Medical Services in New Zealand and The Pacific
XII: Medical Arrangements for Home Defence Forces
XII: Medical Arrangements for Home Defence Forces
During 1940 and 1941 measures were taken to strengthen home defence. The Territorial Force was expanded, reorganised and put on a war footing. With this expansion of the Territorial and home defence programme the following additional medical units were formed: 8 Field Ambulance (Army Reserve), three cavalry field ambulance companies, four motor ambulance convoys, four hygiene sections, and three field ambulance companies for fortress troops, formed from men of the National Military Reserve. In the formation of these every consideration was given to the matter of mobility.
All Territorial units underwent intensive training. The field hygiene sections attended a practical and theoretical course at Trentham, where officers of the Health Department assisted in their tuition. Many busy medical practitioners gave up their annual holidays and entered camp with the Territorials for a period. Several house surgeons from public hospitals were given intensive training so that they could be sent overseas at short notice when they were released for service with 2 NZEF. (Considerable difficulty was being encountered at this stage in obtaining a sufficiency of medical officers for both overseas and Territorial service.)
Preparations for Active Operations in New Zealand
Beginning in December 1941, when New Zealand was threatened with invasion by the Japanese forces, extensive mobilisation of troops was carried out for home defence. Early in 1942 a division was mobilised in each military district – northern, central and southern. These divisions were on 25 May 1942 called 1, 4 and 5 respectively. (Second New Zealand Division was in the Middle East and 3 NZ Division in the Pacific.) An ADMS was appointed to each division in control of the field ambulances, of which there was one for each brigade, and the regimental medical officers.
In addition, a considerable number of fortress troops were posted to each of the four main ports, and these likewise had the services of a field ambulance. Altogether twelve field ambulances (1, 2, 3, 8, 9, 10, 11, 12, 13, 14, 15 and 16), four field hygiene sections (1, 2, 3 and 5) and four motor ambulance convoy sections (1, 2, 3 and 4) were mobilised.
The field ambulances were stationed as follows:
|1 Division (HQ Whangarei)||1 Fd Amb, Warkworth.|
|9 Fd Amb, Kaikohe.|
|Northern Mil. Dist. (Fortress Troops)||12 Fd Amb, Auckland.|
|4 Division (HQ Palmerston North)||2 Fd Amb, Palmerston North.|
|8 Fd Amb, Masterton.|
|10 Fd Amb, Greytown.|
|Army Headquarters||21 Lt Fd Amb, Waiouru.|
|Central Mil. Dist. (Fortress Troops)||13 Fd Amb, Wellington (Johnsonville).|
|5 Division (HQ Riccarton)||3 Fd Amb, Rakaia.|
|11 Fd Amb, Blenheim (partly OUMC).|
|15 Fd Amb, Ashburton (partly OUMC).|
|Southern Mil. Dist. (Forttress Troops)||14 Fd Amb, Christchurch.|
|16 Fd Amb (OUMC), Dunedin.|
A representative conference of senior medical officers held in Wellington on 9 December 1941 considered the question of the redistribution of personnel, transport and equipment to enable each mechanised field ambulance to function in nine self-contained sections.
It was decided that each of the three sections into which each company was divided should be self-contained and similar as regards equipment and number of personnel. This was also to apply to the field ambulance headquarters section, unless the latter was used as a mobile transfusion section. At the same time it was recommended that field ambulance commanders should be allowed to use their judgment according to the tactical situation as to the exact size of any particular section they might detach for special duty. Provision page 280 was to be made in each field ambulance for an adjutant who was not a medical practitioner (appointments were made in 1942).
The standard of medical equipment of any section was to be not less than that of a light field ambulance section. The main alteration was the adding of a regimental medical pannier and a medical companion to No. 2 and No. 3 Sections. One transfusion pannier and seven transfusion companions were to be issued to each field ambulance, the pannier being held by Headquarters and one companion by each section. A tarpaulin 20 ft by 30 ft was issued to each section.
