also found difficulty in getting their feet used to army boots after being some weeks on board ship, and after the first few route marches overseas, the number of cases reporting sick with blistered feet was very high.
Ship's hospital accommodation proved adequate on all ships in spite of upper respiratory infection, common in the camps in New Zealand, being prevalent aboard. Among these cases a gradual progressive increase in severity was noted and the onset of broncho-pneumonia was not unusual. The isolation hospitals for treatment of venereal disease also had a small number of patients. German measles broke out on some of the ships, its incubation period corresponding with infection arising at Fremantle. Its incidence was much higher on the Australian than the New Zealand ships. Lack of space prevented quarantine measures and further cases developed after disembarkation.
Medical supplies generally were adequate, although demands for particular drugs called for their replenishment at Fremantle and Capetown. Plaster-of-paris bandages on the Empress of Britain were found to be useless, the tins being obviously many years old. Medical equipment was incomplete in important details, but medical officers were able to remedy the deficiencies from their personal instruments.
As the convoy drew near to Great Britain in June 1940 at the page 40 time of Dunkirk, first-aid posts were established at strategic points on the ships and surgical teams appointed to act in the case of enemy air attacks, but fortunately no such emergency arose.
1 Leather sandals were issued for use on shipboard from 1941 and also for use overseas later.
Third Echelon—Voyage to Middle East
The Third Echelon embarked for the Middle East on 27 August 1940 on the Mauretania, Empress of Japan, and Orcades. While the accommodation in the Mauretania and the Orcades was good, in the other ship a degree of overcrowding made conditions unpleasant.
The medical arrangements for the Third Echelon were similar to those of the two preceding echelons. Influenza, measles, and mumps were the main causes of hospitalisation but in no case was the incidence serious. The medical officers on the transports were united in their recommendations that inoculations and vaccinations should be completed prior to embarkation. Where the troops were accommodated in hammocks their sore arms caused great discomfort and severe vaccine reactions were suffered by numbers of troops in the tropics.
At Bombay on 16 September 6 Field Ambulance was disembarked and 2 General Hospital was transferred to the Ormonde. The troops who were disembarked found themselves submitted to considerable inconvenience and trying conditions in Bombay and Deolali. Sixth Field Ambulance eventually reached Port Said on 26 October after travelling from India on a most unhygienic ship called the Felix Roussel. In the Red Sea the convoy was attacked by Italian planes but without serious damage resulting, and the Felix Roussel was subjected to a further harmless attack while at Port Sudan.