The New Zealand Medical Service in the Great War 1914-1918
The Samoan Force
The Samoan Force.
A telegram received on August 4th, 1914, by our Governor, Lord Liverpool, from the Imperial Secretary of State, intimated that the occupation of the German Wireless Station at Samoa was an urgent Imperial Service. It was decided by the New Zealand Government to send a force to Samoa consisting of: one battalion of infantry; one company of engineers; two fifteen pounders, two six pounders; with signal, medical and army service corps details in two transports: a total force of 1,383. One section of a field ambulance was detailed for this force, with an establishment of four medical officers, two dental surgeons and 67 N.C.O.'s and men; the Senior Officer, Major Mathew Holmes, N.Z.M.C., of the 4th Wellington Field Ambulance, was appointed P.M.O. on the 7th August. To these medical details were added six nursing sisters of the N.Z.A.N.S. It will be seen that the principle of attaching dental surgeons to field ambulances was recognised in the earliest movements of New Zealand troops. There was little difficulty in assembling and equipping the men, even at short notice, as they were drawn from various sections of the 4th Field Ambulance in the Wellington District. Telegrams were despatched to the various Area Groups on the 9th and more than the required number of men had arrived in Wellington the following day. A surplus of N.C.O.'s was enlisted, but they were quite willing to forego rank and pay and joined as privates. A certain amount of extra medical stores was shipped for the purpose of equipping a small base hospital, also material for making first field dressings of which there was no large stock at that time in New Zealand. The equipment consisted of New Zealand pattern medicine chests and surgical haversacks.
The Force, commanded by Col. R. Logan, A.D.C., N.Z.S.C., sailed in two transports on August 15th under escort of H.M.S. Psyche, Philomel and Pyramus, and later the H.M.S. Australia and Melbourne, and the French warship, Montcalm, which met the convoy at Noumea, New Caledonia, on the 21st. They landed at Apia unopposed on August 29th, and a proclamation was made that day by the officer commanding announcing the occupation of Samoa by New Zealand.page 15
The health of the troops, on the transports was satisfactory. One inoculation of typhoid vaccine was given during the voyage, but owing to the military situation it was found impossible to administer the second dose until some weeks later. Typhoid was not prevalent in Samoa. Only two men made any objection to the prophylactic inoculation and as they persisted in refusing they were returned to New Zealand without landing. When the transports touched at Fiji, the Chief Medical Officer, the Hon. G. W. A. Lynch, gave the N.Z.M.C. officers much valuable advice and some literature dealing with the recognition and treatment of tropical diseases prevailing, also a small supply of necessary drugs; this was the sum of the information available to the P.M.O. in this important matter of local tropical diseases.
After making his necessary dispositions for medical attention to the troops, the P.M.O. visited and inspected the public hospital at Apia, a well-built structure situated in extensive grounds on an excellent site about one mile from the waterfront. The German civilian staff of the hospital consisted of a chief medical officer, an eye specialist, three nurses, a steward, three Samoan and Chinese dressers with a complement of native servants. There were several departments: a Samoan hospital comprising four native huts; a Chinese ward for 20 patients; and an out-patient and administrative block. The operating section was detached. It was arranged that an empty ward somewhat isolated from the others should be appropriated to the use of New Zealand troops. At first the arrangements between the New Zealand military medical staff and the German civil hospital staff appeared to work smoothly enough. But early in September a severe form of conjunctivitis, endemic in Samoa, broke out amongst the troops; it spread rapidly, it is said by fly contamination, and by the 10th 72 cases had been or were under treatment. On the following day Dr. Schwesinger, Acting-Health Officer, informed the P.M.O. that the whole German hospital staff had decided to cease work and that at 9 a.m. the next morning they would vacate the hospital, which meant that at sixteen hours' notice the N.Z.M.C. would be compelled to take over the whole of the civil as well as the military work. The P.M.O. says in his diary, "one point worthy of notice was that the eye specialist, Dr. Glantz, also refused work and, as some form of eye disease is almost universal amongst the natives of Samoa, we had to anticipate a large amount of extra work, as some 50 cases attended daily as outpatients." Every effort was made to retain the services of the staff, temporarily at least, until an eye specialist could be obtained from New Zealand. The salaries of the staff were page 16guaranteed, but without success. The P.M.O. considered that as Dr. Glantz was not acting in a military capacity, he, the specialist, could not be forced to work, although his services were essential. The matter was reported to the G.O.C. and the German staff was deported.