Each section was provided with means of water testing and sterilisation. It was recommended that the number of motor-cycles should be increased so that one could be provided for each section, and also that a wireless set for each section should be obtained if possible. Additional petrol cookers and primuses were to be provided.
The conference also brought to the notice of the Adjutant-General the following points:
That there was a shortage of NZMC and ASC personnel in all field ambulances;
That NZMC personnel were being transferred from field ambulances to other arms of the Territorial services; and
That the posting of conscientious objectors and non-combatants to field medical units was destroying the morale of these units. It was stated in regard to this class of recruit that ‘they should be used for camp fatigues and sanitary squads, and only those with religious objections to the shedding of blood should go into the NZMC.’
Policy of Evacuation
The policy of evacuation during active operations in New Zealand was planned so that all serious cases would be admitted to civilian hospitals. This was set out in a statement at the time as follows:
The casualties will pass back from the Regiments in the Field through the Advanced Dressing Station of a Field Ambulance to its Main Dressing Station, this being carried out by the transport of the Field Ambulance itself. From the Main Dressing Station of the Field Ambulance, the Motor Ambulance Convoy, which is an Army Medical Unit, will convey the patients to the nearest Public Hospital, or possibly to an Ambulance Train which has been arranged to receive them. The Ambulance Train will be under the control of the Health Department.
The Health Department has classified all Hospitals into No. 1, No. 2 and No. 3.page 281
The No. 1 Hospitals are the Base Hospitals which are capable of carrying out all types of Medical and Surgical treatment. Such Hospitals are Auckland, Wellington, Christchurch, Dunedin, also Waikato, Palmerston North, Wanganui, Napier, New Plymouth, Timaru and Invercargill.
The No. 2 Hospitals are buildings such as schools, halls, etc., which during an emergency could be converted into Hospitals which would supplement the No. 1 Hospitals.
When either a No. 1 or No. 3 Hospital comes into the region of active hostilities, the civilian patients would be evacuated. Those fit to go home would be sent there: others not requiring major surgical measures to No. 2 Hospitals, and the remainder requiring such surgical attention, to a No. 1 Hospital further back. The Advance Hospital would thus be ready to receive war casualties. If, as the result of an enemy advance, this Advance Hospital becomes unsuitable for the purpose of holding Army casualties for any length of time, the next Civilian Hospital in the rear would be the one to which wounded would be delivered by the MAC, and the Main Dressing Station of a Field Ambulance would probably take over the Advance Hospital from the Health Department. Possibly the Main Dressing Station would use part of the buildings and the Health Department still retain control of the operating theatre for the treatment of urgent abdominal cases. Therefore it is envisaged that the Main Dressing Station of a Field Ambulance may take over one of the smaller Hospitals which is close to the area of hostilities. During an advance this Hospital would again come under the control of the Health Department and be used to receive patients from the Main Dressing Station of the Field Ambulance which has moved forward.
A conference was held on 7 August 1941 by heads of the Army and Health Departments to plan the policy, and decisions were reached as follows:
DEFINITION OF HOSPITAL DOOR DURING ACTUAL HOSTILITIES IN THE WAR ZONE
The Hospital door to be that of a fully equipped and staffed hospital within a reasonable distance of the firing line outside the zone of actual hostilities. All transport of patients behind this hospital will be the responsibility of the Department of Health, while in front it will be the responsibility of the Army, e.g., MAC.
In accordance with modern procedure the Main Dressing Station may be required to act not only for reception, recording, resuscitation and evacuation, but under certain circumstances it may be necessary for it to act as a surgical centre for urgent surgical disabilities which cannot be evacuated to the civilian hospital within the maximum safety interval of four hours. For this reason it may be necessary for the MDS to take over temporarily one of the No. 3 Grade Hospitals and so avail itself of the operating theatre and other facilities.
THE HOSPITAL TRAIN
Will normally be staffed and run by the Department of Health, and consequently the term ‘Railhead’ has been cancelled. The Hospital Train will be used for the evacuation of soldier, or if necessary, civilian patients page 282 from the civilian hospitals, receiving the wounded, and, in exceptional cases where it may be found necessary to hold and operate on severely wounded at the MDS, the Hospital Train may be sent forward to collect patients from the MDS.
