Medical Services in New Zealand and The Pacific
IN referring to the naval forces of the Dominion the term Royal New Zealand Navy is used throughout the remainder of this narrative, although that designation was not conferred until late in 1941. Along with this change of title, the Royal Naval Reserve (New Zealand Division) and the Royal Naval Volunteer Reserve (New Zealand Division) became known respectively as the Royal New Zealand Naval Reserve and the Royal New Zealand Naval Volunteer Reserve, which new terms are also used throughout the war history.
Naval mobilisation, which commenced in New Zealand on 2 September 1939, required the immediate services of the Reserve medical officers for examinations at the Naval Base, Auckland, and in the RNZNVR depots of the four main cities. Thanks to peacetime planning, the organisation worked smoothly, and within a matter of hours selected personnel were passing through these centres for immediate service at sea or in coast defence stations. In the early stages those called up consisted entirely of ex-naval officers and ratings and members of the RNZNR and RNZNVR, the urgent requirement being for trained personnel to bring ships to war complement, to provide gun crews and signalmen for merchant ships and to establish harbour patrols and naval defence posts. Except in certain special categories for which no reserves existed, no general appeal for recruits was made by the Navy for many months after the outbreak of war.
Although at this early date the examination did not include an X-ray of the chest, a high medical and dental standard was demanded as with few exceptions fitness for sea service was required of all candidates. Complete figures are not available, but out of one group of 321 reservists examined only ten were rejected. Some of the older men and those who had been out of the service for a number of years had not unnaturally developed visual and other defects which limited their employment, and a number of hitherto undetected cases of defective colour vision were discovered among page 164 officers and senior ratings who had originally entered before examination with the Edridge Green lantern and Ishihara plates had become standard routine, and whose defects now precluded them from service afloat. Considerable care had been taken in peacetime in the selection of recruits for the RNZNR and RNZNVR, with the result that medical rejections from that group at mobilisation were very few.
It was, however, necessary to defer the entry of a considerable number of men for urgent dental attention, as at the time only one full-time dental officer was employed on naval service. This work was carried out with the least possible delay by a panel of civilian dentists throughout the country, though some of the reservists in their keenness to serve afloat obtained the necessary treatment at their own expense from private dentists.
One section of mobilised personnel requires special mention. Following an Admiralty scheme, arrangements had been made for the entry of crews of requisitioned trawlers and other merchant vessels taken over for naval purposes, under what was termed a T.124 agreement. This was, in effect, a form of group entry on special conditions, differing in many important respects from a normal naval enlistment. This is not the place to discuss the general merits and demerits of the scheme, which was ultimately abandoned, but a particularly bad feature was the omission of arrangements for proper examination, entry standards and subsequent medical care. It had apparently been assumed that any man who was making his living upon the sea in peacetime would be of good enough physical standard for naval service and adaptable to service conditions in time of war, but the experiment demonstrated most forcibly the necessity for clearly defined standards throughout all branches of naval service, and careful selection of all personnel.
Replacement of Royal Navy Medical Officers by Royal New Zealand Naval Volunteer Reserves
As soon as the immediate requirement of mobilisation had been completed, the medical officers of the RNZNVR were given appointments afloat, replacing the Royal Navy medical officers previously employed and increasing the medical complement to the authorised war strength. The process had necessarily to be gradual, reliefs being effected when ships returned to New Zealand from duty at sea, but it was completed early in 1940, when the sole remaining Royal Navy medical officer was the Director of Naval Medical Services at Auckland, Surgeon Commander E. E. Malone, RN, who had arrived in December 1939 as a relief for Surgeon Commander R. G. Anthony, RN, whose period of loan service had expired.page 165
Surgeon Lieutenant Ewart1 joined the Leander in September 1939, the relief in that ship being completed early in October by the appointment of Surgeon Commander Corkill,2 who became Squadron Medical Officer vice Surgeon Commander J. J. Keevil, RN.
Surgeon Lieutenant-Commander McPhail3 was selected as medical officer for the Monowai, the well-known passenger liner which was being converted into an armed merchant cruiser. In the meantime this officer was employed in the Philomel, rendering much-needed assistance in the depot establishment.
On the return of the Achilles from the River Plate early in 1940, her medical officers were replaced by Surgeon Commander Perry4 and Surgeon Lieutenant Helmore,5 the first-named becoming Squadron Medical Officer in May 1940 when the Leander left the station; he retained that appointment till its abolition in November 1940, when the whole of the administration was transferred to the shore-based Director of Naval Medical Services.
