War Surgery and Medicine
Apart from the Field Surgical Units, which were normally attached to Field Ambulances and Casualty Clearing Stations, provision was made for the performance of specialist surgery in the forward areas by sections of neurosurgical, ophthalmological, and facio-maxillary units.
During the advance from Alamein part of 4 British Neurosurgical Unit under Captain K. Eden, and also an Ophthalmological Unit, were attached to our CCS.page 53
In Italy at first the specialist work was centred at the CCS, but during the latter part of the war hospitals of 200–400 beds were set up, just behind the CCS area, to deal with specialist types of casualties. Here were grouped the neuro-surgeon, maxillo-facial surgeon, and ophthalmologist,' the Trinity,' and to here were diverted from the normal channel of evacuation all the neuro-surgical, plastic, and eye cases. A dentist well qualified in fracture work was also attached, as was a fully qualified general surgical team so that cases of severe multiple injuries could be adequately dealt with. This type of hospital, placed at the foremost convergence of evacuation lines, made it possible to supply specialist treatment in these cases at the earliest moment. Special equipment and extra nursing facilities were provided. The specialist units could not cope with all the cases, partly because of the rush during periods of great activity, partly because of the multiplicity of wounds, and partly because of local conditions rendering it impossible to send all the special cases to the centre. It was therefore held desirable to train a small number of general surgeons in the technique recommended by the special units by attaching them for short periods to these units before appointing them as forward surgeons.
With any future New Zealand force this specialised training will be essential as there will always be a shortage of specialists in these fields, where the civilian needs are insufficient to employ more than a minimum of personnel. New Zealand has only two neurosurgical centres and very few plastic surgery centres. If there was another war and an expeditionary force was sent overseas, there would be insufficient specialised personnel to supply the needs of the overseas force as well as the civilian needs. Arrangements should be made for the training of reserves in these special branches for emergencies of this kind. It should be part of the general defence policy.