There will be a Liaison Officer of the Department of Health attached to ADMS Field Force, who will nominate the Hospital to which the wounded may be evacuated, and will make changes from time to time as required by the exigencies of the position. For instance, if the Field Force should be retiring it may be necessary to completely evacuate the Hospital to one further in the rear: or in an advance enlarge with staff and equipment one of the smaller hospitals….
AMBULANCE RAILWAY CARRIAGES
These are the property of the Army and the Army has priority in their use for manoeuvres and the conveying of sick soldiers from Camp Hospital to Public Hospital where the distance is long, e.g., Waiouru to Wanganui. Equipment belonging to the Health Department will be taken and stored by the Health Dept. when carriage is not being used. Equipment belonging to the Army will be taken over by the Q.M. when not in use. All equipment, however, will be available for either the Army Medical Service or the Department of Health, though the Department using it will be responsible for any shortages afterwards.
In 1942 thousands of recruits, raw, young and inexperienced (the age had been reduced to 18), were mobilised for home defence divisions during the autumn and winter and before the widely-disposed new camps were ready to receive them, so that inevitably there was overcrowding. The loss by enemy action of some thousands of tents in transit from India increased the danger and discomfort. Something had to be done and done at once. The Fletcher Construction Company and other large firms began mass production of hundreds of huts of various sizes – 2-man, 4-man, 8-man. The last – the result of lessons learned in the early stages – was a great success and by far the best hut from every point of view. Major Cowdrey had attended the preliminary conferences and full approval of the design was given by the DGMS. It was, however, agreed that as soon as possible accommodation would be reduced to six, or even five, to each hut.
It was unfortunate that the Department of Health, apparently not aware of the true position and its urgency, condemned the eight-man hut without reference to Army Medical Headquarters. Fortunately, after representation had been made by the DGMS, through the QMG, War Cabinet agreed to the adoption of these huts. The confidence reposed by War Cabinet was justified, as the eight-man hut was easily the most popular with the troops, especially when accommodation was reduced to six men to each hut.page break
Surgeon Lieutenant C. A. Pittar on HMS Achilles during the Graf Spee action, December 1939
Surgeon Lieutenant-Commander I. B. Ewart (left) and Surgeon Lieutenant S. A. Struthers on HMS Leander, Alexandria, July 1941
An aerial view of the base at HMNZS Cook, Shelly Bay, July 1944
Captain W. E. Parry of the Achilles dresses his leg wounds during the Graf Spee action
Flight Lieutenant L. A. Scrivin and LAC C. A. Littlewood attend to patients in the Los Negros hospital
Squadron Leader G. de L. Fenwick (second from right) with medical sergeant and orderlies outside the medical section tent at Espiritu Santo
A blood transfusion at Angan native hospital, Bougainville
No. 1 Squadron aricrew being medically examined at the Personnel Reception Depot, Mangere, after arriving from the Solomon Islands
A ward in NZHS Maunganui
Lieutenant G. Blake Palmer (right) making blood tests at Papakura Camp
Inside one of the sleeping huts, Trentham Camp
A demonstration by 4 NZ Field Ambulance of the use of a regimental water cart, Burnham Camp, November 1939. Maj A. A. Tennent is on the left
Members of 1 NZGH take part in the Second Echelon farewell parade, Wellington Left to right: Capt D. G. Radclifle (with glasses), Capt D. T. Stewart and Capt. J. M. Clarke
2 NZGH marches past Brigadier Bowerbank, Director-General of Medical Services, at Trentham
The Main Dressing Station at the foot of the Kaimai Hills during a 3 Division exercise, October 1942
Third Field Ambulance exercises, Christchurch
The hutted camps were provided with sanitation facilities. (There was some medical criticism of the design and material used.) Good work was often done by the units themselves on construction and maintenance and the field hygiene sections were active in supplementing and improving sanitation arrangements and supervising hygiene.