This controversy introduced consideration of a nice point in the law of the Usages of War as sanctioned by the Hague and other Conventions. It is quite clear, from the original instructions issued to the New Zealand Government by the Secretary of State, that the functions of the New Zealand expedition to Samoa were: (1) To seize the German wireless station; (2) to Occupy Samoa pending ultimate settlement. The agreement upon which the Laws and Usages of War on land are based make a very sharp distinction between "Occupation" of enemy country and "Annexation." Obedience to the "Occupant" is one of the implied conditions of the special position of the peaceful enemy inhabitants. Enemy surgeons, physicians, and pharmacists, may be called upon to render service in connection with their ordinary vocations provided that they are not compelled to take part in the operations of war, and it is agreed that such specialists should remain on duty to carry on their civil functions for the safety of life and the cause of humanity until duly relieved. The sudden withdrawal of medical and sanitary officials could not but inflict hardship upon the inhabitants of the occupied territory, and it is recognised that such functionaries "best fulfil their moral duty towards their own people if they continue in office in the presence of the Invader." (Laws and Usages of War, para. 395). The P.M.O. says that the vacation of the hospital by the remainder of the staff was rather an advantage, but it necessitated the carrying on of the civil work of the hospital: Samoan in and out patients; Chinese patients; the whole of the civil medical work including the duties of Port Health Officer, the Leper Station, and the town sanitary work. To fill the vacancy in the eye department Major Kendall, N.Z.M.C., Opthalmologist, was despatched from New Zealand and took up his duties on the 27th September.
Improvements in sanitary conditions were carried out as rapidly as possible; war was waged on the flies, prevalent in extraordinary numbers; existing houses were prepared for occupation by the troops during the oncoming rainy season; the floors of Samoan huts were dug up and replaced by concrete. Incineration of excreta was not found to be practicable owing to excessive rains, but by improving existing latrines with concrete floors and instituting a pan removal system operated by Chinese labour a sound conservancy page 17scheme was evolved. The sickness rate was certainly high at first: during the four weeks following the landing, 94 cases were admitted to hospital, but with acclimatisation and improved sanitation the sickness rate fell. The principal diseases encountered were the epidemic conjunctivitis already referred to: this, though severe in its onset, resembling somewhat a gonorrheal opthalmia and affecting both eyes in turn, yielded readily enough to treatment with 1 per cent. silver nitrate solution. Cases of permanent blindness amongst the natives seemed to be common, almost all of them suffering from some form of chronic eye disease. Infections of the external auditory canal were also common, stated to have been caused by bites of insects, but were more likely due to bathing in contaminated fresh water; during the first month some 125 eases were treated. A few cases of baccillary dysentery, not of a very severe type, were admitted to hospital. Dengue fever was also noted, but in fewer numbers than was expected, as most newcomers to Samoa are stated to be affected. "With the better housing of the men and improved sanitary arrangements the sickness wastage was kept well in hand during October and November.
On the 25th November, 1914, the P.M.O., Major Holmes, was relieved by Major Dawson, N.Z.M.C., and by the s.s. Navua, which sailed for Auckland on the 26th, several staff officers including the late P.M.O. returned to New Zealand. In December, 1914, in consequence of the destruction of the German fleet in the Pacific, the garrison of Samoa was reduced. The original Force of Occupation returned to New Zealand, when a relief force of men over the age limit for active service arrived to replace them.