Half-way through 1941, Surgeon Commander Malone reverted to the Royal Navy, being replaced by Surgeon Commander Corkill, RNZNVR, the first New Zealander to hold the appointment of Director of Naval Medical Services. This change marked the assumption of complete responsibility for the medical services of the RNZN by officers of the RNZNVR, a policy which continued in force throughout the war.
The remaining medical officers of the RNZNVR, Surgeon Commander Harty6 and Surgeon Lieutenant Pittar, were placed at Admiralty disposal and travelled to the United Kingdom with a large draft of reserve personnel who were at the time surplus to local requirements. At a later stage, the former was recalled for duty in New Zealand ships, while the latter remained with the Royal Navy throughout the war.
Entry of Additional Medical Officers
With the exception of one surgeon lieutenant entered on a short-service engagement in the Royal New Zealand Navy in 1940, no increase in medical staff was necessary before 1941, though numerous applications were received in the early months of the war. During 1940 an appeal was received from the United Kingdom for young medical officers for service with the Royal Navy, but in view of the increasing military demands upon the medical manpower of the Dominion, the New Zealand Government felt unable to accede to the request.
Early in 1941, however, increased naval commitments on the New Zealand Station, in particular an intensive recruiting programme for service with the Royal Navy, the opening of a new large training establishment, and additions to the force of minesweeping and auxiliary vessels in local waters, required some expansion of the small medical service. The immediate need was met by the appointment of four medical officers to temporary commissions in the Royal New Zealand Naval Volunteer Reserve. In subsequent years a further twelve such appointments were made at intervals, and in addition two New Zealand doctors who were already abroad and had joined the RNVR in England were transferred to the RNZNVR.
With the exception of four, entered in the closing months of the war, all these medical officers served overseas in ships of the Royal New Zealand Navy, some of them succeeding in due course to responsible charge appointments ashore and afloat. Without the previous association with the Navy which had been afforded their colleagues in the permanent RNZNVR, it was perhaps not so easy for these new medical officers to adjust themselves to the life of a naval medical officer, but almost without exception they fitted admirably into the organisation. Most of them were fresh from resident hospital appointments, bursting with zeal for increased clinical experience, only to find that such opportunities were limited, that much of the medical work consisted of comparatively dull and uninteresting routine, and that in a sea-going ship the medical officers are expected to undertake various duties outside their chosen professions. These conditions could easily produce a feeling of frustration in one who regarded himself as merely a doctor in uniform, but to those who were prepared to take a full part in the work and life of a ship there was ample opportunity for useful and interesting employment. A particularly good example page 167 of the lengthy war service given by some of the temporary medical officers is that of Surgeon Lieutenant-Commander Walton,1 who served almost continuously at sea from 1941 to 1947, first in junior appointments in the Achilles and Gambia and later as senior medical officer of the Achilles and Bellona.
Brigadier F. T. Bowerbank (left), Brigadier J. M. Twhigg and Lieutenant-Colonel G. F. V. Anson at Medical Headquarters, New Caledonia
A ward in 4 NZ General Hospital, Dumbéa, New Caledonia
A ward in 2 NZ CCS, Guadalcanal, November 1943
Officers of 2 NZ CCS, Guadalcanal
Back row (left to right): Lt G. F. Tegg, CApt C. G. D. Halstead, CApt S. Jolly, Capt M. W. Gatman, Capt R. G. McDonald, Capt E. T. Saunders, (Not identified). Front row: Capt G. F. Rich, Maj J. Dempsey, Lt-Col S. L. Wilson, Col N. C. Speight, Maj C. G. Riley, Lt W. F. Green, Rev. J. W. Parker
A view of the Casualty Clearing Station wards on Guadalcanal
Wounded men being evacuated by landing craft, Pakoi Bay, Vella Lavella
Captain R. P. Tuckey (middle, front row) and RAP staff, Vella Lavella
A native outrigger canoe used for carrying supplies and bringing out wounded, Vella Lavella
Malaria Control Unit, Treasury Islands
An operation being performed in 22 Field Ambulance theatre at Tanaheran, April 1944
Treating yaws at Pinipel Island
One of the few reliable fresh-water wells on Nissan at 14 NZ Brigade Headquarters
A group of limb-fracture patients treated in the prisoner-of-war hospital at Kokkinia, May-September 1941
Front row (left to right): Capt J. le B. Warren, Capt R. S. Stewart, Maj S. G. de Clive Lowe, Lt-Col W. H. B. Bull, Rev. J. S. Hiddlestone, Capt O. S. Hetherington. Back row: Rev. R. J. Griffiths, CApt J. T. Dodgshun, Capt P. Noakes, Capt P. N. R. McDonald, Maj L. H. V. Longmore, Capt D. A. Ballantyne, Capt E. Stevenson-Wright, Capt H. M. Foreman, Rev. W. E. W. Hurst
Repatriated prisoners of war arriving at Alexandria
The very limited number of medical officers authorised for the Royal New Zealand Navy even at the peak of mobilisation made it impossible to hold any drafting margin in home establishments, and resulted in considerable difficulty when urgent reliefs became necessary for ships abroad. Even when the enlistment had been approved by the Medical Manpower Committee, considerable delay was often experienced in obtaining the release of selected doctors from the hospital boards by whom they were employed. It followed that the replacement of a medical officer serving overseas usually left some shore establishment understaffed while reliefs were in transit, and it was seldom possible to provide medical officers with the full leave to which they were entitled.