The field ambulances were kept busy attending to sickness cases. Some units had a large area to serve. For instance, 9 Field Ambulance under Lieutenant-Colonel Pettit1 at Kaikohe handled all evacuations for the very scattered 12 Brigade in the far north. Evacuation to civilian hospital was by railcar to Whangarei, 67 miles away.
In the divisional areas camp hospitals were established. For example, 4 Division in June 1942 had them at Wanganui (10 beds), Feilding (10 beds), Linton (10 beds), Awatapu (12 beds), Awapuni (32 beds), Masterton (24 beds) and Greytown (24 beds); and PA huts were functioning at all these places. The average number of beds occupied in camp hospitals that month in the Division was 56, and in public hospitals 206. It became the custom to keep patients in the camp hospitals longer than the prescribed forty-eight hours, the reason given by some field ambulances being that their staffs could look after the patients better than the local hospitals.
Shortage of Medical Officers
The medical officers for units of the home defence divisions were to some extent a paper strength only, though in the event of active operations it was likely that additional medical officers would have been found from those in civilian practice. In the period of ‘standing to’ the demands of 2 NZEF and the civilian population were so strong that medical manpower could not be diverted to give complete home defence postings where the scope for service was not so great. At 14 July 1942 the establishments of New Zealand units provided for 201 medical officers, including Army Headquarters, mobilisation camps, etc., but the posted strength was only 107, of whom 28 were part-time. Not all units had RMOs, but the greatest deficiencies were in the field ambulances, which had only 34 officers when the establishments provided for 103. Of the medical officers on whole-time duty with the Army and Air Force, a large number were Grade II or III and many were middle-aged or old men. Of the 90, 48 were page 284 Grade I, 27 were Grade II, 12 were Grade III, and three were temporarily unfit. Twenty-six were aged between 40 and 50, 17 between 50 and 60 and eleven over 60. (The last were not in field units.) This group served 64,000 men, and those solely concerned with attending to sick in units numbered 44. There was a demand, partly built up by the social security free medical service, for more doctors to be released for civilian practice, but the reply of the DGMS (Army and Air) was: ‘… should New Zealand be attacked and full mobilisation occur, involving the calling up of an additional 107,000 men who are at present not mobilised, the position regarding medical service would be tragic.’
During the state of emergency field ambulance staffs were kept at a bare minimum, and wherever possible trained non-medical officers, medical orderlies and part-time medical officers were made use of for duties that normally would have been those of full-time medical officers. Also, where possible field ambulance medical officers acted as RMOs for units in their neighbourhood. In the WAAC camps nursing sisters were appointed and did the work of medical officers.
In late 1942 the other ranks of the medical units were reduced in strength as men were withdrawn to essential industries and others sent later to 3 NZ Division. There were also shortages of vehicles that would have created difficulties in an emergency. In the middle of 1942 medical officers with experience in 2 NZEF campaigns in the Middle East criticised the efficiency and training of some of the medical units – they tended to ‘dig themselves in’ and gather surplus equipment and not train for larger numbers of casualties that might have to be treated in a mobile role with reduced equipment. Some of the officers without basic military training acted rather as doctors than as medical officers with a positive responsibility for the health of units and individuals. Hygiene sections had been pressed into engineering functions instead of being advisers and supervisors of health. The experience of the medical officers from overseas enabled reforms to be effected. By the time the medical services were reasonably well organised the invasion threat had passed and organisation of 3 Division then became first priority.
‘Non-medical’ (stretcher-bearer) Officers
The conference of senior medical officers in Wellington on 9 December 1941 recommended that an adjutant who was not a registered medical practitioner be appointed to each field ambulance. The grave shortage of NZMC officers in 1942 led to authority being granted in January for the promotion of suitable NCOs to commissioned rank, one to act as adjutant and instructor to each field ambulance. In April 1942 each field ambulance became entitled to page 285 three non-medical officers, including the quartermaster. By 1943 the number had been increased to four – an adjutant and an officer for each company.
In August 1942 twenty NCOs after training at OCTU, Trentham, were commissioned and posted to field ambulances in New Zealand. Further courses were arranged for prospective non-medical officers (by September 1942 known as stretcher-bearer officers to avoid confusion). The courses were made more extensive to include ordinary OCTU training with other officer cadets as well as more specialised training, such as instruction at casualty departments and MI rooms and in medical stores. When reorganised the course lasted fifteen weeks; earlier courses were much shorter.
In June 1943 there were twenty-six stretcher-bearer officers in the field ambulances and nine in other units (MACs and field hygiene sections), besides nine quartermasters. Other stretcher-bearer officers were serving in the Pacific force at that time.
With the reorganisation of field medical units in New Zealand in July 1943 and their reduction to maintenance and training staffs only, a number of the stretcher-bearer officers had to relinquish appointments, and a proportion of these officers reverted in rank in order to proceed overseas with the 10th Reinforcements.
Reduction of Home Defence Forces
Early in 1943, with the passing of the most dangerous phase of Japanese operations in the Pacific, reductions were made in the forces mobilised for home defence, transfers being made to the Air Force and to industry. By the end of the year there had been a general reorganisation and considerable reduction in the number and size of medical units. All field ambulances were reduced to cadres, with the exception of the fortress field ambulances (12, 13 and 14) which retained an operational role. The other ambulances then retained only maintenance staffs. No medical officers were then required on the strengths of these units. Field hygiene sections and motor ambulance convoys were continued with nominal maintenance staffs.
|Army Headquarters||Establishment||Posted Strength|
|Trentham Mob. Camp||6||6|
|Medical Training Depot||1||1|
|Waiouru Mob. Camp||4||4|
|Field Ambulances (8, 10 and 21)||28||11|
|Northern Military District|
|Field Ambulance (12)||4||2|
|Narrow Neck Camp||4||4|
|Papakura Mob. Camp||3||3|
|Remedial camp, Rotorua||2||2|
|Field Ambulances (1 and 9)||18||8|
|Central Military District|
|Field Ambulance (13)||4||2|
|Field Ambulance (2)||9||4|
|Southern Military District|
|Field Ambulances (14 and 16)||13||1|
|Burnham Mob. Camp||3||3|
|Field Ambulances (3, 15 and 11)||27||6|
Number of doctors serving as part-time medical officers: 28. (Not included: Four hygiene sections (1,2,3 and 5) with non-medical officers.)page 287
Medical Arrangements for the Home Guard
The Home Guard was formed in August 1940 on a voluntary basis and men in civilian life undertook training in the evenings and at weekends. After Japan's entry into the war registration for Home page 288 Guard service was, in 1942, made compulsory for men of military age not already in the Army and for men aged 46 to 50 years. By May 1943 the Home Guard was 124,000 strong, equipped with uniforms, rifles, machine guns and tommy guns. There were skeleton staffs only on whole-time service.
In December 1943 the war situation had improved sufficiently for the Home Guard to be placed on the Army Reserve.
Medical arrangements for the Home Guard were drawn up by the Director-General of Medical Services in March 1942 and formed the basis of the official instructions on the medical organisation for the evacuation of casualties issued on 25 May 1942.
Home Guard Medical Treatment
There was no general medical examination of all Home Guard personnel. The standard of fitness required for recruits to the Home Guard was not as high as that for Territorial service (Grade II). Generally speaking, a man able to follow his normal occupation was considered fit for Home Guard service. As Home Guard units were not on full-time duty, there was not the need for constant medical supervision as there was in the case of Territorial units. In any case, the acute shortage of medical men, both for civilian and army duties, prevented qualified medical officers being attached to Home Guard battalions. In cases of injury or sickness, Home Guardsmen were attended by a medical officer if an army unit was in home service nearby, or by the nearest medical practitioner.
As the Defence Emergency Regulations 1941, Amendment No. 1, brought the Home Guard into the defence forces of the Dominion, the statutory right to claim under the War Pensions Extension Act 1940 was thereby conferred on Home Guardsmen and their dependants in those cases where disability was due to service in the Home Guard or where disability was aggravated by such service.