Temporary assistance in home establishments was obtained on more than one occasion from army medical officers and from ships of the Royal Navy engaged on special service on the New Zealand Station or undergoing refit in Auckland. The base medical facilities of the Royal New Zealand Navy were always freely available to such ships, but this would not have been possible without some reciprocal assistance when staff was short.
Bearing in mind that the naval medical service undertook the responsibility of examining some 14,000 candidates for the Navy and conducted all medical boards and examinations on discharge, in addition to the routine care of serving personnel averaging 6157 over the whole period of the war, it cannot be said to have been overstaffed or wasteful of medical manpower.
Entry and Training of Sick-berth Staff
The immediate requirements of the sick-berth staff on mobilisation were provided by the re-entry of former naval sick-berth ratings, by the recall from Australia of partly trained ratings, and the entry of a small number of volunteers with St. John Ambulance or similar basic training. Failing adequate training facilities at the Base at this period, much of their naval sick-berth instruction had to be deferred till they were drafted to sea. Despite this initial handicap, most of these entries proved highly satisfactory, some of them later qualifying for advancement and for specialist ratings and occupying responsible positions in ships and shore establishments.page 168
In 1941 the completion of the new sick quarters at Devonport permitted the establishment of a training centre for sick-berth staff, from which time all entries, either for the permanent service or for hostilities only, received full courses of instruction before draft to sea. In addition to tuition from medical officers, nursing sisters and senior ratings, elementary training in pharmacy and dispensing was given by the civilian pharmacists appointed to the Dockyard staff in charge of medical stores. Opportunities were given to a limited number of suitable ratings to qualify for the specialist ratings of Theatre Assistant and X-ray Technician.
Periodic examinations, in conformity with the standards of the Royal Navy and open not only to New Zealand ratings but to those from other British ships, were held for advancement to Leading Sick-Berth Attendant, Sick-Berth Petty Officer and Sick-Berth Chief Petty Officer. The promotion of New Zealand ratings to these higher rates as they became qualified permitted the gradual return to the Royal Navy of most of the senior sick-berth ratings who had been serving on loan, though some were retained until the end of the war.
For most of the war, the established complement of the sick-berth branch of the Royal New Zealand Navy did not provide for any rank above Chief Petty Officer, but in 1945 authority was obtained for the appointment of the first Warrant Wardmaster, Mr S. A. Higgs, who had served continuously on loan from the Royal Navy since 1937 as a senior sick-berth rating and had qualified by examination for warrant rank in 1943. On him had fallen much of the responsibility of organising the training school and the development of Sick Quarters, Devonport, into a hospital capable of providing an efficient service for the Royal New Zealand Navy.
From a pre-war strength of 12 ratings, the sick-berth branch expanded to a peak complement of 57, with an additional 7 Wren sick-berth ratings for special duty with the WRNZNS. Although sufficient recruits were obtained for naval requirements, it was disappointing that more men of a suitable type did not volunteer for this branch. It would appear that most New Zealanders choosing naval service were more attracted to branches offering active excitement or mechanical opportunities, or to those which held prospects which might be followed to advantage in later civil life.
An efficient sick-berth staff is a most important part of any naval medical service and requires careful selection. Except for some relaxation of eyesight standards, the physical requirements should be as strict as for any other branch of the Navy, and it is essential to have men of good education, capable of understanding the wide range of technical subjects included in their training. In a small page 169 navy, where establishments are not large enough to justify the employment of whole-time specialists such as dispensers and radiographers, it is necessary for the whole sick-berth staff to receive basic training in all departments of their work.
With few exceptions, the ratings of the New Zealand sick-berth branch performed their varied duties with commendable success. In the cruisers they were of the greatest assistance to their medical officers, not only in nursing duties but also in dispensary and laboratory work and on occasions as assistants at operations, while in the small ships, without medical officers and with limited facilities, some of them were faced with difficult problems requiring resource and initiative which they handled with great credit.